1Health Insurance (Permitted benefits — diagnostic imaging services) Determination 2018

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Health Insurance (Permitted benefits — diagnostic imaging services) Determination 2018

Health Insurance Act 1973

I, Celia Street, delegate of the Minister for Health, make this Determination under section 23DZZIG of the Health Insurance Act 1973.

Dated 13 March 2018

CELIA STREET

Assistant Secretary

Diagnostic Imaging and Pathology Branch

Medical Benefits Division

Department of Health

1 Name

This Determination is the Health Insurance (Permitted benefits — diagnostic imaging services) Determination 2018.

2 Commencement

This Determination commences on the day after it is registered.

3 Authority

This Determination is made under section 23DZZIG of the Health Insurance Act 1973.

4 Definitions

In this Determination:

Act means the Health Insurance Act 1973.

Note: Diagnostic imaging equipment, diagnostic imaging service, hospital and specialist are defined in subsection 3(1) of the Act. Provider, requester and connected are defined in subsection 23DZZID(1) of the Act.

5 Repeal

The Health Insurance (Permitted benefits – diagnostic imaging services) Determination 2008 is repealed.

6 Permitted benefits for diagnostic imaging services

(1) For section 23DZZIG of the Act, a benefit mentioned in Schedule 1 is a class of permitted benefit if:

(a) a beneficiary who is, or is connected to, a requester of a kind of diagnostic imaging service, asks for, or accepts, the benefit from a provider, or a person connected to a provider, of a kind of diagnostic imaging service; or

(b) a provider, or a person connected to a provider, of a kind of diagnostic imaging service offers or provides the benefit to a beneficiary who is, or is connected to, a requester of a kind of diagnostic imaging service.

(2) However, a benefit is not a permitted benefit if:

(a) it is related to the number, kind or value of requests for diagnostic imaging services made by a requester to a particular provider; or

(b) taken with other benefits of the same kind, it exceeds the number that would usually be needed by the beneficiary’s practice.

Schedule 1 Classes of permitted benefits

(section 6)

1 Items related to diagnostic imaging that help the requester to read film or images, or to make requests for the rendering of services relating to diagnostic imaging, if: