Health Insurance (Professional Services Review — Content and Form of Adjudicative Referrals) Guidelines 1999
I, MICHAEL WOOLDRIDGE, Minister for Health and Aged Care, make these Guidelines under subsection 93 (4) of the Health Insurance Act 1973.
Dated 13 December 1999.
MICHAEL WOOLDRIDGE
Minister for Health and Aged Care
Health Insurance (Professional Services Review — Content and Form of Adjudicative Referrals) Guidelines 1999
made under the
Health Insurance Act 1973
Contents
Page
1 Name of Guidelines
2 Commencement
3 Definitions
4 Content of adjudicative referral
5 Form of adjudicative referral
1 Name of Guidelines
These Guidelines are the Health Insurance (Professional Services Review — Content and Form of Adjudicative Referrals) Guidelines 1999.
2 Commencement
These Guidelines commence on gazettal.
3 Definitions
(1) In these Guidelines:
Act means the Health Insurance Act 1973.
(2) An expression used in these Guidelines that is defined in section 81 of the Act has the same meaning in these Guidelines as in that section.
Note Words and expressions defined in s 81 of the Act include investigative referral, person under review, practitioner, referral, and service.
4 Content of adjudicative referral
(1) The content of an adjudicative referral to a Committee in relation to a person under review may include:
(a) information and material received by the Director with the investigative referral relating to the person; and
(b) any other relevant information and material discovered or obtained by the Director.
(2) The information included may relate to services rendered or initiated by:
(a) any of the persons mentioned in paragraph 86 (4) (a) of the Act; and
(b) for comparative purposes:
(i) a class of practitioners; and
(ii) all practitioners.
5 Form of adjudicative referral
An adjudicative referral must be made in writing.