Commonwealth Numbered Acts

HEALTH INSURANCE ACT 1973 No. 42 of 1974 - SECT 16

16. (1) A medical benefit is not, except with the approval of the Commission,
payable in respect of the administration of an anaesthetic in connexion with a
professional service unless the anaesthetic is administered by a practitioner
other than the practitioner who renders the professional service in connexion
with which the anaesthetic is administered.

(2) A medical benefit in respect of assistance at an operation is not payable
if the assistance is rendered by the anaesthetist or a practitioner assisting
the anaesthetist.

(3) Where an item relates to a professional service constituted by-

   (a)  assistance at an operation;

   (b)  the administration of an anaesthetic; or

   (c)  assistance in the administration of an anaesthetic, the amount of
        medical benefit payable in respect of that professional service is the
        same whether the assistance is rendered, or the anaesthetic is
        administered, by one or more than one practitioner.

(4) For the purpose of calculating the amount of medical benefit payable in
respect of the medical expenses incurred in respect of the administration of
an anaesthetic to a person for the purposes of two or more operations
performed on that person while he is under that anaesthetic-

   (a)  the amounts specified as fees in the items that relate to the
        administration of an anaesthetic for the purposes of those operations,
        other than the greater or greatest of those amounts, shall be deemed
        to be reduced as prescribed; and

   (b)  the administration of the anaesthetic shall be deemed to constitute
        one professional service in respect of which the fee specified in the
        table in relation to the State in which the anaesthetic was
        administered is an amount equal to the aggregate of the amounts
        specified as fees in the items relating to the administration of an
        anaesthetic for the purposes of those operations, being those amounts
        as reduced in accordance with paragraph (a).

(5) For the purposes of paragraph (4) (a)-

   (a)  where two or more amounts referred to in that sub-section are equal,
        one of those amounts shall be treated as being greater than the other
        or others of those amounts; and

   (b)  where, by virtue of a reduction in accordance with that subsection, an
        amount is not a multiple of 5 cents, the amount of cents shall be
        increased to the nearest higher amount that is a multiple of 5 cents.