Document ID: chunk:federal_register_of_legislation:F2021L01571:reg:12
Version: federal_register_of_legislation:F2021L01571
Segment Type: reg
Provision Reference: reg 12
Character Range: 17135–19479

12  Use of claims information

        (1)  Except where it is being used by the Department of Health to enable the Chief Executive Medicare to perform health provider compliance functions in accordance with these Rules or where restricted by this instrument, claims information provided to the Department of Health by Services Australia in accordance with section 7(9) may be used by the Department of Health as authorised by the Secretary of the Department of Health, or delegate.

        (2)  The Secretary of the Department of Health, or delegate, must not permit the establishment of a system which stores claims information from both the Medicare Benefits Program and Pharmaceutical Benefits Program in a combined form.

        (3)  Other than where it is linked in accordance with section 8(1) or section 10(2), claims information from the Medicare Benefits Program and Pharmaceutical Benefits Program concerning particular individuals may be linked by a Medicare PIN by the Department of Health only where:

             (a) linkage is necessary for a use authorised by the Secretary of the Department of Health, or delegate;

             (b)  claims information identified by the Medicare PIN or any personal identification components is used solely as a necessary intermediate step to obtain aggregate or de-identified information; and

             (c) such linked records are destroyed within one month of their creation.

        (4)  Claims information from the Medicare Benefits Program and Pharmaceutical Benefits Program shall only be linked in this temporary manner in conjunction with the Medicare PIN where there is no practical alternative.

        (5)  Claims information may be held indefinitely for policy and research purposes by the Department of Health provided that such claims information does not include personal identification components.

        (6)  Where the Department of Health discloses claims information it must be reasonably satisfied that the recipient is not in a position to identify the individual to which the information relates unless:

             (a)  that information is disclosed to Services Australia for the purpose of section 10(7); or

             (b)  that claims information is released under section 130 of the Health Insurance Act 1973 or section 135A of the Act.