Commonwealth Consolidated Regulations

HEALTH INSURANCE REGULATIONS 1975 - REG 2

                In these Regulations, unless the contrary intention appears:

"ACRRM" means the Australian College of Rural and Remote Medicine.

"Appeal Committee" means the General Practice Recognition Appeal Committee established under the Health Insurance (Vocational Registration of General Practitioners) Regulations.

"approved collection centre" has the same meaning as in Part IIA of the Act.

collaborative arrangement :

                (a)    for a participating midwife -- means a collaborative arrangement mentioned in regulation 2C; or

               (b)    for a participating nurse practitioner -- means a collaborative arrangement mentioned in regulation 2F.

"Complaints Unit" means the Complaints Unit of the Department of Health of New South Wales.

"identification number" , in relation to a licensed collection centre, means the identification number allocated to the centre under section 23DNF of the Act.

"investigation" means:

                (a)    in relation to the Chief Executive Medicare -- the investigation by the Chief Executive Medicare of:

                          (i)    a contravention, or possible contravention, of the Act or these regulations; or

                         (ii)    the provision, or possible provision, of:

                                   (A)     excessive pathology services; or

                                   (B)     services that are excessive services within the meaning of Division 3 or 3A of Part V of the Act; or

               (b)    in relation to the Complaints Unit -- the investigation by the Unit of a complaint under the Medical Practitioners Act 1938 of New South Wales.

"Medical Board" means an authority specified in Part 4 or 5 of Schedule 3.

"National Law" means the Health Practitioner Regulation National Law set out in the Schedule to the Health Practitioner Regulation National Law Act 2009 (Qld).

"Nursing and Midwifery Board" means the Nursing and Midwifery Board of Australia established under section 31 of the National Law.

"obstetrician" means a medical practitioner who is a specialist in the specialty of obstetrics and gynaecology (however described).

"obstetric specified medical practitioner" means a medical practitioner mentioned in paragraph 2B (1) (a) or (b).

"paediatrician" means a medical practitioner who is a specialist in the specialty of paediatrics and child health (however described).

"patient episode" means a pathology service, or pathology services whether listed in 1 or more items in the Pathology Services Table, for a single patient whose need for which was determined under subsection 16A (1) of the Act on the same day, whether rendered by 1 or more approved pathology practitioners on 1 or more days.

"provider number" means the number that:

                (a)    is allocated by the Chief Executive Medicare to a practitioner, approved pathology practitioner, optometrist, participating midwife or participating nurse practitioner; and

               (b)    identifies the person and the places where the person practises his or her profession.

"RACGP" means the Royal Australian College of General Practitioners.

"referring practitioner" , in relation to a referral, means:

                (a)    in the case of all referrals -- a medical practitioner; and

               (b)    if the referral is given to a specialist who is an ophthalmologist -- an optometrist; and

                (c)    if the referral:

                          (i)    arises out of a dental service given by a dental practitioner; and

                         (ii)    is to a specialist (but not a consultant physician):

                        a dental practitioner; and

               (d)    if the referral:

                          (i)    arises out of a midwifery service provided by a participating midwife; and

                         (ii)    is to an obstetrician or paediatrician;

                        a participating midwife; and

                (e)    if the referral:

                          (i)    arises out of a nurse practitioner service provided by a participating nurse practitioner; and

                         (ii)    is to a specialist or consultant physician;

                        a participating nurse practitioner.

"requester number" means the identification number allocated by the Chief Executive Medicare to a chiropractor, osteopath, physiotherapist or podiatrist.

"servicing provider" means a treatment provider rendering treatment on behalf of another treatment provider.

specified medical practitioner :

                (a)    for a participating midwife -- means a medical practitioner mentioned in regulation 2B; or

               (b)    for a participating nurse practitioner -- means a medical practitioner mentioned in regulation 2F.

"the Act" means the Health Insurance Act 1973 .

"treatment provider" means:

                (a)    a practitioner; or

               (b)    an approved pathology practitioner; or

                (c)    an optometrist; or

               (d)    a participating midwife; or

                (e)    a participating nurse practitioner.

"usual general practitioner" , for a patient, includes a medical practitioner nominated by the patient.

Note    Several other words and expressions used in these Regulations have a meaning given by subsection 3 (1) of the Act. For example:

*       consultant physician

*       eligible midwife

*       eligible nurse practitioner

*       general practitioner

*       hospital-substitute treatment

*       hospital treatment

*       medical practitioner

*       midwife

*       nurse practitioner

*       participating midwife

*       participating nurse practitioner

*       practitioner

*       private health insurer

*       specialist.