Commonwealth Numbered Regulations - Explanatory Statements

[Index] [Search] [Download] [Related Items] [Help]

HEALTH INSURANCE COMMISSION REGULATIONS (AMENDMENT) 1993 NO. 81

STATUTORY RULES 1993 No. 81

Issued by authority of the Minister for Health

Health Insurance Commission Act 1973

Health Insurance Commission Regulations (Amendment)

Section 44 of the Health Insurance Commission Act 1973 (the Act) provides that the Governor-General may make regulations for the purposes of the Act.

Section 8E of the Act requires that the Health Insurance Commission (the Commission) perform such functions as are prescribed by regulation.

The Government announced that a National Program for Haemophilus Influenza Type B (Hib) Immunisation (the Immunisation Program) would commence on 1 April 1993 instead of, as was originally planned, on 1 July 1993. As a result of the change in the implementation date of the Immunisation Program, the Commonwealth proposes to reimburse persons whose child or children were vaccinated with the Hib vaccine between 1 April and 31 June 1993 and who were otherwise eligible to participate in the Immunisation Program, for the cost of the Hib vaccine. The Commission will assess these claims for reimbursement and refund to those eligible persons the cost of the vaccine.

Under section 8E of the Act the Commission has the power to perform certain functions as are prescribed by regulation. The regulations may prescribe the manner in which the Commission is to carry out any prescribed function.

Subregulation 4(2) of the Health Insurance Commission Regulations (the Regulations) prescribes additional functions which for the purpose of section 8E of the Act, the Commission has the power to perform.

The role proposed for the Commission by virtue of the regulations is to receive the claims from persons, assess those claims for benefits and to pay to those persons those claims determined to be eligible.

The Department of Health, Housing, Local Government, and Community Services (the Department) will provide the Commission with the criteria showing at what age children, and what drugs, are eligible for the Immunisation Program.

When services have been provided, the eligible persons will submit a claim form to the Commission. Claim forms incorrectly completed or claims not meeting the recognised criteria will be rejected and returned to the applicants for reimbursement with a letter of explanation.

The Commission will pay eligible claims. Eligible recipients will be paid by cheque.

Non identifiable data collected in the assessing and processing of claims will be sent to the Department.

The Commission will be printing the stationery for the claims. All costs will be borne by the Department.

Section 41B of the Act allows the making of regulations to modify Part V and section 42 of the Act in connection with the Commission's performance of new functions. Regulation 4A of the Regulations has already modified the Act by inserting new sections 32A and 34AA. These sections deal with certain additional functions forming part of the Commission's functions under the Medicare Scheme and the preparation of estimates in respect of the Commission's Pharmaceutical Benefits function.

The regulations amend the Health Insurance Commission Regulations by the insertion of new regulation 3G, which empowers the Commission to assess and pay on behalf of the Commonwealth, benefits for claims for the purchase of Hib vaccine during the period commencing 1 April 1993 and ending 30 June 1995.

The regulations also consequentially amend Regulation 4A of the Regulations so that Part V of the Act is modified to include, in the Commission's functions, performance by the Commission of the functions of assessing and reimbursing the cost of the Hib vaccine.

The regulations came into effect on the date of their gazettal, with retrospective effect in respect of claims for reimbursement for vaccinations which took place from 1 April 1993.