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HEALTH INSURANCE ACT 1973 - SECT 19C

Medicare benefit not payable where medical practitioner not authorised to render service

             (1)  This section does not apply in relation to a professional service rendered before the commencement of this section.

             (2)  In this section:

"practitioner's licence" means:

                     (a)  a licence to practise as a medical practitioner; or

                     (b)  a registration as a medical practitioner;

under a law of a State or Territory.

             (3)  If:

                     (a)  a medical practitioner is not authorised under a practitioner's licence granted in a State or Territory to render a particular professional service; and

                     (b)  the practitioner renders such a service in that State or Territory;

a medicare benefit is not payable in respect of that service, unless the Minister otherwise directs.

             (4)  If:

                     (a)  a medical practitioner is authorised under a practitioner's licence granted in a State or Territory to render a particular professional service only in the circumstances specified in the licence; and

                     (b)  the practitioner renders such a service in that State or Territory in other circumstances;

a medicare benefit is not payable in respect of that service, unless the Minister otherwise directs.

             (5)  A direction of the Minister under subsection (3) or (4) must be in accordance with guidelines determined by the Minister for the purposes of this section.

             (6)  A determination under subsection (5) is a disallowable instrument for the purposes of section 46A of the Acts Interpretation Act 1901 .

             (7)  If the Minister makes a decision under subsection (3) or (4) refusing to direct that a medicare benefit is payable in respect of a professional service, a notice of that decision must be issued to the person claiming the benefit.



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