National Health Amendment Act 1979 (Cth)

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National Health Amendment Act 1979

No. 54 of 1979

An Act to amend the National Health Act 1953, and for other purposes.

BE IT ENACTED by the Queen, and the Senate and House of Representatives of the Commonwealth of Australia, as follows:

Short title, &c.

1. (1) This Act may be cited as the National Health Amendment Act 1979.

(2) The National Health Act 1953 is in this Act referred to as the Principal Act.

Commencement

2. (1) Subject to sub-section (2), this Act shall come into operation on the day on which it receives the Royal Assent.

(2) Paragraphs 3(1)(b), (c) and (d) and section 16 shall come into operation on 1 September 1979.

Interpretation

3. (1) Section 4 of the Principal Act is amended—

(a) by omitting paragraphs (a) and (b) of the definition of “basic hospital benefits table” in sub-section (1) and substituting the following paragraphs:

“(a) in respect of hospital treatment provided to persons as in-patients in a hospital in a State or Territory to which the table relates, being—

(i) patients who are not nursing-home type patients;

(ii) nursing-home type patients of a hospital in a State at any time when there is not in force between the Commonwealth and the State an agreement under section 30 of the Health Insurance Act 1973 that makes provision in relation to nursing-home type patients; or

(iii) nursing-home type patients of a hospital in an internal Territory at any time when—

(a) in the case of the Northern Territory—there is not in force between the Commonwealth and the Northern Territory an agreement under section 30 of the Health Insurance Act 1973 that makes provision in relation to nursing-home type patients; or

(b) in the case of the Australian Capital Territory—there is not in force, for the purposes of paragraph (b) of the definition of ‘patient contribution’ in sub-section 3(1) of the Health Insurance Act 1973, an amount determined by the Minister,

benefits equal to the amount of the standard hospital fees in relation to that State or Territory;

“(b) in respect of hospital treatment provided to persons as in-patients in a recognized hospital in the State or Territory to which the table relates, being nursing-home type patients (other than nursing-home type patients referred to in paragraph (a))—benefits equal to the fees charged for the provision of hospital treatment in a recognized hospital in that State or Territory in respect of a private patient in other than a single room, having regard to the need for care of the patient, being a patient who—

(i) is a nursing-home type patient; and

(ii) is not entitled to receive compensation or damages in respect of the costs of that hospital treatment,

less the amount of the patient contribution in relation to that patient for each day on which that patient is an inpatient in the hospital;

 

“(ba) in respect of hospital treatment provided to persons as in-patients in a private hospital in a State or Territory to which the table relates, being nursing-home type patients (other than nursing-home type patients referred to in paragraph (a)) but not being patients in respect of whose occupation of an approved bed in the hospital a supplementary daily bed payment is payable under section 34 of the Health Insurance Act 1973— benefits equal to—

(i) an amount equal to the fees or charges incurred in respect of the hospital treatment for the patient concerned (excluding any amount of daily bed payment payable to the hospital in respect of the patient concerned in accordance with section 33 of the Health Insurance Act 1973) less the amount of the patient contribution in relation to the patient concerned for each day on which that patient was an in-patient in the hospital; or

(ii) the amount of the standard hospital fees in relation to that State or Territory,

whichever is the lesser amount;

“(bb) in respect of hospital treatment provided to persons as in-patients in a hospital in a State or Territory (other than the State or Territory to which the table relates)— benefits equal to—

(i) an amount of benefits, calculated in accordance with paragraph (a), (b) or (ba), whichever is appropriate, on the basis that the hospital is situated in the State or Territory to which the table relates; or

(ii) an amount of benefits, calculated in accordance with paragraph (a), (b) or (ba), whichever is appropriate, on the basis that the table relates to the State or Territory in which the hospital is situated,

whichever is the greater amount;”;

(b) by omitting paragraph (a) of the definition of “basic medical benefits table” in sub-section (1) and substituting the following paragraph:

“(a) a range of benefits in respect of the provision of every prescribed professional service, such that the benefit in respect of a professional service is an amount equal to—

(i) where, by virtue of sub-section (1a) of section 10 of the Health Insurance Act 1973, no Commonwealth medical benefit is payable in respect of that professional service—the amount of the guaranteed medical benefit in respect of that professional service; or

(ii) in any other case—the amount by which the amount of the guaranteed medical benefit in respect of that professional service exceeds the amount of the Commonwealth medical benefit in respect of that professional service;”;

(c) by omitting from sub-section (1) the definition of “guaranteed medical benefit” and substituting the following definition:

“‘guaranteed medical benefit’, in relation to a prescribed professional service, means an amount equal to the amount that the Commonwealth medical benefit in respect of the professional service would be if it were calculated in accordance with the following formula and the provisions of sub-section (1a) of section 10 of the Health Insurance Act 1973 were disregarded:

An amount equal to 75% of the fee specified in respect of the service in the table in relation to the State or Territory in which the service is rendered or, if that amount is less by more than $10 than that fee, an amount that is less by $10 than that fee;”;

(d) by inserting in sub-section (1), after the definition of “premises”, the following definition:

“‘prescribed professional service’ means a professional service in respect of which a Commonwealth medical benefit is payable or, but for sub-section (1a) of section 10 of the Health Insurance Act 1973, would be payable;”; and

(e) by omitting from paragraph (b) of the definition of “supplementary hospital table” in sub-section (1a) “accommodation” (wherever occurring) and substituting “treatment”.

(2) The amendments made by sub-section (1) apply to, and in relation to, a registered organization, whether or not the registration was effected before, or is effected after, the commencement of this section.

Interpretation

4. Section 12 of the Principal Act is amended—

(a) by inserting in sub-section (3) “, or was at the relevant time,” after “is” (first occurring); and

(b) by inserting in sub-section (3)”, or has been,” after “is to be”.

Approved patient

5. Section 13 of the Principal Act is amended—

(a) by omitting from sub-section (1) “at a place more than 200 kilometres by the most direct means of surface travel from the place of residence of the person”;

(b) by omitting from sub-paragraph (i) of paragraph (a) of sub-section (2) “is to be” and substituting “was, or is to be,”;

(c) by omitting from sub-paragraph (ii) of paragraph (a) of sub-section (2) “or”;

(d) by adding at the end of sub-section (2) the following word and paragraph:

“; or (c) subject to sub-section (2a), the place of residence of the patient concerned is, or was at the relevant time, 200 kilometres or less, by the most direct means of surface travel from the the place of treatment by the specialist or consultant physician to whom the patient has been referred.”;

(e) by inserting after sub-section (2) the following sub-section:

“(2a) Paragraph (c) of sub-section (2) does not apply in relation to a patient whose place of residence is, or was at the relevant time, on a prescribed island.”; and

(f) by inserting in paragraph (b) of sub-section (3) “, or was at the relevant time,” after “is”.

Approved attendants and approved escorts

6. Section 14 of the Principal Act is amended—

(a) by inserting in sub-paragraph (i) of paragraph (a) of sub-section (1) “, or was at the relevant time,” after “is”;

(b) by inserting in sub-section (2) “, or was,” after “is”;

(c) by omitting from sub-section (3) “has attained the age of 14 years” and substituting “will have attained, or had attained, before the commencement of the journey, the age of 17 years”;

(d) by inserting in sub-section (3) “, or was,” after “is”; and

(e) by omitting paragraph (b) of sub-section (5) and substituting the following paragraph:

“(b) that patient will have attained, or had attained, before the commencement of the journey, the age of 17 years,”.

7. Section 20 of the Principal Act is repealed and the following section substituted:

Payment not to be made in case of late application

“20. A payment under this Part shall not be made if the relevant application under section 13 is not made before the expiration of 6 months after the referral to which the application relates.”.

Refund of payments under this Part

8. Section 22 of the Principal Act is amended by omitting from paragraph (b) of sub-section (1) “is” (first occurring) and substituting “was”.

Approval of person as approved person in relation to a patient

9. (1) Section 58e of the Principal Act is amended—

(a) by omitting from paragraph (b) of sub-section (1) “sixty-five” and substituting “16”;

(b) by omitting from paragraph (b) of sub-section (3) “sixty-five” and substituting”16”;

(c) by inserting after sub-paragraph (iii) of paragraph (c) of subsection (3) the following sub-paragraph:

“(iiia) is a child (including a step-child, foster-child or ex-nuptial child) of the applicant or a child (including a step-child, foster-child or ex-nuptial child) of such a child or a niece or nephew of the applicant;”; and

(d) by inserting after sub-section (3) the following sub-section:

“(3a) A reference in sub-paragraph (iii), (iiia) or (iv) of paragraph (c) of sub-section (3) to a relationship between persons shall be read as including a relationship that exists by reason of adoption.”.

(2) Where—

(a) an approval under sub-section 58e(3) of the National Health Act 1953 is given after the commencement of this section; and

(b) the approval relates to a patient who, at the time when the approval is given—

(i) has not attained the age of 65 years; or

(ii) is a person whose relationship with the applicant is a relationship referred to in sub-paragraph 58e(3)(c)(iiia) of the National Health Act 1953,

the date specified in the approval as the date on which the approval is to take effect shall not be a date earlier than 1 November 1979.

Directions by the Minister to registered organizations

10. Section 73be of the Principal Act is amended by omitting sub-section (7) and substituting the following sub-sections:

“(7) Where—

(a) a notice referred to in sub-section (6) is given with respect to a direction; and

(b) at the expiration of the period during which a resolution disallowing the direction could have been passed—

(i) the notice has not been withdrawn and the relevant motion has not been called on; or

(ii) the relevant motion has been called on, moved and seconded and has not been withdrawn or otherwise disposed of, the direction shall be deemed to have been disallowed.

“(7a) If—

(a) neither House of the Parliament passes a resolution in accordance with sub-section (6) disallowing a direction; and

(b) the direction has not been deemed to have been disallowed under sub-section (7),

the direction takes effect on the day immediately following the last day upon which a resolution disallowing the direction could have been passed.”.

Guidelines for optional tables

11. Section 73e of the Principal Act is amended—

(a) by omitting from sub-paragraph (ii) of paragraph (a) of sub-section (5) “and”;

(b) by inserting after sub-paragraph (ii) of paragraph (a) of sub-section (5) the following sub-paragraph:

“(iia) includes benefits with respect to the provision of hospital treatment in a hospital in respect of nursing-home type patients; and”; and

(c) by omitting sub-section (6d) and substituting the following sub-sections:

“(6d) Where—

(a) a notice referred to in sub-section (6c) is given with respect to an instrument of revocation; and

(b) at the expiration of the period during which a resolution disallowing the revocation could have been passed—

(i) the notice has not been withdrawn and the relevant motion has not been called on; or

(ii) the relevant motion has been called on, moved and seconded and has not been withdrawn or otherwise disposed of,

the revocation shall be deemed to have been disallowed.

“(6da) If—

(a) neither House of the Parliament passes a resolution in accordance with sub-section (6c) disallowing a revocation; and

(b) the revocation has not been deemed to have been disallowed under sub-section (6d),

the revocation takes effect on the day immediately following the last day upon which a resolution disallowing the revocation could have been passed.”.

Conduct of medical benefits funds or hospital benefits funds

12. Section 74b of the Principal Act is amended by omitting from paragraph (c) “sub-section (7)” and substituting “sub-section (7a)”.

Committees

13. (1) Section 136 of the Principal Act is amended by adding at the end of sub-section (1) “, of the Health Insurance Act 1973 or of both this Act and that Act”.

(2) A committee established and in being under section 136 of the National Health Act 1953 immediately before the commencement of this section continues in being after the commencement of this section, notwithstanding the amendments made by sub-section (1) of this section, as if it had been established under section 136 of the Principal Act as amended by this section.

Schedule

14. (1) The Schedule to the Principal Act is amended by inserting after paragraph (d) the following paragraph:

“(da) Where the organization conducts a hospital benefits fund, the amount of fund benefit payable to a contributor to the fund in respect of hospital treatment for a nursing-home type patient will not exceed an amount equal to the fees or charges incurred in respect of that hospital treatment (excluding any amount of daily bed payment payable to the hospital in respect of the patient in accordance with section 33 of the Health Insurance Act 1973) less the amount of the patient contribution in relation to the patient for each day on which the patient was an in-patient in the hospital.”.

(2) The condition set out in sub-section (1) has effect in relation to the registration of an organization, whether the registration was effected before, or is effected after, the commencement of this section.

Amendments not to apply to certain referrals

15. The amendments made by sections 4, 5, 6, 7 and 8 do not apply in relation to referrals by a medical practitioner to a specialist or consultant physician that occurred before the commencement of this section.

Condition of registration

16. The registration under the National Health Act 1953 of an organization that conducts a medical benefits fund shall, whether the registration was effected before, or is effected after, the commencement of this section, be deemed to be subject to the following condition:

The rules of the organization will not provide for a waiting period for eligible persons who, after 31 August, and before 1 November, 1979, become contributors to that fund for benefits in accordance with a basic table or an optional table.

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