Commonwealth of Australia Explanatory Memoranda Commonwealth of Australia Explanatory Memoranda[Index] [Search] [Download] [Bill] [Help]
2008-2009-2010
THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA
SENATE
HEALTHCARE IDENTIFIERS BILL 2010
FURTHER SUPPLEMENTARY EXPLANATORY MEMORANDUM
Amendments to be Moved on Behalf of the Government
(Circulated by the authority of the Minister for Health and Ageing,
The Honourable Nicola Roxon MP)
AMENDMENTS TO THE HEALTHCARE IDENTIFIERS BILL 2010
OUTLINE
The purpose of these amendments is to:
(a) specify the classes of healthcare providers to whom healthcare
identifiers may be assigned by the service operator;
(b) specify the information that the service operator may request before
assigning a healthcare identifier;
(c) specify the Department of Defence as a data source; and
(d) provide for a review of certain decisions by the service operator to
not assign a healthcare identifier.
Classes of healthcare providers
Subclause 9(1)(a) of the Healthcare Identifiers Bill 2010 (the "Bill")
provides that the service operator is authorised to assign a healthcare
identifier to uniquely identify a healthcare provider included in a class
prescribed by the regulations.
The amendments will remove the ability for the regulations to prescribe
classes of healthcare providers to whom the service operator may assign a
healthcare identifier and, instead, specify those classes in a new clause
9A of the Bill.
Information that may be requested
Subclause 9(5) of the Bill provides that the regulations may prescribe
requirements for assigning a healthcare identifier to a healthcare provider
or to a healthcare recipient, including providing for a review of decisions
made under clause 9.
The amendments will omit subclause 9(5) and insert new provisions in the
Bill specifying the requirements for assigning healthcare identifiers.
Data sources
Subclause 12(2)(c) of the Bill provides that the regulations may prescribe
an entity as a data source for the purposes of subclause 12(2).
The amendments will omit clause 12(2)(c) and substitute the Department of
Defence as a data source.
Review of decisions
In addition to omitting subclause 9(5) of the Bill, the amendments will
provide for internal and external merits review of certain decisions by the
service operator to not assign a healthcare identifier.
FINANCIAL IMPACT STATEMENT
There will be no financial impact as a result of the amendments.
HEALTHCARE IDENTIFIERS BILL 2010
NOTES ON AMENDMENTS
Amendment 1
This amendment inserts a new definition of Department of Defence. This
definition is necessary as the Department of Defence will be specified as a
data source under amendment 11.
Amendment 2
This amendment will replace the Bill's definition of healthcare provider
with a revised definition that provides that a healthcare provider means an
individual healthcare provider or a healthcare provider organisation.
Amendment 3 will, amongst other things, insert the terms individual
healthcare provider and healthcare provider organisation into the Bill.
Amendment 3
This amendment will insert a number of new definitions into the Bill. The
key definitions are:
. healthcare provider organisation - this new definition is based on
subclause (b) of the current definition of healthcare provider in
clause 5 of the Bill;
. individual healthcare provider - this new definition is based on
subclause (a) of the current definition of healthcare provider in
clause 5 of the Bill;
. network organisation - will have the meaning given by new subclause
9A(6);
. organisation maintenance officer - in relation to seed organisations,
will have the meaning in new subclause 9A(3)(c) and, in relation to
network organisations, will have the meaning in new subclause
9A(6)(b);
. professional association - will mean an organisation that has the
criteria specified in the definition. These criteria are specified to
help ensure that an individual healthcare provider who wished to be
assigned a healthcare identifier under new subclause 9A(2) of the Bill
is a member of a professional association that has certain minimum
standards;
. responsible officer - will have the meaning given by new subclause
9A(3)(b);
. retirement - of a healthcare identifier will mean a state imposed by
the service operator such that the identifier may no longer be used by
the healthcare provider organisation to which it has been assigned to
identify the organisation;
. seed organisation - will have the meaning given by new subclauses
9A(3) and (4); and
. sole practitioner - will mean a person who is both an individual
healthcare provider and a healthcare provider organisation.
Amendment 4
This amendment will omit the words "included in a class prescribed by the
regulations for the purpose of this paragraph" and substitute the words "to
whom section 9A applies" in subclause 9(1)(a). New clause 9A will specify
classes of individual healthcare providers and healthcare provider
organisations to whom healthcare identifiers may be assigned by the service
operator.
Amendment 5
This amendment is to reflect the new definitions of individual healthcare
provider and healthcare provider organisation that will be inserted by
amendment 3.
Amendment 6
This amendment all make a change to the note below subclause 9(3)(c) of the
Bill consequential to the new definition of sole practitioner to be
inserted into the Bill under amendment 3.
Amendment 7
This amendment will omit subclause 9(5) from the Bill. Requirements for
assigning healthcare identifiers and for a review of decisions, which were
matters able to be prescribed by regulations under subclause 9(5), will be
specified in new clauses 9B and 9C respectively.
Amendment 8
This amendment will insert a new clause 9A that will specify two classes of
individual healthcare provider (subclauses 9A(1) and (2)) and two classes
of healthcare provider organisation (subclauses 9A(3) and (6)).
Subclause 9A(1) provides that clause 9A applies to individual healthcare
providers who are registered by a registration authority as members of a
healthcare profession. This class covers two categories of individual
healthcare providers, being:
. individual healthcare providers who are regulated under a state or
territory law for registering members of a healthcare profession
(individual healthcare providers who are regulated under such state or
territory laws are able to apply direct to the service operator to be
assigned a healthcare identifier); and
. individual healthcare providers who are regulated under the "National
Law" (being the law that has been, or is intended to be, enacted by
each State and Territory as part of establishing a national
registration and accreditation scheme to regulate healthcare providers
in specified professions - see the Health Practitioner Regulation
National Law set out in the Schedule to the Health Practitioner
Regulation National Law Act 2009 (Qld)).
It is anticipated that the National Law will regulate around 500,000
healthcare professionals in 10 professions from July 2010, being
chiropractors, dental care practitioners, medical practitioners, nurses and
midwives, optometrists, osteopaths, pharmacists, physiotherapists,
podiatrists and psychologists.
A further four professions have been identified to be regulated under the
National Law from 2012, being Aboriginal and Torres Strait Islander health
practice, Chinese medicine, medical radiation practice and occupational
therapy. Prior to 2012, individuals in these four professions may be
eligible to be assigned a healthcare identifier under subclause 9A(2).
While subclause 9A(1) of the Bill would permit the service operator to
assign healthcare identifiers to individuals regulated under the National
Law, in practice the service operator will not assign healthcare
identifiers to such individuals. Rather, individuals regulated under the
National Law will be assigned a healthcare identifier by the national
registration authority under subclause 9(2) of the Bill.
Subclause 9A(2) provides that clause 9A applies to individual healthcare
providers who are members of a professional association that relates to the
healthcare that has been, is, or is to be provided by its members and which
has uniform national membership requirements (whether or not in
legislation). Individual healthcare providers who meet these criteria are
able to apply direct to the service operator to be assigned a healthcare
identifier.
Subclause 9A(3) provides that clause 9A applies to a healthcare provider
organisation (a seed organisation) that has: an employee who is an
identified healthcare provider and who provides healthcare as part of his
or her duties (the Bill contains an extended definition of employee); a
responsible officer; and an organisation maintenance officer.
Subclause 9A(3)(b) provides that a responsible officer is the person who
acts on behalf of the seed organisation in its dealings with the service
operator in relation to the tasks specified in subclauses 9A(3)(b)(i) to
(iv).
It is envisaged that the responsible officer will not have day-to-day
contact with the Healthcare Identifiers Service. Rather, he or she will
carry out key tasks on behalf of the healthcare provider organisation, such
as nominating the initial organisation maintenance officer for the
organisation, requesting assignment or retirement of a healthcare
identifier for the seed organisation and requesting the reconfiguration of
healthcare identifiers for a seed organisation as a result of merger
activity between two healthcare provider organisations.
Only seed organisations require a responsible officer. A seed organisation
is required to have only one responsible officer, although the responsible
officer is permitted to delegate his or her powers - see subclause 9A(5).
The ability to delegate will help seed organisations deal with situations
when the responsible officer is not available to act on the organisation's
behalf. Where a responsible officer delegates his or her functions, a
written record of the delegation should be retained by the healthcare
provider organisation.
Responsible officers will also be able to fulfil the roles of organisation
maintenance officer and, under clauses 17 and 31 of the Bill, authorised
employee. Responsible officers are able, but not required, to be an
identified healthcare provider.
Subclause 9A(3)(c), and subclause 9A(6)(b),provide that an organisation
maintenance officer is a person who acts on behalf of a healthcare provider
organisation (whether a seed organisation or a network organisation) in its
dealings with the service operator.
There may be more than one organisation maintenance officer responsible for
each healthcare provider organisation. Organisation maintenance officers
are also able to fulfil the roles of responsible officer and, under clauses
17 and 31 of the Bill, authorised employee. Organisation maintenance
officers are able, but are not required, to be an identified healthcare
provider.
The roles of organisation maintenance officers for seed organisations and
for network organisations are similar and are set out in subclauses
9A(3)(c) and 9A(6)(b) respectively. Those roles include day-to-day
activities such as nominating additional organisation maintenance officers
for healthcare provider organisations, requesting assignment or retirement
of a healthcare identifier for a network organisation, and maintaining
information that is held by the service operator in relation to the
healthcare provider organisation for which the organisation maintenance
officer is responsible.
Under subclause 9A(4), a sole practitioner is a healthcare provider
organisation (specifically, a seed organisation) if he or she provides
healthcare and performs the roles of responsible officer and organisation
maintenance officer. A sole practitioner is able to be assigned two
healthcare identifiers; one under subclause 9(3)(a), and another under
subclause 9(3)(b), of the Bill - see the note under subclause 9(3) of the
Bill. Subclause 9A(4) is part of the framework for ensuring that
obligations applicable to healthcare provider organisations also apply to
sole practitioners.
Subclause 9A(6) provides that clause 9A applies to healthcare provider
organisation (a network organisation) that: is part of, or subordinate to,
a seed organisation that has the characteristics specified in subclauses
9A(6)(a); and has an organisation maintenance officer to act on behalf of
the network organisation in its dealings with the service operator.
In terms of the Healthcare Identifiers Service, network organisations may
be part of or subordinate to seed organisations in a legal, business and/or
administrative sense. A network organisation may, but is not required to,
be part of the same legal entity as its seed organisation or be a related
body corporate of its seed organisation.
For example, a state department of health might be a seed organisation
(assuming it meets the necessary criteria) and be assigned a healthcare
identifier. The state department of health might have a number of network
organisations under it - for example, major public hospitals in that state
- each of which is also assigned a healthcare identifier. Further network
organisations may sit under each of these public hospitals - for example,
one of the public hospitals may have nominated its emergency and radiology
departments to be network organisations.
There is no limit to the number of tiers of network organisations that may
exist under a single seed organisation. Nor is there any limit to the
number of network organisations that may exist within a particular tier
under a single seed organisation.
Subclause 9A(6)(a)(ii) ensures that seed organisations are able to control
which network organisations are associated with them for the purposes of
the Healthcare Identifiers Service.
Subclause 9A(7) ensures that an organisation maintenance officer who acts
on behalf of a network organisation (the first network organisation) is an
individual who is an employee of one of the organisations specified in
subclauses 9A(7)(a) to (c). For subclauses 9A(7)(a) and (b), the
organisation maintenance officer must be an employee of the first network
organisation, or an employee of the seed organisation of the first network
organisation. For subclause 9A(7)(c), the organisation maintenance
officer may be an employee of another network organisation (the second
network organisation), provided that the first and second network
organisations are linked to the same seed organisation and the second
network organisation is hierarchically superior to the first network
organisation. The second network organisation is hierarchically superior
to the first network organisation if there are fewer tiers of network
organisations between it and the seed organisation than between the first
network organisation and the same seed organisation. In the example given
above, the major public hospital network organisation will be
hierarchically superior to the emergency or radiology department network
organisations.
Amendment 9
This amendment will insert a new clause 9B that will prescribe requirements
for assigning a healthcare identifier to a healthcare provider.
Clause 9B outlines the types of information that may be required before the
service operator considers assigning a healthcare identifier to a
healthcare provider, including:
. for individual healthcare providers - information that accurately
identifies the individual healthcare provider and shows that the
individual falls within one of the classes mentioned in subclauses
9A(1) and (2).
Documentation to meet these requirements might include evidence that the
individual is a health professional registered, permitted or approved under
state or territory law to supply a healthcare service, or where there is no
relevant state or territory law, is a member of a professional association
that has uniform national registration requirements relating to the supply
of healthcare services; and
. for healthcare provider organisations - information that accurately
identifies the healthcare provider organisation, that shows that it
falls within one of the classes mentioned in subclauses 9A(3) and (6)
and that identifies its responsible officer (where applicable) and
organisation maintenance officer.
Documentation to meet these requirements might include accreditation
details (for example, for hospitals where mandatory accreditation
requirements apply), evidence that shows that the organisation employs the
necessary individuals or evidence that the organisation provides
healthcare.
Subclause 9B(3) provides that the healthcare provider must give the
information in any form asked for by the service operator.
Subclause 9B(4) provides that if the service operator is not satisfied with
the information provided, it does not have to assign a healthcare
identifier to the healthcare provider.
Amendment 10
This amendment will provide that a review process is available in relation
to decisions made by the service operator not to assign a healthcare
identifier under subclause 9(1)(a) of the Bill.
Subclause 9(1)(a), and clause 9A, of the Bill authorise the service
operator to assign healthcare identifiers to individual healthcare
providers and healthcare provider organisations. As the note to subclause
9C(1) makes clear, the review process will not be available in relation to
a decision to assign a healthcare identifier to a healthcare recipient
under subclause 9(1)(b) of the Bill. Nor will it be available in relation
to a decision to not assign a healthcare identifier under subclause 9(2) of
the Bill.
Subclause 9C(2) requires the service operator to give a written notice to a
person whose interests are affected by a decision not to assign a
healthcare identifier. The notice is required to contain a statement that
the person may apply to have the service operator reconsider its decision
and, if the person is not satisfied with the result of the reconsideration,
that the person may apply to the Administrative Appeals Tribunal for a
further review.
Subclause 9C(3) provides that a failure to give the notice required by
subclause 9C(2) does not affect the validity of the service operator's
decision.
Subclause 9C(4) provides that a person whose interests are affected may
ask the service operator, in writing, to reconsider its decision to refuse
to assign a healthcare identifier. A request for reconsideration is
required to be made within 28 days after the person receives the service
operator's notice.
Subclause 9C(5) requires that a request for reconsideration under subclause
9C(4) must mention the reasons for making the request.
Subclauses 9C(6) and 9C(7) set out requirements on the service operator
following receipt of a request for reconsideration. The service operator
is required to reconsider its decision within 28 days (subclause 9C(6)(a))
and is required to give to the person who made the request a written notice
setting out the result of its reconsideration and the grounds on which the
result was based (subclause 9C(6)(b)), together with a statement that the
person may apply to the Administrative Appeals Tribunal for a review of the
reconsideration (subclause 9C(7)).
Subclause 9C(8) provides that a person not satisfied with a
reconsideration under subclause 9C(6) may apply to the Administrative
Appeals Tribunal for a review of the decision.
Amendment 11
This amendment will prescribe the Department of Defence as a data source.
Data sources are selected on the basis that they are able to provide high
quality demographic and professional information to support the unique
identification of individuals and healthcare providers and limit the risk
of incorrectly assigning a healthcare identifier.
Subclauses 12(2)(a) and 12(2)(b) of the Bill specify Medicare Australia and
the Department of Veterans' Affairs as data sources. Current subclause
12(2)(c) of the Bill provides that the Regulations may prescribe entities
to be data sources.
This amendment will omit current subclause 12(2)(c) and substitute the
Department of Defence. Amendment 1 will insert a new definition for the
Department of Defence in clause 5 of the Bill.
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