Part 6Medical and other treatment or care costs

Part 6—Medical and other treatment or care costs 39—Bulk billing arrangements (1) Bulk billing arrangements may be entered into by the Authority with respect to— (a) the payment of expenses incurred in connection with the treatment of participants in the Scheme at public hospitals; or (b) the payment of expenses incurred in transporting participants in the Scheme by ambulance; or (c) the payment of other treatment expenses incurred by participants in the Scheme. (2) A bulk billing arrangement is an arrangement with the Minister for Health, service providers or others acting on their behalf for the payment by the Authority of any such expenses of participants in the Scheme at the rate provided by the arrangement. (3) For the purposes of this section, the treatment or transport of participants in the Scheme includes the treatment or transport of persons classified as participants in the Scheme in accordance with a bulk billing arrangement. 40—Payment of certain expenses not covered by bulk billing arrangements (1) This section applies to— (a) payment for the treatment of participants in the Scheme at public hospitals; and (b) payment for conveying participants in the Scheme by ambulance; and (c) payment for any medical or dental treatment of, or rehabilitation services provided to, participants in the Scheme, in any case where payment for the expenses concerned has not been made, and is not required to be made, in accordance with a bulk billing arrangement under this Part. (2) The rate at which such a payment is required to be made by the Authority under this Act is as follows: (a) in the case of treatment at public hospitals—at the rate determined by the Minister for Health by order published in the Gazette; (b) in any case in which a maximum rate is fixed under section 41—at the maximum rate so fixed; (c) in the case to which a rate referred to in paragraph (a) or (b) does not apply—at the rate reasonably appropriate to the treatment or service having regard to the customary charge made in the community for the treatment or service. (3) If the Authority does not make a payment under subsection (2), the person or body that provided the treatment or service to which the payment relates may recover the payment from the Authority as a debt in a court of competent jurisdiction. 41—Maximum fees payable for services not provided at public hospitals (1) This section applies to— (a) the fee payable for any medical treatment of a participant in the Scheme; and (b) the fee payable for any dental treatment of a participant in the Scheme; and (c) the fee payable for any rehabilitation service provided to a participant in the Scheme; and (d) the fees payable for any attendant care and support services provided to a participant in the Scheme; and (e) the fees payable for any other services identified by the Minister for the purposes of this section by notice published in the Gazette— (i) on the recommendation of the Authority; and (ii) after consultation with the Minister for Health, but does not apply to any such treatment or service that is provided at a public hospital (whether to an in‑patient or out‑patient) and for which any payment is required to be made to the hospital and not to the treatment or service provider. (2) This section also applies to the fee payable to a private hospital for any treatment at the hospital. (3) The Minister may, by notice published in the Gazette— (a) on the recommendation of the Authority; and (b) after consultation with the Minister for Health, fix the maximum amount for which the Authority is liable in respect of any claim for fees to which this section applies. (4) Any such fees may (but need not) be fixed by reference to fees recommended by a professional association recognised by the Minister for the purposes of this section or by reference to any other scale of fees. (5) A payment by the Authority in respect of a service provided in connection with the treatment, care and support needs of a participant in the Scheme is to be made consistently with any notice published under subsection (3).