{"id":"F2018L01381","name":"Health Insurance (Application for Acceptance of Approved Pathology Authority Undertaking) Determination 2018","slug":"f2018l01381","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439795,"registerId":"F2018L01381-fast-fetch-1775955682022","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Health Insurance (Application for Acceptance of Approved Pathology Authority Undertaking) Determination 2018","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n![Commonwealth Coat of Arms of Australia](image.001.jpeg)\n\n \n\nHealth Insurance (Application for Acceptance of Approved Pathology Authority Undertaking) Determination 2018\n\nI, DAVID WEISS, delegate of the Minister for Health, make the following determination under subsection 23DF(13) of the Health Insurance Act 1973.\n\nDated 26 September 2018\n\nDavid Weiss\n\nFirst Assistant Secretary  Medical Benefits Division  Department of Health\n\n \n\n \n\nContents\n\n1 Name\n\n2 Commencement.........................................1\n\n3 Authority\n\n4 Schedules\n\n5 Determination of particulars and approval of form\n\nSchedule 1— Particulars for Application for Acceptance of Approved Pathology Authority Undertaking              2\n\n Schedule 2—Repeals 7\n\nHealth Insurance (Application For Acceptance Of Approved Pathology Authority Undertaking) Determination 2002\n\n \n\n1  Name\n\n  This instrument is the Health Insurance (Application for Acceptance of Approved Pathology Authority Undertaking) Determination 2018.\n\n2  Commencement\n\n (1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.\n\n \n\n- Commencement information\n- Column 1 Column 2 Column 3\n- Provisions Commencement Date/Details\n- 1. The whole of this instrument The day after this instrument is registered.\n\n\nNote: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.\n\n (2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.\n\n3  Authority\n\n  This instrument is made under subsection 23DF(13) of the Health Insurance Act 1973.\n\n4  Definitions\n\n  In this instrument:\n\nACN has the meaning given by section 9 of the Corporations Act 2001.\n\nAct means the Health Insurance Act1973.\n\nNote: A number of expressions used in this instrument are defined in section 3(1) of the Act, including the following:\n\n(a) ABN;\n\n(b) approved pathology authority;\n\n(c) proprietor.\n\n5  Determination of particulars\n\n (1) For the purposes of paragraph 23DF(2)(c) of the Health Insurance Act 1973, an application under subsection 23DF(1) of that Act must contain the particulars as specified in Schedule 1.\n\n6  Schedules\n\n  Each instrument that is specified in Schedule 2 to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.\n\n \n\n\n\n\nSchedule 1—Particulars for Application for Acceptance of Approved Pathology Authority Undertaking\n\n(Section 5)\n\n1  Application type\n\n (1) Whether the application is:\n\n (a) for a new approved pathology authority undertaking; or\n\n (b) to renew or update the details of an existing pathology authority undertaking.\n\n2  Applicant’s details\n\n (1) Approved pathology authority number (for renewals or amendments only).\n\n (2) Approved pathology authority name.\n\n (3) Registered address.\n\n (4) Address for correspondence.\n\n3  Authorised representative details\n\n (1) Authorised representative’s name.\n\n (2) Authorised representative’s day time phone number.\n\n (3) Authorised representative’s mobile number.\n\n (4) Authorised representative’s fax number.\n\n (5) Authorised representative’s email address.\n\n4  Proprietor details\n\n (1) ABN of the proprietor.\n\n (2) ACN of the proprietor.\n\n (3) Registered trading name if any (must be owned by the applicant).\n\n (4) Date trading name registration expires.\n\n (5) Whether the proprietor is:\n\n (a) an individual; or \n\n (b) a partnership; or \n\n (c) a company; or\n\n (d) a government agency or public body.\n\n \n\n5  Individual details\n\n (1) If the proprietor is an individual, the full name of the individual.\n\n6  Partnership\n\n (1) If the proprietor is a partnership, the following details of each partner within the partnership:\n\n (a) name of individual or company;\n\n (b) individual or company’s percentage share of the partnership;\n\n (c) ABN; and\n\n (d) ACN.\n\n7  Company\n\n (1) If the proprietor is a company, the following details of the company:\n\n (a) registered business name;\n\n (b) ACN;\n\n (c) names of all the directors;\n\n (d) names of each of the principal shareholders on the date of application in order of shareholding; and\n\n (e) approximate percentage of shareholding of each of the principal shareholders.\n\n8  Government agency or public body details\n\n (1) If the proprietor is a government agency or public body, the following details of the agency or body:\n\n (a) registered business name; and\n\n (b) ACN.\n\n9  Principal officers details\n\n (1)  Names and positions of principal officers of the proprietor.\n\n10  Fit and proper person details\n\n (1) Whether the applicant, or any person with whom the applicant has, or proposes to have, a financial, employee/employer or business relationship, is a person:\n\n (a) to whom notice has been given under subsection 23DL(1) of the Act or in relation to whom notice has been given to a chairperson of a Medicare Participation Review Committee under subsections 23DL(4) or 124D of the Act; or\n\n (b) to whom notice has been given under subsection 124FA(3) or 124FE(3) of the Act; or\n\n (c) in relation to whom a Medicare Participation Review Committee has made a determination under section 124F, 124FB, 124FC or 124FF of the Act; or\n\n (d) to whom notice has been given under subsection 102(1) of the Act; or\n\n (e) to whom a final determination under section 106TA of the Act has been made; or\n\n (f) who has been convicted of a relevant offence as defined in section 23DA of the Act.\n\n (2) If the applicant discloses a relationship with a person to whom subsection (1) applies, the name, company name and provider number of the person.\n\n11  Additional information\n\n (1) Any additional information to support the application.\n\n\n\n\nSchedule 2—Repeals\n\nHealth Insurance (Application For Acceptance Of Approved Pathology Authority Undertaking) Determination 2002\n\n1  The whole of the instrument\n\nRepeal the instrument\n\n \n","sortOrder":0}],"analysis":{"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2002 Determination and prescribes a new set of required particulars for applications (Schedule 2 repeal; section 5 and Schedule 1). The source text does not include the 2002 instrument’s text, so it is impossible from this instrument alone to say which particulars, if any, were added or removed. Formally the scope is altered by replacement, but whether substantive coverage of applicants or decision criteria changed cannot be determined from the material supplied."},"complexity_factors":["Clear, prescriptive form requirements: Schedule 1 lists specific fields applicants must provide (applicant type; applicant details; authorised representative; proprietor; company/partnership/individual details; principal officers; fit and proper disclosures) (section 5; Schedule 1).","Cross-references to the Health Insurance Act: 'Fit and proper' disclosures require checking prior notices, determinations and convictions under multiple Act provisions (subsections cited in Schedule 1 item 10 reference ss.23DL(1), 23DL(4), 124D, 124FA(3), 124FE(3), 124F, 124FB, 124FC, 124FF, 102(1), 106TA and 23DA).","Administrative authority and decision-maker: instrument is made under subsection 23DF(13) of the Act and the delegate of the Minister signs the Determination (section 3 and preamble), concentrating intake and acceptance decisions with the Department/ministerial delegate.","Compliance burden concentrated on applicants: required disclosure of ownership, directors, principal shareholders and approximate share percentages (Schedule 1 items 7(d)–(e)) increases record-gathering and potential privacy/verification tasks for private providers.","Governance detail increases verification load: different proprietor types (individual, partnership, company, government agency) each trigger distinct documentary requirements (Schedule 1 items 4–8).","Repeal and replacement: Schedule 2 entirely repeals the 2002 Determination, requiring practitioners and administrators to move to the new form and possibly new processes (Schedule 2).","Low legal complexity but moderate administrative detail: requirements are specific and non-technical (low legislative drafting complexity) but require collation of corporate and legal-history material (operational complexity)."],"plain_english_summary":"This Determination sets out the exact information that must be supplied when applying for acceptance of an approved pathology authority undertaking under the Health Insurance Act 1973. It affects pathology providers (and their owners, partners or corporate officers) seeking recognition under Medicare rules by prescribing corporate, proprietor and \"fit and proper\" particulars. It matters because it defines the applicant’s compliance costs and the data the delegate uses to decide acceptance, and it repeals the earlier 2002 instrument it replaces."},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"The legislation maintains its original narrow purpose: specifying form requirements for pathology authority applications. The 2018 version appears to be a straightforward reissue/update of the 2002 determination it replaces, with no significant expansion beyond the original administrative function."},"complexity_factors":["Short, focused instrument (approximately 3 pages of substantive content)","Only 4 defined terms in section 4 (ACN, Act, plus two note references)","Simple structure: definitions, one operative section, two schedules","Schedule 1 is a straightforward checklist-style form with 11 numbered items","No nested exceptions or complex conditional logic — just 'if X, provide Y' structure","Single cross-reference to parent Act (Health Insurance Act 1973) for definitions and context","Repeal of previous instrument is clean and unambiguous"],"plain_english_summary":"This instrument sets a standard application that pathology authorities must complete to gain, renew or update approval to bill Medicare. It applies to pathology businesses and their proprietors (individuals, partners, companies, or government bodies).\n\nThe form requires detailed business and ownership data (ABN/ACN, officers, partners, directors/shareholders) and fit‑and‑proper checks (sanctions or convictions). It tightens vetting to prevent Medicare fraud and replace the 2002 determination with 2018 updates."}},"importantCases":[],"_links":{"self":"/api/acts/f2018l01381","history":"/api/acts/f2018l01381/history","analysis":"/api/acts/f2018l01381/analysis","conflicts":"/api/acts/f2018l01381/conflicts","importantCases":"/api/acts/f2018l01381/important-cases","documents":"/api/acts/f2018l01381/documents"}}