{"id":"F2007B00991","name":"Health Insurance (Billing Agents - Conditions of Approval) Determination (No. 1) 2004","slug":"health-insurance-billing-agents-conditions-of-approval-determination-no-1-2004","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"repealed","isInForce":false,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":62457,"registerId":"commonwealth-F2007B00991-current","compilationNumber":null,"startDate":"2026-04-02","status":"Repealed","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Health Insurance (Billing Agents - Conditions of Approval) Determination (No. 1) 2004","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 20.2\ntitle: Commonwealth of Australia\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\nCommonwealth of Australia\n\n \n\nHealth Insurance Act 1973\n\n \n\nHealth Insurance (Billing Agents – Conditions of Approval) Determination (No. 1) 2004\n\n \n\nI, Jerry Hearn, delegate of the Minister for Health and Ageing, revoke all previous determinations made under subsection 20AB(5) of the Health Insurance Act 1973, and make this Determination under subsection 20AB(5) of the Health Insurance Act 1973.\n\n \n\nDated      6 February    2004\n\n \n\n(signed by Jerry Hearn)\n\n……………………………………\n\nA/g Assistant Secretary (PN: 01202874)\n\nDelegate of the Minister for Health and Ageing\n\n \n\n \n\nName of Determination\n\n1. This Determination is the Health Insurance (Billing Agents – Conditions of Approval) Determination (No. 1) 2004.\n\nCommencement\n\n2. This Determination commences on gazettal.\n\n### Definition\n\n3. In this Determination:\n\nAct means the Health Insurance Act 1973.\n\nPurpose of Conditions\n\n4. This Determination sets out the conditions to which approval of a billing agent under section 20AB of the Act is subject.\n\n\nBilling agent must comply with undertakings\n\n5. A person or body approved as a billing agent under section 20AB of the Act must comply with undertakings given under Part 3 of one or more of the following guidelines made under subsection 20AB(3) of the Act:\n\n(a) Health Insurance (Approval of Billing Agents) Guidelines 1998;\n\n(b)         Health Insurance (Approval of Billing Agents) Guidelines 2003;\n\n(c)          Health Insurance (Approval of Billing Agents) Guidelines (No. 1) 2004.\n\n \n\n*********************\n","sortOrder":0}],"analysis":{"kimi_summary":{"_metrics":{"model":"kimi-k2.5","source":"moonshot-batch","completionTokens":1582},"content_quality":"ok","complexity_score":2,"scope_assessment":{"changed":false,"description":"This determination appears to be a routine consolidation and update of existing conditions for billing agent approvals. It replaces previous determinations without materially expanding the regulatory scope beyond the statutory purpose of setting conditions under section 20AB of the Health Insurance Act 1973."},"complexity_factors":["Very short instrument with only 5 operative provisions","Single defined term ('Act')","Incorporates obligations by reference to external guidelines not reproduced in the text","Limited conditional logic requiring compliance with undertakings under 'one or more of' three alternative guideline versions"],"plain_english_summary":"**What this does**\n\nThis rule sets the conditions that **billing agents** must follow to keep their approval under Medicare. Billing agents are companies or individuals who lodge Medicare claims and handle payments on behalf of doctors or other health practitioners.\n\n**The key requirement**\n\nIf you are approved as a billing agent, you must honour any promises (called **undertakings**) you made under *Part 3* of specific government guidelines. These guidelines were issued in 1998, 2003, or 2004. In short: if you promised to do something in your application, you actually have to do it.\n\n**Other details**\n\n* This replaces all previous versions of these conditions\n* It takes effect as soon as it is published in the official government gazette"}},"importantCases":[],"_links":{"self":"/api/acts/health-insurance-billing-agents-conditions-of-approval-determination-no-1-2004","history":"/api/acts/health-insurance-billing-agents-conditions-of-approval-determination-no-1-2004/history","analysis":"/api/acts/health-insurance-billing-agents-conditions-of-approval-determination-no-1-2004/analysis","conflicts":"/api/acts/health-insurance-billing-agents-conditions-of-approval-determination-no-1-2004/conflicts","importantCases":"/api/acts/health-insurance-billing-agents-conditions-of-approval-determination-no-1-2004/important-cases","documents":"/api/acts/health-insurance-billing-agents-conditions-of-approval-determination-no-1-2004/documents"}}