Commonwealth Numbered Acts

Health Acts Amendment Act 1981 No. 118 of 1981 - SECT 49

49. Section 4 of the Principal Act is amended-

(a) by omitting paragraphs (a) and (b) of the definition of ''basic
hospital benefits table'' or ''basic table'' in sub-section (1) and
substituting the following paragraphs:

''(a) in respect of hospital treatment provided to persons as in-patients in a
hospital in the State or Territory to which the table relates, being patients
who are not nursing-home type patients-benefits equal to the amount of the
standard hospital fees in relation to that State or Territory;

''(b) in respect of hospital treatment provided to persons as in-patients in a
recognised hospital in the State or Territory to which the table relates,
being the nursing-home type patients-benefits equal to the amount of the
standard hospital fees in relation to that State or Territory less the amount
of the patient contribution in relation to that patient for each day on which
that patient is an in-patient in the hospital;'';

   (b)  by omitting from paragraph (ba) of the definition of ''basic hospital
        benefits table'' or ''basic table'' in sub-section (1) ''(other than
        nursing-home type patients referred to in paragraph (a)) but not being
        patients in respect of whose occupation of an approved bed in the
        hospital a supplementary daily bed payment is payable under section 34
        of the Health  Insurance Act 1973 '';

   (c)  by omitting paragraph (e) of the definition of ''basic hospital
        benefits table'' or ''basic table'' in sub-section (1);

(d) by omitting from sub-section (1) the definition of ''basic medical
benefits table'' or ''basic table'' and substituting the following definition:

'' 'basic medical benefits table' or 'basic table', in relation to a
registered medical benefits organization, means a table that incorporates a
range of benefits of the following kinds and no other benefits:

   (a)  a range of benefits in respect of the provision of every
        professional service, such that, if, in respect of any particular
        professional service a Commonwealth medical benefit is payable to a
        person, then, and only then-

        (i)    a benefit is payable in accordance with the table in respect of
               that professional service; and

        (ii)   the amount of that benefit is an amount equal to the amount by
               which the amount of the guaranteed medical benefit in respect
               of that professional service exceeds the amount of the
               Commonwealth medical benefit so payable;

   (b)  such other benefits (if any) as are prescribed for the purposes of
        this definition;'';

   (e)  by omitting from sub-section (1) the definition of ''guaranteed
        medical benefit'' and substituting the following definition:

'' 'guaranteed medical benefit', in relation to a particular professional
service in respect of which a Commonwealth medical benefit is payable to a
person, means an amount equal to the amount that that Commonwealth medical
benefit would be if it were calculated, in accordance with the Health 
Insurance Act 1973 , on the assumption that sub-section (2) of section 10 of
that Act provided that the amount of a Commonwealth medical benefit should be
calculated in accordance with the following formula:

An amount equal to 85% of the fee specified in respect of the service in the
table in relation to the State or Territory in which the service is rendered
or, if that amount is less by more than $10 than that fee, an amount that is
less by $10 than that fee;'';

   (f)  by adding at the end of the definition of ''nursing home care'' in
        sub-section (1) '', and includes any prescribed service of a kind
        provided in a nursing home'';

   (g)  by omitting from sub-section (1) the definition of ''nursing home fund
        benefit'';

   (h)  by omitting from sub-section (1) the definitions of ''optional
        hospital benefits table'' or ''optional table'' and ''optional medical
        benefits table'' or ''optional table'';

   (j)  by omitting from sub-section (1) the definition of ''prescribed
        professional service'';

   (k)  by omitting from paragraph (a) of the definition of ''supplementary
        hospital table'' in sub-section (1) ''or an optional table''; and

   (l)  by omitting from sub-section (1) the definition of ''uninsured nursing
        home patient''; and

   (m)  by omitting sub-section (1B).