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Health Legislation Amendment Bill (No. 2) 1999
Schedule 2 Consequential amendments of various Acts related to the amendments made by Schedule 1

   

Health Insurance Act 1973

1  Paragraph 20A(2A)(a)

Repeal the paragraph, substitute:

                     (a)  a medicare benefit would, apart from this section, be payable to an eligible person in respect of:

                              (i)  the rendering to a patient of a professional service while the patient is being provided with hospital treatment in a hospital or day hospital facility; or

                             (ii)  the rendering, by a medical practitioner, in an approved procedures facility, of a professional service that has been determined by the Minister under subsection 73BA(2C) of the National Health Act 1953 to be an out-of-hospital procedure; or

                            (iii)  the provision by a specialist of a professional service other than a professional service rendered during an episode of hospital treatment or to which subparagraph (ii) applies; and

2  Paragraph 20A(2C)(a)

Repeal the paragraph, substitute:

                     (a)  a medicare benefit would, apart from this section, be payable to an eligible person in respect of:

                              (i)  the rendering to a patient of a professional service while the patient is being provided with hospital treatment in a hospital or day hospital facility; or

                             (ii)  the rendering, by a medical practitioner, in an approved procedures facility, of a professional service that has been determined by the Minister under subsection 73BA(2C) of the National Health Act 1953 to be an out-of-hospital procedure; or

                            (iii)  the provision by a specialist of a professional service other than a professional service rendered during an episode of hospital treatment or to which subparagraph (ii) applies; and

National Health Act 1953

3   After section 5A(2)

Insert:

          (2A)  Subsection (1) does not imply that an applicable benefits arrangement entered into by a registered organization with a contributor to the health benefits fund conducted by the organization cannot deal with the liability of that contributor to fees and charges in respect of more than one of the various kinds of professional services to which paragraph (1)(ba) is expressed to extend whether or not the arrangement also deals with:

                     (a)  hospital treatment and professional services to which paragraph (1)(a) applies; or

                     (b)  professional services to which paragraph (1)(b) applies.

Note:          The meaning of fees and charges in respect of any kind of professional services to which paragraph (1)(ba) is expressed to extend because of subsection (1A) is modified because of the operation of subsection (1B).

4  After section 5A

Insert:

5AB   Changes in the instruments of a registered organization relating to rates of contribution

                   If a registered organization changes its constitution, its articles of association or its rules so that the constitution, articles or rules as changed:

                     (a)  provide, or purport to provide, for discounted rates of contribution to the health benefit fund conducted by that organization; or

                     (b)  implement, or purport to implement, loyalty bonus schemes of the kind referred to in paragraph (ma) of Schedule 1 for certain contributors to the health benefits fund contributed by that organization;

those changes in the constitution, articles or rules are not to be taken, for any purpose of this Act, to be changes that relate to the rate of contribution of contributors to that fund.

5  Subsection 67(4) (paragraph (a) of the definition of accident and sickness insurance business )

Repeal the paragraph, substitute:

                     (a)  any such business where liability is undertaken with respect to loss arising out of a liability to pay fees or charges in relation to:

                              (i)  the provision in Australia of hospital treatment or an ancillary health benefit; or

                             (ii)  the rendering, by a medical practitioner, in an approved procedures facility, of a professional service that has been determined by the Minister under subsection 73BA(2C) to be an out-of-hospital procedure; or

                            (iii)  the provision by a specialist of a professional service other than a professional service rendered during an episode of hospital treatment or to which subparagraph (ii) applies; or

6  Subsection 67(4) (paragraph (a) of the definition of health insurance business )

Repeal the paragraph, substitute:

                     (a)  with respect to loss arising out of a liability to pay fees or charges in relation to:

                              (i)  the provision in Australia of hospital treatment or an ancillary health benefit; or

                             (ii)  the rendering, by a medical practitioner, in an approved procedures facility, of a professional service that has been determined by the Minister under subsection 73BA(2C) to be an out-of-hospital procedure; or

                            (iii)  the provision by a specialist of a professional service other than a professional service rendered during an episode of hospital treatment or to which subparagraph (ii) applies; or

7  Subsection 73BDA(6)

Repeal the subsection, substitute:

             (6)  A reference in this section to a professional service is a reference to a professional service in respect of which a medicare benefit is payable:

                     (a)  that is rendered by a medical practitioner to a patient while hospital treatment is provided to the patient in a hospital or a day hospital facility; or

                     (b)  that is rendered by a medical practitioner to a contributor to the health benefits fund conducted by a registered organization or to a dependant of that contributor as an out-of-hospital procedure determined by the Minister under subsection 73BA(2C) and provided in an approved procedures facility; or

                     (c)  that:

                              (i)  is rendered by a specialist to a contributor to the health benefits fund conducted by a registered organization or to a dependant of that contributor; and

                             (ii)  is not a professional service to which either paragraph (a) or (b) applies.

8  Subsection 73BDA(8)

Omit “in a hospital”.

9  Paragraph (bf) of Schedule 1

After “of the organization”, insert “that relates to benefits in respect of matters referred to in paragraph 5A(1)(a) or (b), irrespective of any other matters to which it may relate,”.