Commonwealth Consolidated Regulations

HEALTH INSURANCE REGULATIONS 2018 - REG 102

  (1)   Subject to this section:

  (a)   a referral that states it is valid for a fixed period is valid until the end of that period after the first service rendered in accordance with the referral; and

  (b)   a referral that states it is valid indefinitely is valid for an indefinite period; and

  (c)   a referral that does not state a time for which it remains valid is valid until 12 months after the first service rendered in accordance with the referral.

Referrals given by particular persons

  (2)   A referral given by a specialist or consultant physician is valid:

  (a)   for a maximum of 3 months after the first service given in accordance with the referral; or

  (b)   if the referred person is a patient in a hospital at the time of referral and continues to be so for more than 3 months--until the person ceases to be a patient in a hospital.

  (3)   A referral given by a participating midwife is valid for a maximum of 12 months after the first service is given in accordance with the referral, and for one pregnancy only.

  (4)   A referral given by a participating nurse practitioner is valid for a maximum of 12 months after the first service is given in accordance with the referral.

Special cases

  (5)   A referral for a professional service to a patient in a hospital who is not a public patient is valid until the patient ceases to be a patient in the hospital who is not a public patient.

  (6)   A referral that does not comply with subsection   98(1), and is given in the circumstances described in subsection   98(2) (emergencies), is valid for only one attendance on the patient.

  (7)   A written referral that is lost, stolen or destroyed is valid for only one attendance on the patient.