(1) An
out‑patient must be classified under this clause for the purpose of the
payment of the fees and charges set out in Schedule 1 in respect of an
out‑patient.
(2) An
out‑patient must be classified as —
(a) a
compensable out‑patient; or
(b) an
eligible veteran out‑patient, namely, an out‑patient —
(i)
who is a veteran; and
(ii)
who elects to be treated under the DVA arrangement;
or
(c) an
eligible out‑patient, namely, an out‑patient —
(i)
who is an eligible person; but
(ii)
who is not a compensable out‑patient or eligible
veteran out‑patient;
or
(d) an
ineligible out‑patient, namely, an out‑patient —
(i)
who is not an eligible person; and
(ii)
who is not a compensable out‑patient or eligible
veteran out‑patient;
or
(e) a
concessional beneficiary, namely, an out‑patient —
(i)
who is a concessional beneficiary (as defined in the
National Health Act section 84); or
(ii)
who is a dependant as defined by that section of such a
concessional beneficiary;
or
(f) a
pensioner, namely, an out‑patient who holds a pensioner concession card
or a dependant (as defined in the National Health Act section 84) of such
an out‑patient.
(3) At the time
of —
(a)
attendance at a hospital for the purposes of receiving a pathology service
provided by the hospital as an out‑patient service; or
(b)
receiving a pathology service provided by a hospital elsewhere than at the
hospital,
or as soon as
practicable after that time, an eligible person (not being a compensable
patient or a veteran), a concessional beneficiary or a pensioner may elect to
be treated as a private pathology out‑patient for the purpose of that
pathology service.
(4) If a person makes
an election under subclause (3), then —
(a) the
person is classified as a private pathology out‑patient for the purpose
of the payment of any charge for that pathology service fixed in
Schedule 1 Division 4; and
(b)
despite subclause (2)(c), (e) or (f), the person is not
classified as an eligible out‑patient, concessional beneficiary or
pensioner (as the case may be) for that purpose.
(5) For the purposes
of subclause (2)(a), a compensable out‑patient includes a person in
respect of the payment for whose health services one or more of the following
applies or appears prima facie to apply —
(a) the
Workers Compensation and Injury Management Act 2023 ;
(ab) the
Motor Vehicle and Workplace Accidents (Catastrophic Injuries) Act 2016 ;
(b) the
Motor Vehicle (Third Party Insurance) Act 1943 ;
(c) the
law of Australia relating to the Defence Force within the meaning of the
Defence Act 1903 (Commonwealth).
[Clause 14 amended: Gazette 9 Mar 2018
p. 798; SL 2023/87 cl. 10; SL 2024/81 cl. 4;
SL 2024/104 cl. 4.]