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HEALTH INSURANCE ACT 1973 - SECT 19AA

Medicare benefits not payable in respect of services rendered by certain medical practitioners

  (1)   A medicare benefit is not payable in respect of a professional service, rendered after the commencement of this section, if the person who rendered the service:

  (a)   first became a registered medical practitioner on or after 1   November 1996; and

  (b)   was not, at the time the service was rendered:

  (i)   a specialist (whether or not the service was rendered in the performance of the specialist's specialty); or

  (ii)   a consultant physician (whether or not the service was rendered in the performance of the consultant physician's specialty); or

  (iii)   a general practitioner; or

Note:   For general practitioner , see subsection   3(1).

  (iv)   subject to subsection   (3), a person registered under section   3GA; or

  (v)   a person who is covered by an exemption under subsection   19AB(3), being a person who is neither an Australian citizen nor a permanent resident within the meaning of the Migration Act 1958 .

Note:   Subsection   (5) gives a restricted meaning to the term professional service for the purposes of this section.

  (2)   A medicare benefit is not payable in respect of a professional service, rendered after the commencement of this section, if the medical practitioner on whose behalf the service was rendered:

  (a)   first became a registered medical practitioner on or after 1   November 1996; and

  (b)   was not, at the time the service was rendered:

  (i)   a specialist (whether or not the service was rendered in the performance of the specialist's specialty); or

  (ii)   a consultant physician (whether or not the service was rendered in the performance of the consultant physician's specialty); or

  (iii)   a general practitioner; or

Note:   For general practitioner , see subsection   3(1).

  (iv)   subject to subsection   (3), a person registered under section   3GA; or

  (v)   a person who is covered by an exemption under subsection   19AB(3), being a person who is neither an Australian citizen nor a permanent resident within the meaning of the Migration Act 1958 .

Note 1:   An effect of subsection   3(17) is that a service cannot be taken to be rendered on behalf of a medical practitioner if it is rendered by another medical practitioner.

Note 2:   Subsection   (5) gives a restricted meaning to the term professional service for the purposes of this section.

  (3)   Subparagraphs   (1)(b)(iv) and (2)(b)(iv) only apply in relation to a professional service that was rendered:

  (a)   during the period in respect of which, and in the location in respect of which, the person is registered under section   3GA; or

  (b)   in such other circumstances (which may include circumstances relating to the period during which, or the location in which, services are rendered) as are specified in the regulations.

  (4)   For the purposes of this section, a registered medical practitioner who, on 1   November 1996:

  (a)   was a registered medical practitioner who had not commenced, or who had not completed, training as an intern; or

  (b)   was not an Australian citizen or a permanent resident within the meaning of the Migration Act 1958 ;

is taken to have first become a registered medical practitioner on 1   November 1996.

  (5)   In this section:

"intern" means a registered medical practitioner who is undertaking:

  (a)   a period of internship (by whatever name called); or

  (b)   a period of supervised training (by whatever name called);

under a law of a State or Territory specified in the regulations (whether or not the registered medical practitioner is a resident in a hospital for some or all of that period).

"professional service" does not include:

  (a)   a service of a kind referred to in paragraph   (b), (ba) or (c) of the definition of professional service in subsection   3(1); or

  (b)   a professional service (as defined in subsection   3(1)) that is constituted by assistance at an operation.

"registered medical practitioner" means a person:

  (a)   registered under the National Law in the medical profession; or

  (b)   registered or licensed as a medical practitioner under a law of a State or Territory that provided for the registration or licensing of medical practitioners (within the meaning of that law).


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