Health Insurance Regulations 1975
23GCriteria in relation to quality assurance activities: review procedures
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23G Criteria in relation to quality assurance activities: review procedures
(1) The criterion stated in subregulation (2) applies if a quality assurance activity includes: (a) the assessment or evaluation by a person of the services, skill or performance of a health care practitioner for the purpose of determining the health care practitioner’s clinical practising rights; and (b) the making of findings on material questions of fact or law. (2) The purposes of the quality assurance activity must include: (a) the giving of reasons to the health care practitioner for findings: (i) that the person makes; and (ii) with which the health care practitioner is dissatisfied; and (b) an entitlement for the health care practitioner to appeal to another person or body against an adverse finding made by the person; and (c) the disclosure, by the person, of information that: (i) is about the health care practitioner’s clinical practising rights; and (ii) identifies the health care practitioner. (3) In this regulation:
clinical practising rights means:
(a) a health care practitioner’s right to practise a particular profession or use particular skills in:
(i) premises at which health services are provided; or
(ii) an authority of a State or Territory; or
(b) a health care practitioner’s right to hold himself or herself out as having been certified by an association of health professionals as possessing a particular skill or competency.
health care practitioner means a person referred to in paragraph (a) of the definition of quality assurance activity in subsection 124W(1) of the Act.