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HUMAN SERVICES (MEDICARE) REGULATIONS 2017 (F2017L01008) - REG 5

Definitions

             (1)  In this instrument:

"Act " means the Human Services (Medicare) Act 1973 .

"Aged Care Act " means the Aged Care Act 1997 .

"Aged Care Department " means the Department administered by the Aged Care Minister.

"Aged Care Minister " means the Minister administering the Aged Care Act.

"Aged Care Secretary " means the Secretary of the Aged Care Department.

"Aged Care Transitional Act " means the Aged Care (Transitional Provisions) Act 1997 .

"approved supplier " has the meaning given by subsection 84(1) of the National Health Act.

"client " means a person who received a hearing service for which a claim has been made.

"contracted service provider " has the meaning given by section 4 of the Hearing Services Administration Act 1997 .

"de-identified " has the meaning given by subsection 6(1) of the Privacy Act 1988 .

"disclosure function " has the meaning given by subsection 24(5).

"education and prevention functions " has the meaning given by subsection 24(3).

"emergency " means an emergency or disaster that occurs in Australia, or that affects one or more Australian citizens or permanent residents, and includes:

                     (a)  an emergency or disaster that has been the subject of a declaration under section 80J or 80K of the Privacy Act 1988 ; and

                     (b)  any circumstance in relation to which the Australian Government has decided that a program of special assistance involving the provision of a service, benefit, program or facility is to be implemented.

Note:          Examples of an emergency include the following:

(a)    a natural disaster;

(b)    a terrorist act.

"evaluation and reporting functions " has the meaning given by subsection 24(7).

"healthcare providers " includes any of the following:

                     (a)  medical practitioners;

                     (b)  prescribers;

                     (c)  pharmacists;

                     (d)  approved suppliers;

                     (e)  dentists;

                      (f)  State and Territory health departments;

                     (g)  State and Territory mental health authorities;

                     (h)  private and public pain management clinics;

                      (i)  private and public alcohol or drug detoxification centres;

                      (j)  private and public hospitals.

"Health Department " means the Department administered by the Minister administering the National Health Act.

"Health Insurance Act " means the Health Insurance Act 1973 .

"hearing services " has the meaning given by section 4 of the Hearing Services Administration Act 1997 .

"identification and detection functions " has the meaning given by subsection 24(4).

"inappropriate practice " has the meaning given by section 81 of the Health Insurance Act.

"lifetime health cover " has the same meaning as in the Private Health Insurance Act.

"National Health Act " means the National Health Act 1953 .

"nominated prescriber " , in relation to a prescription shopper, means a prescriber nominated by the prescription shopper from time to time to be that person's main prescriber.

"PBS information " means information collected for the administration of the Pharmaceutical Benefits Scheme established under Part VII of the National Health Act.

"person affected by an emergency " has a meaning affected by section 6.

"personal information " has the meaning given by subsection 6(1) of the Privacy Act 1988 .

"Pharmaceutical Benefits Regulations " means the National Health (Pharmaceutical Benefits) Regulations 2017 .

"prescriber " means a person who is authorised to prescribe a pharmaceutical benefit or who purports to be authorised to prescribe a pharmaceutical benefit.

"prescription shopper " means a person who, within any 3 month period, has had supplied to him or her:

                     (a)  pharmaceutical benefits prescribed by 6 or more different prescribers (other than a prescriber who is a specialist within the meaning of subsection 3(1) of the Health Insurance Act and who has prescribed pharmaceutical benefits to a person in that capacity); or

                     (b)  a total of 25 or more target pharmaceutical benefits; or

                     (c)  a total of 50 or more pharmaceutical benefits.

"Prescription Shopping Program " means the program administered by the Department and the Health Department to reduce prescription shopping.

"Private Health Insurance Act " means the Private Health Insurance Act 2007 .

"reappraisal period " is the period under section 27-2 of the Aged Care Act in which a reappraisal of the classification of the level of care needed by an aged care recipient must be made.

"recoverable amount " has the meaning given by subsections 95-1(1) and 95-1(3) of the Aged Care Act.

"State or Territory body " means:

                     (a)  a State or Territory Minister; or

                     (b)  a Department of State of a State or Territory; or

                     (c)  a body (whether incorporated or not) established for a public purpose under a law of a State or Territory.

"target pharmaceutical benefits " means pharmaceutical benefits in any of the following categories of the Anatomical Therapeutic Chemical classification system:

                     (a)  N02 (Analgesics);

                     (b)  N03 (Antiepileptics);

                     (c)  N04 (Anti-Parkinson Drugs);

                     (d)  N05 (Psycholeptics);

                     (e)  N06 (Psychoanaleptics);

                      (f)  N07 (Other central nervous system drugs);

                     (g)  R03 (Drugs for obstructive airway diseases);

                     (h)  C10A (Serum lipid reducing agents);

                      (i)  A02B (Drugs for peptic ulcer and gastro-oesophageal reflux diseases);

                      (j)  J01 (Antibacterials for systemic use);

                     (k)  M01 (Anti-inflammatory and antirheumatic products);

                      (l)  A10A (Insulin and analogues);

                    (m)  C02 (Antihypertensives).

Note:          The Anatomical Therapeutic Chemical classification system is published by the World Health Organisation's Collaborating Centre for Drug Statistics Methodology.

"voucher " has the meaning given by section 4 of the Hearing Services Administration Act 1997 .

             (2)  An expression (other than recoverable amount ) used in Part 2 of this instrument and in the Aged Care Act has the same meaning in that Part as it has in that Act.

Note:          The following expressions are defined in clause 1 of Schedule 1 to the Aged Care Act:

(a)    aged care service;

(b)    approved provider;

(c)    flexible care subsidy;

(d)    home care;

(e)    home care service;

(f)    protected information;

(g)    residential care service.



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