Health Legislation Amendment (Private Health Insurance) Act 2006 (83 of 2006)

Schedule 1   Amendments relating to the Health Insurance Ombudsman

National Health Act 1953

82   After section 82ZTB

Insert:

82ZTBAA Disclosure of personal information to the Health Insurance Ombudsman

(1) This section applies if:

(a) a person provides information or a record to the Health Insurance Ombudsman in accordance with a request under subsection 82ZTB(1); or

(b) a person provides information or a document to the Health Insurance Ombudsman, reasonably believing that this would assist the Health Insurance Ombudsman in investigating a matter under section 82ZT or 82ZTA.

(2) For the purposes of:

(a) the Privacy Act 1988; and

(b) any provision of a law of a State or Territory that provides that personal information contained in the record, information or document may be disclosed if the disclosure is authorised by law;

the providing of the record, information or document to the Health Insurance Ombudsman is taken to be authorised by law.

82ZTBAB Health Insurance Ombudsman may mediate as part of investigation

The Health Insurance Ombudsman may, if the Health Insurance Ombudsman considers it appropriate and consistent with the object of this Part, try to resolve a matter being investigated under this Division by mediating between a registered organization and a health care provider.

82ZTBAC Participation in mediation may be compulsory

(1) The Health Insurance Ombudsman may, having regard to any guidelines under paragraph 82ZV(2)(a), direct:

(a) a registered organization; or

(b) a health care provider;

to participate in mediation under section 82ZTBAB.

(2) The direction must:

(a) be in writing; and

(b) specify the individual or individuals who are subject to the direction; and

(c) be given to the individual or individuals; and

(d) specify the time of the mediation, which must not be earlier than 14 days after the day on which the direction is given to the individual or individuals; and

(e) specify the place of the mediation.

Note: Subsection 33(3) of the Acts Interpretation Act 1901 has the effect that the direction may be varied or revoked.

(3) A person commits an offence if:

(a) the person is an individual who is subject to a direction under subsection (1) to participate in mediation; and

(b) the person, or, if the person is a medical practitioner who has appointed a representative in relation to the mediation under section 82ZTBAD, the person’s representative, fails to participate in part or all of the mediation.

Penalty for an offence against this subsection: 10 penalty units.

82ZTBAD Medical practitioners may appoint representatives

(1) If the Health Insurance Ombudsman directs a medical practitioner under subsection 82ZTBAC(1) to participate in mediation, the medical practitioner may appoint an individual to participate in the mediation on the practitioner’s behalf.

(2) The appointment must be:

(a) in writing; and

(b) signed by the medical practitioner; and

(c) made before the mediation starts.

82ZTBAE Conduct of compulsory mediation

(1) If the Health Insurance Ombudsman directs someone to participate in mediation under section 82ZTBAC, the mediation may be conducted by:

(a) the Health Insurance Ombudsman; or

(b) a person appointed by the Health Insurance Ombudsman under section 82ZUH.

(2) Mediation in which someone is directed to participate under section 82ZTBAC ceases:

(a) if the parties agree to settle the matter being mediated; or

(b) if, having regard to any guidelines under paragraph 82ZV(2)(b), the Health Insurance Ombudsman considers that the matter being mediated cannot be settled by mediation.

(3) A person appointed by the Health Insurance Ombudsman under section 82ZUH to conduct mediation must, as soon as practicable after the mediation is conducted or should have been conducted, report to the Health Insurance Ombudsman about:

(a) whether the mediation was conducted; and

(b) if the mediation failed - the reasons for the failure; and

(c) if the parties agreed to settle the matter being mediated - the terms of the settlement, including any action to be taken.

82ZTBAF Admissibility of things said in mediation

(1) Evidence of anything said, or any admission made, during participation in mediation under section 82ZTBAB is not admissible:

(a) in any court (whether exercising federal jurisdiction or not); or

(b) in any proceedings before a person authorised by a law of the Commonwealth or of a State or Territory, or by the consent of the parties, to hear evidence.

(2) This section applies whether or not someone is directed to participate in the mediation.