Document ID: chunk:federal_register_of_legislation:F2017L00274:schedule:1:p2
Version: federal_register_of_legislation:F2017L00274
Segment Type: schedule
Provision Reference: sch 1 (pt 2/3)
Character Range: 3308–6071

and final report it prepares in respect of the person under review to whom the sample relates.

Note   The Committee must prepare a draft report under section 106KD of the Act, and a final report under section 106L of the Act, in relation to its findings. The draft report may also constitute a final report, where all or a majority of the Committee do not find the person under review engaged in inappropriate practice (see section 106KE of the Act).

9 Determining percentage of inappropriate practice in sample

 (1) A Committee relying on subsection 106K (1) of the Act must work out, in accordance with subsection (2), the proportion of services in the sample in relation to the provision of which the person under review engaged in inappropriate practice.

 (2) For subsection (1), the proportion is to be expressed as a percentage, as follows:

where:
d is the number of services in the sample that the Committee has determined are services in relation to the provision of which the person under review engaged in inappropriate practice, divided by s.
s is the number of services in the sample.
N is the number of services in the class.

 (3) If the percentage worked out under subsection (2) is not a whole percentage, it is to be rounded down to the nearest whole percentage.

10 Disregarding sample results less than 10%

  For the purpose of subsection 106K (1) of the Act, the methodology specified in this Determination may be used by a Committee only if the percentage worked out under section 9 is equal to, or greater than, 10% of the sample of the particular class of referred services under investigation.

Note 1   It is considered that no conclusion can be drawn from a result less than 10%, because the result may not be statistically valid.

Note 2   Information about a service may be considered under section 106H of the Act even if, because of this section, a sample including that service cannot be considered under section 106K of the Act.

Part 3 Transitional

    11 Definitions

In this Part:

commencement time means the commencement of this Determination.

    previous determination means Health Insurance (Professional Services Review — Sampling Methodology) Determination 2006 as in force immediately before the commencement time.

    12 Continued operation of the previous determination to certain investigations

(1) This section applies if:

              (a) before the commencement time a referral has been made to a Committee under section 93 of the Act to investigate the provision of services by a person under review; and

              (b) a final report has not been made in relation to the investigation at the commencement time.

         (2) Despite the repeal of the previous determination, it continues to