Commonwealth Numbered Regulations

1991 No. 82 HEALTH INSURANCE REGULATIONS (AMENDMENT) - REG 5

  5.1   Subregulation 2ADA (4):
Omit "Part 8, 8A, 9A or 11 of the general medical services table", substitute
"Part 8A or 11 of the general medical services table or an item in the
diagnostic imaging services table".
  5.2   Subregulation 2ADA (5):
Omit "table or in Part 8, 8A, 9A or 11 of the general medical services table",
substitute "table, an item in Part 8A or 11 of the general medical services
table or an item in the diagnostic imaging services table".
  5.3   Add at the end:


"(6) Subject to subregulations (7) and (8), the following particulars are
prescribed for the purposes of subsection 19 (6) of the Act in relation to
professional services to which an item in the diagnostic imaging services
table relates:

   (a)  the name and either:

        (i)    the address of the place of practice; or

        (ii)   the provider number in respect of the place of practice;
of the person who requested that professional service;

   (b)  the date on which that professional service was requested;

   (c)  the name and either:

        (i)    the address of the place of practice; or

        (ii)   the provider number in respect of the place of practice; of the
               practitioner who:

        (iii)  is claiming, or receiving, payment of fees in respect of that
               professional service; or

        (iv)   if an assignment has been made, or an agreement entered into,
               in accordance with section 20A of the Act, in relation to the
               medicare benefit in respect of that professional service, is
               the assignee of the right to the payment of that benefit under
               that assignment or agreement.

"(7) If the person referred to in paragraph (6) (a) is a chiropractor, the
reference in subparagraph (6) (a) (ii) to a provider number is a reference to
a requester number.

"(8) For the purposes of subsection 19 (6) of the Act, if the practitioner
referred to in paragraph (6) (c) is not the practitioner who rendered the
professional service referred to in subregulation (6), the following
additional particulars are prescribed in relation to that professional
service, namely the name and either:

   (a)  the address of the place of practice; or

   (b)  the provider number in respect of the place of practice; of the
        second-mentioned practitioner, unless those particulars and the date
        on which the professional service was requested are recorded at the
        place of practice of the first-mentioned practitioner.

"(9) For the purposes of subsection 19 (6) of the Act, if professional
services to which an item in the diagnostic imaging services table relates are
rendered:

   (a)  by a specialist in circumstances specified in subsection 16B (6) of
        the Act; or

   (b)  within an area that is a remote area for the purposes of Division 2 of
        Part IIB of the Act in circumstances specified in subsection 16B (7)
        of the Act; or

   (c)  as an additional necessary service in circumstances specified in
        subsection 16B (10) of the Act; or

   (d)  before 1 January 1993 in circumstances specified in subsection 16B
        (11) of the Act; the following particular is prescribed in relation to
        those services-the letters 'SD', indicating that the services were
        self-determined.

"(10) For the purposes of subsection 19 (6) of the Act, if professional
services to which an item in the diagnostic imaging services table relates are
rendered in circumstances specified in subsection 16B (8) of the Act, the
following particular is prescribed in relation to those services-the word
'emergency'.

"(11) For the purposes of subsection 19 (6) of the Act, if professional
services to which an item in the diagnostic imaging services table relates are
rendered in circumstances specified in subsection 16B (9) of the Act, the
following particular is prescribed in relation to those services-the words
'lost request'.".