Private Health Insurance Act 2007

CHAPTER 4 - HEALTH INSURANCE BUSINESS, HEALTH BENEFITS FUNDS AND MISCELLANEOUS OBLIGATIONS OF PRIVATE HEALTH INSURERS  

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History

Ch 4 heading substituted by No 87 of 2015, s 3 and Sch 1 item 54, effective 1 July 2015. For transitional provisions, see note under s 3-15 . The heading formerly read:

CHAPTER 4 - PRIVATE HEALTH INSURERS

PART 4-5 - MISCELLANEOUS OBLIGATIONS OF PRIVATE HEALTH INSURERS  

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History

Pt 4-5 heading substituted by No 87 of 2015, s 3 and Sch 1 item 66, effective 1 July 2015. For transitional provisions, see note under s 3-15 . The heading formerly read:

PART 4-5 - OTHER OBLIGATIONS OF PRIVATE HEALTH INSURERS

Division 172 - Other obligations  

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History

Div 172 heading substituted by No 87 of 2015, s 3 and Sch 1 item 76, effective 1 July 2015. For transitional provisions, see note under s 3-15 . The heading formerly read:

Division 172 - Miscellaneous

SECTION 172-5   AGREEMENTS WITH MEDICAL PRACTITIONERS  
Medical purchaser-provider agreements

172-5(1)    
If a private health insurer enters into an agreement with a ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

medical practitioner for the provision of treatment to persons insured by the insurer, the agreement must not limit the medical practitioner ' s professional freedom, within the scope of accepted clinical practice, to identify and provide appropriate treatments.

Practitioner agreements

172-5(2)    
If a hospital or day hospital facility enters into an agreement with a ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

medical practitioner, under which treatment is provided to persons insured by the insurer, the agreement must not limit the medical practitioner ' s professional freedom, within the scope of accepted clinical practice, to identify and provide appropriate treatments.

Note:

Medical practitioners may, in dealings with private health insurers, be able to take advantage of the collective bargaining provisions of Subdivision B of Division 2 of Part VII of the Competition and Consumer Act 2010 .

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History

S 172-5 amended by No 103 of 2010, s 3 and Sch 6 items 1 and 84, by substituting " Competition and Consumer Act 2010 " for " Trade Practices Act 1974 " in the note, effective 1 January 2011.

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