Document ID: chunk:federal_register_of_legislation:C2024A00070:clause:1_20aaa:p3
Version: federal_register_of_legislation:C2024A00070
Segment Type: clause
Provision Reference: sch 1 cl 20AAA (pt 3/4)
Character Range: 12240–15042

treatment or hospital‑substitute treatment is provided if:
 (a) another professional service (the related professional service) is rendered while the hospital treatment or hospital‑substitute treatment is provided; and
 (b) the right to payment of the medicare benefit in respect of the related professional service is taken to be assigned to the insurer concerned or an approved billing agent because of the operation of subsection (1) or (3) of this section; and
 (c) the professional service:
 (i) is rendered for a complication that arises during the related professional service; or
 (ii) is unplanned but is rendered during planned treatment of which the related professional service is part, and is, in the view of the professional, necessary and urgent; and
 (d) the right to payment of the medicare benefit has not been assigned under an agreement entered into under subsection 20A(1), or because of the operation of subsection (1) of this section.
 (6) For the purposes of subsection 20A(2A), if subsection (5) of this section applies to the assignor's right to the payment of the medicare benefit in respect of the professional service, it is taken to be assigned to the insurer or approved billing agent mentioned in paragraph (5)(b) of this section.
Note: The insurer or approved billing agent must notify the assignor within 6 months of being paid the medicare benefit: see subsection 127(3).

Treatment provided under authorisation of operator of hospital or organization
 (7) For the purposes of this section, the operator of a hospital, or an organization, authorises the provision of hospital treatment, or hospital‑substitute treatment, to a patient if:
 (a) the operator of the hospital, or the organization, is a body corporate or a body politic; and
 (b) the treatment is provided:
 (i) by a person who is authorised by the operator of the hospital, or the organization, to provide the treatment; or
 (ii) under the management or control of such a person.
Note: In this Act, a hospital is a facility for which a declaration under subsection 121‑5(6) of the Private Health Insurance Act 2007 is in force: see subsection 3(1) of this Act and subsection 121‑5(5) of the Private Health Insurance Act 2007.

Regulations
 (8) Without limiting this section, regulations prescribing requirements for the purposes of this section may specify:
 (a) requirements relating to the content of requests or modifications to be made, or the manner and form in which the requests or modifications are to be made; and
 (b) requirements relating to information that must be given and the manner and form in which the information must be given; and
 (c) requirements relating to the giving of notifications at the time or after modifications are made, or before or after information is given; and
 (d)