NATIONAL HEALTH ACT (No. 2) 1975
No. 13 of 1975
An Act to amend the National Health Act 1953-1974, as amended by the National Health Act 1975.
BE IT ENACTED by the Queen, the Senate and the House of Representatives of Australia, as follows:—
Short title and citation.
1. (1) This Act may be cited as the National Health Act (No. 2) 1975.
(2) The National Health Act 1953-1974, as amended by the National Health Act 1975, is in this Act referred to as the Principal Act.
(3) Section 1 of the National Health Act 1975 is amended by omitting sub-section (4).
(4) The Principal Act, as amended by this Act, may be cited as the National Health Act 1953-1975.
Commencement.
2. This Act shall come into operation on the day on which it receives the Royal Assent.
Interpretation.
3. Section 66 of the Principal Act is amended by omitting from sub-section (1) the definition of “pre-existing ailment” and substituting the following definition:—
“‘pre-existing ailment’, in relation to a contributor, means—
(a) an illness or disability of the contributor in respect of which rules of the organization concerned excluding or limiting eligibility for benefits apply by reason of the fact that symptoms of the illness or disability were in evidence before, or within a specified period after, a particular time; or
(b) pregnancy or other obstetric condition of the contributor in respect of which rules of the organization concerned excluding or limiting eligibility for benefits apply by reason that contributions commenced less than a specified period before the expected date of confinement;”.
Rules of organization establishing special account to contain certain provisions.
4. Section 82e of the Principal Act is amended—
(a) by inserting in sub-section (1), after paragraph (d), the following paragraph:—
“(da) a special account contributor in relation to the special account is entitled to payment of fund benefit in respect of a professional service or hospital treatment rendered to her in connexion with a pregnancy or other obstetric condition unless the service or treatment is rendered during a specified period of not more than 2 months commencing on the day on which she became a contributor; and
(b) by omitting from paragraph (e) of sub-section (1) the words “the last preceding paragraph” and substituting the words “paragraph (d) or (da)”.
Waiver of contributions, and reimbursement of fund benefits, where contributor in receipt of unemployment or sickness benefit.
5. Section 82s of the Principal Act is amended—
(a) by omitting from sub-section (5) the words “Subject to the next succeeding sub-section, this” and substituting the word “This”; and
(b) by omitting sub-section (6).
Overview
The National Health Act (No. 2) 1975 was enacted to amend the National Health Act 1953-1974, addressing specific gaps in the legislative framework related to health benefits and pre-existing conditions. This Act was introduced by the Queen, the Senate, and the House of Representatives of Australia, aiming to refine the eligibility criteria for health benefits and modify certain definitions to better cater to contributors' needs. A key policy objective of this legislation was to ensure that special account contributors receive payment for professional services or hospital treatments related to pregnancy or other obstetric conditions, subject to certain waiting periods, while also allowing for the waiver of contributions and reimbursement of benefits for contributors receiving unemployment or sickness benefits.
Scope and Application
The National Health Act (No. 2) 1975 applies to individuals and entities involved in the healthcare system in Australia, particularly those connected to the health funds managed by the organisation. This Act amends the National Health Act 1953-1974, expanding on its provisions and updating specific definitions and conditions related to health benefits and contributions. The jurisdictional reach of this Act is Commonwealth, applying nationally across Australia. The Act specifies conditions for contributors, particularly regarding pre-existing ailments, pregnancy, and other obstetric conditions, as well as rules for waiving contributions and reimbursing benefits for individuals receiving unemployment or sickness benefits. Notably, this Act excludes certain services or treatments rendered within a specified period after an individual becomes a contributor, thus limiting eligibility for benefits under certain circumstances. The Act also empowers subordinate instruments to further extend or specify the application of these provisions.
Key Provisions
The National Health Act (No. 2) 1975 introduces specific amendments to the National Health Act 1953-1974, as previously amended. Section 1 of this Act establishes the title and citation of the updated legislation, referring to it as the National Health Act 1953-1975. This Act commences on the day it receives Royal Assent, as indicated in Section 2. The primary changes are detailed in Sections 3 and 4. Section 3 revises the definition of "pre-existing ailment" to include illnesses or disabilities with symptoms evident before or shortly after a particular time, or pregnancy or other obstetric conditions where contributions commenced less than a specified period before the expected date of confinement.
The Act further amends the rules of the organization by establishing a special account under Section 4. This account entitles a special account contributor to payment of fund benefits for professional services or hospital treatment related to pregnancy or other obstetric conditions, unless such services or treatment are rendered during a specified period of up to two months from the date the contributor became a member. This amendment modifies existing rules by inserting a new paragraph (da) in sub-section (1) of Section 82e and adjusts references in paragraph (e) of the same sub-section.
In terms of obligations, the Act imposes specific requirements on organizations concerning the establishment and management of special accounts. These entities must ensure that contributors are appropriately informed about their entitlements and any exclusions or limitations regarding benefits, particularly concerning pre-existing conditions and the timing of services related to pregnancy or obstetric conditions. Additionally, the Act mandates that organizations facilitate the waiver of contributions and the reimbursement of fund benefits for contributors receiving unemployment or sickness benefits, as detailed in Section 5. This section streamlines the process by omitting specific subsections and modifying the language to clarify the conditions under which such waivers and reimbursements are applicable.
Regarding consequences for non-compliance, the Act does not explicitly detail offences, penalties, or specific civil or criminal consequences for breaches. However, the amendments suggest that failure to adhere to the revised rules could result in legal repercussions under the broader legislative framework of the National Health Act 1953-1975. These could include administrative penalties, fines, or legal actions as deemed appropriate under the existing provisions of the Principal Act.