Commonwealth Numbered Regulations

HEALTH INSURANCE (PROFESSIONAL SERVICES REVIEW) AMENDMENT REGULATIONS 1999 (NO. 1) 1999 NO. 346 - SCHEDULE 1

(regulation 3)

[1] Regulation 3, note

omit

Note

insert

Note 1

[2] Regulation 3, after the note

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Note 2
The expressions Committee , inappropriate practice , person under review , profession , referred services and service are defined in s 81 of the Act.

[3] After Part 2

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7 Definition

For this Part:

"professional attendance" means a service of a kind mentioned in group A1, A2, A5, A6, A7, A13, A14 or A15 of Part 2 of the general medical services table.

Note
The expressions general medical services table , general practitioner and medical practitioner are defined in s 3 of the Act.

This Part prescribes the circumstances in which referred services constitute a prescribed pattern of services for Part VAA of the Act.

Note
Section 106KA of the Act provides that conduct of a person under review in connection with rendering or initiating services that constitute a prescribed pattern of services may be taken to be inappropriate practice.

For subsection 106KA (3) of the Act, the following groups of practitioners in the profession of medicine are groups to which these Regulations apply:

(a)

general practitioners;

(b)

other medical practitioners rendering professional attendances.

The circumstance in which services that are professional attendances constitute a prescribed pattern of services is that 80 or more such services are rendered on each of 20 or more days in a 12 month period.

For subsection 106KA (5) of the Act, the following circumstances are declared as constituting exceptional circumstances:

(a)

an unusual occurrence causing an unusual level of need for professional attendances;

(b)

an absence of other medical services, for patients of the person under review during the relevant period, having regard to:

(i)

the location of the practice of the person under review; and

(ii)

characteristics of the patients of the person under review.

Note
For relevant period , see s 106KA of the Act.