Hospital Benefits (Private Hospitals) Regulations (Amendment) (Cth)

STATUTORY RULES 1951, No. 119.(c)

 

Repeal.

1. Statutory Rules 1951, No. 28, is repealed.

Heading.

2. Before regulation 1 of the Hospital Benefits (Private Hospitals) Regulations the following heading is inserted:—

“PART I.—PRELIMINARY.”.

3. After regulation 2 of the Hospital Benefits (Private Hospitals) Regulations the following regulation is inserted:—

Parts.

“2A. These Regulations are divided into Parts as follows:—

Part I.—Preliminary. (Regulations 1-3)

Part II.—Approval of Private Hospitals. (Regulations 4-9)

 

(c) Made under the Hospital Benefits Act 1945-1948 on 4th October, 1951; notified in Gazette on 11th October, 1951.

 

Part III.—Fees. (Regulations 10-11)

Part IV.—Payment of Benefits. (Regulations 12-16)

Part V.—Payment of Additional Benefits. (Regulations 16A-16s)

Part VI.—Miscellaneous. (Regulations 17-19).”.

Interpretation.

4. Regulation 3 of the Hospital Benefits (Private Hospitals) Regulations is amended—

(a) by inserting, after the definition of “qualified patient”, the following definition:—

“the Deputy Director”, in relation to a private hospital situated in a State other than the State of Tasmania, means the Commonwealth Deputy Director of Health for that State, in relation to a private hospital situated in the State of Tasmania, means the Senior Commonwealth Medical Officer in that State and, in relation to a private hospital in a Territory of the Commonwealth, means the Director-General;”; and

(b) by omitting the definition of “the Senior Commonwealth Medical Officer”.

Heading.

5. Before regulation 4 of the Hospital Benefits (Private Hospitals) Regulations the following heading is inserted:—

“PART II.—APPROVAL OF PRIVATE HOSPITALS.”.

Applications for approval of private hospitals.

6. Regulation 4 of the Hospital Benefits (Private Hospitals) Regulations is amended by omitting from sub-regulation (2.) the words “the Senior Commonwealth Medical Officer” and inserting in their stead the words “the Deputy Director”.

Private Hospitals Benefits Committees.

7. Regulation 5 of the Hospital Benefits (Private Hospitals) Regulations is amended by omitting the words “the Senior Commonwealth Medical Officer” (wherever occurring) and inserting in their stead the words “the Deputy Director”.

Functions of Committees.

8. Regulation 6 of the Hospital Benefits (Private Hospitals) Regulations is amended by omitting the words “a Senior Commonwealth Medical Officer” and inserting in their stead the words “the Deputy Director”.

Heading.

9. Before regulation 10 of the Hospital Benefits (Private Hospitals) Regulations the following heading is inserted:—

“PART III.—FEES.”.

Heading.

10. Before regulation 12 of the Hospital Benefits (Private Hospitals) Regulations the following heading is inserted:—

“PART IV.—PAYMENTS OF BENEFITS.”.

Heading.

11. After regulation 16 of the Hospital Benefits (Private Hospitals) Regulations the following Part is inserted:—

“PART V.—PAYMENT OF ADDITIONAL BENEFITS.

Interpretation.

“16A.—(1.) In this Part, unless the contrary intention appears—

‘contributing patient’ means a qualified patient who is a contributor to the funds of a registered organization and includes a qualified patient who is the spouse or a dependant of such a contributor;

 

‘organization’ means an organization which, in accordance with its rules, makes payment of amounts at a rate of not less than Six shillings per day to, or in respect of, some or all of the contributors to its funds for hospital treatment provided at a private hospital for a contributor, or the spouse or a dependant of a contributor, to its funds;

‘the Committee’ means the committee referred to in regulation 16D of these Regulations;

‘registered organization’ means an organization registered under this Part.

“(2.) For the purposes of this Part—

(a) a private hospital which, by reason of contributions made by a person for the purpose of obtaining hospital treatment without charge or at a reduced charge, provides hospital treatment to that person or to the spouse or a dependant of that person without charge or at the reduced rate shall be deemed to be an organization under the rules of which an amount of not less than Six shillings per day is payable to such a person for each day on which he is a qualified patient; and

(b)a person shall be deemed to be a dependant of a contributor to the funds of an organization if, in accordance with the rules of the organization, a payment may be made from the funds of the organization for hospital treatment provided at a private hospital for that person or, in the case of a private hospital that is deemed to be an organization by the last preceding sub-regulation, hospital treatment is provided for that person at that private hospital without charge or at a reduced rate.

Application tor registration.

“16B.—(1.) An organization may apply for registration under this Part.

“(2.) The application shall be in accordance with the authorized form and shall he lodged with the Director-General.

“(3.) An organization shall furnish to the Director-General with its application—

(a) a copy of the instrument constituting the organization;

(b)a copy of the articles of association or rules of the organization;

(c) a copy of the revenue account and balance-sheet of the organization for the last completed accounting year prior to the date of the application for registration;

(d)a copy of the last report made by the organization to its members prior to the date of the application for registration ;

(e) a statement showing, in respect of the last completed accounting year of the organization prior to the date of the application for registration—

 (i) the number of persons who were contributors to the funds of the organization at the end of that year, sub-divided according to the class of benefit for which contributions were made; and

 

(ii) the respective number of persons who commenced, and ceased, to contribute to the funds of the organization in that year, sub-divided according to the class of benefit for which contributions were made; and

(f) a statement showing particulars of the tables or classes of benefit provided by the organization and the contributions for, and amount of, those benefits.

“(4.) The application shall be signed on behalf of the organization by a person authorized by the organization for that purpose.

“(5.) The person who signs the application on behalf of the organization shall certify that the copies of the documents furnished with the application are true and correct copies of what they purport to be and that the information contained in the statements so furnished is true and correct.

Director-General may require additional information to be furnished.

“16C.—(1.) The Director-General may, by notice in writing, require an organization, or an officer of an organization, that has applied for registration under this Part to furnish him with such additional information relating to any of the matters specified in sub-regulation (3.) of the last preceding regulation, or to the affairs or finances of the Organization, as is required by the notice.

“(2.) Where an organization fails to comply with a requirement of a notice given under this regulation, the Minister may refuse to entertain the application for registration.

Application to be referred for report to Committee.

“16D. The Director-General shall refer an application for registration, the documents furnished with the application and any information furnished under the last two preceding regulations to a committee consisting of the Commonwealth Actuary or a person appointed by the Commonwealth Actuary and an officer of the Department of Health appointed by the Director-General for examination and report to the Minister.

Recommendation of the Committee.

“16E. The Committee shall, in its report, recommend to the Minister that the application by the organization be granted or refused and in making the recommendation the Committee shall take into account—

(a) the number of contributors to the funds of the organization;

(b) the rate of contributions made by each contributor to the funds of the organization;

(c) the amount of the payments made by the organization to, or in respect of, a contributor for hospital treatment;

(d) the rules of the organization relating to payments out of the funds of the organization; and

(e) the ratio which amounts paid as management and administration expenses bears to the amount of payments made by contributors to the funds of the organization.

Registration.

“16F.—(1.) The Minister may, after taking into consideration the report of the Committee, grant the application for registration on such terms and conditions (if any) as he thinks fit, or refuse the application.

“(2.) The Director-General shall notify the organization in writing of the granting of the application for registration and the terms and conditions (if any) on which the Minister has granted the application or of the refusal of the application, as the case requires.

Public officers.

“16G.— (1.) A registered organization shall, within fourteen days after the receipt by it of the notification of the granting of the application for registration appoint a person to be the public officer of the organization for the purposes of these Regulations and shall, within seven days after the making of the appointment, furnish to the Director-General a notification of the appointment in accordance with the authorized form.

“(2.) The public officer shall perform, on behalf of the registered organization, all acts which are required or permitted to be performed by or under these Regulations and everything done by the public officer in his capacity as public officer shall be deemed to be done by the registered organization.

“(3.) Where a registered organization contravenes, or fails to comply with, any of the provisions of these Regulations applicable to the registered organization, the contravention of, or failure to comply with, that provision shall, without limiting in any way the liability of the organization, be deemed to be a contravention or failure by the public officer, and the public officer shall be punishable accordingly.

“(4.) A registered organization—

(a) may, at any time, revoke the appointment of a person as its public officer and appoint another person to be its public officer in the place of that first-mentioned person; and

(b) shall, where a person ceases to be its public officer, by death or otherwise, forthwith appoint another person to be its public officer in the place of that first-mentioned person.

“(5.) The registered organization shall, within seven days after the making of an appointment under the last preceding sub-regulation, furnish to the Director-General a notification of the appointment in accordance with the authorized form.

Additional benefit.

“16H.— (1.) Where there is payable, under the rules of a registered organization, an amount of not less than Six shillings per day in respect of a contributing patient for each day on which he is a qualified patient, there shall, subject to this Part, be payable in respect of that contributing patient a benefit of Four shillings per day, in addition to the benefit payable under the last preceding Part, for each day on which the contributing patient is a qualified patient.

“(2.) Notwithstanding that, under the rules of a registered organization, an amount is not payable in respect of a contributing patient by reason of the period for which he has made contributions to, or has received payments from, the registered organization or by reason of circumstances specified in those rules or notified to the contributor in accordance with those rules, the amount which would otherwise be payable under those rules shall, for the purposes of the last preceding sub-regulation, be deemed to be payable unless the ground upon which the payment is not made is that the contributing patient has not paid all amounts due and owing by him to the registered organization.

“(3.) For the purposes of this regulation, ‘day’ means a period of twenty-four hours ending at midnight, and the day of admission and the day of discharge or death shall together be counted as one day.

Additional benefit to be paid to registered organization.

“16J.—(1.) The additional benefit payable under this Part in respect of a contributing patient shall be paid to the registered organization to which contributions are paid by the patient or by the spouse of the patient or the person on whom the patient is dependent.

“(2.) Except in the case of a private hospital that is deemed to be an organization under paragraph (a) of sub-regulation (2.) of regulation 16Aof these Regulations, the additional benefit shall not be payable to the organization unless it satisfies the Director-General that the amount (if any) payable under the rules of the organization and the amount of the additional benefit payable under this Part have been paid by the organization—

(a) to the approved private hospital for or in respect of the contributing patient; or

(b)where an account rendered in respect of hospital treatment of a contributing patient has been paid by the patient or by another person on the patient’s behalf, to the person who paid the account.

Claims for payment to be made monthly.

“16K. Payment of the additional benefit under this Part shall not be made unless the registered organization furnishes to the Director-General, as soon as practicable after the end of each month, a claim in the authorized form, in respect of that month, together with such further information and evidence relating to the claim as is indicated in the form to be required to be furnished or as the Director-General requires.

Advances on account of claims.

“16L.—(1.) The Director-General may, in his absolute discretion, make an advance to a registered organization on such terms and conditions as he thinks fit for the purpose of enabling the organization to make payment of the additional benefit payable under this Part.

“(2.) Where an advance has been made in pursuance of the last preceding sub-regulation and the amount payable to the organization in respect of any month is less than the amount of the advance, the amount of the difference shall be recoverable as a debt due to the Commonwealth.

Inspection of books and accounts and power to require information.

“16M.—(1.) Where, in the opinion of the Director-General, it is desirable that the books and accounts of a registered organization be examined, the Director-General may, by writing under his hand, authorize an officer of the Department of Health to examine and report on those books and accounts.

“(2.) An officer authorized under this regulation shall, at all reasonable times, have full and free access to any premises in which those books and accounts are kept and may make extracts from, or copies of, the books and documents.

“(3.) The Director-General may, by notice in writing, require a person who is or has been an officer, servant or agent of a registered organization—

(a) to furnish, within the time specified in the notice, to him or to an officer specified in the notice such information relating to the affairs of the registered organization as is required by the notice;

(b) to attend, at a time and place specified in the notice, before him or an officer specified in the notice and give evidence relating to the affairs of the registered organization; or

(c) to produce, at a time and place specified in the notice, all books, documents and accounts in his custody or under his control relating to the affairs of the registered organization.

“(4.) The Director-General may require the information to be furnished or the evidence to be given on oath and either orally or in writing and, for that purpose, he or the officer specified in the notice may administer an oath.

“(5.) A person shall not—

(a) refuse or fail to comply with a requirement contained in a notice given to him under sub-regulation (3.) of this regulation; or

(b) refuse to be sworn.

Annual accounts and statements to be furnished.

“16N.— (1.) Aregistered organization shall, within three months after the expiration of the organization’s accounting year, or within such further time as the Director-General, on the application of the organization, allows, furnish to the Director-General—

(a) a copy of the balance-sheet and revenue account of the organization for that year;

(b) a statement setting out details of the management and administrative expenses and other disbursements incurred or made in that year in respect of both payments for hospital treatment and other payments; and

(c) a statement showing, in respect of that year—

 (i) the number of persons who were contributors to the funds of the organization at the end of that year, sub-divided according to the class of benefit for which they made contributions; and

(ii) the respective numbers of persons who commenced to contribute, and who ceased to contribute, to the funds of the organization in that year, subdivided according to the class of benefit for which they made contributions.

“(2.) The organization shall certify that the copies of the documents furnished under the last preceding sub-regulation are true and correct copies of what they purport to be and that the information contained in the statements so furnished is true and correct.

Additional functions of the Committee.

“16P.—(1.) The Director-General may refer for examination to the Committee any reports and extracts from, and copies of, books and documents made by an officer under regulation 16m of these Regulations and the copies and the statements referred to in the last preceding regulation.

“(2.) The Committee may make such recommendations to the Minister as it thinks fit.

Cancellation or suspension of registration.

“16Q.—(1.) The Minister may, by notice in writing, suspend, for such period as is specified in the notice, the registration of an organization or may cancel the registration of an organization where—

(a) the Committee has recommended the suspension or cancellation of the registration of the organization;

(b)the organization fails to comply with the terms and conditions under which the registration was granted; or

(c) the organization fails to furnish the documents referred to in regulation 16N of these Regulations.

“(2.) The additional benefit is not payable under this Part in respect of any period for which the registration of the organization is suspended.

Notification of change of particulars.

“16B. If, subsequent to the registration of an organization under this Part, a change takes place in the particulars specified in the application of the organization for registration, in the tables or classes of benefits provided by the organization or the contributions for, or the amount of, those benefits, the organization shall, within fourteen days after the change takes place, notify the Director-General in writing of the change.

False representations prohibited.

“16S. A person shall not, for any purpose whatsoever, make a representation that an organization, association or body that is not a registered organization is a registered organization.”.

Heading.

12. Before regulation 17 of the Hospital Benefits (Private Hospitals) Regulations the following heading is inserted:—

“PART VI.—MISCELLANEOUS.”.

Offences.

13. Regulation 18 of the Hospital Benefits (Private Hospitals) Regulations is amended—

(a) by inserting in sub-regulation (1.), after the word “person”, the words “or registered organization”; and

(b