EXPLANATORY STATEMENT
Human Services (Medicare) (Medicare Programs) Specification 2015
The concept of “Medicare programs” exists in the Human Services (Medicare) Act 1973 for the purpose of secrecy provisions governing programs delivered by Department of Human Services (the department), to ensure permitted flows of customer information across the programmes delivered by the department. Section 130 of the Health Insurance Act 1973 provides that it is an offence to make a record of, or divulge or communicate to any person, information acquired in the performance of his or her duties. One exception to this offence is where the information is recorded, divulged or communicated for the purpose of enabling a person to perform functions in relation to a Medicare program.
Section 41G of the Human Services (Medicare) Act 1973 is a general interpretation provision that defines “Medicare program” for the purposes of any law of the Commonwealth as:
- services, benefits, programs or facilities that are provided for under the Health Insurance Act 1973, the National Health Act 1953, the Dental Benefits Act 2008, the Aged Care Act 1997, the Aged Care (Transitional Provisions) Act 1997, the Healthcare Identifiers Act 2010, the Private Health Insurance Act 2007, or the Health and Other Services (Compensation) Act 1995 (paragraph 41G (a)); and
- services, benefits, programs or facilities specified in a legislative instrument made by the Minister (paragraph 41G (b)).
The Human Services (Medicare) (Medicare Programs) Specification 2015 specifies, for the purposes of paragraph 41G (b), programs that are currently delivered by the department but which are not delivered under the legislation specified in paragraph 41G (a). This instrument ensures that information obtained for the purposes of a Medicare program will be able to be used for the purposes of other Medicare programs.
The specification repeals and replaces the Human Services (Medicare) (Medicare Programs) Specification 2011. The only substantial change is to add the Aged Care Gateway to the list of Medicare programs.
The Aged Care Gateway is an identifiable entry point to the Aged Care system. The purpose of the Aged Care Gateway is to enable timely and reliable information to be accessed by older people, their families and carers. It is also designed to help people navigate the Aged Care system and will provide referrals for assessment and service provision. When a customer wishes to register for and/or access the Aged Care Gateway, their identity will need to be verified and authenticated to allow creation of a Central Client Record. It is proposed that an identity match will be performed by validating an individual’s Medicare registration information. The proposed data to be used for these purposes includes an individual’s Name, Date of birth, and Medicare Card number and Individual Reference Number. Enabling the use of an individual’s Medicare details helps to ensure integrity of the Aged Care registration process.
The specification is of an administrative nature and ensures that aged care clients creating a client record in the Aged Care Gateway can have their identity verified by reference to their Medicare information. Specifying the Aged Care Gateway as a Medicare program ensures that this transfer of information does not contravene section 130 of the Health Insurance Act 1973. Accordingly, no public consultation on the specification was considered necessary.
As this is an internal cross departmental process, there is no impact on clients or third parties for the specification.
The specification commences on 1 July 2015.
No statutory preconditions are needed to be satisfied prior to the making of the specification.
Statement of compatibility with human rights
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011
The instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.
The instrument does not engage any of the applicable rights or freedoms. It is compatible with human rights as it does not raise any human rights issues.
Overview
The Human Services (Medicare) (Medicare Programs) Specification 2015 was enacted to address the need for a clear definition and scope of "Medicare programs" under the Human Services (Medicare) Act 1973, ensuring that information flows appropriately across various programs delivered by the Department of Human Services. The legislation was introduced to clarify the exceptions under Section 130 of the Health Insurance Act 1973, which prohibits the recording, divulging, or communicating of information acquired in the performance of duties, except for purposes directly related to Medicare programs. The specification was developed to replace the previous 2011 version and to add the Aged Care Gateway to the list of Medicare programs, facilitating the use of Medicare details for identity verification in aged care registrations. This administrative update aims to ensure compliance with privacy laws while streamlining the registration process for the Aged Care Gateway, with no impact on clients or third parties. The specification is consistent with human rights as it does not engage any applicable rights or freedoms under the Human Rights (Parliamentary Scrutiny) Act 2011.
Scope and Application
The Human Services (Medicare) (Medicare Programs) Specification 2015 applies to the administrative processes within the Department of Human Services, ensuring that information acquired in the course of performing duties can be appropriately shared across various Medicare programs. This specification is crucial for maintaining the integrity and functionality of these programs, which are defined under the Health Insurance Act 1973 and other relevant legislation, including the National Health Act 1953, the Dental Benefits Act 2008, the Aged Care Act 1997, and others. Specifically, the specification identifies the Aged Care Gateway as a Medicare program, enabling the use of an individual's Medicare details for identity verification and authentication purposes. This ensures that the transfer of information complies with secrecy provisions and does not contravene section 130 of the Health Insurance Act 1973. The specification is of administrative nature and has no impact on clients or third parties. It commenced on 1 July 2015 and there are no statutory preconditions required prior to its making. The instrument is compatible with human rights, as it does not engage any of the applicable rights or freedoms.
Key Provisions
The Human Services (Medicare) (Medicare Programs) Specification 2015 (F2015L00789) primarily concerns the administrative framework governing the transfer and use of information across various Medicare programs. It specifies programs that are recognised as Medicare programs under section 41G of the Human Services (Medicare) Act 1973. This includes both programs governed by specific acts such as the Health Insurance Act 1973 and the Aged Care Act 1997, as well as those specified by the Minister through a legislative instrument. The key provision here is the inclusion of the Aged Care Gateway as a Medicare program, which was not explicitly mentioned in the 2011 specification.
Under this legislation, entities and individuals involved in the administration of these programs are required to ensure that the transfer of information complies with secrecy provisions outlined in section 130 of the Health Insurance Act 1973. This means that while it is an offence to make a record of, or divulge information obtained in the performance of duties, there is an exception for information used to perform functions related to a Medicare program. The specification facilitates this by ensuring that the use of an individual’s Medicare details for identity verification in the Aged Care Gateway does not contravene these secrecy provisions.
Entities governed by this Act must adhere to strict protocols for handling and transferring personal information across Medicare programs. Specifically, they must ensure that when a customer wishes to register for and/or access the Aged Care Gateway, their identity is verified using their Medicare registration information. This includes validating details such as Name, Date of birth, Medicare Card number, and Individual Reference Number to create a Central Client Record. These requirements ensure the integrity of the Aged Care registration process.
The legislation also outlines potential consequences for non-compliance. While specific penalties are not detailed in the explanatory statement, breaches of the Health Insurance Act 1973's secrecy provisions can lead to criminal penalties. These can include fines and imprisonment, although the exact penalties would be determined by the relevant courts. The specification itself does not introduce new offences but ensures that existing provisions are not inadvertently breached through the transfer of information across specified programs.