Health Benefits Reinsurance (Trust Fund Principles) Amendment Determination 1999 (No. 1)
I, MICHAEL WOOLDRIDGE, Minister for Health and Aged Care, make this Determination under subsection 73BC (5B) of the National Health Act 1953.
Dated 30 September 1999.
M WOOLDRIDGE
Minister for Health and Aged Care
Health Benefits Reinsurance (Trust Fund Principles) Amendment Determination 1999 (No. 1)
made under the
National Health Act 1953
Contents
Page
1 Name of Determination
2 Commencement
3 Amendment of Health Benefits Reinsurance (Trust Fund Principles) Determination 1998
Schedule 1 Amendments
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Do not delete : Division placeholder
1 Name of Determination
This Determination is the Health Benefits Reinsurance (Trust Fund Principles) Amendment Determination 1999 (No. 1).
2 Commencement
This Determination commences on 1 October 1999.
3 Amendment of Health Benefits Reinsurance (Trust Fund Principles) Determination 1998
Schedule 1 amends the Health Benefits Reinsurance (Trust Fund Principles) Determination 1998.
Schedule 1 Amendments
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(section 3)
[1] After section 1.3
insert
1.3A Meaning of current financial year
For section 1.3B, current financial year means a financial year for which the Council:
(a) is making a determination for subsection 73BC (6); or
(b) is deciding an amount for subsection 73BC (12).
1.3B Meaning of prescribed information
(1) Prescribed information means information, received from any source, that meets the criteria set out in subsections (2), (3) and (4).
(2) Prescribed information is information:
(a) that is about a calculation made for section 2.6 or 3.3 for a quarter that ended:
(i) during the current financial year; or
(ii) before the date by which the organisation is required, under subsection 82L (2) of the Act, to give the Council information about the financial year in which the quarter occurred; and
(b) that is received by the Council no later than by the end of the current financial year.
Example 1
Prescribed information may include information about a calculation made for the September quarter of 1998 if the information is received by the Council at any time until 30 September 1999.
This is because the organisation has until 30 September 1999 to give the Council information to prepare the Council’s report to the Minister about the 1998-1999 financial year (see subsection 82L (2) and section 82PA of the Act).
Example 2
Prescribed information does not include information about a calculation made for the June quarter of 1999 if the information is received after 30 September 1999.
This is because, by 30 September 1999, the Council must have received information about the 1998-1999 financial year to prepare its report.
(3) However, if exceptional circumstances apply, prescribed information may include information about a calculation for a quarter that ended before a quarter mentioned in paragraph (2) (a).
(4) Prescribed information must indicate that, for a quarter:
(a) the Council determined a payment, for subsection 73BC (6) of the Act, that was not an appropriate payment; or
(b) the Council decided an amount, for subsection 73BC (12) of the Act, on the basis of inaccurate information.
1.3C Meaning of exceptional circumstances
(1) For subsection 1.3B (3), exceptional circumstances includes the circumstances mentioned in this section.
(2) For a calculation made for section 2.6, an exceptional circumstance may be demonstrated by evidence, to the Council’s satisfaction:
(a) that the registered organisation did not exercise proper care in giving the Council information to which the Council is entitled under section 82G of the Act; or
(b) that the Council will be able to make the calculation more efficiently if it takes into account information about a calculation made for a quarter mentioned in subsection 1.3B (3).
(3) For a calculation made for section 3.3, an exceptional circumstance may be demonstrated by evidence, to the Council’s satisfaction, that the Council will be able to make the calculation more efficiently if it takes into account information about a calculation made for a quarter mentioned in subsection 1.3B (3).
[2] After subsection 2.2 (1)
insert
(1A) The Council may also take into account prescribed information in calculating the amounts to be paid into the Fund, for a particular quarter, by a registered organisation.
[3] Subsection 2.2 (2)
omit
subsection (1)
insert
subsections (1) and (1A)
Overview
The Health Benefits Reinsurance (Trust Fund Principles) Amendment Determination 1999 (No. 1) was enacted to make adjustments to the Health Benefits Reinsurance (Trust Fund Principles) Determination 1998 under the National Health Act 1953. This legislative instrument was introduced by the Australian Government to address the need for more precise definitions and clearer guidelines regarding the collection and application of prescribed information in the context of health benefits reinsurance. The determination was made by the Minister for Health and Aged Care, Michael Wooldridge, and aims to refine the criteria and procedures for handling financial information within the health benefits reinsurance framework. This amendment is intended to enhance the efficiency and accuracy of the Council's calculations and determinations related to reinsurance payments and amounts.
Scope and Application
The Health Benefits Reinsurance (Trust Fund Principles) Amendment Determination 1999 (No. 1) applies to the administration and operation of the Health Benefits Reinsurance Fund, specifically under the National Health Act 1953. This determination impacts registered organisations that are subject to the Act, modifying the original Health Benefits Reinsurance (Trust Fund Principles) Determination 1998. The amendments primarily focus on the definition and use of prescribed information in determining payments and amounts to be paid into the Fund by registered organisations. The determination is effective from 1 October 1999 and is applicable nationally, aligning with the jurisdictional reach of the National Health Act. The Act allows for further elaboration and specification of the determination through subordinate instruments, ensuring its adaptability to changing circumstances and regulatory needs. This particular amendment does not introduce any explicit exclusions or exemptions, but rather refines the existing framework for financial reporting and Fund contributions.
Key Provisions
The Health Benefits Reinsurance (Trust Fund Principles) Amendment Determination 1999 (No. 1) amends the Health Benefits Reinsurance (Trust Fund Principles) Determination 1998, which is made under the National Health Act 1953. The amendments introduced by this Determination are set out in Schedule 1 and focus on the definitions and uses of certain types of information and circumstances that impact the calculation of amounts to be paid into the Fund by registered organisations. Specifically, the amendments introduce new definitions for 'current financial year' (section 1.3A), 'prescribed information' (section 1.3B), and 'exceptional circumstances' (section 1.3C). Additionally, the Council is now permitted to take into account prescribed information when calculating the amounts to be paid into the Fund for a particular quarter by a registered organisation (subsection 2.2(1A)).
The Determination imposes certain obligations on the Council and registered organisations. The Council must ensure that it receives and considers prescribed information within the specified timeframes and under the conditions outlined. Registered organisations are required to provide the Council with the necessary information in a timely manner and in accordance with the criteria set out in the Determination. The Council must also determine whether exceptional circumstances apply and decide whether to take prescribed information into account when making calculations. These obligations are designed to ensure that the Fund is properly managed and that the payments made by registered organisations are based on accurate and timely information.
Failure to comply with the requirements of the Determination can result in significant consequences. While the Determination itself does not explicitly outline specific offences, penalties, or consequences for breach, it is made under the National Health Act 1953, which may contain provisions related to non-compliance. Under the Act, breaches of certain requirements can lead to civil or criminal penalties, including fines and imprisonment, depending on the nature and severity of the breach. The exact penalties would be determined based on the specific provisions of the National Health Act 1953 and any relevant regulations or guidelines. It is important for the parties governed by this Determination to adhere to the requirements to avoid potential legal and financial repercussions.