Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE COMMISSION REGULATIONS (AMENDMENT) 1993 NO. 89

EXPLANATORY STATEMENT

STATUTORY RULES 1993 No. 89

Issued by authority of the Minister for Health

Health Insurance Commission Act 1973

Health Insurance Commission Regulations (Amendment)

Section 44 of the Health Insurance Commission Act 1973 (the Act) provides that the Governor-General may make regulations for the purposes of the Act.

Section 8E of the Act requires the Health insurance Commission (the Commission) to perform such functions as are prescribed by regulation.

Subregulation 4(2) of the Health Insurance Commission Regulations (the Regulations) prescribes additional functions which, for the purpose of section 9E of the Act, the Commission has the power to perform. A number of additional functions have already been prescribed by way of previous amendments to the Regulations.

As a result of Government initiatives In altering the eligibility for certain Commonwealth benefits, some additional 380,000 pensioners are now eligible for a Pensioner Health Benefit Card which allows pensioners-to have hearing aids supplied and fitted free of charge. The provision of hearing services by the Commonwealth is via the Australian Hearing Services (the AHS). It has been decided to "contract" with private sector providers to assist in the provision of hearing services. The AHS is established by section 7 of the Hearing Services Act 1991 (the Hearing Act) and one of its functions under paragraph 8(1)(d) of the Hearing Act is to enter into arrangements for supply of hearing products and hearing services. It is proposed that the Commission will assume the function of payment to private sector providers for services to eligible AHS clients. This will require the Commission to perform processing tasks including claims assessment and the payment of benefits to approved private sector providers on behalf of the AHS.

The AHS will release Information to the Commission under paragraph 67(7)(c) of the Hearing Act which will enable the processing of claims, the maintenance of current client service records and the establishment of an "audit trail" as the Commission is only making payments on behalf of the ARS.

The proposed regulations will amend the Health Insurance Commission Regulations by the Insertion of a new regulation 3H which will empower the Commission to perform the function of payment, on behalf of the AHS, of claims by a "benefit provider" (private sector providers who have entered into an arrangement with the AHS under paragraph 8(1)(d) of the Hearing Act).

The proposed regulations also specify the information which the Commission may release to the AHS with regard to each claim processed by the Commission. This aspect of the proposed regulations was prepared in consultation with the Privacy Commissioner.

The proposed regulations would commence on 1 May 1993. The retrospectivity of the proposed regulations will not affect the rights of any person (other than the Commonwealth) In a manner prejudicial to that person, nor will they impose any liability on such a person. They are, therefore, in accordance with subsection 48(2) of the Acts Interpretation Act 1901. The proposed regulation provides for the processing of claims after the date of gazettal in respect of the supply of hearing services which occurred from 1 May 1993 and does not affect the entitlement of a person to receive benefits from the AHS.


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