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Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Bill 2003

 

 

 

 

 

 

Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003

 

No. 33, 2003

 

 

 

 

 

An Act to amend the Health Insurance Act 1973 , and for related purposes

   

   



Contents

1............ Short title............................................................................................ 1

2............ Commencement.................................................................................. 2

3............ Schedule(s).......................................................................................... 2

Schedule 1—Diagnostic Imaging Register                                                                3

Health Insurance Act 1973                                                                                         3

Schedule 2—Radiation Oncology Register                                                             21

Health Insurance Act 1973                                                                                       21

Schedule 3—Referral arrangements for diagnostic imaging services     39

Health Insurance Act 1973                                                                                       39

Schedule 4—Osteopaths                                                                                                    46

Health Insurance Act 1973                                                                                       46

 



 

 

 

Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003

No. 33, 2003

 

 

 

An Act to amend the Health Insurance Act 1973 , and for related purposes

[ Assented to 15 April 2003 ]

The Parliament of Australia enacts:

1   Short title

                   This Act may be cited as the Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003 .

2   Commencement

             (1)  Each provision of this Act specified in column 1 of the table commences, or is taken to have commenced, on the day or at the time specified in column 2 of the table.

 

Commencement information

Column 1

Column 2

Column 3

Provision(s)

Commencement

Date/Details

1.  Sections 1 to 3 and anything in this Act not elsewhere covered by this table

The day on which this Act receives the Royal Assent

15 April 2003

2.  Schedule 1

The day on which this Act receives the Royal Assent

15 April 2003

3.  Schedule 2

Immediately after the commencement of Schedule 1 to this Act

15 April 2003

4.  Schedules 3 and 4

The day on which this Act receives the Royal Assent

15 April 2003

Note:          This table relates only to the provisions of this Act as originally passed by the Parliament and assented to. It will not be expanded to deal with provisions inserted in this Act after assent.

             (2)  Column 3 of the table is for additional information that is not part of this Act. This information may be included in any published version of this Act.

3   Schedule(s)

                   Each Act that is specified in a Schedule to this Act is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this Act has effect according to its terms.



 

Schedule 1 Diagnostic Imaging Register

   

Health Insurance Act 1973

1  Subsection 3(1)

Insert:

ABN has the meaning given by section 41 of the A New Tax System (Australian Business Number) Act 1999 .

2  Subsection 3(1)

Insert:

base for mobile diagnostic imaging equipment has the meaning given by section 23DZL.

3  Subsection 3(1)

Insert:

diagnostic imaging premises has the meaning given by section 23DZM.

4  Subsection 3(1)

Insert:

Diagnostic Imaging Register means the Register kept under section 23DZK.

5  Subsection 3(1)

Insert:

listed , in relation to diagnostic imaging equipment, has the meaning given by subsections 16D(4) and (5).

6  Subsection 3(1)

Insert:

ordinarily located :

                     (a)  in relation to diagnostic imaging premises—has a meaning affected by subsection 16D(6); and

                     (b)  in relation to bases for mobile diagnostic imaging equipment—has a meaning affected by subsection 16D(8).

7  Subsection 3(1)

Insert:

primary information , for the purposes of Division 4 of Part IIB, has the meaning given by section 23DZR.

8  Subsection 3(1) (definition of proprietor )

Repeal the definition, substitute:

proprietor :

                     (a)  in relation to a pathology laboratory, means the person or authority having effective control of:

                              (i)  the laboratory premises, whether or not the holder of an estate or interest in the premises; and

                             (ii)  the use of equipment used in the laboratory; and

                            (iii)  the employment of staff in the laboratory; and

                     (b)  in relation to diagnostic imaging premises or a base for mobile diagnostic imaging equipment—has the meaning given by section 23DZO.

9  Subsection 3(1)

Insert:

registered :

                     (a)  in relation to diagnostic imaging premises—has the meaning given by subsection 16D(2); and

                     (b)  in relation to a base for mobile diagnostic imaging equipment—has the meaning given by subsection 16D(3).

10  After section 16C

Insert:

16D   Medicare benefits not payable for certain diagnostic imaging services

             (1)  Unless the Minister otherwise directs, a medicare benefit is not payable in respect of a diagnostic imaging service rendered by or on behalf of a medical practitioner unless the diagnostic imaging procedure used in rendering that service is:

                     (a)  carried out using diagnostic imaging equipment that:

                              (i)  is ordinarily located at registered diagnostic imaging premises; and

                             (ii)  is of a type that, on the day on which the procedure is carried out, is listed for the premises; or

                     (b)  carried out using diagnostic imaging equipment that:

                              (i)  is ordinarily located at a registered base for mobile diagnostic imaging equipment when not in use; and

                             (ii)  is not ordinarily located at diagnostic imaging premises; and

                            (iii)  is of a type that, on the day on which the procedure is carried out, is listed for the base.

Meaning of registered diagnostic imaging premises and registered base for mobile diagnostic imaging equipment

             (2)  Diagnostic imaging premises are registered at a particular time if a registration for the premises under Division 4 of Part IIB is in effect at that time.

             (3)  A base for mobile diagnostic imaging equipment is registered at a particular time if a registration for the base under Division 4 of Part IIB is in effect at that time.

What equipment is listed for premises or a base?

             (4)  Diagnostic imaging equipment is of a type listed for particular diagnostic imaging premises at a particular time if, at that time:

                     (a)  the Diagnostic Imaging Register states that equipment of a particular type is ordinarily located at the premises; and

                     (b)  the equipment is of that type.

             (5)  Diagnostic imaging equipment is of a type listed for a particular base for mobile diagnostic imaging equipment at a particular time if, at that time:

                     (a)  the Diagnostic Imaging Register states that pieces of equipment of a particular type are ordinarily located at the base when not in use and not ordinarily located at diagnostic imaging premises; and

                     (b)  the equipment is of that type.

Some circumstances in which diagnostic imaging equipment is taken to be ordinarily located at diagnostic imaging premises

             (6)  Diagnostic imaging equipment is taken to be ordinarily located at diagnostic imaging premises if:

                     (a)  the equipment is:

                              (i)  on trial at the premises for a period of not more than 3 months; and

                             (ii)  of the same type as equipment listed for the premises during the period of the trial; or

                     (b)  each of the following circumstances exist:

                              (i)  the equipment (the substituted equipment ) is used, for a period of not more than 3 months, in substitution for diagnostic imaging equipment that is not in operation;

                             (ii)  the substituted equipment is of the same type as the equipment that is not in operation;

                            (iii)  the equipment that is not in operation is ordinarily located at the premises.

             (7)  Nothing in subsection (6) limits the circumstances in which diagnostic imaging equipment is ordinarily located at diagnostic imaging premises for the purposes of this Part or Division 4 of Part IIB.

Some circumstances in which diagnostic imaging equipment is taken to be ordinarily located at a base for mobile diagnostic imaging equipment when not in use and not ordinarily located at diagnostic imaging premises

             (8)  Diagnostic imaging equipment is taken to be ordinarily located at a base for mobile diagnostic imaging equipment when not in use, and not ordinarily located at diagnostic imaging premises, if:

                     (a)  the equipment is:

                              (i)  on trial through the base for a period of not more than 3 months; and

                             (ii)  not ordinarily located, or taken to be ordinarily located, at diagnostic imaging premises during the period of the trial; and

                            (iii)  of the same type as equipment listed for the base during the period of the trial; or

                     (b)  each of the following circumstances exist:

                              (i)  the equipment (the substituted equipment ) is used, for a period of not more than 3 months, in substitution for diagnostic imaging equipment that is not in operation;

                             (ii)  the substituted equipment is of the same type as the equipment that is not in operation;

                            (iii)  the equipment that is not in operation is ordinarily located at the base when not in use and not ordinarily located at diagnostic imaging premises.

             (9)  Nothing in subsection (8) limits the circumstances in which diagnostic imaging equipment is ordinarily located at a base for mobile diagnostic imaging equipment, but not ordinarily located at diagnostic imaging premises, for the purposes of this Part or Division 4 of Part IIB.

16E   Medicare benefit is payable once a suspension of a registration is lifted

                   If, but for this section, medicare benefit would not be payable in respect of a diagnostic imaging service rendered by or on behalf of a medical practitioner because the diagnostic imaging procedure used in rendering that service is:

                     (a)  carried out using diagnostic imaging equipment that is ordinarily located at diagnostic imaging premises the registration of which has been suspended; or

                     (b)  carried out using diagnostic imaging equipment that:

                              (i)  when not in use, is ordinarily located at a base for mobile diagnostic imaging equipment the registration of which is suspended; and

                             (ii)  is not ordinarily located at diagnostic imaging premises;

medicare benefit becomes payable in respect of the service when the suspension ceases to have effect, provided the suspension does not cease to have effect because the registration is cancelled under section 23DZY.

11  At the end of Part IIB

Add:

Division 4 Diagnostic Imaging Register

23DZK   Diagnostic Imaging Register

             (1)  The Minister must keep a Diagnostic Imaging Register.

             (2)  The Register is kept for the following purposes:

                     (a)  gathering information on the provision of diagnostic imaging services, including (but not limited to) the structure of medical practices connected with the provision of those services, for the purposes of planning and developing the Commonwealth medicare benefits program;

                     (b)  identifying whether medicare benefit is payable for a particular diagnostic imaging service rendered to a person;

                     (c)  assisting in identifying whether inappropriate practice (as defined for the purposes of Part VAA of this Act) is taking place;

                     (d)  assisting in identifying whether prohibited diagnostic imaging practices are taking place.

23DZL   What is a base for mobile diagnostic imaging equipment ?

                   Premises are a base for mobile diagnostic imaging equipment if:

                     (a)  diagnostic imaging equipment is ordinarily located at the premises when not in use; and

                     (b)  the diagnostic imaging procedures carried out using the equipment are not carried out at the premises; and

                     (c)  the diagnostic imaging procedures carried out using the equipment are carried out under a single business name.

23DZM   What are diagnostic imaging premises ?

                   Diagnostic imaging premises means a building or a part of a building at which diagnostic imaging procedures are carried out under a single business name.

23DZN   Who may apply for registration?

             (1)  The proprietor of diagnostic imaging premises may apply to the Minister for the registration of the premises.

             (2)  The proprietor of a base for mobile diagnostic imaging equipment may apply to the Minister for registration of the base.

23DZO   Who is a proprietor ?

             (1)  The proprietor of diagnostic imaging premises is the person or government agency who has effective control of:

                     (a)  the premises, whether or not the holder of an estate or interest in the premises; and

                     (b)  the use of the diagnostic imaging equipment used at the premises; and

                     (c)  the employment of staff (including medical practitioners) connected with the premises.

             (2)  The proprietor of a base for mobile diagnostic imaging equipment is the person or government agency who has effective control of:

                     (a)  the base, whether or not the holder of an estate or interest in the base; and

                     (b)  the use of diagnostic imaging equipment ordinarily located at the base when not in use; and

                     (c)  the employment of staff (including medical practitioners) connected with the base.

             (3)  In this section:

employment includes:

                     (a)  appointment or employment by the Commonwealth, a State or Territory; and

                     (b)  appointment or employment by a government agency; and

                     (c)  full-time, part-time and casual work; and

                     (d)  work under a contract for services.

government agency includes:

                     (a)  a Department of the Commonwealth or of a State or Territory; and

                     (b)  an authority (incorporated or unincorporated) established for a public purpose by or under a Commonwealth, State or Territory law.

Note:          Section 23DZZI contains rules on the application of this Division to partnerships.

23DZP   Application procedure

             (1)  An application for registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment must:

                     (a)  be in writing; and

                     (b)  be in accordance with the approved form; and

                     (c)  include the primary information; and

                     (d)  include the other information prescribed for the purposes of this paragraph.

             (2)  Information may only be prescribed if it is relevant to the purposes for which the Register is kept.

23DZQ   Registration

             (1)  If an application for registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment is properly made, the Minister must register the premises or base by:

                     (a)  allocating a unique location specific practice number to the premises or base; and

                     (b)  including the following information on the Register:

                              (i)  the location specific practice number for the premises or base;

                             (ii)  the day on which the registration takes effect;

                            (iii)  the primary information;

                            (iv)  the other information prescribed for the purposes of this subparagraph.

             (2)  Registration takes effect on:

                     (a)  the day on which the application is properly made; or

                     (b)  the day specified by the applicant in the application;

whichever is later.

             (3)  Registration ceases to have effect on the day on which it is cancelled.

             (4)  Registration does not have effect while it is suspended.

             (5)  Information may only be prescribed if it is relevant to the purposes for which the Register is kept.

             (6)  The Minister must notify the proprietor, in writing, of:

                     (a)  the location specific practice number for the premises or base; and

                     (b)  the date on which registration takes effect;

within 28 days after the application for registration is properly made.

23DZR   Primary information

             (1)  The following information is primary information :

                     (a)  details of the proprietor (including, where the proprietor is a company, its Australian Company Number) of the diagnostic imaging premises or the base for mobile diagnostic imaging equipment (as the case requires);

                     (b)  the business name under which diagnostic imaging procedures are carried out;

                     (c)  the ABN under which diagnostic imaging procedures are carried out:

                              (i)  in the case of diagnostic imaging premises—using diagnostic imaging equipment that is ordinarily located at the premises; or

                             (ii)  in the case of a base for mobile diagnostic imaging equipment—using diagnostic imaging equipment ordinarily located at the base when not in use that is not ordinarily located at diagnostic imaging premises;

                     (d)  in the case of diagnostic imaging premises:

                              (i)  the address of the premises; and

                             (ii)  a statement identifying the types of diagnostic imaging equipment ordinarily located at the premises;

                     (e)  in the case of a base for mobile diagnostic imaging equipment:

                              (i)  the address of the base; and

                             (ii)  the address of the proprietor; and

                            (iii)  a statement identifying the type of each piece of diagnostic imaging equipment that is ordinarily located at the base when not in use and is not ordinarily located at diagnostic imaging premises;

                      (f)  details of the legal relationships that give rise to a right to use the equipment.

             (2)  The regulations may prescribe types of diagnostic imaging equipment for the purposes of this section.

23DZS   Register may be maintained electronically

                   The Register may be maintained electronically.

23DZT   Extract of the Register to be made available on request

             (1)  A person may, for the purposes of determining whether medicare benefit is likely to be payable in respect of a particular diagnostic imaging service, request an extract of the Register in relation to diagnostic imaging premises or a base for mobile diagnostic imaging equipment specified in the request.

             (2)  An extract of the Register containing the following information must be made available to the person on that request:

                     (a)  the business name under which diagnostic imaging procedures are carried out at the premises or using equipment listed for the base;

                     (b)  the address of the premises or base;

                     (c)  the location specific practice number for the premises or base;

                     (d)  if a suspension of the registration of the premises or base is in effect at the time the extract is given—a statement of that fact and the date on which the suspension took effect;

                     (e)  if a cancellation of the registration of the premises or base is in effect at the time the extract is given—a statement of that fact and the date on which the cancellation took effect.

23DZU   Minister may publish an extract of the Register on the Internet

                   The Minister may publish on the Internet an extract of the Register containing the following information in relation to diagnostic imaging premises or a base for mobile diagnostic imaging equipment:

                     (a)  the business name under which diagnostic imaging procedures are carried out using equipment listed for the premises or the base;

                     (b)  the address of the premises or base;

                     (c)  the location specific practice number for the premises or base;

                     (d)  a statement identifying the periods during which the current or a previous registration has had effect.

23DZV   Proprietors to notify the Minister of changes to primary information

             (1)  The proprietor of registered diagnostic imaging premises must notify the Minister in writing of changes to the primary information in relation to the premises within 28 days after the change occurs.

             (2)  The proprietor of a registered base for mobile diagnostic imaging equipment must notify the Minister of changes to the primary information in relation to the base within 28 days after the change occurs.

23DZW   Minister may request further information

             (1)  The Minister may give notice in writing to the proprietor of registered diagnostic imaging premises or a registered base for mobile diagnostic imaging equipment, requesting the proprietor to give the Minister information of the kind specified in the notice.

             (2)  The information must be given to the Minister:

                     (a)  within 28 days after the notice is given; or

                     (b)  if a longer period is specified in the notice—within that longer period.

This is the response period .

             (3)  The kinds of information specified in the notice must be relevant to the purposes for which the Register is kept.

23DZX   Suspension for failure to comply with a request

             (1)  The Minister must suspend the registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment if the proprietor of the premises or base has failed to comply with a request for information under section 23DZW within the response period.

             (2)  The suspension takes effect on the day after the end of the response period.

             (3)  The suspension ceases to have effect:

                     (a)  if the request is complied with within 3 months after the end of the response period (the compliance period )—on the day on which it is complied with; or

                     (b)  if the registration of the premises or base is cancelled because the proprietor fails to comply with the request within the compliance period—on the day immediately after the end of that period.

             (4)  The Minister must give the proprietor notice in writing that the registration of the premises or base has been suspended.

             (5)  The Minister must note the day on which the suspension takes effect on the Register.

23DZY   Cancellation for failure to provide information within 3 months after the response period

             (1)  The Minister must cancel the registration of registered diagnostic imaging premises or a registered base for mobile diagnostic imaging equipment if the proprietor of the premises or base fails to comply with a request for information under section 23DZW within the compliance period.

             (2)  The cancellation takes effect on the day immediately after the end of the response period.

             (3)  The Minister must give the proprietor written notice of the cancellation.

23DZZ   Cancellation at the request of the proprietor

             (1)  The Minister must cancel the registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment if the proprietor requests, in writing, the Minister to do so.

             (2)  The cancellation takes effect on:

                     (a)  the day immediately after the request is given to the Minister; or

                     (b)  the day specified by the proprietor in the request;

whichever is later.

23DZZA   Cancellation on other grounds

             (1)  The Minister may cancel the registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment if:

                     (a)  the registration was obtained improperly; or

                     (b)  the proprietor has failed to notify the Minister of changes to primary information.

             (2)  The Minister must give the proprietor notice in writing of the Minister’s decision to cancel the registration of the premises or base.

             (3)  The Minister must set out his or her reasons for the decision in that notice.

             (4)  The cancellation takes effect on:

                     (a)  the day on which the Minister gives the proprietor the notice; or

                     (b)  the day specified in the notice;

whichever is later.

23DZZB   Cancellation to be noted on the Register

                   If the registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment is cancelled, the Minister must note the day on which the cancellation takes effect on the Register.

23DZZC   Limits on registration after cancellation under section 23DZY or 23DZZA

             (1)  If the registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment is cancelled under section 23DZY or 23DZZA, the proprietor is not entitled to apply for registration of the premises or base within a period of 12 months after the cancellation without the Minister’s permission.

             (2)  In deciding whether to permit the proprietor to apply to have the premises or base registered, the Minister must take into account whether:

                     (a)  the act or omission that gave rise to the cancellation was inadvertent; and

                     (b)  it is reasonable to conclude, in all the circumstances, that the proprietor will comply with this Division in making the application and after registration of the premises or base.

             (3)  If the Minister decides not to permit the proprietor to apply to have the premises or base registered, the Minister must give the proprietor notice in writing of the fact.

             (4)  The Minister must set out his or her reasons for the decision in that notice.

23DZZD   Minister must invite submissions before cancelling registration

             (1)  Before cancelling the registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment under section 23DZZA, the Minister must invite the proprietor of the premises or base to make a submission to the Minister giving reasons why that action should not be taken.

             (2)  The invitation must be given by notice in writing to the proprietor.

             (3)  The submission must be given in writing to the Minister:

                     (a)  within 28 days after the notice is given; or

                     (b)  if a longer period is specified in the notice—within that longer period.

23DZZE   Application to Administrative Appeals Tribunal for review of a decision to cancel registration

             (1)  Application may be made to the Administrative Appeals Tribunal for review of a decision:

                     (a)  to cancel the registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment under section 23DZZA; and

                     (b)  not to permit a proprietor to apply for registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment under section 23DZZC.

             (2)  The application must be made:

                     (a)  where the decision is to cancel the registration of the premises or base under section 23DZZA—within 28 days after the notice of the decision is given to the proprietor under that section; and

                     (b)  where the decision is not to permit the proprietor of the premises or base to apply for registration of the premises or base under section 23DZZC—within 28 days after the notice of the decision is given to the proprietor under that section.

23DZZF   Proprietor of unregistered premises must notify patients that medicare benefit not payable

             (1)  The proprietor of diagnostic imaging premises commits an offence if a diagnostic imaging procedure is carried out on a person under the following circumstances:

                     (a)  the procedure is carried out either at the premises or elsewhere using equipment that is ordinarily located at the premises; and

                     (b)  the premises are not registered; and

                     (c)  the proprietor has neither:

                              (i)  given the person notice in writing that medicare benefit will not be payable for a diagnostic imaging service rendered using the procedure; nor

                             (ii)  caused written notice to that effect to be displayed prominently at the place where the procedure is carried out.

Maximum penalty:    10 penalty units.

             (2)  Strict liability applies to all of the physical elements of the offence.

Note:          For strict liability , see section 6.1 of the Criminal Code .

23DZZG   Proprietor of unregistered base must notify patients that medicare benefit not payable

             (1)  The proprietor of a base for mobile diagnostic imaging equipment commits an offence if a diagnostic imaging procedure is carried out on a person under the following circumstances:

                     (a)  the procedure is carried out using equipment that is ordinarily located at the base when not in use, and is not ordinarily located at diagnostic imaging premises; and

                     (b)  the base is not registered; and

                     (c)  the proprietor has neither:

                              (i)  given the person notice in writing that medicare benefit will not be payable for a diagnostic imaging service rendered using the procedure; nor

                             (ii)  caused written notice to that effect to be displayed prominently at the place where the procedure is carried out.

Maximum penalty:    10 penalty units.

             (2)  Strict liability applies to all of the physical elements of the offence.

Note:          For strict liability , see section 6.1 of the Criminal Code .

23DZZH   Debt recovery where proprietor fails to inform patient that premises or base not registered

                   If:

                     (a)  a procedure used in rendering a diagnostic imaging service is carried out in the following circumstances:

                              (i)  the procedure is carried out using diagnostic imaging equipment that is ordinarily located at diagnostic imaging premises that are not registered; or

                             (ii)  the procedure is carried out using diagnostic imaging equipment that, when not in use, is ordinarily located at an unregistered base for mobile diagnostic imaging equipment and the equipment is not ordinarily located at diagnostic imaging premises; and

                     (b)  the proprietor of the premises or base failed to inform the person to whom the diagnostic imaging service was rendered that no medicare benefit would be payable for the service; and

                     (c)  the Minister makes a direction under subsection 16D(1) that medicare benefit will be paid for the service;

an amount equal to the medicare benefit is recoverable from the proprietor as a debt due to the Commonwealth.

23DZZI   Application of this Division to partnerships

             (1)  Where a partnership, rather than a person or government agency, is in effective control of:

                     (a)  diagnostic imaging premises, whether or not the holder of an estate or interest in the premises; and

                     (b)  the use of the diagnostic imaging equipment used at the premises; and

                     (c)  the employment of staff (including medical practitioners) connected with the premises;

each partner in the partnership is taken to be a proprietor of the premises for the purposes of this Division.

             (2)  Where a partnership, rather than a person or government agency, is in effective control of:

                     (a)  a base for mobile diagnostic imaging equipment, whether or not the holder of an estate or interest in the base; and

                     (b)  the use of diagnostic imaging equipment ordinarily located at the base when not in use; and

                     (c)  the employment of staff (including medical practitioners) connected with the base;

each partner in the partnership is taken to be a proprietor of the premises for the purposes of this Division.

             (3)  However:

                     (a)  an obligation under this Division, although imposed on each partner in the partnership, may be discharged by any of them; and

                     (b)  a right under this Division, if exercised by one of the partners in the partnership, is taken to have been exercised on behalf of all of them; and

                     (c)  no more than one partner may be punished for one offence under this Part.

             (4)  In this section:

employment has the same meaning as in section 23DZO.

government agency has the same meaning as in section 23DZO.

12  Transitional provisions

(1)        The amendment made by item 10 of this Schedule applies to diagnostic imaging services rendered using diagnostic imaging procedures carried out after the earlier of the following:

                     (a)  a single day to be fixed by Proclamation;

                     (b)  the first day after the end of the period of 6 months beginning on the day on which this Act receives the Royal Assent.

(2)        The amendment made by item 11 of this Schedule, to the extent that it adds sections 23DZZF, 23DZZG and 23DZZH to the Health Insurance Act 1973 , applies to diagnostic imaging procedures carried out after the earlier of the following:

                     (a)  a single day to be fixed by Proclamation;

                     (b)  the first day after the end of the period of 6 months beginning on the day on which this Act receives the Royal Assent.



 

Schedule 2 Radiation Oncology Register

   

Health Insurance Act 1973

1  Subsection 3(1)

Insert:

base for mobile radiation oncology equipment has the meaning given by section 23DZZK.

2  Subsection 3(1) (definition of listed )

Repeal the definition, substitute:

listed :

                     (a)  in relation to diagnostic imaging equipment—has the meaning given by subsections 16D(4) and (5); and

                     (b)  in relation to radiation oncology equipment—has the meaning given by subsections 16F(6) and (7).

3  Subsection 3(1) (at the end of the definition of ordinarily located )

Add:

             ; and (c)  in relation to radiation oncology premises—has a meaning affected by subsection 16F(8); and

                     (d)  in relation to bases for mobile radiation oncology equipment—has a meaning affected by subsection 16F(10).

4  Subsection 3(1) (definition of primary information )

Repeal the definition, substitute:

primary information :

                     (a)  for the purposes of Division 4 of Part IIB—has the meaning given by section 23DZR; and

                     (b)  for the purposes of Part IIC—has the meaning given by section 23DZZQ.

5  Subsection 3(1) (at the end of the definition of proprietor )

Add:

             ; and (c)  in relation to radiation oncology premises or a base for mobile radiation oncology equipment—has the meaning given by section 23DZZN.

6  Subsection 3(1)

Insert:

radiation oncology equipment means equipment that is primarily used in rendering a radiation oncology service.

7  Subsection 3(1)

Insert:

radiation oncology premises has the meaning given by section 23DZZL.

8  Subsection 3(1)

Insert:

Radiation Oncology Register means the Register kept under section 23DZZJ.

9  Subsection 3(1)

Insert:

radiation oncology service has the meaning given by subsection 16F(2).

10  Subsection 3(1) (at the end of the definition of registered )

Add:

             ; and (c)  in relation to radiation oncology premises—has the meaning given by subsection 16F(4); and

                     (d)  in relation to a base for mobile radiation oncology equipment—has the meaning given by subsection 16F(5).

11  After section 16E

Insert:

16F   Medicare benefits not payable for certain radiation oncology services

             (1)  Unless the Minister otherwise directs, a medicare benefit is not payable in respect of a radiation oncology service rendered by or on behalf of a medical practitioner unless the service is:

                     (a)  rendered using radiation oncology equipment that:

                              (i)  is ordinarily located at registered radiation oncology premises; and

                             (ii)  is of a type that, on the day on which the service is rendered, is listed for the premises; or

                     (b)  rendered using radiation oncology equipment that:

                              (i)  is ordinarily located at a registered base for mobile radiation oncology equipment when not in use; and

                             (ii)  is not ordinarily located at radiation oncology premises; and

                            (iii)  is of a type that, on the day on which the service is rendered, is listed for the base.

Meaning of radiation oncology service

             (2)  A radiation oncology service is a service prescribed as a radiation oncology service.

             (3)  Radiation oncology services may be prescribed by reference to items in the general medical services table.

Meaning of registered radiation oncology premises and registered base for mobile radiation oncology equipment

             (4)  Radiation oncology premises are registered at a particular time if a registration for the premises under Part IIC is in effect at that time.

             (5)  A base for mobile radiation oncology equipment is registered at a particular time if a registration for the base under Part IIC is in effect at that time.

What equipment is listed for premises or a base?

             (6)  Radiation oncology equipment is of a type listed for particular radiation oncology premises at a particular time if, at that time:

                     (a)  the Radiation Oncology Register states that equipment of a particular type is ordinarily located at the premises; and

                     (b)  the equipment is of that type.

             (7)  Radiation oncology equipment is of a type listed for a particular base for mobile radiation oncology equipment at a particular time if, at that time:

                     (a)  the Radiation Oncology Register states that pieces of equipment of a particular type are ordinarily located at the base when not in use and not ordinarily located at radiation oncology premises; and

                     (b)  the equipment is of that type.

Some circumstances in which radiation oncology equipment is taken to be ordinarily located at radiation oncology premises

             (8)  Radiation oncology equipment is taken to be ordinarily located at radiation oncology premises if:

                     (a)  the equipment is:

                              (i)  on trial at the premises for a period of not more than 3 months; and

                             (ii)  of the same type as equipment listed for the premises during the period of the trial; or

                     (b)  each of the following circumstances exist:

                              (i)  the equipment (the substituted equipment ) is used, for a period of not more than 3 months, in substitution for radiation oncology equipment that is not in operation;

                             (ii)  the substituted equipment is of the same type as the equipment that is not in operation;

                            (iii)  the equipment that is not in operation is ordinarily located at the premises.

             (9)  Nothing in subsection (8) limits the circumstances in which radiation oncology equipment is ordinarily located at radiation oncology premises for the purposes of this Part or Part IIC.

Some circumstances in which radiation oncology equipment is taken to be ordinarily located at a base for mobile radiation oncology equipment when not in use and not ordinarily located at radiation oncology premises

           (10)  Radiation oncology equipment is taken to be ordinarily located at a base for mobile radiation oncology equipment when not in use, and not ordinarily located at radiation oncology premises, if:

                     (a)  the equipment is:

                              (i)  on trial through the base for a period of not more than 3 months; and

                             (ii)  not ordinarily located, or taken to be ordinarily located, at radiation oncology premises during the period of the trial; and

                            (iii)  of the same type as equipment listed for the base during the period of the trial; or

                     (b)  each of the following circumstances exist:

                              (i)  the equipment (the substituted equipment ) is used, for a period of not more than 3 months, in substitution for radiation oncology equipment that is not in operation;

                             (ii)  the substituted equipment is of the same type as the equipment that is not in operation;

                            (iii)  the equipment that is not in operation is ordinarily located at the base when not in use and not ordinarily located at radiation oncology premises.

           (11)  Nothing in subsection (10) limits the circumstances in which radiation oncology equipment is ordinarily located at a base for mobile radiation oncology equipment, but not ordinarily located at radiation oncology premises, for the purposes of this Part or Part IIC.

16G   Medicare benefit is payable once a suspension of a registration is lifted

                   If, but for this section, medicare benefit would not be payable in respect of a radiation oncology service rendered by or on behalf of a medical practitioner because the service is:

                     (a)  rendered using radiation oncology equipment that is ordinarily located at radiation oncology premises the registration of which has been suspended; or

                     (b)  rendered using radiation oncology equipment that:

                              (i)  when not in use, is ordinarily located at a base for mobile radiation oncology equipment the registration of which is suspended; and

                             (ii)  is not ordinarily located at radiation oncology premises;

medicare benefit becomes payable in respect of the service when the suspension ceases to have effect, provided the suspension does not cease to have effect because the registration is cancelled under section 23DZZX.

12  After Part IIB

Insert:

Part IIC Radiation Oncology Register

   

23DZZJ   Radiation Oncology Register

             (1)  The Minister must keep a Radiation Oncology Register.

             (2)  The Register is kept for the following purposes:

                     (a)  gathering information on the provision of radiation oncology services, including (but not limited to) the structure of medical practices connected with the provision of those services, for the purposes of planning and developing the Commonwealth medicare benefits program;

                     (b)  identifying whether medicare benefit is payable for a particular radiation oncology service rendered to a person;

                     (c)  assisting in identifying whether inappropriate practice (as defined for the purposes of Part VAA of this Act) is taking place.

23DZZK   What is a base for mobile radiation oncology equipment ?

                   Premises are a base for mobile radiation oncology equipment if:

                     (a)  radiation oncology equipment is ordinarily located at the premises when not in use; and

                     (b)  the radiation oncology services rendered using the equipment are not rendered at the premises; and

                     (c)  the radiation oncology services rendered using the equipment are rendered under a single business name.

23DZZL   What are radiation oncology premises ?

                   Radiation oncology premises means a building or part of a building at which radiation oncology procedures are carried out under a single business name.

23DZZM   Who may apply for registration?

             (1)  The proprietor of radiation oncology premises may apply to the Minister for the registration of the premises.

             (2)  The proprietor of a base for mobile radiation oncology equipment may apply to the Minister for registration of the base.

23DZZN   Who is a proprietor ?

             (1)  The proprietor of radiation oncology premises is the person or government agency who has effective control of:

                     (a)  the premises, whether or not the holder of an estate or interest in the premises; and

                     (b)  the use of the radiation oncology equipment used at the premises; and

                     (c)  the employment of staff (including medical practitioners) connected with the premises.

             (2)  The proprietor of a base for mobile radiation oncology equipment is the person or government agency who has effective control of:

                     (a)  the base, whether or not the holder of an estate or interest in the base; and

                     (b)  the use of radiation oncology equipment ordinarily located at the base when not in use; and

                     (c)  the employment of staff (including medical practitioners) connected with the base.

             (3)  In this section:

employment includes:

                     (a)  appointment or employment by the Commonwealth, a State or Territory; and

                     (b)  appointment or employment by a government agency; and

                     (c)  full-time, part-time and casual work; and

                     (d)  work under a contract for services.

government agency includes:

                     (a)  a Department of the Commonwealth or of a State or Territory; and

                     (b)  an authority (incorporated or unincorporated) established for a public purpose by or under a Commonwealth, State or Territory law.

Note:          Section 23DZZZH contains rules on the application of this Part to partnerships.

23DZZO   Application procedure

             (1)  An application for registration of radiation oncology premises or a base for mobile radiation oncology equipment must:

                     (a)  be in writing; and

                     (b)  be in accordance with the approved form; and

                     (c)  include the primary information; and

                     (d)  include the other information prescribed for the purposes of this paragraph.

             (2)  Information may only be prescribed if it is relevant to the purposes for which the Register is kept.

23DZZP   Registration

             (1)  If an application for registration of radiation oncology premises or a base for mobile radiation oncology equipment is properly made, the Minister must register the premises or base by:

                     (a)  allocating a unique location specific practice number to the premises or base; and

                     (b)  including the following information on the Register:

                              (i)  the location specific practice number for the premises or base;

                             (ii)  the day on which the registration takes effect;

                            (iii)  the primary information;

                            (iv)  the other information prescribed for the purposes of this subparagraph.

             (2)  Registration takes effect on:

                     (a)  the day on which the application is properly made; or

                     (b)  the day specified by the applicant in the application;

whichever is later.

             (3)  Registration ceases to have effect on the day on which it is cancelled.

             (4)  Registration does not have effect while it is suspended.

             (5)  Information may only be prescribed if it is relevant to the purposes for which the Register is kept.

             (6)  The Minister must notify the proprietor, in writing, of:

                     (a)  the location specific practice number for the premises or base; and

                     (b)  the date on which registration takes effect;

within 28 days after the application for registration is properly made.

23DZZQ   Primary information

             (1)  The following information is primary information :

                     (a)  details of the proprietor (including, where the proprietor is a company, its Australian Company Number) of the radiation oncology premises or the base for mobile radiation oncology equipment (as the case requires);

                     (b)  the business name under which radiation oncology services are rendered;

                     (c)  the ABN under which radiation oncology services are rendered:

                              (i)  in the case of radiation oncology premises—using radiation oncology equipment that is ordinarily located at the premises; or

                             (ii)  in the case of a base for mobile radiation oncology equipment—using radiation oncology equipment ordinarily located at the base when not in use that is not ordinarily located at radiation oncology premises;

                     (d)  in the case of radiation oncology premises:

                              (i)  the address of the premises; and

                             (ii)  a statement identifying the types of radiation oncology equipment ordinarily located at the premises;

                     (e)  in the case of a base for mobile radiation oncology equipment:

                              (i)  the address of the base; and

                             (ii)  the address of the proprietor; and

                            (iii)  a statement identifying the type of each piece of radiation oncology equipment that is ordinarily located at the base when not in use and is not ordinarily located at radiation oncology premises;

                      (f)  details of the legal relationships that give rise to a right to use the equipment.

             (2)  The regulations may prescribe types of radiation oncology equipment for the purposes of this section.

23DZZR   Register may be maintained electronically

                   The Register may be maintained electronically.

23DZZS   Extract of the Register to be made available on request

             (1)  A person may, for the purposes of determining whether medicare benefit is likely to be payable in respect of a particular radiation oncology service, request an extract of the Register in relation to radiation oncology premises or a base for mobile radiation oncology equipment specified in the request.

             (2)  An extract of the Register containing the following information must be made available to the person on that request:

                     (a)  the business name under which radiation oncology services are rendered at the premises or using equipment listed for the base;

                     (b)  the address of the premises or base;

                     (c)  the location specific practice number for the premises or base;

                     (d)  if a suspension of the registration of the premises or base is in effect at the time the extract is given—a statement of that fact and the date on which the suspension took effect;

                     (e)  if a cancellation of the registration of the premises or base is in effect at the time the extract is given—a statement of that fact and the date on which the cancellation took effect.

23DZZT   Minister may publish an extract of the Register on the Internet

                   The Minister may publish on the Internet an extract of the Register containing the following information in relation to radiation oncology premises or a base for mobile radiation oncology equipment:

                     (a)  the business name under which radiation oncology procedures are carried out using equipment listed for the premises or the base;

                     (b)  the address of the premises or base;

                     (c)  the location specific practice number for the premises or base;

                     (d)  a statement identifying the periods during which the current or a previous registration has had effect.

23DZZU   Proprietors to notify the Minister of changes to primary information

             (1)  The proprietor of registered radiation oncology premises must notify the Minister in writing of changes to the primary information in relation to the premises within 28 days after the change occurs.

             (2)  The proprietor of a registered base for mobile radiation oncology equipment must notify the Minister of changes to the primary information in relation to the base within 28 days after the change occurs.

23DZZV   Minister may request further information

             (1)  The Minister may give notice in writing to the proprietor of registered radiation oncology premises or a registered base for mobile radiation oncology equipment, requesting the proprietor to give the Minister information of the kind specified in the notice.

             (2)  The information must be given to the Minister:

                     (a)  within 28 days after the notice is given; or

                     (b)  if a longer period is specified in the notice—within that longer period.

This is the response period .

             (3)  The kinds of information specified in the notice must be relevant to the purposes for which the Register is kept.

23DZZW   Suspension for failure to comply with a request

             (1)  The Minister must suspend the registration of radiation oncology premises or a base for mobile radiation oncology equipment if the proprietor of the premises or base has failed to comply with a request for information under section 23DZZV within the response period.

             (2)  The suspension takes effect on the day after the end of the response period.

             (3)  The suspension ceases to have effect:

                     (a)  if the request is complied with within 3 months after the end of the response period (the compliance period )—on the day on which it is complied with; or

                     (b)  if the registration of the premises or base is cancelled because the proprietor fails to comply with the request within the compliance period—on the day immediately after the end of that period.

             (4)  The Minister must give the proprietor notice in writing that the registration of the premises or base has been suspended.

             (5)  The Minister must note the day on which the suspension takes effect on the Register.

23DZZX   Cancellation for failure to provide information within 3 months after the response period

             (1)  The Minister must cancel the registration of registered radiation oncology premises or a registered base for mobile radiation oncology equipment if the proprietor of the premises or base fails to comply with a request for information under section 23DZZV within the compliance period.

             (2)  The cancellation takes effect on the day immediately after the end of the response period.

             (3)  The Minister must give the proprietor written notice of the cancellation.

23DZZY   Cancellation at the request of the proprietor

             (1)  The Minister must cancel the registration of radiation oncology premises or a base for mobile radiation oncology equipment if the proprietor requests, in writing, the Minister to do so.

             (2)  The cancellation takes effect on:

                     (a)  the day immediately after the request is given to the Minister; or

                     (b)  the day specified by the proprietor in the request;

whichever is later.

23DZZZ   Cancellation on other grounds

             (1)  The Minister may cancel the registration of radiation oncology premises or a base for mobile radiation oncology equipment if:

                     (a)  the registration was obtained improperly; or

                     (b)  the proprietor has failed to notify the Minister of changes to primary information.

             (2)  The Minister must give the proprietor notice in writing of the Minister’s decision to cancel the registration of the premises or base.

             (3)  The Minister must set out his or her reasons for the decision in that notice.

             (4)  The cancellation takes effect on:

                     (a)  the day on which the Minister gives the proprietor the notice; or

                     (b)  the day specified in the notice;

whichever is later.

23DZZZA   Cancellation to be noted on the Register

                   If the registration of radiation oncology premises or a base for mobile radiation oncology equipment is cancelled, the Minister must note the day on which the cancellation takes effect on the Register.

23DZZZB   Limits on registration after cancellation under section 23DZZX or 23DZZZ

             (1)  If the registration of radiation oncology premises or a base for mobile radiation oncology equipment is cancelled under section 23DZZX or 23DZZZ, the proprietor is not entitled to apply for registration of the premises or base within a period of 12 months after the cancellation without the Minister’s permission.

             (2)  In deciding whether to permit the proprietor to apply to have the premises or base registered, the Minister must take into account whether:

                     (a)  the act or omission that gave rise to the cancellation was inadvertent; and

                     (b)  it is reasonable to conclude, in all the circumstances, that the proprietor will comply with this Part in making the application and after registration of the premises or base.

             (3)  If the Minister decides not to permit the proprietor to apply to have the premises or base registered, the Minister must give the proprietor notice in writing of the fact.

             (4)  The Minister must set out his or her reasons for the decision in that notice.

23DZZZC   Minister must invite submissions before cancelling registration

             (1)  Before cancelling the registration of radiation oncology premises or a base for mobile radiation oncology equipment under section 23DZZZ, the Minister must invite the proprietor of the premises or base to make a submission to the Minister giving reasons why that action should not be taken.

             (2)  The invitation must be given by notice in writing to the proprietor.

             (3)  The submission must be given in writing to the Minister:

                     (a)  within 28 days after the notice is given; or

                     (b)  if a longer period is specified in the notice—within that longer period.

23DZZZD   Application to Administrative Appeals Tribunal for review of a decision to cancel registration

             (1)  Application may be made to the Administrative Appeals Tribunal for review of a decision:

                     (a)  to cancel the registration of radiation oncology premises or a base for mobile radiation oncology equipment under section 23DZZZ; and

                     (b)  not to permit a proprietor to apply for registration of radiation oncology premises or a base for mobile radiation oncology equipment under section 23DZZZB.

             (2)  The application must be made:

                     (a)  where the decision is to cancel the registration of the premises or base under section 23DZZZ—within 28 days after the notice of the decision is given to the proprietor under that section; and

                     (b)  where the decision is not to permit the proprietor of the premises or base to apply for registration of the premises or base—within 28 days after the notice of the decision is given to the proprietor under section 23DZZZB.

23DZZZE   Proprietor of unregistered premises must notify patients that medicare benefit not payable

             (1)  The proprietor of radiation oncology premises commits an offence if a radiation oncology service is rendered on a person under the following circumstances:

                     (a)  the service is rendered either at the premises or elsewhere using equipment that is ordinarily located at the premises; and

                     (b)  the premises are not registered; and

                     (c)  the proprietor has neither:

                              (i)  given the person notice in writing that medicare benefit will not be payable for the service; nor

                             (ii)  caused written notice to that effect to be displayed prominently at the place where the service is rendered.

Maximum penalty:    10 penalty units.

             (2)  Strict liability applies to all of the physical elements of the offence.

Note:          For strict liability , see section 6.1 of the Criminal Code .

23DZZZF   Proprietor of unregistered base must notify patients that medicare benefit not payable

             (1)  The proprietor of a base for mobile radiation oncology equipment commits an offence if a radiation oncology service is rendered on a person under the following circumstances:

                     (a)  the service is rendered using equipment that is ordinarily located at the base when not in use, and is not ordinarily located at radiation oncology premises; and

                     (b)  the base is not registered; and

                     (c)  the proprietor has neither:

                              (i)  given the person notice in writing that medicare benefit will not be payable for the service; nor

                             (ii)  caused written notice to that effect to be displayed prominently at the place where the service is rendered.

Maximum penalty:    10 penalty units.

             (2)  Strict liability applies to all of the physical elements of the offence.

Note:          For strict liability , see section 6.1 of the Criminal Code .

23DZZZG   Debt recovery where proprietor fails to inform patient that premises or base not registered

                   If:

                     (a)  a radiation oncology service is rendered in the following circumstances:

                              (i)  the service is rendered using radiation oncology equipment that is ordinarily located at radiation oncology premises that are not registered; or

                             (ii)  the service is rendered using radiation oncology equipment that, when not in use, is ordinarily located at an unregistered base for mobile radiation oncology equipment and the equipment is not ordinarily located at radiation oncology premises; and

                     (b)  the proprietor of the premises or base failed to inform the person to whom the radiation oncology service was rendered that no medicare benefit would be payable on the service; and

                     (c)  the Minister makes a direction under subsection 16F(1) that medicare benefit will be paid for the service;

an amount equal to the medicare benefit is recoverable from the proprietor as a debt due to the Commonwealth.

23DZZZH   Application of this Part to partnerships

             (1)  Where a partnership, rather than a person or government agency, is in effective control of:

                     (a)  radiation oncology premises, whether or not the holder of an estate or interest in the premises; and

                     (b)  the use of the radiation oncology equipment used at the premises; and

                     (c)  the employment of staff (including medical practitioners) connected with the premises;

each partner in the partnership is taken to be a proprietor of the premises for the purposes of this Part.

             (2)  Where a partnership, rather than a person or government agency, is in effective control of:

                     (a)  a base for mobile radiation oncology equipment, whether or not the holder of an estate or interest in the base; and

                     (b)  the use of radiation oncology equipment ordinarily located at the base when not in use; and

                     (c)  the employment of staff (including medical practitioners) connected with the base;

each partner in the partnership is taken to be a proprietor of the premises for the purposes of this Part.

             (3)  However:

                     (a)  an obligation under this Part, although imposed on each partner in the partnership, may be discharged by any of them; and

                     (b)  a right under this Part, if exercised by one of the partners in the partnership, is taken to have been exercised on behalf of all of them; and

                     (c)  no more than one partner may be punished for one offence under this Part.

             (4)  In this section:

employment has the same meaning as in section 23DZZN.

government agency has the same meaning as in section 23DZZN.

13  Transitional provisions

(1)        The amendment made by item 11 of this Schedule applies to radiation oncology services rendered after the earlier of the following:

                     (a)  a single day to be fixed by Proclamation;

                     (b)  the first day after the end of the period of 6 months beginning on the day on which this Act receives the Royal Assent.

(2)        The amendment made by item 12 of this Schedule, to the extent that it adds sections 23DZZZE, 23DZZZF and 23DZZZG to the Health Insurance Act 1973 , applies to radiation oncology services rendered after the earlier of the following:

                     (a)  a single day to be fixed by Proclamation;

                     (b)  the first day after the end of the period of 6 months beginning on the day on which this Act receives the Royal Assent.



 

Schedule 3 Referral arrangements for diagnostic imaging services

   

Health Insurance Act 1973

1  Paragraph 16B(7)(c)

Omit “under that Division”, substitute “under section 23DX”.

2  Subsection 16B(10)

Repeal the subsection, substitute:

Exemption—additional services

           (10)  Subsection (1) does not apply if:

                     (a)  the diagnostic imaging service (the additional service ) was rendered in relation to the person because the providing practitioner formed the opinion that the results obtained from the rendering of another diagnostic imaging service in relation to the person, pursuant to a subsection 16B(1) request, indicate that the additional service is necessary; and

                     (b)  the additional service is a service in relation to which a medicare benefit is payable regardless of whether the service is rendered on the request of a specialist or a consultant physician.

Note:          Medicare benefit is only payable on some diagnostic imaging services if they are rendered on the request of a specialist or consultant physician. The additional service must not be one of those services.

Exemption—substituted services

        (10A)  Subsection (1) does not apply if:

                     (a)  the diagnostic imaging service (the substituted service ) was rendered in relation to the person in substitution for another service for which a subsection 16B(1) request has been made; and

                     (b)  the substituted service was rendered because the providing practitioner formed the opinion that it would be more appropriate in the diagnosis of the person’s condition to render the substituted service than the service requested; and

                     (c)  the substituted service would be accepted by the general body of specialists or consultant physicians in the specialty practised by the providing practitioner as more appropriate in the diagnosis of the person’s condition than the service requested; and

                     (d)  before providing the substituted service, the providing practitioner has either consulted the practitioner who made the subsection 16B(1) request, or taken all reasonable steps to consult that practitioner; and

                     (e)  the substituted service is a service in relation to which a medicare benefit is payable regardless of whether the service is rendered on the request of a specialist or a consultant physician.

Note:          Medicare benefit is only payable on some diagnostic imaging services if they are rendered on the request of a specialist or consultant physician. The substituted service must not be one of those services.

3  Section 23DV

Repeal the section, substitute:

23DV   Application for remote area exemption

             (1)  A medical practitioner may apply in writing to the Minister, in the form approved by the Minister, for a remote area exemption under section 23DX (an exemption from the requirements in subsection 16B(1)).

             (2)  A practitioner may apply in writing to the Minister, in the form approved by the Minister, for a remote area exemption under section 23DXA to station diagnostic imaging equipment or an employee at specified premises of another practitioner.

4  Section 23DX

After “remote area exemption”, insert “under this section”.

Note:          The heading to section 23DX is altered by adding at the end “ —provision of services where requirements of subsection 16B(1) are not met

5  After section 23DX

Insert:

23DXA   Grant of remote area exemption—stationing diagnostic imaging equipment and employees at the premises of another practitioner

                   The Minister must, by written notice given to the applicant, grant a remote area exemption under this section to the applicant to station diagnostic imaging equipment or an employee at premises specified in the application if the Minister is satisfied that:

                     (a)  the application is in the form approved by the Minister; and

                     (b)  those premises are in an area that is a remote area for the purposes of this Division; and

                     (c)  the facilities for rendering diagnostic imaging services in that area (including facilities provided by practitioners visiting the area regularly and facilities provided by practitioners to whom a remote area exemption has been granted under section 23DX) are such that patients in the area would suffer physical or financial hardship if the exemption were not granted.

6  Subsection 23DY(1)

After “remote area exemption”, insert “under section 23DX”.

Note:          The heading to section 23DY is altered by adding at the end “ under section 23DX

7  After section 23DY

Insert:

23DYA   Restrictions on remote area exemptions under section 23DXA

             (1)  If the Minister is satisfied that the physical or financial hardship referred to in paragraph 23DXA(c) would only be suffered if an exemption were not granted to station equipment of a particular kind or an employee qualified to render services of a particular kind at the premises of another practitioner, the Minister may, in the notice granting the remote area exemption under section 23DXA, restrict the remote area exemption to the stationing of equipment of that kind or an employee with qualifications to render services of that kind.

             (2)  The notice must contain the reasons for any such restriction.

             (3)  The person to whom the remote area exemption is granted may, at any time, apply in writing to the Minister, in the form approved by the Minister, for:

                     (a)  the restriction to be removed; or

                     (b)  its scope to be reduced.

             (4)  The Minister may, within 60 days after such an application is made, give the applicant written notice requesting the applicant to give to the Minister such further information relating to the application as is specified in the notice.

             (5)  If the Minister is satisfied that physical or financial hardship of a kind referred to in paragraph 23DXA(c) will be suffered if the restriction is not removed, or its scope is not reduced, the Minister must, by written notice given to the applicant, remove the restriction, or reduce its scope, accordingly.

8  Subsection 23DZ(1)

Omit “section 23DV or subsection 23DY(3)”, substitute “section 23DV, subsection 23DY(3) or subsection 23DYA(3)”.

9  Subparagraph 23DZ(2)(a)(i)

After “remote area exemption”, insert “under the relevant section”.

10  Subparagraph 23DZ(2)(a)(ii)

After “remote area exemption”, insert “under the relevant section”.

11  After paragraph 23DZ(2)(b)

Insert:

               ; or (c)  in the case of an application under subsection 23DYA(3):

                              (i)  at the end of 60 days after the application is made, a request has not been made to the applicant under subsection 23DYA(4) and the Minister has not given the applicant a written notice under subsection 23DYA(5); or

                             (ii)  a request has been made under subsection 23DYA(4) and, at the end of 60 days after the request was made, the Minister has not given the applicant a written notice under subsection 23DYA(5);

12  Subsection 23DZC(1)

After “medical practitioner”, insert “under section 23DX”.

13  After subsection 23DZC(1)

Insert:

          (1A)  The Minister may revoke a remote area exemption that has been granted to a practitioner under section 23DXA if the Minister is satisfied that:

                     (a)  the premises in relation to which the exemption has been granted are situated in an area that is no longer a remote area for the purposes of this Division; or

                     (b)  the facilities for rendering diagnostic imaging services in that area (including facilities provided by practitioners visiting the area regularly and facilities provided by practitioners to whom a remote area exemption has been granted under section 23DX) are no longer such that patients in the area would suffer physical or financial hardship if the exemption were revoked; or

                     (c)  where a Medicare Participation Review Committee has advised the Minister under subsection 124FF(6) that the remote area exemption should be revoked—the remote area exemption should be revoked for the reasons given by the Committee in its advice.

14  Subsection 23DZC(2)

Omit “The Minister must not revoke the remote area exemption unless:”, substitute “The Minister must not revoke a remote area exemption unless:”.

15  Section 23DZD

Repeal the section, substitute:

23DZD   Review of decisions

                   Applications may be made to the Administrative Appeals Tribunal for review of:

                     (a)  a decision under subsection 23DY(1) to restrict a remote area exemption under section 23DX to certain R-type diagnostic imaging services; or

                     (b)  a decision under subsection 23DYA(1) to restrict a remote area exemption under section 23DXA to the station of equipment of a particular kind, or an employee with qualifications to perform services of a particular kind, at the premises of another practitioner; or

                     (c)  a decision under subsection 23DY(5) reducing the scope of a remote area exemption under section 23DX; or

                     (d)  a decision under subsection 23DYA(5) reducing the scope of a remote area exemption under section 23DXA; or

                     (e)  a decision refusing to grant a remote area exemption under section 23DX or 23DXA; or

                      (f)  a decision refusing an application under subsection 23DY(3) for:

                              (i)  a restriction on a remote area exemption under section 23DX to be removed; or

                             (ii)  the scope of such a restriction to be reduced; or

                     (g)  a decision refusing an application under subsection 23DYA(3) for:

                              (i)  a restriction on a remote area exemption under section 23DXA to be removed; or

                             (ii)  the scope of such a restriction to be reduced; or

                     (h)  a decision under section 23DZC revoking a remote area exemption under section 23DX or section 23DXA.

16  Paragraph 23DZG(g)

Repeal the paragraph, substitute:

                     (g)  the person is a practitioner who, while not covered by a remote area exemption under section 23DXA to station diagnostic imaging equipment or an employee at the premises of another practitioner, stations diagnostic imaging equipment or an employee at those premises (whether it is a full-time arrangement or not), so that diagnostic imaging services may be rendered to the practitioner’s patients by or on behalf of the practitioner.

17  At the end of section 23DZG

Add:

             (2)  A practitioner is covered by a remote area exemption under section 23DXA to station diagnostic imaging equipment or an employee at the premises of another practitioner if:

                     (a)  the practitioner has been granted an exemption under that section to station diagnostic imaging equipment or an employee at those premises; and

                     (b)  the exemption is in force; and

                     (c)  if the exemption is restricted under subsection 23DYA(1) to the stationing of equipment of a particular kind or an employee with qualifications to render services of a particular kind at the premises—the equipment is of that kind or the employee has qualifications to render services of that kind (as the case may be).

18  Subsection 124FF(6)

After “remote area exemption” (first occurring), insert “either under section 23DX or section 23DXA”.

19  Application

The amendments made by items 16 and 17 of this Schedule apply where diagnostic imaging equipment or an employee is stationed, or remains stationed, at premises after 30 June 2003.



 

Schedule 4 Osteopaths

   

Health Insurance Act 1973

1  Subsection 3(1)

Insert:

osteopath means a person registered or licensed to practise osteopathy under a law of a State or Territory that provides for the registration or licensing of osteopaths.

2  At the end of subparagraph 16B(1)(b)(v)

Add “or”.

3  After subparagraph 16B(1)(b)(v)

Insert:

                            (vi)  subject to subsection (3C), an osteopath;

4  After subsection 16B(3B)

Insert:

[Osteopaths may only request certain services]

          (3C)  A request made by an osteopath, acting in his or her capacity as an osteopath, for an R-type diagnostic imaging service to be rendered is not effective for the purposes of subsection (1) unless it is a request for a service of a kind specified in regulations made for the purposes of this subsection.

5  Paragraph 16B(9)(a)

Omit “or podiatrist”, substitute “, podiatrist or osteopath,”.

6  Paragraph 16B(9)(b)

Omit “or podiatrist”, substitute “, podiatrist or osteopath,”.

7  At the end of subsection 16B(9)

Add:

             ; and (g)  if the requesting practitioner is an osteopath who made the request in his or her capacity as an osteopath—the request is not rendered ineffective by the operation of subsection (3C).

8  Subsection 23DQ(4) (at the end of the definition of practitioner )

Add:

                ; or (f)  an osteopath.

9  Section 23DZF (definition of practitioner )

Omit “and a podiatrist”, substitute “, a podiatrist and an osteopath”.

10  Subsection 81(1) (at the end of the definition of practitioner )

Add:

               ; or (h)  an osteopath.

11  Subsection 81(1) (at the end of the definition of profession )

Add:

                   ; (g)  osteopathy.

12  Paragraph 106ZPA(1)(c)

Omit “7”, substitute “8”.

13  At the end of subsection 106ZPA(1)

Add:

                  ; and (viii)  one is to be an osteopath.

14  Subsection 124B(1) (at the end of the definition of practitioner )

Add:

               ; or (h)  an osteopath.



 

 [ Minister’s second reading speech made in—

House of Representatives on 11 December 2002

Senate on 26 March 2003 ]

 

 

(250/02)