Commonwealth Consolidated Acts

HEALTH INSURANCE ACT 1973 - SECT 19

  (1)   A medicare benefit is not payable in respect of a professional service that is a medical examination for the purposes of:

  (a)   life insurance;

  (b)   superannuation or provident account schemes; or

  (c)   admission to membership of a friendly society.

  (2)   Unless the Minister otherwise directs, a medicare benefit is not payable in respect of a professional service that has been rendered by, or on behalf of, or under an arrangement with:

  (a)   the Commonwealth;

  (b)   a State;

  (c)   a local governing body; or

  (d)   an authority established by a law of the Commonwealth, a law of a State or a law of an internal Territory.

  (3)   Unless the Minister otherwise directs, a medicare benefit is not payable in respect of a professional service rendered to a person if:

  (a)   the medical expenses in respect of that professional service were incurred by the employer of that person; or

  (b)   the person to whom that professional service was rendered was employed in an industrial undertaking and that professional service was rendered to him or her for purposes connected with the operation of that undertaking.

  (4)   A medicare benefit is not payable in respect of a professional service rendered in the course of the carrying out of a mass immunization.

  (5)   Unless the Minister otherwise directs, a medicare benefit is not payable in respect of a health screening service, that is to say, a professional service that is a medical examination or test that is not reasonably required for the management of the medical condition of the patient.

  (6)   A medicare benefit is not payable in respect of a professional service unless the person by or on behalf of whom the professional service was rendered, or an employee of that person, has recorded on the account, or on the receipt, for fees in respect of the service or, if an assignment has been made, or an agreement has been entered into, in accordance with section   20A, in relation to the medicare benefit in respect of the service, on the form of the assignment or agreement, as the case may be, such particulars as are prescribed in relation to professional services generally or in relation to a class of professional services in which that professional service is included.