Commonwealth of Australia Explanatory Memoranda

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HEALTH PRACTITIONER REGULATION (CONSEQUENTIAL AMENDMENTS) BILL 2010

                             2008 - 2009 - 2010




               THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA




                          HOUSE OF REPRESENTATIVES




          HEALTH PRACTITIONER REGULATION (CONSEQUENTIAL AMENDMENTS)
                             AMENDMENT BILL 2010







                    SUPPLEMENTARY EXPLANATORY MEMORANDUM




             Amendments to be Moved on Behalf of the Government











     (Circulated by the authority of the Minister for Health and Ageing,
                          the Hon Nicola Roxon MP)
  HEALTH PRACTITIONER REGULATION (CONSEQUENTIAL AMENDMENTS) AMENDMENT BILL
                                    2010

OUTLINE

Under the National Registration and Accreditation Scheme for health
professions (the Scheme), national arrangements for the registration and
accreditation of health professionals will be implemented by states and
territories adopting the Health Practitioner Regulation National Law Act
2009 (Qld) (the National Law) as a law of their jurisdiction.

The Commonwealth is not required to adopt the National Law.  However,
consequential amendments to Commonwealth legislation to recognise and
support the implementation of the Scheme are required.  On 24 February
2010, the Health Practitioner Regulation (Consequential Amendments) Bill
(the Bill) was introduced into the House of Representatives. The Bill
amends the Health Insurance Act 1973 (the Act) and the Crimes Act 1914.

On 25 February 2010, the Senate Selection of Bills Committee referred the
Bill to the Community Affairs Legislation Committee for Inquiry (the
Inquiry), to report by 11 May 2010. The Committee is to consider the
implications of the Bill for healthcare providers.

Amendments to the Bill are proposed for to address stakeholder concerns
raised in submissions to the Inquiry to:
     a) clarify the purpose of the regulation making power relating to
        recognition as a consultant physician or specialist for the purpose
        of Medicare;
     b) extend the scope of sections 19C, 19CB and 19DA of the Act to apply
        these provisions to all categories of registered health
        professionals; and
     c) amend the definition of 'nursing care' to clarify that nursing care
        may only be provided by or under the supervision of a registered
        nurse (Division 1).



FINANCIAL IMPACT STATEMENT
Nil


  HEALTH PRACTITIONER REGULATION (CONSEQUENTIAL AMENDMENTS) AMENDMENTS BILL
                                    2010

NOTES ON CLAUSES

Amendment (1)

The Bill currently repeals the definition of 'consultant physician' in
subsection 3(1) of the Act and inserts a new definition.

The new definition provides that a medical practitioner will be a
consultant physician in relation to a particular specialty if:
   (i) he or she is registered in that specialty under a law of a state or
   territory;
   (ii) the specialty is prescribed in regulations made under the Act; and
   (iii) he or she satisfies any other requirements prescribed by
   regulations in relation to the specialty.

Amendment (1) amends paragraph (iii) of this definition to clarify that
this regulation making power is to create a mechanism to distinguish
between practitioners who can be both specialists or consultant physicians
in relation to a particular speciality, for the purposes of Medicare.

Amendment (2)
The Bill currently deletes 'registered' form the definition of 'nursing
care', so the definition would be 'nursing care given by or under the
supervision of a nurse'. Amendment (2) amends the definition of 'nursing
care' so that the definition would be 'nursing care given by or under the
supervision of a nurse who is covered by paragraph (a) of the definition of
nurse'. This is intended to clarify that nursing care may only be done by
or under the supervision of registered nurses, being those persons who are
now covered by paragraph (a) of the definition of 'nurse'. This reflects
the clinical practice of the nursing profession where enrolled nurses work
under the supervision of registered nurses.

Amendment (3)
The Bill currently repeals the definition of 'specialist' in subsection
3(1) of the Act and inserts a new definition.

The new definition provides that a medical practitioner will be a
specialist in relation to a particular specialty if:
   (i)    he or she is registered in that specialty under a law of a state
   or territory;
   (ii) the specialty is prescribed in regulations made under the Act; and
   (iii) he or she satisfies any other requirements prescribed by
      regulations in relation to the specialty.

Amendment (3) amends paragraph (iii) of this definition to clarify that
this regulation making power is to create a mechanism to distinguish
between practitioners who can be both specialists or consultant physicians
in relation to a particular speciality, for the purposes of Medicare.



Amendments (4) to (9)
Sections 19C, 19CB and 19DA of the Act currently only apply to medical
practitioners.  Although the Bill makes minor amendments to these
provisions, these amendments simply modernise the language and do not
affect the scope of the provisions. In recent years an increasing range of
health professionals, such as psychologists, speech pathologists and
chiropractors have become able to provide Medicare eligible services.
However, these health professionals are not currently subject to sections
19C, 19CB and 19DA of the Act.
Amendments (4) to (9) widen the scope of sections 19C, 19CB and 19DA of the
Act so they apply to all health professionals registered under a state or
territory law who render Medicare eligible services.

 . Amendment (4)
Section 19C of the Act prohibits the payment of Medicare benefits for a
service provided by a medical practitioner where that service is beyond the
scope of the practitioner's registration, that is, the service is not
authorised under the practitioner's registration or not authorised to be
provided in the circumstances in which it was provided.

Amendment (4) repeals subsection 19C(2) and inserts two new definitions:
'practitioner' and 'practitioner's registration'. The proposed definition
of practitioner has the effect of widening the scope of section 19C to
apply not just to medical practitioners but also to all health
professionals that are registered under a state or territory law and who
provide Medicare eligible services.

The new definition of 'practitioner's registration' is a consequential
amendment as a result of the new categories of health professionals to whom
section 19C applies.

The note removes the word 'medical' from the heading of the section.


 . Amendments (5) and (6)
These amendments omit 'medical' from paragraphs 19C(3)(a) and 19C(4)(a)
respectively. These are consequential amendments as a result of the
widening of the application of the provisions to health professionals other
than medical practitioners.


 . Amendments (7) and (8)

Section 19CB imposes a penalty on a medical practitioner who fails to
comply with a direction given by the Minister to notify his or her patients
that Medicare benefits will not be payable for a service which is provided
beyond the scope of his or her registration.

These amendments expand the application of section 19CB to health
professionals other than medical practitioners. Amendment (7) inserts a new
subsection (1A) to section 19CB to define 'practitioner' and
'practitioner's registration' for the purposes of this section. These terms
have the same meaning as in section 19C. Amendment (8) is a technical
change consequential to the expansion of the scope of section 19CB.

The note removes the word 'medical' from the heading of the section.

 . Amendment (9)

Section 19DA prohibits a medical practitioner whose registration is
suspended or cancelled from providing a service unless the practitioner
first informs his or her patient that Medicare benefits will not be payable
for the service.  A penalty is imposed on practitioners who fail to comply
with this provision.

The Bill currently replaces the definition of 'deregistered practitioner'
in subsection 19DA(1). It provides that a deregistered practitioner is a
person who was registered under a law of state or territory as a medical
practitioner but who is not currently so registered. Amendment (9) provides
a new definition of 'deregistered practitioner', being a person who was
registered under a law of state or territory as a practitioner but who is
not currently so registered. Practitioner has the same meaning as in
section 19C.