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Health Legislation Amendment Bill (No. 3) 1999

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1998-99

 

 

THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA

 

 

THE SENATE

 

 

Health Legislation Amendment Bill (No. 3) 1999

 

 

Schedule of the amendments made by the Senate

 

 

 

 

 

(1)     Clause 2, page 2 (after line 13), at the end of the clause, add:

             (6)  Item 1 of Schedule 4 is taken to have commenced on the same day as item 44 of Schedule 1 to the Health Insurance Amendment (Professional Services Review) Act 1999 , immediately after the commencement of that last-mentioned item.

(2)     Schedule 1, page 14 (after line 19), after item 26, insert:

26A  Subsection 78(3)

Omit “or (2)”, substitute “, (2) or (7)”.

26B  At the end of section 78

Add:

             (7)  After receiving notification from the Secretary that the Minister has not made a declaration under subsection (4) in relation to a notification by an organization, a registered organization must take all reasonable steps to notify each affected contributor, explaining (in plain English) the change before the change takes effect.

(3)     Schedule 1, page 14 (after line 19), after item 26, insert:

26C  At the end of section 78

Add:

             (8)  The Minister must cause a report of changes in the rates of contribution by contributors of registered organizations to be laid before each House of the Parliament within 15 sitting days after the end of a quarter.

             (9)  The report shall relate only to changes in rates of contribution by contributors:

                     (a)  that have been notified by the registered organization to the Secretary in accordance with subsection (1); and

                     (b)  in respect of which the Minister has not made a declaration under subsection (4).

           (10)  If, during any quarter, there has been no notification by a registered organization of a change relating to rates of contribution by contributors, to which paragraphs (9)(a) and (b) apply, there is no requirement for a report under subsection (8) to be provided to the Minister in respect of that quarter.

           (11)  In this section:

quarter means a period of 3 months beginning on 1 January, 1 April, 1 July or 1 October of any year.

(4)     Schedule 1, page 18 (after line 29), after item 47, insert:

47A  Saving provision pending establishment of new prudential standards

(1)       In this item:

new prudential standards day has the same meaning as in subsection 4(1) of the Principal Act as amended by this Act.

Principal Act means the National Health Act 1953 .

(2)       Despite the insertion of paragraph 72A(ca) of the Principal Act by item 11, the Principal Act continues to have effect until the new prudential standards day as if that insertion had not been made.

Note:       The heading to item 48 is altered by omitting “ Saving ” and substituting “ Other saving ”.

(5)     Schedule 2, page 21 (after line 5), before item 1, insert:

1A  Subsection 4(1)

Insert:

new prudential standards day means the day on which the Council establishes:

                     (a)  a solvency standard for the purposes of Division 3A of Part VI of this Act; and

                     (b)  a capital adequacy standard for the purposes of Division 3B of that Part.

(6)     Schedule 2, item 3, page 23 (line 4), omit “is to establish”, substitute “must, as soon as practicable but, in any case, not later than 1 January 2001, establish”.

(7)     Schedule 2, item 3, page 23 (after line 14), after subsection (3), insert:

          (3A)  If, in establishing a standard, the Council decides:

                     (a)  not to adopt advice concerning a standard from the Australian Government Actuary; or

                     (b)  to adopt advice concerning a standard from the Australian Government Actuary with variations;

the Council must publish in the Gazette a statement that sets out the Council’s reasons for not adopting, or for varying, that advice.

(8)     Schedule 2, item 3, page 26 (line 25), omit “is to establish”, substitute “must, on the same day as it establishes a solvency standard under section 73BCB, establish”.

(9)     Schedule 2, page 30 (after line 10), after item 4, insert:

4A  After section 82B

Insert:

82BA  Purposes of Council

             (1)  The Council is established for the following purposes:

                     (a)  to regulate registered organizations in accordance with this Act, other laws of the Commonwealth and any directions given by the Minister;

                     (b)  to develop policies about the performance of its regulatory functions.

             (2)  In carrying out its purposes, the Council must take all reasonable steps to achieve an appropriate balance between the following objectives:

                     (a)  the objective of fostering an efficient and competitive health insurance industry;

                     (b)  the objective of protecting the interests of consumers;

                     (c)  the objective of minimising the level of health insurance premiums;

                     (d)  the objective of ensuring the prudential safety of individual registered organizations.

(10)   Schedule 2, page 30 (after line 10), after item 4, insert:

4B  At the end of section 82D

Add:

             (4)  A person cannot be appointed as a member of the Council if that person is a director, officer or employee of a body regulated by the Council.

(11)   Schedule 2, item 43, page 41 (line 20), before “there”, insert “on or after the new prudential standards day”.

(12)   Schedule 2, item 43, page 41 (line 22), before “there”, insert “on or after the new prudential standards day”.

(13)   Schedule 2, item 43, page 42 (line 19), after “section 73BE or”, insert “, on or after the new prudential standards day,”.

(14)   Schedule 2, item 43, page 81 (line 20), before “there”, insert “on or after the new prudential standards day”.

(15)   Schedule 2, item 43, page 81 (line 22), before “there”, insert “on or after the new prudential standards day”.

(16)   Schedule 2, item 43, page 82 (line 19), after “section 73BE or”, insert “, on or after the new prudential standards day,”.

(17)   Schedule 2, page 97 (after line 35), after item 47, insert:

47A  Saving provisions relating to new prudential standards

(1)       In this item:

new prudential standards day has the same meaning as in subsection 4(1) of the Principal Act as amended by this Act.

Principal Act means the National Health Act 1953 .

(2)       Despite the repeal of section 73BAB of the Principal Act by item 2:

                     (a)  that section is taken to have continued in force in relation to registered organizations until the new prudential standards day as if it had not been so repealed; and

                     (b)  any regulation or other subordinate instrument made under or for the purposes of that section that was in force immediately before the repeal of the section continues in force until the new prudential standards day unless, before that day, that regulation is disallowed, or that regulation or other instrument is revoked or varied in accordance with the section as so continued in force.



(3)       Despite the repeal of section 73BAC of the Principal Act by item 2:

                     (a)  that section is taken to have continued in force in relation to registered organizations until the new prudential standards day as if it had not been so repealed; and

                     (b)  any exemption under that section that was in force immediately before the repeal of the section continues to have effect, according to its tenor, until the end of the period specified in the exemption or until the new prudential standards day, whichever first occurs, unless that exemption is earlier revoked under the section as so continued in force; and

                     (c)  any application for such an exemption made before the repeal of the section that had not been dealt with before the repeal is to be dealt with, on and after the repeal, in accordance with the section as continued in force.

(4)       Despite:

                     (a)  the amendment of subsection 73BEB(1) of the Principal Act by item 4; and

                     (b)  the repeal of paragraph 82G(1)(c) of the Principal Act by item 5; and

                     (c)  the repeal of paragraph 82G(1)(q) of the Principal Act by item 8;

the Principal Act continues to have effect, until the new prudential standards day, as if that amendment and those repeals had not been made.

(5)       Despite the repeal of paragraphs 82G(1)(f) and (g) of the Principal Act by item 7, the Principal Act continues to have effect until the new prudential standards day as if item 7 had not repealed and replaced those provisions but had provided instead solely for the repeal of subparagraph 82G(1)(g)(ii) and the substitution of the following subparagraph:

                             (ii)  to take such action as is appropriate;

(18)   Schedule 3, page 110 (after line 14), after item 55, insert:

55A  After subsection 18-15(1)

Insert:

          (1A)  Without limiting subsection (1), the *Managing Director may make a determination under paragraph (1)(b) if the Managing Director is of the opinion that information given by or on behalf of:

                     (a)  the Commonwealth; or

                     (b)  a *health fund;

to a person from whom an amount is recoverable about that person’s entitlements under this Act was incorrect or misleading in a material particular.

(19)   Schedule 3, item 56, page 110 (after line 26), after subsection (1), insert:

          (1A)  If the HIC decides to make such a set-off in respect of a person or his or her estate, the *Managing Director must serve on the person or his or her legal personal representative or the legal personal representative of his or her estate a notice of the decision.

(20)   Schedule 3, page 110 (after line 31), after item 56, insert:

56A  At the end of Division 18

Add:

18-25  Reconsideration of certain decisions under this Division

             (1)  You may apply to the HIC for the HIC to reconsider the following decisions:

                     (a)  a decision that an amount is recoverable as a debt due to the Commonwealth under:

                              (i)  paragraph 18-5(1)(a) or (b); or

                             (ii)  paragraph 18-5(1)(f) in respect of a payment made to an individual; or

                     (b)  a decision under subsection 18-20(1) to set off a debt against an amount otherwise payable to a person or his or her estate.

             (2)  The application must:

                     (a)  be in writing; and

                     (b)  set out the reasons for the application.

             (3)  The application must be made within:

                     (a)  28 days after the day on which you are notified of the decision; or

                     (b)  if, either before or after the end of that period of 28 days, the HIC extends the period within which the application may be made—the extended period for making the application.

             (4)  Upon receiving such an application, the HIC must:

                     (a)  reconsider the decision; and

                     (b)  either affirm or revoke the decision.

             (5)  If the HIC revokes the decision, the revocation is taken to be a decision:

                     (a)  in the case of a decision mentioned in paragraph (1)(a)—to waive the debt; or

                     (b)  in the case of a decision mentioned in paragraph (1)(b)—not to set off a debt against an otherwise payable amount.

             (6)  The HIC must give you a notice stating its decision on the reconsideration together with a statement of the reasons for its decision.

             (7)  The HIC must make its decision on reconsideration of a decision within 28 days after the day on which it received an application for reconsideration.

             (8)  The HIC is taken, for the purposes of this Division, to have made a decision confirming the original decision if it has not told the applicant of its decision on the reconsideration before the end of the period of 28 days.

(21)   Schedule 3, page 114 (after line 7), after item 61, insert:

61A  At the end of section 19-10

Add:

                   ; (g)  a decision by the HIC under section 18-25 on reconsideration of a decision:

                              (i)  that an amount is recoverable as a debt due to the Commonwealth under:

                                        (A)  paragraph 18-5(1)(a) or (b); or

                                        (B)  paragraph 18-5(1)(f) in respect of a payment made to an individual; or

                             (ii)  under subsection 18-20(1) to set off a debt against an amount otherwise payable to a person or his or her estate.



(22)   Page 118 (after line 31), at the end of the bill, add:

Schedule 4—The professional services review scheme

 

Health Insurance Act 1973

1  Section 19B

Omit “106T” (wherever occurring), substitute “106TA”.

2  Subsections 106KA(1) to (3)

Repeal the subsections, substitute:

             (1)  Subject to subsections (2) and (2A), if, during a particular period (the relevant period ), the circumstances in which some or all of the referred services were rendered or initiated constituted a prescribed pattern of services, the conduct of the person under review in connection with rendering or initiating services during that period in those circumstances is taken, for the purposes of this Part, to have constituted engaging in inappropriate practice.

             (2)  If the person under review satisfies the Committee that, on a particular day or particular days during the relevant period, exceptional circumstances existed that affected the rendering or initiating of services by the person, the person’s conduct in connection with rendering or initiating services on that day or those days is not taken by subsection (1) to have constituted engaging in inappropriate practice.

          (2A)  However, subsection (2) does not affect the operation of subsection (1) in respect of the remaining day or days during the relevant period on which the person rendered or initiated referred services even if the circumstances in which the referred services were rendered or initiated on that day or those days would not, if considered alone, have constituted a prescribed pattern of services.

             (3)  The regulations may prescribe, in relation to:

                     (a)  a particular profession; or

                     (b)  an identified group or groups of practitioners in a particular profession;

circumstances in which services of a particular kind or description that are rendered or initiated constitute, or do not constitute, a prescribed pattern of services for the purposes of subsection (1).

 

 

 

 

HARRY EVANS

Clerk of the Senate

 

The Senate

21 October 1999