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This is a Bill, not an Act. For current law, see the Acts databases.
1998-1999-2000-2001
The
Parliament of the
Commonwealth of
Australia
HOUSE OF
REPRESENTATIVES
Presented and read a first
time
Health
Legislation Amendment Bill (No. 2)
2001
No. ,
2001
(Health and Aged
Care)
A Bill for an Act to amend
legislation relating to health, and for related purposes
ISBN: 0642 468613
Contents
Part 1—Membership of the Australian Institute of Health and
Welfare 3
Part 2—The Australian Institute of Health and Welfare Ethics
Committee 5
Part 1—Recognition of
specialists 7
Part 2—Pay doctor via claimant
cheques 11
Part 1—Low claims and late
claims 13
Part 2—Premium
reductions 17
Part 3—Technical
amendment 19
Health Legislation Amendment Act (No. 3)
1999 20
A Bill for an Act to amend legislation relating to
health, and for related purposes
The Parliament of Australia enacts:
This Act may be cited as the Health Legislation Amendment Act
(No. 2) 2001.
(1) Subject to this section, this Act commences on the day on which it
receives the Royal Assent.
(2) Items 7, 8, 9 and 10 of Schedule 3 are taken to have
commenced on the day on which the Private Health Insurance Incentives Act
1998 commenced.
(3) Item 12 of Schedule 3 is taken to have commenced on
1 January 1999.
Subject to section 2, each Act that is specified in a Schedule to
this Act is amended or repealed as set out in the applicable items in the
Schedule concerned, and any other item in a Schedule to this Act has effect
according to its terms.
Part 1—Membership
of the Australian Institute of Health and Welfare
1 Paragraphs 8(1)(f), (fa), (fb) and
(fc)
Repeal the paragraphs, substitute:
(f) a person nominated by the Minister who has knowledge of the needs of
consumers of health services;
(fa) a person nominated by the Minister who has knowledge of the needs of
consumers of welfare services;
(fb) a person nominated by the Minister who has knowledge of the needs of
consumers of housing assistance services;
(fc) a person nominated by the Minister who has expertise in research into
public health issues;
2 After subsection 8(1)
Insert:
(1AA) Without limiting the persons who may be nominated by the Minister,
the Minister must:
(a) before nominating the member referred to in paragraph (1)(f),
seek recommendations from such bodies (if any) representing consumers of health
services as are prescribed for the purpose; and
(b) before nominating the member referred to in paragraph 8(1)(fa), seek
recommendations from such bodies (if any) representing consumers of welfare
services as are prescribed for the purpose; and
(c) before nominating the member referred to in paragraph 8(1)(fb), seek
recommendations from such bodies (if any) representing consumers of housing
assistance services as are prescribed for the purpose; and
(d) before nominating the member referred to in paragraph 8(1)(fc), seek
recommendations from such peak public health research bodies (if any) as are
prescribed for the purpose.
3 Schedule
Repeal the Schedule.
4 Application
The amendments made by this Part apply to appointments made after the
commencement of this Part.
Part 2—The
Australian Institute of Health and Welfare Ethics Committee
5 Subsection 3(1) (definition of Ethics
Committee)
Omit “Health Ethics Committee of the Australian Institute of Health
and Welfare”, substitute “Australian Institute of Health and Welfare
Ethics Committee”.
6 Subsection 16(1)
Omit “Health Ethics Committee of the Australian Institute of Health
and Welfare”, substitute “Australian Institute of Health and Welfare
Ethics Committee”.
7 Subsection 16(3)
Repeal the subsection, substitute:
(3) Regulations for the purpose of subsection (2) must not be
inconsistent with recommendations of the National Health and Medical Research
Council.
8 Subsections 29(2A) and
(2B)
After “health-related”, insert “or
welfare-related”.
9 Transitional provision
(1) Immediately after the commencement of this item, the Institute is taken
to have appointed each member of the former Ethics Committee as a member of the
Australian Institute of Health and Welfare Ethics Committee.
(2) The appointment of each such member is taken to end at the time when
the member’s term of appointment as a member of the former Ethics
Committee would have ended under the instrument appointing the person as a
member of that Committee.
(3) In this item:
former Ethics Committee means the Health Ethics Committee of
the Australian Institute of Health and Welfare, within the meaning of the
Australian Institute of Health and Welfare Act 1987 as in force
immediately before the commencement of this item.
Part 1—Recognition
of specialists
1 Subsection 3(1) (definition of
specialist)
Omit “3D”, substitute “3DB”.
2 Subsection 3(1) (at the end of the definition
of specialist)
Add “, or a medical practitioner who is taken to be so recognised
under section 3D”.
3 Section 3D
Repeal the section, substitute:
(1) A medical practitioner is taken to be recognised as a specialist in a
particular specialty, for the purposes of this Act, if a relevant organisation
in relation to the specialty gives the Managing Director of the Commission
written notice stating that the medical practitioner meets the criteria for the
specialty (see subsection (2)).
(2) A medical practitioner meets the criteria for a
specialty if the medical practitioner:
(a) is domiciled in Australia; and
(b) is a fellow of a relevant organisation in relation to the specialty;
and
(c) has obtained, as a result of successfully completing an appropriate
course of study, a relevant qualification in relation to the relevant
organisation.
(3) The Managing Director of the Commission must notify the medical
practitioner as soon as reasonably practicable of his or her recognition as a
specialist in the specialty.
(4) This section does not limit section 3DB.
(5) In this section:
relevant organisation, in relation to a specialty, means an
organisation declared by the regulations to be a professional organisation in
relation to the specialty.
relevant qualification, in relation to a relevant
organisation, means a qualification declared by the regulations to be a relevant
qualification in relation to the relevant organisation.
(1) The recognition of a medical practitioner as a specialist in a
particular specialty under subsection 3D(1) has effect, or is taken to have had
effect, on and from the day specified in the notice given to the medical
practitioner under subsection 3D(3).
(2) The day specified may be before the day on which the notice is given,
but must not be before the day specified by the relevant organisation to be the
day on which the medical practitioner first met the criteria for the
specialty.
(3) The recognition of a medical practitioner as a specialist in a
specialty under subsection 3D(1) ceases if:
(a) a relevant organisation in relation to the specialty gives the
Managing Director of the Commission written notice stating that the medical
practitioner no longer meets the criteria for the specialty, or has ceased to
practise medicine in Australia; or
(b) the medical practitioner requests that he or she cease to be so
recognised.
(1) A medical practitioner may apply to the Minister for a determination
that the medical practitioner is a specialist in a particular specialty
if:
(a) the medical practitioner is domiciled in Australia; and
(b) the medical practitioner is registered under a law of a State or
Territory as a specialist in a particular specialty.
(2) A medical practitioner may also apply to the Minister for a
determination that the medical practitioner is a specialist in a particular
specialty if the medical practitioner meets the criteria for the specialty,
within the meaning of subsection 3D(2).
(3) An application under subsection (1) or (2) must be:
(a) in writing; and
(b) accompanied by the prescribed fee.
(4) After receiving such an application, the Minister must:
(a) determine that the medical practitioner be recognised for the purposes
of this Act as a specialist in the specialty; or
(b) under subsection 61(1), refer the question whether the medical
practitioner should be so recognised to the appropriate Specialist Recognition
Advisory Committee;
and must notify the medical practitioner concerned, in writing,
accordingly.
(5) In this section:
appropriate Specialist Recognition Advisory Committee, in
relation to a medical practitioner, means the Specialist Recognition Advisory
Committee established for the State or Territory in which the medical
practitioner is domiciled.
(1) A determination under paragraph 3DB(4)(a) that a medical practitioner
is recognised as a specialist in a particular specialty has effect, or is taken
to have had effect, on and from the day specified in the
determination.
(2) The day specified may be before the day on which the determination is
made.
(3) The determination ceases to have effect if:
(a) the medical practitioner ceases to be domiciled in Australia;
or
(b) the medical practitioner ceases to practise medicine in
Australia.
(4) The Minister must revoke the determination if the medical practitioner
requests that the Minister do so.
4 Section 51
Repeal the section.
5 Subsection 61(1B)
Omit “subsection 3D(1)”, substitute
“section 3DB”.
6
Transitional—regulations
(1) Regulations that were in force immediately before the commencement of
this item for the purposes of subparagraph 3D(1)(a)(i) or (ii) of the old HI Act
have effect, after the commencement of this item, as if they had been made for
the purposes of the definition of relevant organisation or
relevant qualification, as the case requires, under subsection
3D(5) of the new HI Act.
(2) Regulations that were in force immediately before the commencement of
this item and that prescribed a fee for the purposes of subsection 3D(1) of the
old HI Act have effect, after the commencement of this item, as if they had been
made for the purposes of paragraph 3DB(3)(b).
(3) This item does not prevent the amendment or repeal of the Health
Insurance Regulations by regulations made under the new HI Act.
(4) In this item:
new HI Act means the Health Insurance Act 1973 as in
force after the commencement of this item.
old HI Act means the Health Insurance Act 1973 as in
force immediately before the commencement of this item.
Part 2—Pay
doctor via claimant cheques
7 At the end of
section 20
Add:
(3) If:
(a) a cheque for an amount of a medicare benefit payable in respect of a
professional service is given or sent under subsection (2) at the request
of the person to whom the medicare benefit is payable; and
(b) the professional service was rendered by or on behalf of a general
practitioner; and
(c) the cheque is not presented for payment during the period of 90 days
beginning on the day on which the cheque was given or sent under that
subsection;
the Commission may pay to the general practitioner by whom, or on whose
behalf, the professional service was rendered an amount equal to the amount of
the medicare benefit.
(4) If the Commission pays an amount under subsection (3) to a
general practitioner by whom, or on whose behalf, a professional service was
rendered, then:
(a) the request under subsection (2), by the person to whom the
medicare benefit concerned is payable, to give or send a cheque for the amount
of the medicare benefit is taken to have been withdrawn; and
(b) the person may not subsequently make a request under
subsection (2) in respect of that medicare benefit.
(5) Without limiting subsection (3), an amount may be paid under that
subsection by means of electronic transmission of the amount to an account kept
with a bank, in such circumstances, and subject to such conditions, as are
prescribed by the regulations.
8 Application
The amendment made by item 7 of this Schedule applies to cheques given
or sent under subsection 20(2) of the Health Insurance Act 1973
after:
(a) 1 July 2001; or
(b) if the day on which this Act receives the Royal Assent is after
1 July 2001—that day.
Part 1—Low
claims and late claims
1 After section 15-20
Insert:
(1) This section applies to a *health
fund in respect of a month if:
(a) the health fund is a *participating
fund in respect of the month; and
(b) the health fund made a claim in respect of the month under
section 15-5; and
(c) the amount claimed by the health fund was less than the sum of the
amounts by which premiums in respect of the month under the appropriate health
insurance policies issued by the health fund were reduced because of the
operation of this Chapter.
(2) The *health fund may apply to the
*Managing Director for payment of an amount
(the additional amount) not exceeding the difference
between:
(a) the sum of the amounts by which premiums in respect of the month under
the *appropriate health insurance policies
issued by the health fund were reduced because of the operation of this Chapter;
and
(b) the amount already paid to the health fund under section 15-5 in
respect of the month.
(3) An application under subsection (2) may relate to more than one
month.
(1) This section applies to a *health
fund in respect of a month if:
(a) the health fund did not make a claim in respect of the month on or
before the last day of the *notification period
for the month; and
(b) premiums in respect of the month under the
*appropriate health insurance policies issued
by the health fund were reduced because of the operation of this
Chapter.
(2) The *health fund may apply to the
*Managing Director for payment of an amount
(the additional amount) not exceeding the sum of the amounts by
which premiums in respect of the month under the
*appropriate health insurance policies issued
by the health fund were reduced because of the operation of this
Chapter.
(3) An application under subsection (2) may relate to more than one
month.
(1) An application by a *health fund
under section 15-21 or 15-22 for payment of an additional amount must
contain the following:
(a) the name of the health fund;
(b) the additional amount sought;
(c) the month, or months, in respect of which the additional amount is
sought;
(d) a certificate in writing signed by a registered company auditor that
the additional amount sought is correct;
(e) such other details as the *Managing
Director determines in writing.
(2) The application must be made:
(a) if the application relates to only one month—within 3 years of
the last day of the *notification period for
that month; or
(b) if the application relates to more than one month—within 3 years
of the last day of the notification period for the first of those
months.
(3) An application under section 15-21 must also contain, in respect
of each month to which the application relates, an explanation of why the amount
claimed under section 15-5 was less than the sum of the amounts by which
premiums in respect of the month under the
*appropriate health insurance policies issued
by the *health fund were reduced because of the
operation of this Chapter.
(4) An application under section 15-22 must also contain, in respect
of each month to which the application relates, an explanation of why the
*health fund did not make a claim on or before
the last day of the *notification period for
the month.
(1) If a *health fund makes an
application under section 15-21 or 15-22 for payment of an additional
amount, the *Managing Director must pay the
additional amount sought if the Managing Director is satisfied:
(a) that the additional amount sought is correct; and
(b) that it would be reasonable to grant the application, having regard to
the explanation mentioned in subsection 15-23(3) or (4).
(2) The *Managing Director may refuse the
application, or decide to pay only part of the additional amount sought, if the
Managing Director is satisfied:
(a) that the additional amount sought is incorrect; or
(b) that it would not be reasonable to grant the application, having
regard to the explanation mentioned in subsection 15-23(3) or (4).
(3) The *Managing Director must notify
the *health fund of the Managing
Director’s decision on the application.
(4) A notice under subsection (3) must include reasons for the
decision.
(5) The *Managing Director is taken, for
the purposes of this Act, to have decided that:
(a) the additional amount sought is correct; and
(b) that it would be reasonable to grant the application;
if the Managing Director does not give notice of his or her decision that
the additional amount sought is incorrect, or that it would not be reasonable to
grant the application, within the period of 3 months after the application was
received by the Managing Director.
(6) If the *Managing Director is taken to
have made a decision under subsection (5) in respect of a
*health fund, the Managing Director is taken to
have given notice of that decision to the health fund.
2 Subsection 15-25(1)
After “15-20(1A)”, insert “or 15-24(3)”.
3 Paragraphs 18-5(1)(c), (ca), (d) and
(e)
After “15-5”, insert “or 15-24”.
4 Paragraph 19-10(e)
After “15-10”, insert “, or an additional amount sought
under section 15-21 or 15-22,”.
5 Application
A *health fund may make an application
under section 15-21 or 15-22 of the Private Health Insurance Incentives
Act 1998, as amended by this Part, in respect of a month occurring before or
after the commencement of this item.
6 Subsection 11-25(1)
Omit “it must, within 28 days after the day on which the refusal
occurs,”, substitute “it must”.
7 After subsection 12-5(1)
Insert:
(1A) The amount by which the premium is to be reduced depends on whether
or not a person was registered, or eligible to apply for registration, before
1 January 1999 under the Private Health Insurance Incentives Act
1997 in respect of the policy for the financial year.
(1B) If the financial year is the financial year that began on 1 July
1998, and no person was so registered or eligible to apply for registration, the
amount of the reduction is 30% of the amount of the premium payable under the
policy for the financial year.
8 Subsection 12-5(2)
After “1998,”, insert “and a person was so registered or
eligible to apply for registration,”.
9 After subsection 12-5(2)
Insert:
(2A) If the financial year is a later financial year, and no person was so
registered or eligible to apply for registration, the amount of the reduction is
30% of the amount of the premium payable under the policy for the financial
year.
10 Subsection 12-5(3)
After “financial year,” (second occurring), insert “and a
person was so registered or eligible to apply for
registration,”.
11 Transitional provision
If:
(a) before the commencement day, a
*health fund reduced premiums in respect of a
month in accordance with section 12-5 of the Private Health Insurance
Incentives Act 1998; and
(b) the fund made a claim under section 15-10 in relation to the
month within the period specified in that section;
the amendments made by this Schedule are taken not to affect the amount
paid, or payable, to the fund in respect of the month.
12 Subsection 15-5(2)
Omit “The HIC must pay to the
*health fund”, substitute “If a
*health fund makes a claim that the HIC decides
is correct, the HIC must pay to the fund”.
Health Legislation
Amendment Act (No. 3) 1999
1 Part 2 of
Schedule 3
Repeal the Part.