EXPLANATORY STATEMENT
HEALTH INSURANCE ACT 1973
DECLARATION OF QUALITY ASSURANCE ACTIVITY UNDER
SECTION 124X OF THE HEALTH INSURANCE ACT 1973 – QAA 3/2014
Part VC of the Health Insurance Act 1973 (the Act) creates a scheme (known as the Commonwealth Qualified Privilege Scheme) to encourage efficient quality assurance activities. Those activities help to ensure the quality of health services that are funded by the Government, through Medicare benefits, the Pharmaceutical Benefits Scheme, Public Hospitals and/or Health Program Grants. The scheme encourages participation in such activities by protecting certain information from disclosure, and also by providing some protection from civil liability to certain persons engaged in those activities in good faith, in respect of those activities.
In order for Part VC of the Act to apply to an activity, the Minister or his delegate must make a declaration pursuant to section 124X of the Act, that the activity described in the Declaration is a quality assurance activity to which Part VC applies. Regulations 23C to 23G of the Health Insurance Regulations 1975 (the Regulations) set out the public interest criteria that must be met by quality assurance activities in order to be declared under section 124X of the Act.
The purpose of the Declaration of Quality Assurance Activity under section 124X of the Health Insurance Act 1973 – QAA 3/2014 (the Declaration) is to declare the activity titled ‘The I-Med Network peer review quality assurance activity for I-Med Radiologists’ as a quality assurance activity under section 124X of the Act. The activity is being conducted by I-Med Network.
Before the Minister or his delegate can make a declaration, certain requirements must be met:
- firstly, the Minister or his delegate must be satisfied that the persons engaged in the activity are authorised to do so as described in section 124X(3)(a) of the Act – this requirement is met as the persons engaged in the activity described in the Declaration are authorised to do so by I-Med Network, a body that provides health care.
- secondly, section 124X(3)(b) of the Act provides that the Minister or his delegate must be satisfied that it is in the public interest to have Part VC of the Act apply to the activity, having regard to the criteria prescribed in Regulations 23C to 23G – the activity described in the Declaration meets the relevant criteria prescribed by the Regulations, as amongst other things, the declaration will encourage greater participation in the activity and acceptance, implementation and monitoring of any recommendations which arise from the activity.
The quality assurance activity described in the Declaration relates to a quality framework in which the individual practice, performance and competence of I-Med radiologists is evaluated by way of peer review through the assessment of the radiology services provided, gathering of collateral information from third parties, direct observations and/or performance improvement discussions.
The objectives of the activity are to minimise patient adverse outcomes and improve quality and safety on a nationally consistent basis.
Declaring the activity as a quality assurance activity under section 124X of the Act will provide protection to persons engaged in the activity and will encourage participation and provision of full and frank comments and opinions.
Consultation
Consultation regarding the application for declaration for this activity was undertaken in December 2013. This included obtaining advice on the potential value of declaring the activity as a quality assurance activity for the purposes of the Act, the methodology used to conduct the activity, and whether the application meets the criteria required for a declaration to be made, particularly the criteria relating to whether it is in the public interest to declare the activity.
Those consulted included members of the Qualified Privilege Advisory Group, which includes an external clinician; a legal expert; a quality manager working in the field of health care quality assurance; and a consumer representative.
The declaration of the activity will not result in any direct or substantial indirect effect on business.
This Declaration commences the day after registration on the Federal Register of Legislative Instruments. Pursuant to section 124X(4) of the Act, this Declaration, unless sooner revoked, ceases to be in force at the end of 5 years after the instrument of declaration was signed.
This Declaration is a legislative instrument for the purposes of the Legislative Instruments Act 2003.