EXPLANATORY STATEMENT
ISSUED BY THE AUTHORITY OF
THE MINISTER FOR HEALTH AND AGEING
HEALTH INSURANCE ACT 1973
DECLARATION OF QUALITY ASSURANCE ACTIVITIES UNDER SECTION 124X
QAA No. 3/2004
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, for example, through Medicare benefits. The scheme encourages participation in such activities by protecting certain information from disclosure, and also by protecting the persons engaged in those activities, in good faith, from civil liability in respect of those activities. In order for Part VC to apply to an activity, the Minister must make a Declaration.
This Declaration applies Part VC of the Act to Australian General Practice Accreditation Limited (AGPAL) – accreditation of general practices (Item 1), Quality Practice Accreditation Proprietary Limited (QPA) – accreditation of general practices (Item 2), and Quality Improvement Practice Proprietary Limited (QIP) – accreditation of optometric practices (Item 3) – (the Activities).
The Declaration is a disallowable instrument for the purposes of section 46A of the Acts Interpretation Act 1901.
The Activities relate to the quality of health services which would be eligible for payment in respect of Medicare Benefits.
Both the Activities at Item 1 and Item 2 of the Schedule have the purpose of assessing and accrediting general practices to the standards established by the Royal Australian College of General Practitioners. The Activity at Item 3 of the Schedule has the purpose of assessing and accrediting general practices to the standards established by the Optometrists Association of Australia.
Before the Minister can make a declaration, certain requirements must be met.
Firstly, the organisations engaged in the activities must be authorised to do so. The authorisation can be by a law of the Commonwealth, or a State or Territory; by an association of health professionals; by a body that provides health care; or by an educational institution. The organisations engaged in the Activity at Item 1 and Item 2 of the Schedule are authorised to do so by the Commonwealth government.
The organisation engaged in the Activity at Item 3 of the Schedule is authorised to do so by the Optometrists Association Australia.
Secondly, the Minister has to be satisfied that it is in the public interest to have Part VC of the Act apply to the Activities. The Minister must have regard to criteria prescribed by the regulations. The criteria relevant to the Activities are in regulations 23C, 23D and 23E or 23F of the Health Insurance Regulations. The Activities meet those criteria as follows:
· As required by Regulation 23C, the Activities include the disclosure of non-identifying information that concerns the quality of service assessed, evaluated or studied or the factors affecting the quality of the service, thereby satisfying the requirement that information is provided at times and in a manner acceptable to the Minister. In the Activity under Item 1 of the Schedule, non-identifying information will be made available through AGPAL’s bi-annual conference and through its publication “Quality News”, which is published on a quarterly basis. Copies of the publications will be available to the Minister for Health and Ageing.
In the Activity under Item 2 of the Schedule, aggregated findings will be regularly reported to practices, professional organisations and the Commonwealth Department of Health and Ageing. Copies of reports will be available to the Minister for Health and Ageing.
In the Activity under Item 3 of the Schedule, the organisation engaged in the Activity will publish research based on de-identified data and provide copies of the research papers to the Minister for Health and Ageing.
· The Activities under Items 1, 2 and 3 are exempt from Regulation 23D as they are being undertaken in more than one state.
· As required by Regulation 23E, the Minister is satisfied that the Activity under Item 3 of the Schedule is of a kind that have not been engaged in Australia before because none has been declared and the necessary protections for those participating were not available. The Declaration is needed to ensure that the Activity has the protections of immunity from suit and prohibitions on the disclosure of information. These are to make the Activity effective, by encouraging the full participation in the Activity of persons who provide health services.
· As required by Regulation 23F, the Minister is satisfied that the Activities under Items 1 and 2 are of a kind that have been engaged in Australia before. In respect of Item 1, this activity has been previously declared (QAA No. 1/1999). In respect of Item 2, two previous declarations have been made in relation to this kind of activity, including a declaration covering AGPAL’s practice accreditation activity (referred to above). The quality assurance activity to be undertaken by QPA is the same kind of activity as that undertaken by AGPAL. The application of Part VC of the Act to the activities described in Item 1 and 2 is necessary to make the activity effective by encouraging participation in the activity by persons who provide health services, to a greater extent than the participation in the activity, by persons who provide health services, in previous activity.
A Regulation Impact Statement (RIS) is not necessary for this Declaration because the declaration of the activity will not have a direct or substantial indirect effect on business.
The Declaration was signed by the Minister on 22 December 2004 and comes into operation on the day after registration on the Federal Register of Legislative Instruments. 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.
QAA No. 3/2004