National Health Act 1970 (Cth)
An
Act to amend the
[
BE it enacted by the Queen’s Most Excellent Majesty, the Senate, and the House of Representatives of the Commonwealth of Australia, as follows:—
Part I.—Preliminary.
(2.) The
(3.) The
Principal Act, as amended by this Act, may be cited as the
(2.) Sections 35 and 48 of this Act shall come into operation on the first day of July, One thousand nine hundred and seventy-one.
(3.) The remaining provisions of this Act shall come into operation on a date to be fixed by Proclamation.
Part I.—Preliminary (Sections 1-3).
Part II.—Amendments of the Principal Act (Sections 4-58).
Part III.—Transitional Provisions (Sections 59-64).
Part II.—Amendments of the Principal Act.
(
a ) by omitting the words—“Part II.—National Health Services (Sections 7-11).”
and inserting in their stead the words—
“Part II.—National Health Services (Sections 9-11).”; and
(
b ) by omitting the words—“Division 3.—Insured Patients in Approved Hospitals (Sections 46-52).
“Division 4.—Uninsured Patients and Pensioners in Approved Hospitals (Sections 53-55).”
and inserting in their stead the words—
“Division 3.—Certain Insured Patients in Approved Hospitals (Sections 46-52).
“Division 4.—Certain Uninsured Patients, and Pensioners, in Approved Hospitals (Sections 53-55).
“Division 4a.—Patients treated without Charge in Approved Hospitals (Sections 55a-55b).”.
(
a )by inserting in sub-section (1.), after the definition of “registered organization”, the following definition:—“‘restricted membership organization’ means an organization the rules of which restrict eligibility for membership by reference to—
(
a )employment or former employment in a profession, trade, industry or calling;(
b )employment or former employment by a particular employer or by an employer included in a particular class of employers;(
c ) membership or former membership of a particular profession, professional association or union;(
d )membership or former membership of the Defence Force or of a part of the Defence Force; or(
e ) any other prescribed matter,not being an organization that has notified the Director-General in writing that it does not wish to be subject to the provisions of this Act relating to restricted membership organizations;”; and
(
b ) by adding at the end of sub-section (1.) the following definitions:—“‘the Northern Territory’ means the Northern Territory of Australia;
‘the proclaimed date’ means the date fixed by Proclamation under sub-section (3.) of section two of the
National Health Act 1970.”.
“9b. The Minister may provide, or arrange for the provision of, vaccine for the purpose of immunizing persons against any of the following diseases:—
(
a ) poliomyelitis;(
b ) measles; and(
c ) rubella.”.
(
a ) by omitting from sub-section (1.) the definition of “contributor” and inserting in its stead the following definition:—“‘contributor’ means a person—
(
a )who pays contributions, or on whose behalf contributions are paid, to a medical benefits fund conducted by a registered medical benefits organization; and(
b )who is, if there is rendered to him any professional service, entitled, subject to the rules of the organization—(i) to receive from the organization an amount equal to the amount set out as the fund medical benefit in relation to a professional service of that kind in the table of fund medical benefits in respect of a State, being a State in which the organization is lawfully carrying on business as a registered medical benefits organization, set out in a Schedule to this Act as in force at the time when the service is rendered; or
(ii) to have the professional service provided without charge under a contract arrangement,
and, except in relation to the payment of contributions, includes a dependant of such a person;”;
(
b )by omitting from sub-section (1.) the definitions of “professional service” and “the Committee” and inserting in their stead the following definitions:—“‘medical service’ means a service that is specified in an item in the First Schedule to this Act;
‘professional service’ means—
(
a )a medical service that is rendered by, or on behalf of, a medical practitioner; or(
b )a prescribed medical service that is rendered in an operating theatre of an approved hospital by a legally qualified dentist or dental practitioner approved by the Director-General for the purposes of this definition;‘the basic Commonwealth medical benefit’, in relation to a professional service, means the amount that was, at the date on which the professional service was rendered, the amount indicated as the basic Commonwealth benefit in relation to a professional service of that kind in the table of Commonwealth medical benefits set out in the First Schedule to this Act;
‘the Committee’ means the Registration Committee referred to in section seventy of this Act;
‘the specified excess’, in respect of a professional service, means the amount indicated as the specified excess in respect of that professional service in the relevant table of fund medical benefits in relation to the contributor to whom the professional service is rendered.”; and
(
c ) by adding at the end thereof the following sub-sections:—“(4.) A reference in this Part to the relevant table of fund medical benefits shall be read, in relation to a contributor, as a reference to the table of fund medical benefits set out in a Schedule to this Act that is the relevant table, in accordance with the rules of the organization concerned, in respect of the contributor and where a reference is in relation to a particular professional service, shall be read as a reference to that table as in force at the time at which that professional service was rendered.
“(5.) Where a medical service rendered to a person includes a medical procedure that would, but for this sub-section, itself be a medical service, that procedure shall, in respect of that person, be deemed not to be a medical service.”.
“13a.—(1.) The regulations may provide that this Act shall have effect as if a table in a Schedule to this Act were varied—
(
a ) by omitting an item from the table;(
b ) by inserting an item in the table; or(
c ) by substituting another amount for an amount set out in an item in the table.
“(2.) Regulations under this section shall, unless
sooner repealed, cease to be in force on the day next following the fifteenth
sitting day of the House of Representatives after the expiration of a period of
twelve months commencing on the day on which the regulations are notified in
the
“(1.) Where, on or after the proclaimed date, medical expenses are incurred by a contributor in respect of a professional service rendered to the contributor or to a dependant of the contributor, an amount equal
to the basic Commonwealth medical benefit in respect of that professional service is payable subject to and in accordance with the provisions of this Part.
“(1a.) Where—
(
a )on or after the proclaimed date, medical expenses are incurred by a contributor in respect of professional services consisting of two or more operations performed on the one occasion on the contributor or on one dependant of the contributor;(
b ) an additional Commonwealth medical benefit is not payable under the next succeeding sub-section in respect of professional services that include those operations; and(
c ) the aggregate of the specified excesses in respect of those professional services exceeds Five dollars,
an additional Commonwealth medical benefit of an amount equal to the amount by which that aggregate exceeds Five dollars is payable, subject to and in accordance with the provisions of this Part, in respect of those professional services.
“(1b.) Where—
(
a )on or after the proclaimed date, medical expenses are incurred by a contributor in respect of one or more professional services (not being an operation or operations) rendered to the contributor, or to a dependant of the contributor—(i) in preparation for, and immediately preceding, the rendering to the contributor or to the dependant, as the case may be, of a professional service that consists of an operation or of professional services that consist of two or more operations performed on the one occasion;
(ii) by way of assistance at such an operation or such operations; or
(iii) by way of providing, immediately after such an operation or such operations, care required by the contributor or the dependant, as the case may be, in consequence of the operation or operations; and
(
b )the aggregate of the specified excesses in respect of all the professional services (including the operation or operations) exceeds Five dollars,
an additional Commonwealth medical benefit of an amount equal to the amount by which that aggregate exceeds Five dollars is payable, subject to and in accordance with the provisions of this Part, in respect of all the professional services.
“(1c.) Where—
(
a )on or after the proclaimed date, medical expenses are incurred by a contributor in respect of a professional service rendered to the contributor or to a dependant of the contributor;(
b )the professional service is a service to which an item in Division 9 or 10 of Part 10 of the First Schedule applies;(
c ) an additional Commonwealth medical benefit is not payable under either of the last two preceding sub-sections in respect of professional services that include that professional service; and(
d )the specified excess in respect of the professional service is to be ascertained in accordance with a formula set out in a Schedule to this Act and the amount so ascertained exceeds Five dollars,
an additional Commonwealth medical benefit of an amount equal to the amount by which the specified excess exceeds Five dollars is payable, subject to and in accordance with the provisions of this Part, in respect of the professional service.”.
“16a.—(1.) Subject to this section, for the purpose of calculating the amount of Commonwealth benefit payable in respect of the medical expenses incurred by a contributor in respect of two or more operations, each constituting a professional service covered by an item in the First Schedule to this Act, that are performed on the one occasion on the contributor or on one dependant of the contributor, the amounts indicated in those items as basic Commonwealth benefit, other than the greatest of those amounts, shall be deemed to be reduced as follows:—
(
a )the greatest of the amounts to be deemed to be reduced shall be deemed to be reduced by one-half; and(
b )the other amount, or each of the other amounts, to be deemed to be reduced shall be deemed to be reduced by three-quarters,
and, where an item in a Schedule to this Act other than the First Schedule relates to an item in the First Schedule to this Act that indicates an amount of basic Commonwealth benefit that is, in accordance with the foregoing provisions of this sub-section, to be deemed to be reduced by a specified fraction, the amounts indicated as the fund medical benefit and as the specified excess in that item in that other Schedule shall be deemed to be reduced by the same fraction.
“(2.) For the purposes of this section, where two amounts are equal, one of those amounts shall be treated as being greater than the other or others of those amounts.
“(3.) This section does not apply in relation to an operation, being one of two or more operations performed under the one anaesthetic on the same person, if the medical practitioner who performed the operation—
(
a )did not perform, or assist at, the other operation or any of the other operations; and(
b ) did not administer the anaesthetic.
“(4.) In this section, ‘operation’ does not include a medical service specified in Division 2 of Part 10 of the First Schedule to this Act.
“16.—(1.) Where, in respect of professional services rendered to a contributor or to a dependant of a contributor (being professional services in respect of which an additional Commonwealth medical benefit is payable under section fourteen of this Act), the aggregate of—
(
a )the amount of Commonwealth benefit that would, but for this section, be payable in respect of the professional services; and(
b )the amounts indicated as fund medical benefit in respect of the professional services in the relevant table of fund medical benefits,
exceeds the medical expenses incurred by the contributor in respect of the professional services—
(
c ) the additional Commonwealth medical benefit payable, but for this section, in respect of the professional services shall be reduced by the amount of the excess; or(
d )if the excess is equal to or greater than the additional Commonwealth medical benefit so payable, that additional Commonwealth medical benefit is not payable in respect of the professional services.
“(2.) The rules of a registered medical benefits organization may include a rule that where, in respect of a professional service rendered to a contributor or to a dependant of a contributor, the aggregate of—
(
a )the amount of the basic Commonwealth medical benefit in respect of the professional service; and(
b )the amount indicated as the fund medical benefit in respect of the professional service in the relevant table of fund medical benefits,
exceeds the medical expenses incurred by the contributor in respect of the professional service—
(
c ) fund benefit payable, but for that rule, in respect of the professional service shall be reduced by the amount of the excess; or(
d )if the excess is equal to or greater than the fund benefit so payable, fund benefit is not payable in respect of that professional service.
“(3.) Where, in respect of a professional service rendered to a contributor or to a dependant of a contributor, the aggregate of—
(
a )the amount of Commonwealth benefit that would, but for this sub-section, be payable in respect of the professional service; and(
b ) the amount of fund benefit payable in respect of the professional service,
exceeds the medical expenses incurred by the contributor in respect of the professional service—
(
c ) any Commonwealth benefit payable, but for this sub-section, in respect of the professional service shall be reduced by the amount of the excess; or(
d )if the excess is equal to or greater than the Commonwealth benefit so payable, Commonwealth benefit is not payable in respect of that professional service.”.
“(3.) Where an item in the First Schedule to this Act relates to a professional service constituted by—
(
a ) assistance at an operation;(
b ) the administration of an anaesthetic; or(
c ) assistance in the administration of an anaesthetic,
the amount indicated in that item as the amount of basic Commonwealth benefit is the amount payable in respect of that professional service whether the assistance is rendered or the anaesthetic is administered by one or more than one medical practitioner.”.
“18a. Where
a person becomes a contributor on or after the proclaimed date (not being a
person who, immediately before he so becomes a contributor, was a contributor
within the meaning of Part III. of the
(
a )in the case of a person who, immediately before becoming a contributor, was a contributor within the meaning of Part III. of theNational Health Act 1953-1969—on the day on which that person became a contributor within the meaning of that Part; or(
b ) in any other case—on the day on which that person becomes a contributor,
unless, under the rules of the registered medical benefits organization concerned, fund benefit is paid by the organization in respect of those medical expenses.”.
“‘professional service’ does not include a medical service covered by item 631, 641, 651 or 661 in the First Schedule to this Act or by any item in Part 7 or Part 8 of that Schedule;”.
(
a )by omitting sub-sections (1.) and (2.) and inserting in their stead the following sub-sections:—“(1.) Where, in respect of medical expenses incurred by a contributor, he has received or established his right to receive a payment by way of compensation or damages (including a payment in settlement of a claim for compensation or damages) under the law of the Commonwealth or of a State or Territory, and the amount of that payment is not less than the aggregate of the amount of Commonwealth benefit and the amount of fund benefit that would be payable in respect of those medical expenses if he had not received or established his right to receive that payment, Commonwealth benefit is not payable in respect of those medical expenses.
“(2.) Where, in respect of medical expenses incurred by a contributor, he has received or established his right to receive a payment of the kind referred to in the last preceding subsection, but the amount of that payment is less than the aggregate referred to in that sub-section, Commonwealth benefit is not payable in respect of those medical expenses except to the extent of such amount as the Director-General determines, but not exceeding the amount by which that aggregate exceeds the sum of the amount of fund benefit payable in respect of those medical expenses and the amount of the payment of the kind referred to in the last preceding sub-section that he has received or established his right to receive.”; and
(
b )by omitting from sub-section (3.) the words “may, in his discretion,” and inserting in their stead the word “shall”.
“28. Where a registration of a registered medical benefits organization is suspended or cancelled, the Minister may, by instrument in writing—
(
a )direct that, subject to any further directions under this section, Commonwealth benefit shall continue to be paid, for such period as is specified in the direction, as if the suspension or cancellation had not taken place; and(
b )give further directions with respect to the persons to whom, the manner in which and the conditions subject to which such Commonwealth benefit is to be paid.”.
“29a.—(1.) There shall be, in respect of—
(
a ) each State;(
b ) the Australian Capital Territory; and(
c ) the Northern Territory,
a Specialist Recognition Advisory Committee.
“(2.) Each Committee shall consist of five medical practitioners appointed by the Minister in accordance with section twenty-nine c of this Act.
“(3.) The exercise or performance of the powers or functions of a Committee is not affected by reason only of there being a vacancy or vacancies in the membership of the Committee.
“(4.) A member of a Committee holds office for a period of three years but he shall be removable by the Minister in any case of misconduct or incapacity.
“(5.) A member of the Specialist Recognition Appeal Committee is not eligible to be nominated or appointed under this section to a Committee.
“(6.) At a meeting of a Committee three members form a quorum.
“(7.) The regulations may make provision for and in relation to the procedure of the Committee.
“29b.—(1.) There shall be a Specialist Recognition Appeal Committee, which shall consist of five medical practitioners appointed by the Minister in accordance with the next succeeding section.
“(2.) The exercise or performance of the powers or functions of the Committee is not affected by reason only of there being a vacancy or vacancies in the membership of the Committee.
“(3.) A member of the Committee holds office for a period of three years but he shall be removable by the Minister in any case of misconduct or incapacity.
“(4.) A member of a Specialist Recognition Advisory Committee is not eligible to be nominated or appointed under this section to the Committee.
“(5.) At a meeting of the Committee three members form a quorum.
“(6.) The regulations may make provision for and in relation to the procedure of the Committee.
“29c.—(1.) Before making appointments to a Committee, the Minister shall request each of the following bodies to nominate a panel of not less than three medical practitioners for consideration for appointment to the Committee:—
(
a ) the Australian Medical Association;(
b ) the Royal Australasian College of Surgeons;(
c ) the Royal Australasian College of Physicians;(
d )the Australian Council of the Royal College of Obstetricians and Gynaecologists; and(
e ) the Royal Australian College of General Practitioners.
“(2.) When, in accordance with a request under the last preceding sub-section, each of the bodies referred to in that sub-section has nominated a panel of medical practitioners for consideration for appointment to a Committee, the Minister shall appoint to the Committee one medical practitioner from each of the panels.
“(3.) Where a member of a Committee dies or resigns or the appointment of a member of a Committee is terminated, the Minister shall request the body by whom the member was nominated to nominate a panel of not less than three medical practitioners for consideration for appointment to fill the place of the member, and the Minister shall appoint one of those medical practitioners to fill that place.
“(4.) In this section, ‘Committee’ means a Specialist Recognition Advisory Committee or the Specialist Recognition Appeal Committee.
“29d.—(1.) The Director-General may refer to a Specialist Recognition Advisory Committee the question whether a particular medical practitioner should, having regard to his qualifications, experience and standing in the medical profession and the nature of his practice, be recognized for the purposes of this Act as a specialist, or as a consultant physician, in a particular specialty.
“(2.) Before considering a question referred to it under the last preceding sub-section, a Committee may, with the Minister’s approval, engage as a consultant a medical practitioner who has qualifications, experience and standing in the medical profession in the specialty to which the question before the Committee relates.
“(3.) A Committee shall consider a question referred to it under sub-section (1.) of this section and shall submit to the Director-General a recommendation agreed to by a majority of the members present at a meeting of the Committee.
“(4.) On the receipt of a recommendation under the last preceding sub-section, the Director-General shall determine, for the purposes of this Act, in accordance with the said recommendation, that the medical practitioner concerned is to be recognized as a consultant physician or as a specialist, as the case may be, in the specialty concerned or that he is not to be so recognized.
“(5.) Where the Director-General makes a determination under the last preceding sub-section, he shall—
(
a )notify each registered medical benefits organization, in writing, accordingly; and(
b )where the determination is that the medical practitioner is not to be recognized—notify the medical practitioner, in writing, accordingly.
“(6.) The Director-General shall not determine that a medical practitioner is not to be recognized as a consultant physician or as a specialist in respect of a specialty in respect of which the medical practitioner is registered as a consultant physician or as a specialist, as the case may be, under a law of a State or of a Territory forming part of the Commonwealth.
“(7.) Nothing in this section prevents the recognition, for the purposes of this Act, as a consultant physician or as a specialist in respect of a specialty, of a medical practitioner in relation to whom no determination has been made under this section.
“(8.) A determination of the Director-General that a medical practitioner is not to be recognized as a consultant physician or as a specialist does not affect entitlement to Commonwealth benefit in respect of a professional service rendered before the date of the determination.
“29e.—(1.) Where the Director-General notifies a medical practitioner that the Director-General has determined that the medical practitioner is not to be recognized, for the purposes of this Act, as
a consultant physician, or as a specialist, in a specialty, the medical practitioner may, within one month after the receipt of that notification, lodge an appeal with the Specialist Recognition Appeal Committee.
“(2.) Before considering an appeal, the Specialist Recognition Appeal Committee may, with the Minister’s approval, engage as a consultant a medical practitioner who has qualifications, experience and standing in the medical profession in the specialty to which the appeal relates.
“(3.) The Committee shall consider an appeal so lodged and, if a majority of the members present at a meeting of the Committee is of opinion that the appeal should be allowed, the Committee shall allow the appeal, but otherwise shall dismiss the appeal.
“(4.) Where the Committee allows or dismisses an appeal, it shall notify the appellant and the Director-General, in writing, accordingly.
“(5.) Where the Committee allows an appeal, the Director-General shall make the appropriate determination in relation to the appellant.
“29f. A medical practitioner engaged as a consultant under either of the last two preceding sections shall be paid such professional fee in respect of his services as the Minister determines.”.
(
a )by omitting from the definition of “contributor” in sub-section (1.) the words “the hospital benefits fund” and inserting in their stead the words “a hospital benefits fund”;(
b )by omitting from the definition of “dependant” in sub-section (1.) the words “the fund of a registered hospital benefits organization” and inserting in their stead the words “a hospital benefits fund conducted by a registered hospital benefits organization”; and(
c ) by omitting from sub-section (2.) the words “the hospital benefits fund of a registered hospital benefits organization” and inserting in their stead the words “a hospital benefits fund conducted by a registered hospital benefits organization “.
“(2.) Commonwealth benefit under this Division in respect of any day is not payable to the organization unless and until the organization has paid to the contributor, or to the proprietor on behalf of the contributor, otherwise than by way of hospital fund benefit, an amount equal to the amount of Commonwealth benefit.”.
“50. Where a registration of a registered hospital benefits organization is suspended or cancelled, the Minister may, by instrument in writing—
(
a )direct that, subject to any further directions under this section, Commonwealth benefit shall continue to be paid, for such period as is specified in the direction, as if the suspension or cancellation had not taken place; and(
b )give further directions with respect to the persons to whom, the manner in which and the conditions subject to which such Commonwealth benefit is to be paid.”.
(
a ) by adding at the end of sub-section (2.) the words “or under Division 4a of this Part”;(
b ) by omitting from paragraph (b ) of sub-section (3.) the word “or”; and(
c ) by omitting paragraph (c ) of sub-section (3.).
“55a. Subject to this Part, where the proprietor of an approved hospital certifies in the authorized form that no fees were charged in respect of some or all of the qualified hospital patients in that hospital during a specified period, there is payable to the proprietor of that hospital, in respect of each patient to whom the certificate relates, Commonwealth benefit of Two dollars for each day on which the patient was a qualified hospital patient in that hospital during that period.
“55b. A Commonwealth benefit under this Division is not payable in respect of a qualified hospital patient for any day for which Commonwealth benefit is payable in respect of that patient under section fifty-four of this Act.”.
(
a )by omitting from sub-section (1.) the definitions of “special account contributor” and “standard rate benefit” and inserting in their stead the following definitions:—“‘special account’ means a special account established by a
registered organization for the purposes of Division 2 of this Part.
‘special account contributor’ means a contributor the amounts of whose contributions are for the time being required to be credited to a special account, and includes a person who is a contributor by virtue of being a dependant of a special account contributor;”; and
(
b ) by adding at the end thereof the following sub-sections:—“(3.) For the purposes of this Part, a registered medical benefits organization shall be deemed to carry on business as a registered medical benefits organization in a State or Territory if, for the purposes of, or purposes related to, the enrolment of contributors to a medical benefits fund conducted by it or the payment of benefits to such contributors—
(
a ) it uses premises in that State or Territory; or(
b ) it uses, in that State or Territory, the services of a servant or agent.“(4.) For the purposes of this Part, a registered hospital benefits organization shall be deemed to carry on business as a registered hospital benefits organization in a State or Territory if, for the purposes of, or purposes related to, the enrolment of contributors to a hospital benefits fund conducted by it or the payment of benefits to such contributors—
(
a ) it uses premises in that State or Territory; or(
b ) it uses, in that State or Territory, the services of a servant or agent.“(5.) A reference in this Part to the relevant table of fund medical benefits shall be read, in relation to a contributor, as a reference to the table of fund medical benefits set out in a Schedule to this Act that is the relevant table, in accordance with the rules of the organization concerned, in respect of the contributor.
“(6.) For the purposes of this Part, the Australian Capital Territory shall be deemed to form part of the State of New South Wales.”.
“67.—(1.) An organization may apply for registration as a registered medical benefits organization in respect of a specified State or in respect of the Northern Territory, or may make more than one such application.
“(2.) An organization (not being a restricted membership organization) is not eligible to be registered as a registered medical benefits organization in respect of a State unless, under the rules of the organization—
(
a )a medical benefits fund is to be conducted by the organization in respect of that State;(
b )there is to be credited to that fund the whole of the income of the organization arising out of the carrying on in that State of business as a registered medical benefits organization or if, in accordance with those rules, the Northern Territory is to be treated as part of that State, the whole of the income of the organization arising out of the carrying on of such business in that State and in the Northern Territory;(
c ) no amount is to be debited to that fund other than—(i) payments by the organization of medical fund benefits, or any other benefits payable under the rules of the organization, in respect of contributors to the fund;
(ii) costs incurred by the organization wholly and exclusively in the carrying on in that State of business as a registered medical benefits organization or if, in accordance with those rules, the Northern Territory is to be treated as part of that State, incurred by the organization wholly and exclusively in carrying on such business in that State and in the Northern Territory;
(iii) such proportion of any costs incurred by the organization in the carrying on of business as a registered medical benefits organization, not being costs incurred wholly and exclusively in relation to business in a particular State or in the Northern Territory, as is approved by the Director-General as being an equitable proportion; and
(iv) any amount transferred, with the approval of the Minister, to another medical benefits fund conducted by the organization; and
(
d )where a person who contributes to that fund, or a dependant of such a person, has a professional service rendered to him, the person is, subject to those rules, entitled—(i) to be paid out of that fund an amount equal to the fund medical benefit indicated in respect of the professional service, in the relevant table of fund medical benefits; or
(ii) to have the professional service provided without charge under a contract arrangement.
“(3.) An organization (not being a restricted membership organization) is not eligible to be registered as a registered medical benefits organization in respect of the Northern Territory unless—
(
a ) under the rules of the organization—(i) the Northern Territory is to be treated as part of a State in respect of which the organization is registered or is eligible to be registered as a registered medical benefits organization; or
(ii) a medical benefits fund is to be conducted by the organization in respect of the Northern Territory; and
(
b )where, under the rules of the organization, a medical benefits fund is to be conducted by the organization in respect of the Northern Territory, those rules contain provisions complying with the requirements of the last preceding sub-section, as modified by the substitution of references to the Northern Territory for references to a State.
“(4.) A restricted membership organization is not eligible to be registered as a registered medical benefits organization in respect of any State or in respect of the Northern Territory unless, under the rules of the organization—
(
a ) a medical benefits fund is to be conducted by the organization;(
b )there is to be credited to that fund the whole of the income of the organization arising out of the carrying on by the organization of business as a registered medical benefits organization;(
c ) no amount is to be debited to that fund other than—(i) payments by the organization of medical fund benefits, or any other benefits payable under the rules of the organization, in respect of contributors to the fund; and
(ii) costs incurred by the organization in the carrying on of business as a registered medical benefits organization; and
(
d )where a person who contributes to that fund, or a dependant of such a person, has a professional service rendered to him, the person is, subject to those rules, entitled—(i) to be paid out of that fund an amount equal to the fund benefit set out, in respect of the professional service, in the relevant table of fund medical benefits; or
(ii) to have that professional service provided without charge under a contract arrangement.
“(5.) An organization is not eligible to be registered as a registered medical benefits organization in respect of any State or in respect of the Northern Territory unless, under the rules of the organization—
(
a )a person who contributes to a medical benefits fund conducted by the organization is not eligible to contribute to another medical benefits fund conducted by the organization; and(
b )a person who contributes to a medical benefits fund conducted by another registered medical benefits organization is not eligible to contribute to a medical benefits fund conducted by the first-mentioned organization.
“68.—(1.) An organization may apply for registration as a registered hospital benefits organization in respect of a specified State or in respect of the Northern Territory, or may make more than one such application.
“(2.) An organization (not being a restricted membership organization) is not eligible to be registered as a registered hospital benefits organization in respect of a State unless, under the rules of the organization
(
a ) a hospital benefits fund is to be conducted by the organization in respect of that State;(
b )there is to be credited to that fund the whole of the income of the organization arising out of the carrying on by the organization in that State of business as a registered hospital benefits organization and if, in accordance with those rules, the Northern Territory is to be treated as part of that State, the whole of the income of the organization arising out of the carrying on of such business by the organization in the Northern Territory; and(
c ) no amount is to be debited to that fund other than—(i) payments by the organization of hospital fund benefits, or any other benefits payable under the rules of the organization, in respect of contributors to the fund;
(ii) costs incurred by the organization wholly and exclusively in the carrying on in that State of business as a registered hospital benefits organization or if, in accordance with those rules, the Northern Territory is to be treated as part of that State, incurred by the organization wholly and exclusively in carrying on such business in that State and in the Northern Territory;
(iii) such proportion of any costs incurred by the organization in respect of the carrying on of business as a registered hospital benefits organization, not being costs incurred wholly and exclusively in relation to business in a particular State or in the Northern Territory, as is approved by the Director-General as being an equitable proportion; and
(iv) any amount transferred, with the approval of the Minister, to another hospital benefits fund conducted by the organization.
“(3.) An organization (not being a restricted membership organization) is not eligible to be registered as a registered hospital benefits organization in respect of the Northern Territory unless—
(
a ) under the rules of the organization—(i) the Northern Territory is to be treated as part of a State in respect of which the organization is registered or is eligible to be registered as a registered hospital benefits organization; or
(ii) a hospital benefits fund is to be conducted by the organization in respect of the Northern Territory; and
(
b )where, under the rules of the organization, a hospital benefits fund is to be conducted by the organization in respect of the Northern Territory, those rules contain provisions complying with the requirements of the last preceding sub-section, as modified by the substitution of references to the Northern Territory for references to a State.
“(4.) A restricted membership organization is not eligible to be registered as a registered hospital benefits organization in respect of any
State or in respect of the Northern Territory unless, under the rules of the organization—
(
a ) a hospital benefits fund is to be conducted by the organization;(
b )there is to be credited to that fund the whole of the income of the organization arising out of the carrying on by the organization of business as a registered hospital benefits organization; and(
c ) no amount is to be debited to that fund other than—(i) payments by the organization of hospital fund benefits, or any other benefits payable under the rules of the organization, in respect of contributors to the fund; and
(ii) costs incurred by the organization in carrying on a business as a registered hospital benefits organization.”.
(
a )by omitting from sub-section (1.) the word “may” and inserting in its stead the word “shall”; and(
b )by omitting from sub-section (2.) the word “may” and inserting in its stead the word “shall”.
“72. The Committee shall submit to the Minister a report on the application and, in its report, recommend to the Minister that registration of the organization be granted or refused.
“72a. The Committee, in making a recommendation with respect to an application for registration of an organization in respect of a State or Territory, and the Minister, in exercising his powers with respect to such an application, shall consider whether the organization is eligible to be registered and shall also take into account—
(
a ) the number of persons who contribute, or are likely to contribute, to the relevant fund of the organization;(
b ) the rates of contributions to that fund;(
c )the rules of the organization relating to that fund and, in particular, whether those rules contain appropriate provisions, having regard to the provisions of this Act;(
d )the ratio that the likely amount of the management and administrative expenses in respect of the conduct of that fund bears to the likely amount of contributions to that fund; or(
e ) any other matter that the Minister or the Committee, as the case may be , considers relevant, having regard to the public interest.”.
“(1.) The Minister may, after considering the report of the Committee, grant, subject to such terms and conditions (if any) as he thinks fit, or refuse, the application and, if he grants the application, he shall register the organization accordingly.”.
(2.) Section 73 of the Principal Act is further amended by adding at the end thereof the following sub-sections:—
“(7.) Where the Minister grants an application for
registration of an organization, he shall, within one month after he has so
granted the application, publish in the
(
a ) the name of the organization;(
b ) the name of the State or Territory to which the registration relates;(
c ) the date of registration;(
d )the fact that the registration is subject to the conditions set out in section seventy-three b of this Act; and(
e ) if the grant is subject to any other terms or conditions—those other terms and conditions.
“(8.) Where the Minister refuses an application for
registration of an organization, he shall, within one month after he has so
refused the application, publish in the
“(9.) Where the Minister takes action in pursuance of
sub-section (6.) of this section in relation to an organization, he shall,
within one month after so taking action, publish in the
(
a ) the name of the organization;(
b ) particulars of the action so taken, including—(i) where a term or condition has been varied—the term or condition as so varied;
(ii) where a term or condition has been revoked—the term or condition so revoked; or
(iii) where a term or condition has been added—the term or condition so added; and
(
c ) the date on which the action was taken.”.
“73b. Where an organization is registered after the proclaimed date, the registration shall be deemed to be subject to each of the following conditions:—
(
a )a condition that the rules of the organization will at all times include such provision as is required to enable section eighty-two s and section eighty-two t of this Act to apply in relation to the organization;(
b )a condition that the organization will not carry on business in Australia as a registered medical benefits organization or as a registered hospital benefits organization except in a State or Territory in respect of which it is registered as a registered medical benefits organization or as a registered hospital benefits organization, as the case may be; and(
c ) a condition that the organization will cause such alterations to be made to its rules as are necessary to enable it to comply with any direction given to it by the Minister with respect to the variation of the rates of contributions payable to the organization by all or any contributors.”.
“76.—(1.) A registered organization which makes any report to all or any of its members at any time after the thirtieth day of June, One thousand nine hundred and seventy-one, shall, within one month after making the report or within such further time as the Director-General allows, furnish a copy of the report to the Director-General.
“(2.) A registered organization shall, within three months after the expiration of each year commencing with the year ending on the thirtieth day of June, One thousand nine hundred and seventy-one, or within such further time as the Director-General allows, furnish to the Director-General—
(
a )such financial accounts and statements in respect of that year as. the Director-General requires to be furnished for use in preparing the report referred to in the next succeeding section; and(
b ) such other statements in respect of that year as are prescribed,
certified on behalf of the organization, as prescribed, to be true and correct.
Penalty: Two hundred dollars.
“76a.—(1.) The Director-General shall, as soon as practicable after the thirtieth day of June in each year, commencing with the year One thousand nine hundred and seventy-one, furnish to the Minister a report on the operations of registered organizations during the year ending on that date.
“(2.) The report shall include, in respect of each medical benefits fund or hospital benefits fund conducted by the registered organization during the year to which the report relates, the following information in respect of the fund or, if the fund includes a special account, in respect of the part of the fund other than the special account:—
(
a ) contributions payable to the fund;(
b ) other amounts payable to the fund;(
c ) medical fund benefits or hospital fund benefits payable out of the fund;(
d ) other benefits payable out of the fund;(
e ) management expenses;(
f ) other amounts payable out of the fund;(
g ) the balance of the fund as at the end of that year;(
h ) details of how the reserves of the fund have been invested; and (i ) such other information as the Minister requires to be included.
“(3.) Where a special account is maintained in a fund during a year the report in respect of that year shall include, in respect of that special account, similar information as is required to be included in respect of the remainder of the fund.
“(4.) The Minister shall lay each report under this section before each House of the Parliament within fifteen sitting days of that House after it is received by the Minister.”.
“80a. The regulations—
(
a )may, for the purpose of the exercise by the Minister of the powers referred to in the next succeeding paragraph, prescribe limits in respect of management expenses in relation to all or any medical benefits funds and hospital benefits funds conducted by all or any registered organizations; and(
b )may empower the Minister to deduct from any Commonwealth benefit payable to a registered organization in relation to the conduct of a medical benefits fund or hospital benefits fund by the organization an amount equal to the amount by which any management expenses in relation to that fund exceed any limit so prescribed that is applicable in respect of that fund.”.
“82a. For the purposes of this Division, a registered organization may, with the approval of the Minister, establish a special account in a medical benefits fund or hospital benefits fund conducted by the registered organization.”.
(2.) A special account established under the section repealed by the last preceding sub-section that was subsisting immediately before the commencement of this section shall be deemed, for the purposes of the Principal Act, as amended at any time, to have been established under the section inserted in the Principal Act by that sub-section.
(
a )by omitting sub-section (1.) and inserting in its stead the following sub-section:—“(1.) Where, after the establishment of a special account by a registered medical benefits organization—
(
a )a claim for medical fund benefit is lodged by, or on behalf of, an ordinary contributor (being a contributor with respect to the medical benefits fund in which the special account is established) in respect of a professional service that is rendered to him or to one of his dependants; and(
b )by reason only of the rules of the organization relating to the eligibility of an ordinary contributor to be paid fund benefit in respect of a pre-existing ailment or relating to the maximum fund benefit payable to an ordinary contributor, the organization is entitled to disallow, and does disallow, the claim,the organization shall credit to the special account the amount of the contributions referred to in sub-section (2.) of this section.”;
(
b ) by inserting in paragraph (a ) of sub-section (1a.), after the word “contributor”, the words “(being a contributor with respect to the hospital benefits fund in which the special account is established)”; and(
c ) by inserting in paragraph (a )of sub-section (3.), after the words “ordinary contributor”, the words “(being a contributor with respect to the hospital benefits fund in which the special account is established)”.
“the organization may elect to treat the contributor as having become, on any day that is included in the days in respect of which the benefit is so payable, a special account contributor in relation to the special account established in the hospital benefits fund in respect of which he is a contributor and, if it so elects, shall, subject to section eighty-two g of this Act, credit to that special account contributions by or on behalf of that contributor in respect of the week in which that day is included and all subsequent weeks.”.
(
a ) by inserting in paragraph (a ) of sub-section (1.), after the word “contributor” (first occurring), the words “in relation to the special account”;(
b ) by inserting in paragraph (b )of sub-section (1.), after the word “contributor” (first occurring), the words “in relation to the special account”;(
c ) by inserting in paragraph (c )of sub-section (1.), after the word “contributor” (first occurring), the words “in relation to the special account”;(
d ) by omitting paragraph (ca )of sub-section (1.) and inserting in its stead the following paragraph:—
“ (ca )in the case of a registered medical benefits organization, a special account contributor in relation to the special account is not, in respect of a claim for medical fund benefit in relation to professional services (being professional services rendered on or after the date of the establishment of the special account or the day on which there became payable the first contribution in respect of the contributor the amount of which was credited to the special account, whichever is the later) excluded from entitlement to fund benefit by any rule of the organization relating to the eligibility of a contributor for payment of fund benefit in respect of a pre-existing ailment or relating to maximum fund benefit payable;”;(
e ) by inserting in paragraph (d )of sub-section (1.), after the word “contributor” (first occurring), the words “in relation to the special account”;(
f ) by adding at the end of paragraph (g ) of sub-section (1.) the word “and”;(
g ) by omitting paragraph (h ) and paragraph (j )of sub-section (1.) and inserting in their stead the following paragraph:—
“ (h )in the case of a registered hospital benefits organization, benefit is not payable from the special account in respect of a period during which a special account contributor in relation to the special account was a patient in an institution other than an approved hospital, unless payment of the benefit has been approved by the Director-General”;(
h ) by omitting from sub-section (2.) the words “of the fund”; and(
i ) by inserting in sub-section (2.) after the word “contributor” (first occurring), the words “in relation to the special account”.
(
a )by inserting after the words “special account contributors” (first occurring) the words “in relation to a special account”;(
b )by omitting the words “the special account contributors within that specified class” and inserting in their stead the words “those special account contributors”; and(
c ) by adding at the end thereof the following sub-section:—“(2.) A person who is a special account contributor shall be deemed, for the purposes of the last preceding sub-section, not to be a special account contributor during any period during which there is in force in respect of him a determination under section eighty-two u of this Act that is a Class B determination or a Class C determination for the purposes of Division 3 of Part VI.”.
“(3.) In this section, ‘accounting year’ means the year ending on the thirtieth day of June, One thousand nine hundred and seventy-one, or on any subsequent thirtieth day of June.”.
(
a )by omitting from sub-section (1.) the definitions of “approved scale of benefits” and “Assistant Director-General” and inserting in their stead the following definitions:—
5.00 | |||||
7569 | 76.00 | 5.00 | 7917 | 32.00 | 5.00 |
7573 | 76.00 | 5.00 | 7921 | 64.00 | 5.00 |
7577 | 50.00 | 5.00 | 7925 | 54.00 | 5.00 |
7581 | 25.00 | 5.00 | 7929 | 64.00 | 5.00 |
7582 | 34.00 | 5.00 | 7950 | 14.00 | 5.00 |
7586 | 42.00 | 5.00 | 7952 | 15.00 | 5.00 |
7590 | 50.00 | 5.00 | 7953 | 14.50 | 5.00 |
7594 | 64.00 | 5.00 | 7954 | 24.00 | 5.00 |
7598 | 32.00 | 5.00 | 7958 | 14.00 | 5.00 |
7602 | 42.00 | 5.00 | 7962 | 7.60 | 3.00 |
7607 | 64.00 | 5.00 | 7966 | 20.00 | 5.00 |
7611 | 24.00 | 5.00 | 7970 | 14.00 | 4.00 |
7616 | 42.00 | 5.00 | 7974 | 32.00 | 5.00 |
7620 | 24.00 | 5.00 | 7978 | 20.00 | 5.00 |
7625 | 64.00 | 5.00 | 7982 | 14.00 | 4.00 |
7629 | 6.40 | 2.00 | 7986 | 34.00 | 5.00 |
7631 | 7.60 | 3.00 | 7990 | 10.40 | 4.00 |
7635 | 50.00 | 5.00 | 7994 | 7.60 | 3.00 |
7640 | 36.00 | 5.00 | 7998 | 22.00 | 5.00 |
7644 | 32.00 | 5.00 | 8002 | 36.00 | 5.00 |
7649 | 18.00 | 5.00 | 8007 | 18.00 | 5.00 |
7653 | 6.40 | 2.00 | 8011 | 28.00 | 5.00 |
7655 | 7.60 | 3.00 | 8015 | 28.00 | 5.00 |
7659 | 7.40 | 2.00 | 8020 | 50.00 | 5.00 |
Seventh Schedule—
Number of item in First Schedule | Fund medical benefit | Specified excess | Number of item in First Schedule | Fund medical benefit | Specified excess |
$ | $ | $ | $ | ||
8024 | 16.00 | 5.00 | 8180 | 9.80 | 3.00 |
8029 | 50.00 | 5.00 | 8184 | 26.00 | 5.00 |
8033 | 36.00 | 5.00 | 8188 | 22.00 | 5.00 |
8037 | 98.00 | 5.00 | 8192 | 22.00 | 5.00 |
8042 | 34.00 | 5.00 | 8196 | 24.00 | 5.00 |
8046 | 64.00 | 5.00 | 8200 | 32.00 | 5.00 |
8050 | 50.00 | 5.00 | 8204 | 50.00 | 5.00 |
8054 | 42.00 | 5.00 | 8208 | 70.00 | 5.00 |
8058 | 42.00 | 5.00 | 8212 | 9.80 | 3.00 |
8062 | 24.00 | 5.00 | 8216 | 24.00 | 5.00 |
8066 | 20.00 | 5.00 | 8220 | 18.00 | 5.00 |
8070 | 24.00 | 5.00 | 8224 | 38.00 | 5.00 |
8110 | 18.00 | 5.00 | 8228 | 12.80 | 4.00 |
8114 | 28.00 | 5.00 | 8232 | 42.00 | 5.00 |
8119 | 32.00 | 5.00 | 8236 | 28.00 | 5.00 |
8123 | 18.00 | 5.00 | 8240 | 46.00 | 5.00 |
8128 | 32.00 | 5.00 | 8244 | 62.00 | 5.00 |
8132 | 18.00 | 5.00 | 8248 | 24.00 | 5.00 |
8136 | 42.00 | 5.00 | 8252 | 18.00 | 5.00 |
8141 | 32.00 | 5.00 | 8256 | 36.00 | 5.00 |
8145 | 20.00 | 5.00 | 8260 | 86.00 | 5.00 |
8150 | 11.60 | 4.00 | 8264 | 14.40 | 5.00 |
8154 | 24.00 | 5.00 | 8268 | 46.00 | 5.00 |
8159 | 50.00 | 5.00 | 8272 | 58.00 | 5.00 |
8163 | 24.00 | 5.00 | 8276 | 24.00 | 5.00 |
8167 | 50.00 | 5.00 | 8280 | 42.00 | 5.00 |
8172 | 28.00 | 5.00 | 8284 | 42.00 | 5.00 |
8176 | 42.00 | 5.00 | 8288 | 50.00 | 5.00 |
0
0
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