EXPLANATORY STATEMENT
STATUTORY RULES 1983 NO. 95
HEALTH INSURANCE ACT 1973
HEALTH INSURANCE REGULATIONS (AMENDMENT)
Issued by Authority of the Minister for Health
Section 133 of the Health Insurance Act 1973 (‘the Act’) provides in part that the Governor-General may make regulations, not inconsistent with the Act, prescribing all matters required or permitted by the Act to be prescribed, or necessary or convenient to be prescribed for carrying out or giving effect to the Act.
Sub-section 130(1) of the Act provides that a person shall not, directly or indirectly, except in the performance of his duties, or in the exercise of his powers or functions, under the Act, and while he is, or after he ceases to be, an officer, make a record of, or divulge or communicate to any person, any information with respect to the affairs of another person acquired by him in the performance of his duties, or in the exercise of his powers or functions, under the Act. An “officer” is, by virtue of sub-section 130(14) of the Act, a person performing duties, or exercising powers or functions, under, or in relation to, the Act.
Paragraph 130(3)(b) of the Act provides that, notwithstanding the prohibition imposed by sub-section 130(1), information which is subject to that sub-section may be divulged by the Secretary of the Department of Health or by the General Manager of the Health Insurance Commission to any prescribed authority or person. Sub-section 130(4) of the Act, however, prohibits information so divulged from being further divulged by the recipient authority or person, and by any person or employee under the control of that person or authority.
Regulation 9B of the Health Insurance Regulations (‘the Regulations’) prescribes authorities and persons for the purposes of paragraph 130(3)(b) of the Act.
The regulations amend regulation 9B of the Regulations to prescribe, for the purposes of paragraph 130(3)(b) of the Act, a person who, for the time being, is performing the duties of either of the positions of Legal Officer, position number 7101/48, or Legal Officer, position number 7101/289, in the Complaints Unit in the Department of Health of the State of New South Wales. The State Complaints Unit has the responsibility of investigating, where
appropriate, complaints received in the office of the New South Wales Minister for Health regarding health services in New South Wales.
The prescribing, for the purposes of paragraph 130(3)(b) of the Act, of these officers of the State Complaints Unit has been necessary to permit information which is subject to sub-section 130(1) of the Act (in particular, matters relating to the investigation and prosecution of medical benefits fraud) to be communicated to them at meetings of the Commonwealth “State Co-ordinating Group on Medical Fraud”. This body was formed to assist co-ordination between agencies of the Commonwealth Government concerned with the investigation and prosecution of possible offences arising from the payment of medicare benefits under the Act. The attendance of the State officers at meetings of the Co-ordinating Group, which has been requested by the New South Wales Minister for Health, is expected to facilitate the conduct of relevant investigations by both Commonwealth and State authorities.
The draft statutory rules came into operation on the date of their notification in the Commonwealth of Australia Gazette.