Senate debates

Wednesday, 14 June 2023

Bills

Health Insurance Amendment (Professional Services Review Scheme) Bill 2023, Statute Law Amendment (Prescribed Forms and Other Updates) Bill 2023; Second Reading

6:18 pm

Photo of Murray WattMurray Watt (Queensland, Australian Labor Party, Minister for Agriculture, Fisheries and Forestry) Share this | Hansard source

I move:

That these bills be now read a second time.

I seek leave to have the second reading speeches incorporated in Hansard.

Leave granted.

The speech es read as follow s

HEALTH INSURANCE AMENDMENT (PROFESSIONAL SERVICES REVIEW SCHEME) BILL 2023

Australia's universal health care system, Medicare, provides free and subsidised access for all Australians to most health care services.

The Health Insurance Amendment (Professional Services Review Scheme) Bill 2023 responds to the independent Review of Medicare Integrity and Compliance undertaken by Dr Pradeep Philip, known as the Philip Review. The Philip Review was commissioned by the Government last November to respond to concerns about the operation of the Medicare system.

While the Philip Review found that the majority of health professionals are well meaning and protective of the health system, it also noted that changes are needed to modernise the compliance system underpinning Medicare to ensure it remains rigorous and effective.

The Government is committed to protecting the integrity of Medicare. This Bill makes a number of priority amendments in response to recommendations from the Review.

The measures in this Bill will strengthen the operation of the Professional Services Review, known as the PSR, as well as improving the effectiveness of the current process for auditing payments relating to Medicare services.

In essence, the Bill:

          The PSR is an independent statutory agency responsible for protecting the integrity of the Medicare program by investigating whether a person has engaged in inappropriate practice. In doing so, the PSR protects patients and the community in general from the risks associated with inappropriate practice and protects the community from having to meet the cost of services provided as a result of inappropriate practice.

          The PSR addresses the behaviour of a person who may have engaged in inappropriate practice through review by the Director or by Committees made up of clinical professional peers of the person under review.

          Currently, the Director of the PSR cannot be appointed without the agreement of the AMA. The Government considers that this veto power is not consistent with public expectations and undermines confidence in the independence of the PSR as a regulator. This veto power has also never been exercised, raising further questions of the need for this requirement. Given the potential conflict between the PSR's objective to safeguard Medicare and the AMA's role in representing the interests of medical practitioners who may be subject to PSR review, it is appropriate for the veto power to be removed.

          The Bill will also enable direct consultation with relevant medical peak bodies regarding appointments of Deputy Directors and Panel members of the PSR, instead of making arrangements for the AMA to coordinate and provide advice, as is the current requirement.

          Similarly, the Bill removes the requirement to consult with the AMA on the appointment of the Chair and other members of the Determining Authority. Instead, the Minister is to consult directly with relevant peak bodies on appointments of medical practitioner members of the Determining Authority, which is consistent with current requirements for other health practitioners subject to the PSR arrangements.

          These changes will remove potential conflicts of interest to enhance public perceptions of the PSR Scheme and ensure the PSR process can operate with impartiality and independence.

          Allowing for Associate Directors to be appointed will also improve the PSR process by managing conflicts of interest, unexpected absences, and high case volumes. The Director of the PSR is currently the sole decision maker for most aspects of the PSR Scheme. There is no contingency in place if the Director is unable to make decisions on a particular matter due to a conflict of interest or if they are otherwise unavailable. To address the risk that a case may lapse if a statutory time limit passes while the Director is unavailable to make a decision, the Bill makes provisions for a new statutory office of Associate Director.

          The Bill will provide for multiple Associate Directors to be appointed on a full or part-time basis which will allow for the recruitment of more wide-ranging medical expertise. An Associate Director would be able to review inappropriate practice in the same way as the Director, and make relevant decisions such as whether to enter into a written agreement with a person under review or to refer them to a Committee of their peers.

          Associate Directors will not have any functions relating to the administration of the PSR. The Director will remain the sole statutory agency head and the accountable authority under the Public Governance, Performance and Accountability Act 2013.

          Finally, the Bill will remove the need for engagement with stakeholder groups about documents relevant to substantiating Medicare payments, as a · prerequisite for issuing a notice to produce documents during an audit. This amendment will strengthen and speed up Medicare compliance functions, without limiting the types of documents a person may provide during an audit of payments.

          Importantly, this change will not have any impact on procedural fairness requirements for a person being audited.

          There will continue to be an opportunity for the person to make submissions about their compliance matter and to provide any information or documents they consider relevant.

          Robust structures to identify and address non-compliance and inappropriate practice are essential to ensure that Commonwealth resources are directed to necessary health services and to ensure that Medicare remains sustainable. By supporting the integrity of Medicare, this Bill will ultimately benefit all Australians.

          The Statute Law Amendment (Prescribed Forms and Other Updates) Bill 2023 amends 85 Commonwealth Acts to enhance administration and promote consistency across the statute book. It does this by amending references to prescribed forms in the statute law of the Commonwealth, making minor and technical changes to the Commonwealth statute book, and repealing certain obsolete Acts and provisions of Acts.

          Statute Law Revision Acts and Statute Stocktake Acts have been passed since 1934 in order to remove obsolete and spent provisions from the statute book and correct drafting mistakes. They are traditionally non-controversial and are essential to keep the Commonwealth statute book accurate and up-to-date.

          Statute law revision and update Bills aim to enhance the clarity and efficiency of the statute book. The amendments are minor in nature and either make no change, or only minor changes, to the substance of the law.

          This Bill contains 6 Schedules. Schedule 1 updates references to prescribed forms in 33 Acts across the Commonwealth statute book.

          The provisions amended by Schedule 1 currently provide for forms to be prescribed by regulations. Those forms generally impose requirements for things to occur, such as particular information to be provided. Modern legislative drafting approaches recognise that requiring forms to be prescribed in regulations can be unnecessarily restrictive. In some situations, it will remain important to provide for a form to be prescribed by, or set out in, an Act or regulations. However, in other cases, it is more appropriate for the form to be approved by a specified person or body by notifiable instrument. This enables minor updates or significant improvements to be made to those forms, without requiring further regulations to be made. Where prescribed or approved forms are made by notifiable instrument they will still appear of the Federal Register of Legislation.

          Schedule 1 of the Bill amends provisions that require forms to be prescribed by regulations and replaces them with other approaches that are best-suited to the context of the particular form. These amendments will ensure well-targeted requirements will apply, taking into account the best modern practices available in the relevant circumstances. They will ensure there is still oversight of the information to be provided while enabling flexibility in updating and improving forms.

          Schedule 2 updates language relating to persons with disability to focus on the person, rather than the disability. These amendments give effect to the recommendations made by Economic Justice Australia in its August 2022 research report, Handicapped—Use of outdated terminology in Social Security law and policy.

          The object of the amendments in Schedule 2 is to prevent negative impacts on the lives of people with disability resulting from the way they are referred to in particular legislative provisions. These amendments are not intended to change the way these provisions operate.

          Schedule 3 updates references in Commonwealth Acts to Northern Territory Acts, to make those references consistent with the way the Northern Territory now cites its Acts.

          Schedules 4 to 6 of the Bill correct technical errors that have occurred in Acts as a result of drafting and clerical mistakes, and repeal spent and obsolete provisions of Acts.

          The amendments in Schedules 4 to 6 enhance readability, facilitate interpretation and administration, and promote consistency across the Commonwealth statute book.

          These ongoing improvements to legislation are important to ensure that the Commonwealth statute book remains up-to-date, accurate and user-friendly.

          STATUTE LAW AMENDMENT (PRESCRIBED FORMS AND OTHER UPDATES) BILL 2023

          The Statute Law Amendment (Prescribed Forms and Other Updates) Bill 2023 amends 85 Commonwealth Acts to enhance administration and promote consistency across the statute book. It does this by amending references to prescribed forms in the statute law of the Commonwealth, making minor and technical changes to the Commonwealth statute book, and repealing certain obsolete Acts and provisions of Acts.

          Statute Law Revision Acts and Statute Stocktake Acts have been passed since 1934 in order to remove obsolete and spent provisions from the statute book and correct drafting mistakes. They are traditionally non-controversial and are essential to keep the Commonwealth statute book accurate and up-to-date.

          Statute law revision and update Bills aim to enhance the clarity and efficiency of the statute book. The amendments are minor in nature and either make no change, or only minor changes, to the substance of the law.

          This Bill contains 6 Schedules. Schedule 1 updates references to prescribed forms in 33 Acts across the Commonwealth statute book.

          The provisions amended by Schedule 1 currently provide for forms to be prescribed by regulations. Those forms generally impose requirements for things to occur, such as particular information to be provided. Modern legislative drafting approaches recognise that requiring forms to be prescribed in regulations can be unnecessarily restrictive. In some situations, it will remain important to provide for a form to be prescribed by, or set out in, an Act or regulations. However, in other cases, it is more appropriate for the form to be approved by a specified person or body by notifiable instrument. This enables minor updates or significant improvements to be made to those forms, without requiring further regulations to be made. Where prescribed or approved forms are made by notifiable instrument they will still appear of the Federal Register of Legislation.

          Schedule 1 of the Bill amends provisions that require forms to be prescribed by regulations and replaces them with other approaches that are best-suited to the context of the particular form. These amendments will ensure well-targeted requirements will apply, taking into account the best modern practices available in the relevant circumstances. They will ensure there is still oversight of the information to be provided while enabling flexibility in updating and improving forms.

          Schedule 2 updates language relating to persons with disability to focus on the person, rather than the disability. These amendments give effect to the recommendations made by Economic Justice Australia in its August 2022 research report, Handicapped—Use of outdated terminology in Social Security law and policy.

          The object of the amendments in Schedule 2 is to prevent negative impacts on the lives of people with disability resulting from the way they are referred to in particular legislative provisions. These amendments are not intended to change the way these provisions operate.

          Schedule 3 updates references in Commonwealth Acts to Northern Territory Acts, to make those references consistent with the way the Northern Territory now cites its Acts.

          Schedules 4 to 6 of the Bill correct technical errors that have occurred in Acts as a result of drafting and clerical mistakes, and repeal spent and obsolete provisions of Acts.

          The amendments in Schedules 4 to 6 enhance readability, facilitate interpretation and administration, and promote consistency across the Commonwealth statute book.

          These ongoing improvements to legislation are important to ensure that the Commonwealth statute book remains up-to-date, accurate and user-friendly.

          Debate adjourned.

          Ordered that the bills be listed on the Notice Paper as separate orders of the day.

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