EXPLANATORY STATEMENT
HEALTH INSURANCE ACT 1973
DECLARATION OF RELEVANT PROFESSIONAL BODIES UNDER SUBSECTION 129AAD(13)
INSTRUMENT NUMBER RPB 1 OF 2011
Summary
Paragraph 129AAD(1) (c) of the Health Insurance Act 1973 (the Act) requires the Medicare Australia (MA) Chief Executive Officer (CEO), amongst other things, to take “reasonable steps to consult with a relevant professional body about the types of documents that contain information relevant to” a compliance audit of a Medicare Benefit paid in respect of a service. Subsection 129AAD(13) provides that the Minister may, by legislative instrument, declare a body to be a relevant professional body. A relevant professional body for the purposes of section 129AAD is a body declared as such by the Minister for Health and Ageing subsection 129AAD(12)].
Purpose
The purpose of this Declaration is to enable the MA CEO to consult any of the professional bodies listed in the Schedule about the types of documents that contain information relevant to a compliance audit.
Background
Section 129AAD of the Act was added by the Health Insurance Amendment (Compliance) Act 2011 (the Amending Act), which commenced on 9 April 2011. The Amending Act gives effect to two components of the Increased Medicare Benefits Schedule Compliance Audits (IMCA) initiative, which was announced in the
2008-09 Budget.
The Amending Act applies to compliance audits allowing the MA CEO to give a notice requiring a person to produce documents to substantiate a Medicare benefit paid in respect of a service; and providing for recovery if a practitioner is unable to substantiate a Medicare benefit paid in respect of a service and potentially for an administrative penalty.
Consultation
The Department of Health and Ageing has consulted with MA, the Australian Medical Association (AMA) and Allied Health Professions Australia (AHPA) in relation to the selection of bodies listed in the Instrument. Comments from the AMA and AHPA (and its member organisations) have been taken into account in finalising the List of Relevant Professional Bodies contained in the Schedule to the Declaration.
The List includes professional bodies such as the AMA as well as Colleges, Societies and Associations representing a wide variety of General Practitioners, specialists and Allied Health Professionals.
This Declaration commences on the day after it is registered on the Federal Register of Legislative Instruments.
This Declaration is a legislative instrument for the purposes of the Legislative Instruments Act 2003.