EXPLANATORY STATEMENT
ISSUED BY THE AUTHORITY OF
THE MINISTER FOR HEALTH
HEALTH INSURANCE ACT 1973
DECLARATION OF QUALITY ASSURANCE ACTIVITY
UNDER SECTION 124X
QAA No: 5/2016
Part VC of the Health Insurance Act 1973 (the Act) creates a 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 to apply to an activity, the Minister 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 the section 124X.
The Declaration is a legislative instrument for the purposes of the Legislation Act 2003. This Declaration has effect from the day after registration on the Federal Register of Legislative Instruments. Section 124X(4) of the Act prescribes that, unless sooner revoked, this determination ceases to be in force at the end of 5 years after the instrument of declaration was signed.
This declaration under subsection 124X(1) applies Part VC of the Act to the following activity:
- Quality Practice Accreditation Pty. Ltd.: Accreditation for entry into or maintenance of Practice Incentive Program (PIP)
An overview of the activity for which the Declaration pursuant to s124X is made is contained in Attachment A.
Before the Minister can make a declaration, certain requirements must be met.
Firstly, the Minister must be satisfied that the persons engaged in the activity are authorised to do so as described in paragraph 124X(3)(a) of the Act.
The activity meets the requirements of paragraph 124X (3)(a) in that the persons engaged in this activity are authorised to do so by the Quality Practice Accreditation which is a research body that undertakes primary care accreditation.
Secondly, paragraph 124X (3)(b) of the Act provides that the Minister must be satisfied that it is in the public interest to have Part VC of the Act apply to the activity. In doing so, the Minister must have regard to criteria prescribed by the Regulations. The criteria relevant to the activity are in regulations 23C, 23D and 23E or 23F.
The activity meets the criteria as follows:
- As required by regulation 23C, the activity includes the disclosure of non-identifying, aggregated information that concerns the quality of service assessed, evaluated or studied. Reports, compliant with privacy guidelines, are provided to professional organisations, such as the Australian Institute of Health and Welfare.
- Regulation 23D does not apply as the activity will be undertaken in more than one State or Territory.
- Regulation 23E does not apply as the activity has previously been engaged in Australia.
- Regulation 23F applies as the activity has previously been carried out in Australia. The Minister’s declaration will encourage greater participation in the activity by persons who provide health services by providing participants with a greater degree of confidence and security that their participation is solely to the benefit of establishing and improving quality assurance.
- Regulation 23G does not apply as the activity does not include the assessment or evaluation by a person of the services, skill or performance of a health practitioner for the purpose of determining the health care practitioner’s clinical practicing rights.
CONSULTATION
The Quality Practice Accreditation Pty. Ltd.’s (QPA) accreditation of general practice was previously declared to be a quality assurance activity under section 124X of the Act (see QAA 1/2011. QPA applied to continue their activity as being a quality assurance activity under the Act.
An assessment of the application included an assessment of 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 met the criteria required for declaration as set out in the Regulations.
The declaration of this activity will not result in any direct or substantial indirect effect on business.
The Declaration comes into operation on the day after registration on the Federal Register Legislation.
As provided by subsection 124X(4) a declaration ceases to be in force at the end of 5 years after the instrument of declaration is signed, unless revoked earlier.
ATTACHMENT A
ACCREDITATION FOR ENTRY INTO OR MAINTENANCE OF PRACTICE INCENTIVE PROGRAM (PIP)
1. PURPOSE OF ACTIVITY
Quality Practice Accreditation Pty. Ltd.’s (QPA) accreditation of general practice involves the practice signing a declaration to ensure they meet the Royal Australian College of General Practitioners (RACGP) definition of a general practice to ensure QPA can process their application.
QPA provides a detailed document review assessment and on site visit to assess the general practice against the current RACGP Standards, for the purposes of the Practice Incentive Program (PIP).
All practices involves in QPA’s ‘General Practice Accreditation Plus’ program are required to provide QPA with information regarding their practice management systems and quality assurance activities, prior to any onsite practice visit.
QPA provides trained surveyors to undertake an onsite assessment of the general practice using a survey protocol covering the RACGP standards’ indicators. The practice report is reviewed by QPA’s independent Accreditation Committee who determine to award or defer accreditation.
The objectives of the activity are:
- Enhance and improve the quality of care delivered to general practice patients in Australia;
- Confirm general practices meet the required RACGP standards;
- Promote continued quality improvement; and
- Enhance practice development and efficiency.