Commonwealth of Australia Explanatory Memoranda Commonwealth of Australia Explanatory Memoranda[Index] [Search] [Download] [Bill] [Help]
2013-2014
THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA
THE SENATE
Private Health Insurance Amendment (GP Services) Bill 2014
EXPLANATORY MEMORANDUM
(Circulated by authority of Senator R Di Natale)
PRIVATE HEALTH INSURANCE AMENDMENT (GP SERVICES) BILL 2014
OUTLINE
As a rule, private health insurance in Australia covers treatment in private hospitals and by
allied health providers who do not receive a rebate from Medicare. It does not cover
treatment by general practitioners in private practice, even when a co-payment is payable by
the patient. The Private Health Insurance Act 2007 contains provisions that prohibit private
insurers from covering services for which a Medicare benefit is payable. However, there
exists some ambiguity regarding whether a private insurer may contract with a medical clinic
for other services that are not specific services that are covered by Medicare (such as a
consultation with a GP) but are ancillary (such as receiving preferential treatment in
obtaining the appointment).
In order to safeguard the integrity and efficiency of our universal insurer - Medicare - it is
necessary to clarify that such arrangements, which create a two-tiered system that favours the
insured, are against the spirit and intent of the law.
This Bill amends the Private Health Insurance Act 2007 to make it clear that private health
insurers may not enter into arrangements with primary care providers that provide
preferential treatment to their members.
NOTES ON CLAUSES
1. Clause 1 - Short Title
This is a formal provision specifying the short title.
2. Clause 2 - Commencement
This clause provides for the commencement of the Act on the day after it receives the
Royal Assent.
3. Clause 3 - Schedules
This clause provides that an Act that is specified in a Schedule is amended or repealed as
set out in that Schedule, and any other item in a Schedule operates according to its terms.
Schedule 1 - Amendments of Private Health Insurance Act 2007
Item 1
This item inserts a new Part 3-7 which includes new section 105-5 regarding GP services.
Subsection (1) prohibits insurers from entering into an agreement or arrangement for general
practice services or for preferential access to GP services. Examples might include obtaining
appointments sooner, access to cheaper appointments, or availability of after-hours care not
available to other patients.
2
Paragraph (1)(a) prohibits an insurer from arranging for services to be rendered by a GP.
Paragraph (1)(b) prohibits an insurer from obtaining preferential treatment in accessing GP
services.
Subsection (2) defines GP service as general treatment as defined in the Act, for which a
Medicare benefit is payable.
Items 2 and 3
These items are consequential amendments.
3
Statement of Compatibility with Human Rights
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011
Private Health Insurance Amendment (GP Services) Bill 2014
This Bill is compatible with the human rights and freedoms recognised or declared in the
international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny)
Act 2011.
Overview of the Bill
This Bill amends the Private Health Insurance Act 2007 to clarify allowed interactions
between private health insurers and general practitioners.
Human rights implications
This Bill affects the right to healthcare as expressed for instance in item 12 of the
International Covenant on Economic, Social and Cultural Rights. This Bill affirms the right
to equal and universal healthcare for all Australians and so is compatible with this right.
Senator Di Natale
4