!!!WARNING - The data on this site may not be up to date. SCALEplus is being progressively replaced by ComLaw .
[Browse Databases] [Alphabetical Index] ['He' Index] [Download Act] [Search Act] HEALTH INSURANCE ACT 1973 !!!The following amendments (No. 155, 2005 and No. 163, 2005 and No. 104, 2006) have not been incorporated. - List of Sections
Section
Compilation Information Contents Long Title HEALTH INSURANCE ACT 1973 1.
Short title [ see Note 1]
2.
Commencement [ see Note 1]
3.
Interpretation
3AAA.
Accreditation of podiatrists
3AAB.
Review by Administrative Appeals Tribunal
3AA.
Approved pathology practitioners to ensure proper supervision of pathology services
3A.
Determination that particular patients need acute care
3B.
Certification of patients needing acute care
3BA.
Prescribed dental patients
3C.
Health service not specified in an item
3D.
Recognition as specialists of members of certain organisations on advice from the organisation
3DA.
Period of section 3D recognition
3DB.
Alternative method of recognition as a specialist
3DC.
Period of effect of determination
3E.
Recognition as consultant physicians etc. of certain medical practitioners
3EA.
Recognised Fellows of the Royal Australian College of General Practitioners
3EB.
Revocation of determinations
3F.
Vocationally registered general practitioners
3G.
Removal from Register
3GA.
Register of Approved Placements
3GB.
Removal from the Register
3GC.
Medical Training Review Panel
3H.
References to RACGP may be varied
4.
General medical services table
4AAA.
Multiple general medical services
4AA.
Diagnostic imaging services table
4AB.
Multiple diagnostic imaging services
4A.
Pathology services table
4B.
Multiple pathology services
4BA.
Pathologist-determinable services
4BB.
Prescribed pathology services
4BC.
Manner of making determinations under sections 4BA and 4BB
6.
Certain persons in Australia to be treated as eligible persons etc.
6A.
Certain prescribed persons in Australia to be treated as eligible persons etc.
7.
Agreement for reciprocal treatment of visitors to Australia and other countries
7A.
External Territories
7B.
Application of the Criminal Code
HEALTH INSURANCE ACT 1973 8.
Interpretation
8A.
Minister may determine registered family is FTB(A) family
9.
Medicare benefits calculated by reference to fees
10.
Entitlement to Medicare benefit
10AA.
Registered families
10AB.
Consequences of altered family composition
10AC.
Safety-net—families
10ACA.
Extended safety-net—families
10AD.
Safety-net—individuals
10ADA.
Extended safety-net—individuals
10AE.
Confirmation of family composition
10A.
Indexation
14.
Medicare benefit not to exceed medical expenses incurred
15.
Medicare benefit in respect of 2 or more operations
16.
Administration of anaesthetic and assistance at operation
16A.
Medicare benefits in relation to pathology services
16B.
Medicare benefits in relation to R-type diagnostic imaging services
16C.
Medicare benefits in relation to diagnostic imaging services rendered in contravention of State or Territory laws
16D.
Medicare benefits not payable for certain diagnostic imaging services
16E.
Medicare benefit is payable once a suspension of a registration is lifted
16F.
Medicare benefits not payable for certain radiation oncology services
16G.
Medicare benefit is payable once a suspension of a registration is lifted
17.
Medicare benefits not payable in respect of certain medical expenses
18.
Medicare benefit not payable where compensation etc. payable
19.
Medicare benefit not payable in respect of certain professional services
19A.
Medicare benefit not payable in respect of services rendered in prescribed circumstances
19AA.
Medicare benefits not payable in respect of services rendered by certain medical practitioners
19AB.
Medicare benefits not payable in respect of services rendered by certain overseas trained doctors etc.
19ABA.
Medicare benefits not payable in respect of services rendered by doctors who breach certain contracts with the Commonwealth
19AC.
Reconsideration and review of decisions under subsection 19AB(3)
19AD.
Reports by Minister
19B.
Medicare benefit not payable in respect of services rendered by disqualified practitioners
19C.
Medicare benefit not payable where medical practitioner not authorised to render service
19CA.
Review of decisions
19CB.
Offence in relation to a medical practitioner rendering an unauthorised service
19CC.
Offence in relation to a medical practitioner rendering a service covered by section 19AA, 19AB or 19ABA
19D.
Offences in relation to disqualification of practitioner
19DA.
Offence in relation to deregistered practitioner
19DB.
Offence where approval of premises as accredited pathology laboratory has been revoked
20.
Persons entitled to medicare benefit
20A.
Assignment of Medicare benefit
20AB.
Approved billing agents
20AC.
Revoking approvals of billing agents
20AD.
Review of decisions
20B.
Claims for medicare benefit
20BA.
Confirmation of referral to a consultant physician or specialist
23A.
Common form of undertaking
23B.
Undertaking by optometrist
23D.
Date of effect of acceptance or refusal of undertaking by Minister
23DAA.
Review of refusal of undertaking
HEALTH INSURANCE ACT 1973 HEALTH INSURANCE ACT 1973 23DA.
Interpretation
23DB.
Forms of undertaking
23DBA.
Categories of eligible pathology laboratories
HEALTH INSURANCE ACT 1973 23DC.
Giving an acceptance of approved pathology practitioner undertaking
23DD.
Period of effect of approved pathology practitioner undertaking
23DDA.
Backdated undertakings
23DE.
Approved pathology practitioner may terminate undertaking
23DF.
Giving an acceptance of approved pathology authority undertaking
23DG.
Period of effect of approved pathology authority undertaking
23DGA.
Backdated undertakings
23DH.
Approved pathology authority may terminate undertaking
23DK.
Request forms and confirmation forms
23DKA.
Other records of pathology services
HEALTH INSURANCE ACT 1973 23DL.
Breaches of undertakings by approved pathology practitioners and approved pathology authorities
HEALTH INSURANCE ACT 1973 23DN.
Accredited pathology laboratories
23DNA.
Determination of principles for accreditation as pathology laboratory
23DNAAA.
Backdated approvals
HEALTH INSURANCE ACT 1973 23DNBA.
Grant of approval for collection centre
23DNBB.
Identification number
23DNG.
Revocation of approval
23DNH.
Cancellation of approval
23DNI.
Partial refund of tax for early cancellation of approval
23DNJ.
Inspection of specimen collection centres
23DNK.
Notice that specimen collection centre is approved
23DNL.
Offence in relation to unapproved specimen collection centres
HEALTH INSURANCE ACT 1973 23DO.
Review of decisions
23DP.
Offences in relation to request forms and confirmation forms
HEALTH INSURANCE ACT 1973 HEALTH INSURANCE ACT 1973 23DQ.
Form etc. of requests
23DR.
Retention of requests etc.
23DS.
Other records of diagnostic imaging services
HEALTH INSURANCE ACT 1973 23DSA.
Definitions
23DSB.
Approval of program
23DSC.
Registration of participants in approved program
23DSD.
Deregistration
HEALTH INSURANCE ACT 1973 23DT.
Interpretation
23DU.
Remote areas
23DV.
Application for remote area exemption
23DW.
Request for further information
23DX.
Grant of remote area exemption—provision of services where requirements of subsection 16B(1) are not met
23DXA.
Grant of remote area exemption—stationing diagnostic imaging equipment and employees at the premises of another practitioner
23DY.
Restrictions on remote area exemptions under section 23DX
23DYA.
Restrictions on remote area exemptions under section 23DXA
23DZ.
Refusal of application
23DZA.
Commencement and duration of remote area exemption
23DZB.
Renewal of remote area exemption
23DZC.
Revocation of remote area exemption
23DZD.
Review of decisions
23DZE.
Statements to accompany notification of decisions
HEALTH INSURANCE ACT 1973 23DZF.
Interpretation
23DZG.
Prohibited diagnostic imaging practices
23DZH.
Notices etc. in relation to possible prohibited diagnostic imaging practices
23DZJ.
Minister may take further action
HEALTH INSURANCE ACT 1973 23DZK.
Diagnostic Imaging Register
23DZL.
What is a base for mobile diagnostic imaging equipment ?
23DZM.
What are diagnostic imaging premises ?
23DZN.
Who may apply for registration?
23DZO.
Who is a proprietor ?
23DZP.
Application procedure
23DZQ.
Registration
23DZR.
Primary information
23DZS.
Register may be maintained electronically
23DZT.
Extract of the Register to be made available on request
23DZU.
Minister may publish an extract of the Register on the Internet
23DZV.
Proprietors to notify the Minister of changes to primary information
23DZW.
Minister may request further information
23DZX.
Suspension for failure to comply with a request
23DZY.
Cancellation for failure to provide information within 3 months after the response period
23DZZ.
Cancellation at the request of the proprietor
23DZZA.
Cancellation on other grounds
23DZZB.
Cancellation to be noted on the Register
23DZZC.
Limits on registration after cancellation under section 23DZY or 23DZZA
23DZZD.
Minister must invite submissions before cancelling registration
23DZZE.
Application to Administrative Appeals Tribunal for review of a decision to cancel registration
23DZZF.
Proprietor of unregistered premises must notify patients that medicare benefit not payable
23DZZG.
Proprietor of unregistered base must notify patients that medicare benefit not payable
23DZZH.
Debt recovery where proprietor fails to inform patient that premises or base not registered
23DZZI.
Application of this Division to partnerships
HEALTH INSURANCE ACT 1973 23DZZJ.
Radiation Oncology Register
23DZZK.
What is a base for mobile radiation oncology equipment ?
23DZZL.
What are radiation oncology premises ?
23DZZM.
Who may apply for registration?
23DZZN.
Who is a proprietor ?
23DZZO.
Application procedure
23DZZP.
Registration
23DZZQ.
Primary information
23DZZR.
Register may be maintained electronically
23DZZS.
Extract of the Register to be made available on request
23DZZT.
Minister may publish an extract of the Register on the Internet
23DZZU.
Proprietors to notify the Minister of changes to primary information
23DZZV.
Minister may request further information
23DZZW.
Suspension for failure to comply with a request
23DZZX.
Cancellation for failure to provide information within 3 months after the response period
23DZZY.
Cancellation at the request of the proprietor
23DZZZ.
Cancellation on other grounds
23DZZZA.
Cancellation to be noted on the Register
23DZZZB.
Limits on registration after cancellation under section 23DZZX or 23DZZZ
23DZZZC.
Minister must invite submissions before cancelling registration
23DZZZD.
Application to Administrative Appeals Tribunal for review of a decision to cancel registration
23DZZZE.
Proprietor of unregistered premises must notify patients that medicare benefit not payable
23DZZZF.
Proprietor of unregistered base must notify patients that medicare benefit not payable
23DZZZG.
Debt recovery where proprietor fails to inform patient that premises or base not registered
23DZZZH.
Application of this Part to partnerships
HEALTH INSURANCE ACT 1973 23E.
Interpretation
23EA.
Declarations in relation to private hospitals
23EB.
Review of decisions
24.
Agreement with States for provision of public hospital services and other health services from 1 July 1993
25.
Terms and conditions of financial assistance
26.
Conditions relating to Medicare Principles and Commitments
27.
Variation of an Agreement
28.
Certain variations of an Agreement to be made by special procedures
29.
Tabling of an Agreement
30.
Appropriation
38B.
Advances
HEALTH INSURANCE ACT 1973 39.
Interpretation
40.
Approval of organizations
41.
Approval of health services
41A.
Approval of health service development projects
42.
Entitlement to health program grant [ see Note 2]
42A.
Entitlement to grant in respect of approved project
42B.
Grants in respect of certain payments made by approved organizations
43.
Conditions of payment of grants
45.
Claims for grants
46.
Advances
HEALTH INSURANCE ACT 1973 46A.
Definitions
46B.
Medicare Australia CEO's functions in relation to the Register
46C.
How Register is to be kept
46D.
Provisions relating to making of payments
46E.
Powers of Medicare Australia CEO
HEALTH INSURANCE ACT 1973 HEALTH INSURANCE ACT 1973 47.
Interpretation
48.
Establishment of Specialist Recognition Advisory Committees
49.
Establishment of Specialist Recognition Appeal Committee
50.
Panels for appointments to Committees
50A.
Compliance with request
50B.
Consequences of failure to comply with request
50C.
Date of effect of certain appointments
52.
Election of Chairperson of Committee
53.
Appointment of persons to act in place of member
54.
Termination of appointment
55.
Resignation
56.
Appointment to vacant office
57.
Irregularities in nomination of members
58.
Remuneration and allowances
59.
Meetings of Committees
60.
Proceedings at meetings
61.
Recognition as consultant physician etc. of medical practitioners on recommendations of Committees
62.
Appeal against refusal of recognition as consultant physician etc.
63.
Committee may inform itself in any manner
64.
Chairperson may engage consultants
HEALTH INSURANCE ACT 1973 65.
Interpretation
66.
Medicare Benefits Advisory Committee
67.
Functions of Committee
68.
Election of Chairperson and Deputy Chairperson
69.
Exercise of powers and functions of Chairperson by Deputy Chairperson
70.
Appointment of person to act in place of member
71.
Termination of appointment
72.
Resignation of members
73.
Appointment to vacant office
74.
Remuneration and allowances
75.
Meetings of Committee
76.
Proceedings at meetings
77.
Committee may inform itself in any manner
78.
Chairperson may engage consultants
HEALTH INSURANCE ACT 1973 79.
Other Committees
HEALTH INSURANCE ACT 1973 HEALTH INSURANCE ACT 1973 79A.
Object of this Part
80.
Main features of the Professional Services Review Scheme
80A.
Additional operation of this Part
81.
Definitions
82.
Definitions of inappropriate practice
HEALTH INSURANCE ACT 1973 83.
The Director of Professional Services Review
84.
The Professional Services Review Panel
85.
Deputy Directors of Professional Services Review
HEALTH INSURANCE ACT 1973 86.
Medicare Australia CEO may request Director to review provision of services
87.
Medicare Australia CEO must notify person of request
HEALTH INSURANCE ACT 1973 88.
Director may request further information
88A.
Director must decide whether to review
88B.
Scope of Director's review
89.
When Director must review
89A.
Director may refer material to Medicare Australia CEO if fraud is suspected
89B.
Power of Director to require the production of documents or the giving of information
89C.
Director's action following review
90.
Director may consult on decisions
91.
Decision to take no further action
92.
Agreement entered into between Director and person under review
92A.
If agreement is not ratified
93.
Referral to a Committee
94.
Director taken to have made a decision after 12 months
HEALTH INSURANCE ACT 1973 HEALTH INSURANCE ACT 1973 95.
Constitution of Committees
96.
Challenging appointments to Committees
96A.
If Committee members are unavailable
HEALTH INSURANCE ACT 1973 97.
Meetings
98.
Conduct of meetings
99.
Other procedural matters relating to meetings
101.
Hearings
102.
Notice of hearings
103.
Rights of persons under review at hearings
104.
Consequences of failing to appear, give evidence or answer a question when required
105.
Disqualification for failing to appear, give evidence or answer a question when required
105A.
Power of Committee to require the production of documents or the giving of information
106.
Conduct of hearings
106A.
Evidence at hearings
106B.
Summons to give evidence etc.
106C.
Allowances for witnesses at hearings
106D.
Failure to attend
106E.
Refusal to be sworn or to answer questions
106EA.
Contempt of Committee
106F.
Protection of Committee members, representatives and witnesses at hearings
HEALTH INSURANCE ACT 1973 106G.
Application of Subdivision
106H.
Committee findings, scope of investigation etc.
106J.
Committee may request Director's review
106K.
Committee may have regard to samples of services
106KA.
Patterns of services
106KB.
Generic findings of inappropriate practice
106KC.
Notification by Committee to Director of matters of concern to profession
106KD.
Preparation of draft report
106KE.
Draft report contains no finding of inappropriate practice
106L.
Final report of Committee
106M.
Referral of matter to a regulatory body to be mentioned in Committee's report
106N.
Committee may refer material to Medicare Australia CEO if fraud is suspected
HEALTH INSURANCE ACT 1973 106Q.
The Determining Authority
106R.
Agreements sent to Authority for ratification
106S.
Director may give Determining Authority information
106SA.
Authority to invite submissions before making a draft determination
106T.
Draft determination
106TA.
Final determination
106U.
Content of draft and final determinations
106UAA.
Referral of matter by Determining Authority to a regulatory body not to be taken into account by the Authority in making draft or final determinations
106UA.
Notification of final determination before it takes effect
106V.
When final determinations take effect
106W.
Notification of final determination
106X.
Notification of the Chairperson of Medicare Participation Review Committees
HEALTH INSURANCE ACT 1973 106XA.
Referring to an appropriate regulatory body any significant threat to life or health
106XB.
Referring to appropriate regulatory body any non-compliance by a practitioner with professional standards
HEALTH INSURANCE ACT 1973 HEALTH INSURANCE ACT 1973 106Y.
Term of office
106Z.
Director's terms and conditions of appointment
106ZA.
Outside employment
106ZB.
Leave of absence
106ZC.
Resignation
106ZD.
Termination of the Director's appointment
106ZE.
Acting appointments
106ZF.
Remuneration and allowances
HEALTH INSURANCE ACT 1973 106ZG.
Term of office
106ZH.
Panel member's terms and conditions of appointment
106ZI.
Outside employment
106ZJ.
Resignation
106ZK.
Termination of a Panel member's appointment
106ZL.
Remuneration and allowances
HEALTH INSURANCE ACT 1973 106ZM.
Staff
106ZN.
Arrangements with other Commonwealth bodies
106ZP.
Engagement of consultants
HEALTH INSURANCE ACT 1973 106ZPA.
Constitution of Determining Authority
106ZPB.
Appointment of members of the Authority
106ZPC.
Term of office
106ZPD.
Terms and conditions of appointment
106ZPE.
Outside employment
106ZPF.
Resignation
106ZPG.
Termination of appointment
106ZPH.
Acting appointments
106ZPI.
Remuneration and allowances
106ZPJ.
Protection of members of the Authority
106ZPK.
Meetings of the Determining Authority
HEALTH INSURANCE ACT 1973 106ZPL.
Director to arrange for provision of services
HEALTH INSURANCE ACT 1973 106ZPM.
Failure of person under review to produce documents or give information
106ZPN.
Failure by person other than person under review to produce documents or give information
106ZPO.
False or misleading answers
106ZPP.
False or misleading documents
106ZPQ.
No privilege against self-incrimination
106ZPR.
Publication of particulars of reports and determinations
106ZQ.
Annual report
106ZR.
Disclosure of Committee deliberations etc.
HEALTH INSURANCE ACT 1973 124B.
Interpretation
124C.
Chairpersons
124D.
Chairperson etc. to be notified if practitioner convicted of relevant offence
124E.
Chairperson to establish Medicare Participation Review Committee
124EA.
Membership of Committees
124EB.
Qualification of members
124EC.
Provision of information to the person in relation to whom a Committee is convened
124F.
Determinations in relation to relevant offences
124FA.
Committee may add parties to proceedings in relation to breach of undertaking by approved pathology practitioner or approved pathology authority
124FAA.
Determinations in relation to excessive servicing etc.
124FB.
Determinations in relation to breach of undertaking by approved pathology practitioner
124FC.
Determinations in relation to breach of undertaking by approved pathology authority
124FD.
Committee may be established and proceedings may continue after undertaking ceases to be in force
124FE.
Committee may add parties to proceedings in relation to prohibited diagnostic imaging practices
124FF.
Determinations in relation to prohibited diagnostic imaging practices
124G.
Hearings
124H.
Guidelines relating to making a determination
124J.
Procedure of hearings
124K.
Hearings to be in public except in special circumstances
124L.
Summons to give evidence etc.
124M.
Refusal to be sworn etc.
124N.
Protection of members of Committees etc.
124P.
Contempt
124Q.
Chairperson to give notice of determinations by Committee
124R.
Review by Administrative Appeals Tribunal
124S.
Giving effect to determinations
124T.
Chairperson to abolish Committee
124U.
Fees and allowances
HEALTH INSURANCE ACT 1973 124V.
Object of this Part
124W.
Interpretation
124X.
Minister may declare quality assurance activity to be an activity to which this Part applies
124Y.
Information about declared quality assurance activity not to be disclosed
124Z.
Minister may authorise disclosure of information about a serious offence
124ZA.
Declarations to be disallowable instruments
124ZB.
Immunity from suit of members of assessment or evaluation committees
124ZC.
This Part is to complement corresponding State and Territory laws
HEALTH INSURANCE ACT 1973 125.
Payments by the Commonwealth
HEALTH INSURANCE ACT 1973 126.
Prohibition of certain medical insurance
127.
Assignor of medicare benefit to be given copy of assignment etc.
128.
Offences in relation to returns
128A.
False statements relating to medicare benefits etc.
128B.
Knowingly making false statements relating to medicare benefits etc.
128C.
Charging of fees for provision of public hospital services to public patients
129.
False statements etc.
129AA.
Bribery
129AAA.
Prohibited practices in relation to the rendering of pathology services
129AAB.
Offences against 2 or more provisions
129AAC.
Statements inadmissible as evidence
129AC.
Recovery of amounts paid because of false statements
129AD.
Recovery of amounts
129AE.
Recovery of amounts paid in respect of certain diagnostic imaging services
129AF.
State and Territory authorities to be notified of contraventions of certain laws
129A.
Special arrangements for optometrical services
130.
Officers to observe secrecy
130AA.
Prosecution of offences
130G.
Evidence
131.
Delegation
131A.
Delegation by Secretary: references to the Secretary, the Department etc.
132.
Evidence
133.
Regulations
HEALTH INSURANCE ACT 1973 HEALTH INSURANCE ACT 1973 Note 2 Table A [Browse Databases] [Alphabetical Index] ['He' Index] [Download Act] [Search Act] [Back to top]