93Divulging information—complaints and investigations

#### 93 Divulging information—complaints and investigations (1) For the purposes of subsection 130(3A) of the Act: (a) each of the following authorities or persons is a prescribed authority or person: (i) the Australian Health Practitioner Regulation Agency; (ii) a National Board; (iia) each State or Territory Board of a National Board; (iii) the Health Care Complaints Commission of New South Wales; (iv) the Office of the Health Ombudsman of Queensland; (v) an APS employee mentioned in paragraph 92(a); and (b) this section sets out the circumstances in which information may be provided to a prescribed authority or person and the kind of information that may be provided. Circumstances in which information may be provided (2) Information may be provided to an authority mentioned in any of subparagraphs (1)(a)(i) to (iv) if: (a) a patient has complained to the Chief Executive Medicare about a health practitioner; and (b) the Chief Executive Medicare reasonably believes that the complaint should be referred to the authority for possible investigation. (3) Information may be provided to an authority mentioned in any of subparagraphs (1)(a)(i) to (iv) if the authority tells the Chief Executive Medicare that a patient has made a complaint to the authority about a health practitioner. (4) Information may also be provided to a person mentioned in subparagraph (1)(a)(v) in the circumstances mentioned in subsection (2) or (3). (5) Information may be provided to an authority or person mentioned in paragraph (1)(a) if a health practitioner is the subject of an investigation by the Chief Executive Medicare. (6) However, information may only be provided to a State or Territory authority under subsection (5) if: (a) the health practitioner is, was, or is applying to be, registered or licensed to practice in that State or Territory; or (b) the health practitioner is or was practising in that State or Territory. Information that may be provided (7) The following information may be provided in relation to a health practitioner who is the subject of a complaint or investigation mentioned in subsection (2), (3) or (5): (a) name; (b) the address of each location at which the health practitioner practises (including any former location at which the health practitioner practised in the period that is the subject of the complaint or investigation); (c) if the health practitioner has been allocated a provider number or requester number—the number; (d) whether the health practitioner has previously been the subject of an investigation by the Chief Executive Medicare and, if so, the status of the investigation. (8) Information relating to a service may be provided if: (a) a health practitioner who is the subject of a complaint or investigation mentioned in subsection (2), (3) or (5): (i) rendered the service; or (ii) supervised the rendering of the service; or (iii) requested the service; or (iv) claimed or received payment of fees in relation to the service; or (v) was the assignee under an assignment or agreement, made or entered into in accordance with section 20A of the Act, in relation to the medicare benefit in respect of the service; and (b) the Chief Executive Medicare reasonably believes that the service is relevant to the complaint or investigation. (9) The information mentioned in subsection (10) relating to a patient may be provided if the patient has made a complaint mentioned in subsection (2) or (3). (9A) The information mentioned in subsection (10) relating to a patient may also be provided if: (a) the patient has received a service; and (b) a health practitioner who is the subject of a complaint or investigation mentioned in subsection (2), (3) or (5): (i) rendered the service; or (ii) supervised the rendering of the service; or (iii) requested the service; or (iv) claimed or received payment of fees in relation to the service; or (v) was the assignee under an assignment or agreement, made or entered into in accordance with section 20A of the Act, in relation to the medicare benefit in respect of the service; and (c) the Chief Executive Medicare reasonably believes that the service is relevant to the complaint or investigation. (10) For the purposes of subsections (9) and (9A), the information relating to the patient is the following: (a) name; (b) contact information; (c) sex; (d) date of birth; (e) medicare number; (f) if the patient is not a permanent Australian resident: (i) date of last entry into Australia; and (ii) expected date of departure from Australia; and (iii) name of country of residence.