EXPLANATORY STATEMENT
Subject : Health Insurance Act 1973 Health Insurance Regulations (Amendment)
1989 No. 54
ISSUED ON THE AUTHORITY OF THE MINISTER FOR COMMUNITY SERVICES AND HEALTH
Subsection 133(1) of the Health Insurance Act 1973 (the Act) provides 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.
Provider numbers are allocated to medical practitioners for purposes related to the administration of Medicare. They have, until now, been allocated by the Secretary to the Department of Community Services and Health or a person authorised by him. The term ‘provider number’ was defined in the Health Insurance Regulations accordingly.
It was considered, however, that the allocation of these numbers would, in the future, be more appropriately and effectively carried out by the Health Insurance Commission. The above definition of ‘provider number’ needed, therefore, to be amended to allow this to happen. The Regulations have accordingly amended this definition by replacing the previous reference to the Permanent Head with a reference to the Health Insurance Commission.
Regulation 9A of the Health Insurance Regulations previously prescribed, for the purposes of section 100 of the Act, the allowances for expenses payable to witnesses appearing before Medical Services Committees of Inquiry (MSCIs). It also purported to prescribe allowances payable to witnesses appearing before Optometrical Services Committees of Inquiry (OSCIs). Due to an anomaly, however, in the interrelationship between the Act and the Regulations, allowances to witnesses appearing before OSCIs were not legally payable. To date, therefore, no such allowances have been paid.
The Regulations therefore, have amended Regulation 9A to correct this anomaly and prescribe, for the purposes of section 106FE of the Act, allowances payable to witnesses appearing before OSCIs. They will now be in the same position as witnesses appearing before MSCIs. The Regulations also index all such allowances (payable to both MSCI & OSCI witnesses) to those payable to witnesses appearing before the Federal Court.
Overview
The Health Insurance Act 1973, as amended by the Health Insurance Regulations (Amendment) 1989, addresses the need for improved administration of Medicare through the allocation of provider numbers to medical practitioners. Initially, these numbers were assigned by the Secretary to the Department of Community Services and Health or an authorised person. However, to better facilitate the administration of Medicare, the allocation of provider numbers has been transferred to the Health Insurance Commission. This change is reflected in the amendment to the definition of ‘provider number’ in the Health Insurance Regulations, replacing the previous reference to the Permanent Head with the Health Insurance Commission. Additionally, the Regulations address an anomaly whereby allowances for expenses payable to witnesses appearing before Optometrical Services Committees of Inquiry (OSCIs) were not legally payable due to an interrelationship between the Act and the Regulations. This oversight has been rectified by amending Regulation 9A to prescribe allowances payable to OSCI witnesses, aligning them with those payable to witnesses before Medical Services Committees of Inquiry and indexing them to the allowances for Federal Court witnesses.
Scope and Application
The Health Insurance Act 1973 and its subsequent regulations, including the Health Insurance Regulations (Amendment) 1989 No. 54, govern the administration of Medicare in Australia, specifically relating to the allocation of provider numbers to medical practitioners and the allowances for expenses payable to witnesses appearing before certain committees of inquiry. This Act applies to medical practitioners and witnesses involved in proceedings before Medical Services Committees of Inquiry (MSCIs) and Optometrical Services Committees of Inquiry (OSCIs). The amendments to the Health Insurance Regulations ensure that provider numbers are allocated by the Health Insurance Commission, rather than the Secretary to the Department of Community Services and Health, enhancing the efficiency and appropriateness of the allocation process. Additionally, the Regulations rectify a legal anomaly by prescribing allowances for witnesses appearing before OSCIs, aligning their entitlements with those of witnesses appearing before MSCIs, and indexing these allowances to those payable to witnesses appearing before the Federal Court. These regulatory changes are designed to streamline administrative processes and ensure consistent and fair treatment of all parties involved in Medicare-related inquiries.
Key Provisions
The Health Insurance Regulations (Amendment) 1989 No. 54 brings about two significant changes to the Health Insurance Act 1973. Firstly, it amends the definition of ‘provider number’ to reflect the change in the entity responsible for its allocation (Reg. 3). Previously, provider numbers were allocated by the Secretary to the Department of Community Services and Health or an authorised person. However, it is now deemed more appropriate for the Health Insurance Commission to handle this allocation. This change is necessary to streamline the administration of Medicare and ensure efficiency in the allocation process. Secondly, the amendment rectifies an anomaly regarding the allowances for expenses payable to witnesses appearing before Optometrical Services Committees of Inquiry (OSCIs) (Reg. 9A).
Under the amended regulations, the Health Insurance Commission is now responsible for assigning provider numbers, thereby ensuring a more streamlined and efficient allocation process (Reg. 3). This change is intended to facilitate the administration of Medicare, ensuring that medical practitioners can seamlessly access the necessary administrative support. Additionally, the amendment corrects an oversight in the previous regulations by legally enabling allowances for expenses payable to witnesses appearing before OSCIs (Reg. 9A). This ensures that witnesses in optometrical services inquiries are treated equitably with those in medical services inquiries.
The obligations imposed by the amended regulations primarily affect the Health Insurance Commission, which is now responsible for the allocation of provider numbers (Reg. 3). This shift in responsibility necessitates that the Commission implement systems and processes to efficiently manage and issue provider numbers to medical practitioners. Additionally, the Commission must ensure that all allowances for expenses payable to witnesses appearing before OSCIs are processed correctly and in accordance with the prescribed rates (Reg. 9A). This includes maintaining records and verifying the eligibility of witnesses to receive these allowances.
Failure to comply with the amended regulations may result in legal and financial consequences. Although the regulations do not explicitly outline specific offences or penalties, breaches of the Health Insurance Act 1973 generally may lead to civil or criminal penalties. For example, providing false or misleading information during the allocation of provider numbers could lead to disciplinary action under the Act. Similarly, failure to pay the legally prescribed allowances to witnesses may result in legal action for non-compliance. The exact penalties would depend on the nature and severity of the breach, as outlined in the principal Act.