Commonwealth Numbered Acts

HEALTH LEGISLATION AMENDMENT ACT (NO. 2) 1998 No. 37, 1998 - SCHEDULE 7

Health Insurance Act 1973

1 Subsection 3(1)

Insert:

approved billing agent means a person or body in respect of whom an approval under section 20AB is in force.

2 After subsection 20A(2B)

Insert:

(2C) Subject to subsection (2D), if:

(a) a medicare benefit would, apart from this section, be payable to an eligible person in respect of a professional service rendered to a patient while hospital treatment is provided to the patient in a hospital or a day hospital facility; and

(b) the eligible person requests that the medicare benefit payable in respect of the professional service be paid to the approved billing agent specified in the request; and

(c) any requirements specified in the regulations in relation to such a request have been met; and

(d) the medical practitioner by whom or on whose behalf the professional service was rendered assigns to the approved billing agent his or her right to all amounts that the eligible person would, apart from the assignment, owe to the medical practitioner in relation to the professional service; and

(e) any requirements specified in the regulations in relation to such an assignment have been met;

(2D) Subsection (2C) does not apply in relation to a medicare benefit in relation to which subsection (2A) applies.

3 After section 20A

Insert:

SECT 20AB Approved billing agents

(1) The Council may, in writing, approve as a billing agent a person who, or body that, has applied for approval.

(2) The application must:

(a) meet any requirements specified in the regulations; and

(b) be accompanied by the fee (if any) specified in the regulations.

(3) In considering whether to approve a person or body, the Council must comply with any guidelines made in writing by the Minister.

(4) The Council must give to the applicant written notice of the decision whether to approve a person or body.

Note: Section 27A of the Administrative Appeals Tribunal Act 1975 requires the person to be notified of the person's review rights.

(6) Guidelines made under subsection (3) and conditions determined under subsection (5) are disallowable instruments for the purposes of section 46A of the Acts Interpretation Act 1901 .

SECT 20AC Revoking approvals of billing agents

(1) The Council may revoke the approval of an approved billing agent if the Council is satisfied that:

(a) if the Council were considering whether to approve the billing agent under section 20AB, the guidelines under subsection 20AB(3) would prevent the approval; or

(b) the billing agent has contravened the conditions to which the approval is subject under subsection 20AB(5).

(a) include the Council's reasons for considering the revocation; and

(b) invite the billing agent to make written submissions to the Council within the period of 28 days (the submission period ) after being given the notice.

(4) The Council must give to the billing agent written notice of the decision.

Note: Section 27A of the Administrative Appeals Tribunal Act 1975 requires the person to be notified of the person's review rights.

SECT 20AD Review of decisions

(1) If the Council:

(a) decides not to approve a person or body as a billing agent under section 20AB; or

(b) revokes the approval of a person or body as a billing agent under section 20AC;

(2) On receiving an application under subsection (1) relating to a decision not to approve a person or body as a billing agent under section 20AB, the Council must reconsider the decision and:

(a) affirm the decision; or

(b) approve the person or body as a billing agent.

(3) On receiving an application under subsection (1) relating to a revocation of the approval of a person or body under section 20AC, the Council must reconsider the decision and:

(a) affirm the revocation; or

(b) reinstate the approval of the person or body.

(4) The Council must give to the applicant written notice of the Council's decision on the revocation.

Note: Section 27A of the Administrative Appeals Tribunal Act 1975 requires the person to be notified of the person's review rights.

(6) In this section:

decision has the same meaning as in the Administrative Appeals Tribunal Act 1975 .