Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (VOCATIONAL REGISTRATION OF GENERAL PRACTITIONERS)REGULATIONS (AMENDMENT) 1996 NO. 350

STATUTORY RULES 1996 No. 350

Issued by Authority of the Minister for Health and Family Services

Health Insurance Act 1973

Health Insurance (Vocational Registration of General Practitioners) Regulations (Amendment)

The Health Insurance Act 1973 ("the Act") provides, in part, for the registration of medical practitioners as vocationally registered general practitioners.

Section 133 of the Act provides that the Governor-General may make regulations for the purposes of the Act.

The Health Insurance Amendment Act (No. 2) 1996 introduced minimum proficiency requirements which medical practitioners must meet before the services they provide attract Medicare benefits. At the same time the arrangements for the Vocational Registration of general practitioners were updated to reflect the end of the 'grandparent' period on 3 1 December 1994, As a consequence amendments are required to the Health Insurance (Vocational Registration of General Practitioners) Regulations ("the Regulations") to reflect the amendments to the Act.

The purpose of the Regulations is to:

1. introduce new criteria for the inclusion or removal of general practitioners from the Vocational Register. The criteria were formerly specified in a document published by the Royal Australian College of General Practitioners;

2. establish new Committees to make decisions on the eligibility for registration and cancellation of registration.,

3. establish new Committees to hear appeals from registration and cancellation decisions, and

4. provide for the necessary notices of registration, cancellation and appeal decisions.

Further details of the Regulations are set out in the Attachment.

The regulations commenced on 24 December 1996.

ATTACHMENT

DETAILS OF THE HEALTH INSURANCE (VOCATIONAL REGISTRATION OF GENERAL PRACTITIONERS) REGULATIONS (AMENDMENT)

Regulation 1 provides for these Regulations to commence on 24 December 1996.

Regulation 2 provides for the Health Insurance (Vocational Registration of General Practitioners) Regulations to be amended by these Regulations.

Regulation 3 amends sub regulation 2(1) to add four new definitions and amend two of the existing definitions. New definitions are provided of the terms "general practice", "managing director", "predominantly" (a word used in defining general practice) and "quarter". The existing definitions of "appeal committee" and "eligibility committee" are revised to reflect the change in the names of these committees following an expansion of their roles.

Regulation 4 is a 'technical' amendment reflecting the reduction in the number of Eligibility Committees.

Regulation 5 - inserts a new Regulation 3A which specifies the General Practice Eligibility Committee and the General Practice Appeal Committee as the bodies, other than the Royal Australian College of General Practitioners (RACGP), authorised to make decisions concerning who are to be entered on or removed from the Vocational Register.

Regulation 6 requires the RACGP and the Eligibility Committee to provide the Managing Director of the Health Insurance Commission with written notice in the event that either body should decline to certify that a practitioner is eligible for registration. The regulation also requires the Health Insurance Commission to notify general practitioners of the decisions of the RACGP, the Eligibility Committees or the Appeal Committees.

Regulation 6 - inserts a new Regulation 4A which sets out the appeal fights of unsuccessful applicants. It is intended that an applicant should have 28 days to lodge an appeal from the date that the Health Insurance Commission gives notice that their application for Registration was unsuccessful. In the event that an appeal is dismissed, proposed subregulation 4A(4) sets out requirements for the Appeal Committee to give written notice of its decision.

Regulation 6 - inserts a new Regulation 4B which provides transitional arrangements so that applications currently under consideration by the existing Vocational Registration Eligibility Committees and the Vocational Registration Appeal Committee are to be continued to be considered by the new Committees.

Regulation 7 - inserts new Regulations 5, 5A and 5B which set out the eligibility criteria for all cases where a practitioner seeks to have his or her name included on the Register.

New Regulation 5 provides the criteria for the registration of applicants whose application was lodged before 1 January 1995 and is still under consideration by either the Eligibility Committee or the Appeal Committee at the time when the new regulations are introduced. These applications are to be assessed against the criteria in force at the time when the application was lodged.

New Regulation 5A sets out the criteria for the readmission to the register of a practitioner whose name has previously been removed from the Register. A practitioner will be eligible for registration if:

a)       the RACGP or Eligibility Committee certifies that the individual practitioner's medical practice has been or is about to be predominantly general practice; and

b)       the RACGP certifies that the practitioner now meets its minimum requirements for taking part in continuing medical education and quality assurance programs.

New Regulation 5B sets out the criteria for registration for new applications received after 1 January 1995 for practitioners who have not previously been on the register. These practitioners will be eligible for registration if:

a)       the RACGP or Eligibility Committee certifies that the individual practitioner's medical practice has been or is about to be predominantly general practice; and

b)       the RACGP certifies that the practitioner is a Fellow of the RACGP; and

c)       the RACGP certifies that the practitioner now meets its minimum requirements for taking part in continuing medical education and quality assurance programs.

Regulation 8 - inserts a new Regulation 6 which gives the RACGP, the Eligibility Committee and the Appeal Committee power to remove a practitioner who does not satisfy the legislative requirements for continued inclusion on the Register. The regulation provides for the removal of a medical practitioner from the register if their practice is not predominantly in general practice. Specifically it is intended that where an individual practitioner is not working predominantly in general practice for the previous quarter of the year, then they must be removed from the register. The new regulation also empowers both the RACGP and the Appeal Committee to remove a practitioner's name from the register where he or she has failed to meet the minimum requirements of the RACGP for taking part in continuing medical education and quality assurance programs.

Regulation 9 - repeals Regulation 7. Under the existing Regulation 7, a Committee is required to have regard to the eligibility criteria published by the RACGP before proceeding to consider a case on its merits. However, with the inclusion of the new eligibility criteria in new Regulations 5 and 6, there is no longer a need for Regulation 7.

Regulation 10 - inserts a new Regulation 8 which replaces the existing Regulation 8 and provides that a doctor who has been advised that his or her name is to be removed from the Register but who has appealed the decision within the time, then the doctor is to remain on the Register pending the outcome of their appeal.

Regulation 11 - inserts a new Regulation 9 which provides for the establishment of the General Practice Eligibility Committee to carry out legislative responsibilities in relation to the Vocational Register. The General Practice Eligibility -Committee will replace the current Vocational Registration Eligibility Committees established in each State and Territory. Now that the grandparenting period is complete and the back log of applications has been largely dealt with the workload does not warrant separate State and Territory committees and one is likely to be sufficient.

Regulation 11 - inserts a new Regulation 9A provides the Minister with the flexibility to establish one or more additional eligibility committees should there be sufficient workload at some point in the future.

Regulation 12 - inserts new Regulations 10 and 10A provides for the establishment of a new General Practice Recognition Appeal Committee to replace the existing Vocational Registration Appeal Committee in a manner consistent with new Regulations 9 and 9A.

The new titles of General Practice Eligibility and Appeal Committees reflect the change in emphasis in the Act to recognise General Practice as a discrete professional discipline. It also reflects the intention to widen the role of the Appeal Committee under the Health Insurance Regulations. Under separate amendments proposed to the Health Insurance Regulations, the Appeal Committee will also consider appeals in respect of decisions relating to recognition of certain fellows of the RACGP.

Regulation 13 - amends Regulations 11. Sub Regulation 11 (1) requires that membership of the Committees must be drawn from practitioners who are either vocationally registered or Fellows of the RACGP.

Sub Regulation 11(1A) provides for the existing members of the Vocational Registration Appeal Committee to continue on as appointees to the new Appeal Committee.

Sub Regulation 11(3) specifies the bodies that the Minister is required to seek nominations for membership of the Committees.

Sub Regulation 11(4) requires that the RACGP and the AMA have at least 14 days to provide the nominations.

Sub Regulation 11(5 and 6) provides the Minister with increased discretion in appointing persons to the Committees.

Regulation 14 - inserts a new Sub Regulation 13(1) which allows for the substitution of a Committee member where a member is unable to attend a meeting of the Committee. The new Sub Regulation provides the Minister with discretion as to whether the body (if any) which originally nominated the member should be consulted.

Regulations 15 - inserts new Regulations 16 which requires that where a nominated member cannot serve out their term on a Committee the Minister must invite the body which originally nominated the member to nominate a replacement. The new Regulation however, provides the Minister with increased discretion in appointing a replacement.

Regulation 16 - inserts a new Regulation 21 which makes provision for the Committees to receive confidential information from the Health Insurance Commission which is reasonably relevant to the performance of their functions under the legislation.