Commonwealth Consolidated Acts

HEALTH INSURANCE ACT 1973 - SECT 20BA

  (1)   If:

  (a)   a person refers a patient, in writing, to a consultant physician or a specialist; and

  (b)   the physician or specialist receives the referral; and

  (c)   the physician or specialist renders a specialist medical service to the patient as a consequence of the referral;

the physician or specialist must:

  (d)   retain the referral for the period of 2 years beginning on the day on which the service was rendered to the patient; and

  (e)   produce the referral, if asked to do so by the Chief Executive Medicare, to a medical practitioner who is a Departmental employee (within the meaning of the Human Services (Medicare) Act 1973 ) within 7 days after receiving the request.

  (2)   The consultant physician or specialist must not fail to comply with the Chief Executive Medicare's request.

Penalty:   5 penalty units.

  (2A)   Subsection   (2) does not apply if the physician or specialist has a reasonable excuse.

Note:   The defendant bears an evidential burden in relation to the matter in subsection   (2A). See subsection   13.3(3) of the Criminal Code .

  (3)   If:

  (a)   a consultant physician or specialist renders a specialist medical service to a patient; and

  (b)   either:

  (i)   the service was rendered to the patient in an emergency situation without a referral; or

  (ii)   the service was rendered as a consequence of a referral that was recorded on a hospital record and not given to the physician or specialist to retain on his or her records;

the Chief Executive Medicare may request the physician or specialist to produce such information as is in his or her possession or control relating to whether the patient was so treated:

  (c)   to a medical practitioner who is a Departmental employee (within the meaning of the Human Services (Medicare) Act 1973 ); and

  (d)   within 7 days after receiving the Chief Executive Medicare's request.

  (4)   The consultant physician or specialist must not fail to comply with the Chief Executive Medicare's request.

Penalty:   5 penalty units.

  (4A)   Subsection   (4) does not apply if the physician or specialist has a reasonable excuse.

Note:   The defendant bears an evidential burden in relation to the matter in subsection   (4A). See subsection   13.3(3) of the Criminal Code .

  (5)   A medical practitioner who is a Departmental employee (within the meaning of the Human Services (Medicare) Act 1973 ) may make and retain copies of, or take and retain extracts from, any referral or information produced under subsections   (1) and (3).

  (6)   If a referral retained by a physician or specialist, or information as to whether a service was rendered in a circumstance referred to in subsection   (3), has been recorded on a film, tape disk or other medium approved by the Minister, in writing, for the purposes of storage and subsequent retrieval when required:

  (a)   the retention of the referral or information as so recorded is taken to be a retention of the referral or information; and

  (b)   the production of the referral or other information as so recorded is taken to be a production of the referral or information.

  (6A)   An offence under subsection   (2) or (4) is an offence of strict liability.

Note:   For strict liability, see section   6.1 of the Criminal Code .

  (7)   In this section:

"hospital record" includes the medical records of a person who received medical treatment in the hospital.

"specialist medical service" means a professional service specified in an item in the general medical services table as an item that is to be rendered by a consultant physician, or a specialist, in the practice of his or her specialty.

  (8)   This section does not apply to a referral issued, or a service rendered, before the commencement of this section.