Note Some terms used in this Scheme are defined in the Act, including:
contribution year
Chief Executive Medicare
MDO
medical indemnity cover
medical indemnity insurer
medical practitioner
medicare benefit
Secretary.
In this Scheme, unless the contrary intention appears:
Act means the Medical Indemnity Act 2002 as amended from time to time.
actual income means the amount calculated under section 25.
APRA means the Australian Prudential Regulation Authority established by the Australian Prudential Regulation Authority Act 1998.
Australia includes an external Territory.
base fee means a fee of $250,000 paid to a contractor in respect of meeting the obligations imposed on it by this Scheme.
contracted insurer means a medical indemnity insurer which is a party to a PSS contract that is in force.
contracted MDO means an MDO which is a party to a PSS contract that is in force.
contractor means a contracted insurer or a contracted MDO.
deferred payment day has the same meaning as under section 62 of the Act.
Department means the Department of Health and Ageing.
eligible member has the meaning given by section 12.
estimated income means a reasonable estimate by the medical practitioner of his or her income for the premium period, calculated in the same manner as for actual income under section 25.
general practitioner has the same meaning as under subsection 3(1) of the Health Insurance Act 1973.
gratuitous services means medical services provided free of any charge or other benefit and include without limitation good Samaritan acts or omissions, volunteer services and prescription and referral writing.
gross indemnity costs means an amount calculated in accordance with section 24.
GST has the same meaning as in the A New Tax System (Goods and Services Tax) Act 1999.
Law means any applicable Commonwealth, State or Territory statute, regulation, or subordinate legislation in force from time to time.
lowest base premium, in respect of a non-procedural general practitioner referred to in paragraph 15 (1) (b), means the lowest premium, including any discount but excluding any risk surcharge, within the meaning of that term in section 24, available from the contracted insurer to a non-procedural general practitioner who is in the same income band and practises in the same specialty.
member means a medical practitioner who has a contract of insurance providing medical indemnity cover with a contracted insurer or, where the context permits, a former contracted insurer.
member with a MISS entitlement has the meaning given by subsection 12 (2).
membership fees means, in respect of a member, fees charged by an MDO associated with the contracted insurer for membership services.
MISS means the Medical Indemnity Subsidy Scheme 2003 formulated under subsection 43(1) of the Medical Indemnity Act 2002, as in force at 30 June 2004.
MISS calculation means the amount calculated under the Schedule.
non-therapeutic cosmetic procedure means a procedure that is cosmetic in nature and is not a professional service mentioned in the general medical services table under the Health Insurance Act 1973 or a health service specified in a determination made under subsection 3C(1) of that Act.
payment day has the same meaning as under section 61 of the Act.
personal information has the same meaning as in the Privacy Act 1988.
premium, for a medical indemnity cover policy, means the amount assessed by the contracted insurer, in accordance with the conditions in the PSS contract, which indemnifies the medical practitioner against claims arising from the practitioner's medical practice, including legal action by third parties.
premium period means the period for which the contractor collects the premium, as specified in the PSS contract.
private medical service, of a member, means a medical service provided by the member to a patient on a private (not public) basis and for which the member either holds medical indemnity cover (in his or her own name) with the contracted insurer or for which the member is personally liable.
procedural general practitioner means a general practitioner, who is liable to pay a premium for medical indemnity cover for procedural general practice, including a vocationally or non-vocationally registered general practitioner, overseas-trained doctor or other medical practitioner (including a medical practitioner undertaking a placement as a procedural general practitioner registrar in the course of a training program conducted by or on behalf of General Practice and Educational Training Limited) whose practice includes the non-referred provision of professional services mentioned in the general medical services table under the Health Insurance Act 1973, or health services specified in a determination made under subsection 3C(1) of the Health Insurance Act 1973, of one or more of the following types:
(a) administration of anaesthetic;
(b) surgical procedures for which hospital facilities are or would normally be required;
(c) obstetric procedures;
(d) accident and emergency medicine;
(e) invasive medical procedures, except the administration of Implanon,
but does not include a medical practitioner who is charged a premium higher than the premium charged to non-procedural general practitioners solely because of the performance of non-therapeutic cosmetic procedures.
PSS calculation means the amount calculated under section 14.
PSS contract means a contract authorised by section 7.
public sector organisation means an entity whose primary function is to provide health services to the public at no charge. Public sector organisation may include, without limitation, a State or Territory government department, a public hospital, an area health service or a public health clinic where the entity's primary purpose is to provide health services to the public at no charge.
responsible officer means a person for the time being holding or occupying the position of:
(a) the Assistant Secretary of the Branch of the Department which has responsibility for administering the Scheme; or
(b) the First Assistant Secretary of the Division of the Department which has responsibility for administering the Scheme.
retroactive cover means, for a medical practitioner and a contracted insurer, claims-made based cover for the medical practitioner in relation to claims that may be made in respect of incidents occurring prior to the inception of the practitioner's current medical indemnity cover.
run-off cover means medical indemnity cover for a medical practitioner in relation to compensation claims that may be made against the person:
(a) after the insurer or MDO ceases to provide claims-made based cover to the person; and
(b) in respect of acts or omissions occurring before the first contract for provision of the cover takes effect,
but does not include medical indemnity cover of the type referred to in subsections 12 (7) or (8).
rural area means a rural or remote area in levels 3 to 7 of the Rural, Remote and Metropolitan Areas Classification.
rural calculation means the amount calculated under section 15.
rural procedural general practitioner means a member who is a procedural general practitioner practising in a rural area.
Rural, Remote and Metropolitan Areas Classification means the document so titled, as in force on 1 January 2001, setting out certain categories of areas in Australia that have been determined by the Department by reference to population size and remoteness of locality on the basis of 1991 census data published by the Australian Bureau of Statistics in 1994.
subsidy means a subsidy payable under this Scheme.
State includes Territory.
vocationally registered general practitioner has the meaning given under section 3F of the Health Insurance Act 1973.
Schedule
Part 52. Definitions - Premium Support Scheme 2004 - 52. Definitions | Zoe