Commonwealth Numbered Regulations

MEDICAL INDEMNITY REGULATIONS 2020 (F2020L00454)

TABLE OF PROVISIONS

   PART 1--PRELIMINARY

   1.      Name  
   2.      Commencement  
   3.      Authority  
   4.      Schedules  
   5.      Simplified outline of this instrument  
   6.      Definitions  

   PART 2--CLAIM HANDLING FEES FOR CLAIMS FOR WHICH IBNR INDEMNITY PAYABLE

   7.      Simplified outline of this Part  
   8.      Authority for this Part  
   9.      When claim handling fee is payable for claim for which IBNR indemnity payable  
   10.     Amount of claim handling fee  

   PART 3--CLAIM HANDLING FEES FOR ELIGIBLE RUN-OFF CLAIMS

   11.     Simplified outline of this Part  
   12.     Authority for this Part  
   13.     When claim handling fee is payable for eligible run-off claim  
   14.     Amount of claim handling fee for eligible run-off claim  

   PART 4--COMPULSORY RUN-OFF COVER ADMINISTRATION PAYMENTS

   15.     Simplified outline of this Part  
   16.     Authority for this Part  
   17.     When compulsory run-off cover administration payment is payable  
   18.     Amount of compulsory run-off cover administration payment  
   19.     One-off payments to particular insurers for past costs  

   PART 5--PAYMENT OF CLAIM HANDLING FEES AND SOME COMPULSORY RUN-OFF COVER ADMINISTRATION PAYMENTS

   20.     Simplified outline of this Part  
   21.     Authority for this Part  
   22.     Time of payment  

   PART 6--PREMIUM SUPPORT SCHEME

           Division 1--Introduction

   23.     Simplified outline of this Part  
   24.     Authority for this Part  
   25.     Object of this Part  

           Division 2--Eligibility for payment

   26.     General conditions  

           Division 3--When is a medical practitioner an eligible medical practitioner for a premium period

              Subdivision A--General

   27.     Who is an eligible medical practitioner for a premium period?  
   28.     Practitioner with no or low private practice income for premium period is not eligible medical practitioner  
   29.     Practitioner practising wholly outside Australia and external Territories is not eligible medical practitioner  
   30.     Practitioner who has not paid insurer for subsidy that insurer must repay is not eligible medical practitioner  

              Subdivision B--Procedural general practitioners practising in rural areas

   31.     Who is a procedural general practitioner?  
   32.     When is a procedural general practitioner practising in a rural area?  

              Subdivision C--Medical practitioners with substantial insurance costs

   33.     When does a medical practitioner have substantial insurance costs?  
   34.     What are gross indemnity costs?  
   35.     What is private practice income?  

           Division 4--Applications for subsidies

              Subdivision A--Application for advance subsidy

   36.     Application for advance subsidy may be made before, or within 14 months after, start of premium year  

              Subdivision B--Final application for subsidy

   37.     Final application to be made within 13 months after end of premium year  

              Subdivision C--Determining applications for subsidy and applications for adjustment of advance subsidy

   38.     Chief Executive Medicare to determine applications for subsidy  
   39.     Chief Executive Medicare to determine applications for adjustment of advance subsidy  

           Division 5--Amount of subsidy

              Subdivision A--Procedural general practitioners practising in rural areas

   40.     Amount of subsidy for procedural general practitioner practising in rural area  

              Subdivision B--Practitioners with substantial insurance costs

   41.     Amount of subsidy for practitioner with substantial insurance costs  

              Subdivision C--Practitioners with MISS entitlement under old scheme

   42.     Amount of subsidy for practitioner with MISS entitlement under old scheme  

              Subdivision D--Eligible medical practitioners with multiple or varying eligibility

   43.     If medical practitioner eligible on different grounds for same period  
   44.     If medical practitioner eligible on different grounds for different periods  

              Subdivision E--Reconciling advance subsidy and subsidy

   45.     Amount of subsidy reduced by advance subsidy  

           Division 6--Conditions to be complied with by insurers

              Subdivision A--Simplified outline

   46.     Simplified outline of this Division  

              Subdivision B--Asking medical practitioners about participating in scheme

   47.     Asking medical practitioners about participating in scheme  

              Subdivision C--Invoicing

   48.     Contents of invoices given to eligible medical practitioners  

              Subdivision D--Repaying overpayments of subsidy

   49.     Overpayments generally  
   50.     Repaying advance subsidy exceeding final amount  
   51.     Repaying advance subsidy for premium year if no later application made for premium year  

              Subdivision E--Keeping records

   52.     Records relevant to subsidy to be kept for 5 years  

              Subdivision F--Reporting on changes in medical practitioners' circumstances

   53.     Reporting between making application for advance subsidy and making final application for subsidy  
   54.     Reporting after making final application for subsidy  

           Division 7--Review of decisions relevant to subsidies

   55.     Authorised reviewing officers  
   56.     Applications by medical practitioners and medical indemnity insurers for review of decisions  
   57.     Review of original decision by authorised reviewing officer  
   58.     Review by Administrative Appeals Tribunal  

   PART 7--PAYMENTS FOR ADMINISTERING PREMIUM SUPPORT SCHEME

   59.     Simplified outline of this Part  
   60.     Authority for this Part  
   61.     When premium support scheme administration payment is payable  
   62.     Amount of premium support scheme administration payment  
   63.     One-off payments to certain insurers  

   PART 8--RECOVERY OF OVERPAYMENTS AND AMOUNTS REQUIRED TO BE REPAID

   64.     Simplified outline of this Part  
   65.     Authority for this Part  
   66.     Recovery of overpayments and amounts required to be repaid  

   PART 9--APPLICATION, SAVING AND TRANSITIONAL PROVISIONS

           Division 1--Provisions for this instrument as originally made

   67.     Application of Part 6  
   68.     Transitional--agreement to payment of subsidy to insurer  
   69.     Saving--old scheme  
   70.     Transitional--premium support scheme administration payment for financial years starting on 1 July 2020 and 1 July 2021