Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE AMENDMENT REGULATIONS 2004 (NO. 1) 2004 NO. 46

Subsection 133(1) of the Health Insurance Act 1973 (the Act) provides that the Governor-General may make regulations, not inconsistent with the Act, prescribing all matters required or permitted by the Act to be prescribed, or necessary or convenient to be prescribed for carrying out or giving effect to the Act.

The Act provides, in part, for payment of medicare benefits in respect of professional services rendered to eligible persons. Section 9 of the Act provides that medicare benefits shall be calculated by reference to the fees for medical services set out in prescribed tables.

Subsection 19 (6) of the Act provides that 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, such particulars as are prescribed in relation to professional services.

The Regulations ensure that the particulars to be recorded on the account or on the receipt in relation to professional services accurately reflect current business practice. They also ensure adequate information is provided to enable the Health Insurance Commission to effectively administer the safety net provisions proposed in the Australian Government's MedicarePlus package. The Regulations require that accounts or receipts include the following additional information:

•       the amount charged in respect of the service;

•       the total amount paid in respect of the service; and

•       the amount outstanding in respect of the service.

Details of the Regulations are set out in the Attachment.

The Regulations commence on gazettal.

ATTACHMENT

DETAILS OF THE HEALTH INSURANCE AMENDMENT REGULATIONS 2004 (No. 1)

Regulation 1 - Name of Regulations

Provides that the name of the Regulations is the Health Insurance Amendment Regulations 2004 (No. 1).

Regulation 2 - Commencement

Provides that the Regulations commence on gazettal.

Regulation 3 - Amendment

Provides that regulation 13(1)(b) of the Health Insurance Regulations 1975 is substituted with:

(b) the date on which the service was given;

(c) the amount charged in respect of the service;

(d) the total amount paid in respect of the service;

(e) any amount outstanding in respect of the service.