Health Legislation Amendment (Private Health Industry Measures) Act 2002 (Cth)

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Health Legislation Amendment (Private Health Industry Measures) Act 2002

No. 76, 2002

An Act to amend legislation relating to health, and for related purposes

Contents

Health Legislation Amendment (Private Health Industry Measures) Act 2002

No. 76, 2002

An Act to amend legislation relating to health, and for related purposes

[Assented to 8 October 2002]

The Parliament of Australia enacts:

1Short title

This Act may be cited as the Health Legislation Amendment (Private Health Industry Measures) Act 2002.

2Commencement
  1. (1)

    Each provision of this Act specified in column 1 of the table commences, or is taken to have commenced, on the day or at the time specified in column 2 of the table.

Commencement information

Column 1

Column 2

Column 3

Provision(s)

Commencement

Date/Details

1.

Sections 1 to 3 and anything in this Act not elsewhere covered by this table

The day on which this Act receives the Royal Assent

8 October 2002

2.

Schedule 1, items 1 to 7

The day on which this Act receives the Royal Assent

8 October 2002

3.

Schedule 1, items 8 and 9

The 28th day after the day on which this Act receives the Royal Assent

5 November 2002

4.

Schedule 2

A single day to be fixed by Proclamation, subject to subsection (3)

8 April 2003

Note: This table relates only to the provisions of this Act as originally passed by the Parliament and assented to. It will not be expanded to deal with provisions inserted in this Act after assent.

  1. (2)

    Column 3 of the table is for additional information that is not part of this Act. This information may be included in any published version of this Act.

  2. (3)

    If a provision covered by item 4 of the table does not commence within the period of 6 months beginning on the day on which this Act receives the Royal Assent, it commences on the first day after the end of that period.

3Schedule(s)

Each Act that is specified in a Schedule to this Act is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this Act has effect according to its terms.

Schedule 1—Amendment of the National Health Act 1953

Part 1Amendments relating to gap cover schemes

1

At the end of section 73BDB

Add:

  1. ; (d)

    a gap cover scheme of a registered organization to the extent that the scheme provides:

    1. (i)

      for payment by the registered organization to medical practitioners participating in the scheme for the provision of professional services to eligible contributors; or

    2. (ii)

      for assignment, in accordance with subsection 20A(2AA) of the Health Insurance Act 1973, to the organization, approved billing agents, hospitals, day hospital facilities or other persons, of medicare benefits payable in respect of professional services.

  1. (2)

    In this section:

medical practitioner has the same meaning as in subsection 73BDA(7).

2

After paragraph (hb) of Schedule 1

Insert:

  1. (hba)

    The organization will, at the request of a contributor to the health benefits fund conducted by it, give to a medical practitioner such information that the organization has that will enable or assist the medical practitioner to inform the contributor, in accordance with subsection 73BDD(7), of any amounts that the contributor can reasonably be expected to pay for treatment.

3

Paragraph (o) of Schedule 1

After “subsection 20A(2A)”, insert “or (2AA)”.

Part 2Amendments to clarify obligations of registered organizations to provide information

4

Subsection 73ABC(1)

After “any person”, insert “, including an officer of the Department,”.

5

Subsection 73ABC(3)

After “makes available”, insert “under subsection (1) (whether to an officer of the Department or to any other person)”.

6

Paragraph (ha) of Schedule 1

Omit “to the contributors to the health benefits fund conducted by it”, substitute “to any person”.

7

After paragraph (ha) of Schedule 1

Insert:

  1. (haa)

    the organization will:

    1. (i)

      provide each new contributor to the health benefits fund with all details of the contributor’s entitlements to benefits; and

    2. (ii)

      at the request of any existing contributor, provide the contributor with all of the details of the contributor’s entitlements to benefits.

  2. (hab)

    the organization will, on a State‑by‑State basis, produce and maintain, in both written and electronic format, material detailing all tables of benefits or products that are available to contributors and will ensure that the material:

    1. (i)

      is freely available to any person; and

    2. (ii)

      includes advice as to the existence of, and contact details for, the Private Health Insurance Ombudsman; and

    3. (iii)

      indicates the date at which it is correct; and

    4. (iv)

      is on display in its written format at all of the organization’s offices and outlets; and

    5. (v)

      can be accessed in its electronic format.

Part 3Amendment relating to Employee Health Benefits Scheme

8

Subsection 67(7)

Repeal the subsection.

Part 4Amendment relating to discounted premiums

9

Subparagraph (s)(i) of Schedule 1

Omit “6”, substitute “3”.

Schedule 2—Amendment of the Health Insurance Act 1973 regarding billing agents

1

Subsections 20AB(1), (3) and (4)

Omit “Council”, substitute “Commission”.

2

Subsections 20AC(1) and (2)

Omit “Council” (wherever occurring), substitute “Commission”.

3

Paragraph 20AC(2)(a)

Omit “Council’s”, substitute “Commission’s”.

4

Subsections 20AC(3), (4) and (5)

Omit “Council” (wherever occurring), substitute “Commission”.

5

Subsections 20AD(1), (2), (3) and (4)

Omit “Council” (wherever occurring), substitute “Commission”.

6

Subsection 20AD(4)

Omit “Council’s”, substitute “Commission’s”.

7

Subsection 20AD(5)

Omit “Council”, substitute “Commission”.

8

Transitional provisions

(1) If, before the commencement of the amendments made by items 1 to 7 of this Schedule:

  1. (a)

    a person or body has applied to the Council under section 20AB of the Health Insurance Act 1973 for approval as a billing agent; but

  2. (b)

    the Council has not completed its consideration of that application;

then:

  1. (c)

    section 20AB of that Act as in force immediately before the commencement of those amendments is taken to continue in force for the purpose of enabling the Council to complete its consideration of that application; and

  2. (d)

    section 20AD of that Act as so in force is taken to continue to apply in relation to any review of a decision made under section 20AB as so continued in force.

(2) If, before the amendments made by items 1 to 7 of this Schedule:

  1. (a)

    the Council has, under section 20AC of the Health Insurance Act 1973, notified a person or body approved as a billing agent that it is considering revocation of that approval; but

  2. (b)

    the Council has not made a decision in respect of the revocation;

then:

  1. (c)

    section 20AC of that Act as in force immediately before the commencement of those amendments is taken to continue in force for the purpose of enabling the Council to complete its consideration of any submissions made in respect of the revocation and make a decision in respect of the revocation; and

  2. (d)

    section 20AD of that Act as so in force is taken to continue to apply in relation to any review of a decision to revoke made under section 20AB as so continued in force.

(3) If, before the amendments made by items 1 to 7 of this Schedule:

  1. (a)

    a person or body has applied to the Council under section 20AD of the Health Insurance Act 1973 for reconsideration of a decision not to approve a person or body as a billing agent or of a decision to revoke the approval of that person or body as a billing agent; but

  2. (b)

    the Council has not completed its reconsideration of that decision;

section 20AD of that Act as in force immediately before the commencement of those amendments is taken to continue in force:

  1. (c)

    so as to permit the completion of that reconsideration; and

  2. (d)

    if the applicant for that reconsideration subsequently seeks a review of the decision on that reconsideration by the Administrative Appeals Tribunal—so as to permit that review to be undertaken.

(4) If, before the commencement of the amendments made by items 1 to 7 of this Schedule:

  1. (a)

    a person or body has made application under section 20AD of the Health Insurance Act 1973 for review by the Administrative Appeals Tribunal of a decision of the Council in relation to an approval of that person or body as a billing agent or the revocation of such an approval; but

  2. (b)

    the Administrative Appeals Tribunal has not yet completed its review of that decision;

section 20AD of that Act as in force immediately before the commencement of those amendments is taken to continue in force so as to facilitate the completion by the Tribunal of that review.

(5) Any approval of a person or body as a billing agent made by the Council:

  1. (a)

    before the date of commencement of the amendments made by items 1 to 7 of this Schedule; or

  2. (b)

    on or after that date by virtue of the operation of subitem (1), (3) or (4);

is to be taken, for the purposes of the operation of the Health Insurance Act 1973 as in force on and after that approval, to be an approval of that person or body as such billing agent by the Commission under section 20AB of that Act as amended by this Act.

(6) Any revocation of the approval of a person as a billing agent that is made by the Council:

  1. (a)

    before the date of commencement of the amendments made by items 1 to 7 of this Schedule; or

  2. (b)

    on or after that date by virtue of the operation of subitem (2), (3) or (4);

is to be taken, for the purposes of the operation of the Health Insurance Act 1973 as in force on and after that revocation, to be a revocation of the approval of that person or body as a billing agent by the Commission under section 20AC of that Act as amended by this Act.

(7) In this item:

Commission means the Health Insurance Commission established under the Health Insurance Commission Act 1973.

Council means the Private Health Insurance Administration Council established by section 82B of the National Health Act 1953.

[Minister’s second reading speech made in—

Senate on 21 March 2002

House of Representatives on 19 September 2002]

(89/02)

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