Document ID: chunk:federal_register_of_legislation:F2018L00377:front:0:p1
Version: federal_register_of_legislation:F2018L00377
Segment Type: other
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Character Range: 0–2883

Health Insurance (Permitted Benefits — Pathology Services) Determination 2018
Health Insurance Act 1973

I, DAVID WEISS, delegate of the Minister for Health, make this Determination under section 23DZZIG of the Health Insurance Act 1973.

Dated   21 March 2018

DAVID WEISS
First Assistant Secretary
Medical Benefits Division
Health Financing Group
Department of Health

1 Name

  This instrument is the Health Insurance (Permitted Benefits – Pathology Services) Determination 2018.

2 Authority

  This instrument is made under section 23DZZIG of the Health Insurance Act 1973.

3 Commencement

  This instrument commences on the day after it is registered.

4 Repeal

  The Health Insurance (Permitted benefits – pathology services) Determination 2008 is repealed.

5 Definitions

  In this instrument:
Act means the Health Insurance Act 1973.
hospital treatment has the meaning given by section 121‑5 of the Private Health Insurance Act 2007.

Note   Accredited pathology laboratory, approved pathology practitioner, hospital and pathology service are defined in subsection 3 (1) of the Act. Provider and requester are defined in subsection 23DZZID (1) of the Act.

6 Permitted benefits for pathology services

 (1) For section 23DZZIG of the Act, a benefit mentioned in Schedule 1 is a permitted benefit if:
 (a) a beneficiary who is, or is connected to, a requester of a kind of pathology service, asks for, or accepts, the benefit from a provider, or a person connected to a provider, of a kind of pathology service; or
 (b) a provider, or a person connected to a provider, of a kind of pathology service offers or provides the benefit to a beneficiary who is, or is connected to, a requester of a kind of pathology service.

 (2) However, a benefit is not a permitted benefit if:
 (a) it is related to the number, kind or value of requests for pathology services made by a requester to a particular provider; or
 (b) taken with other benefits of the same kind, it exceeds the number that would usually be needed by the beneficiary's practice.
Schedule 1 Permitted benefits
(section 6)

 1 Items related to pathology that help the requester to make requests or view pathology reports if they can only be used for purposes connected with pathology

Example
Requesting software

 2 The provision of the following staff at premises of the beneficiary:
 (a) an approved pathology practitioner, or a person rendering services on behalf of an approved pathology practitioner, stationed at the premises for the sole purpose of providing preliminary analysis or advice in relation to specimens collected during any of the following procedures performed at the premises:
 (i) a procedure performed by fine needle aspiration;
 (ii) bone marrow aspiration or trephine;
 (iii) frozen section examination;
 (b) for premises that are a hospital — staff stationed at the