1Short title
This Act may be cited as the Dental Benefits Act 2008.
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Bill homepage (APH)This Act may be cited as the Dental Benefits Act 2008.
This Act commences on the day after it receives the Royal Assent.
The following is a simplified outline of this Act:
• This Act sets up a framework for the provision of dental benefits.
• Dental benefit is payable if dental expenses are incurred in respect of a dental service rendered to an eligible dental patient.
• The amount of dental benefit payable is the amount specified in, or determined in accordance with, the Dental Benefits Rules.
• If dental benefit is payable, it is payable by the Chief Executive Medicare to the person who incurs the dental expenses in respect of the dental service. In some circumstances, dental benefit is payable to the dental provider.
• Claims for dental benefit must be lodged with the Chief Executive Medicare.
• The Chief Executive Medicare is to issue vouchers in relation to a dental service to persons who qualify for a voucher.
• A person qualifies for a voucher if the person meets the requirements of this Act or if the Dental Benefits Rules provide that the person qualifies for a voucher.
• A person in respect of whom a voucher is in effect is an eligible dental patient. The Dental Benefit Rules may also provide that certain eligible persons are eligible dental patients.
• The Minister may make Dental Benefit Rules which may provide for a Dental Benefits Schedule.
• This Act also makes provision in relation to the obtaining of documents relevant to ascertaining whether amounts should have been paid, the disclosure of information, offences against this Act and other matters.
In this Act:
ABSTUDY scheme means the scheme known as ABSTUDY.
approved form means a form approved, in writing, by the Chief Executive Medicare.
associate, in relation to a corporation, means:
a director (within the meaning of the Corporations Act 2001), secretary or manager of the corporation; or
a receiver, or a receiver and manager, of any part of the undertaking of the corporation appointed under a power contained in any instrument; or
a liquidator of the corporation appointed in a voluntary winding up.
Australia, when used in a geographical sense, includes Norfolk Island, the Territory of Cocos (Keeling) Islands and the Territory of Christmas Island.
authorised disclosure has the meaning given by subsection 34(4).
bank includes, but is not limited to, a body corporate that is an ADI (authorised deposit‑taking institution) for the purposes of the Banking Act 1959.
Chief Executive Centrelink has the same meaning as in the Human Services (Centrelink) Act 1997.
Chief Executive Medicare has the same meaning as in the Human Services (Medicare) Act 1973.
clinically relevant service means a service that is generally accepted in the dental profession as being necessary for the appropriate care or treatment of the patient to whom it is rendered.
dental benefit means dental benefit payable under Part 3.
Dental Benefits Rules means the Dental Benefits Rules referred to in section 60.
Dental Benefits Schedule means the Dental Benefits Schedule referred to in section 61.
dental expenses means an amount payable in respect of a dental service.
dental practitioner has the same meaning as in the Health Insurance Act 1973.
dental provider has the meaning given by section 6.
dental service means a clinically relevant service specified in an item, being a service rendered by or on behalf of a dental provider.
disclose, in relation to information, includes divulge or communicate.
disqualified practitioner: a dental practitioner is a disqualified practitioner if:
the dental practitioner is fully disqualified under an agreement in effect under section 92 of the Health Insurance Act 1973; or
the dental practitioner is fully disqualified under section 105 of that Act; or
a final determination under section 106TA of that Act containing a direction under paragraph 106U(1)(h) of that Act that the dental practitioner be fully disqualified is in effect.
Under section 106ZPM of the Health Insurance Act 1973 (which deals with failure to produce certain documents or give certain information), a person may be taken to be a disqualified practitioner for the purposes of sections 20B to 20E of this Act.
eligible dental patient has the meaning given by section 5.
eligible person means:
a person who is an eligible person within the meaning of section 3 of the Health Insurance Act 1973; or
a person who is treated as such a person because of section 6, 6A or 7 of that Act.
entrusted public official has the meaning given by subsection 34(2).
FTB(A) person has the meaning given by subsection 24(2).
Human Services employee means a Departmental employee, within the meaning of the Human Services (Medicare) Act 1973.
item means an item in the Dental Benefits Schedule.
making a statement, when used in Division 3 of Part 6, includes a reference to issuing or presenting a document.
medical practitioner has the same meaning as in the Health Insurance Act 1973.
medicare number has the same meaning as in subsection 84(1) of the National Health Act 1953.
medicare program has the same meaning as in the Human Services (Medicare) Act 1973.
partly disqualified practitioner: a dental practitioner is a partly disqualified practitioner in relation to a dental service if:
the dental practitioner is partly disqualified under an agreement in effect under section 92 of the Health Insurance Act 1973 in respect of the service; or
a final determination under section 106TA of that Act containing a direction under paragraph 106U(1)(g) of that Act that the dental practitioner be partly disqualified is in effect in respect of the service.
private health insurer has the same meaning as in the Private Health Insurance Act 2007.
protected information has the meaning given by subsection 34(3).
qualifies for a voucher has the meaning given by sections 23 and 26.
rendered on behalf of a dental provider has the meaning given by section 7.
satisfies the means test has the meaning given by section 24.
Secretary means the Secretary of the Department.
this Act includes:
the regulations; and
the Dental Benefits Rules.
use, in relation to information, includes make a record of.
voucher means a voucher issued under Part 4.
youth allowance means a payment under Part 2.11 of the Social Security Act 1991.
An eligible dental patient, in relation to a dental service, is:
a person in respect of whom a voucher in relation to the dental service is in effect; or
an eligible person included in a class of eligible persons specified in the Dental Benefits Rules to be eligible dental patients in relation to the dental service; or
if the Dental Benefits Rules provide that all eligible persons are eligible dental patients in relation to the dental service—an eligible person.
Without limiting the way in which a class of eligible persons may be described for the purposes of paragraph (1)(b), the class may be described by reference to one or both of the following:
age;
receipt of a specified pension, benefit or allowance at a specified time or throughout a specified period.
A dental provider, in relation to a dental service, means the following:
a dental practitioner who has general registration, or specialist registration, in the dentists division of the dental profession under a law of a State or Territory;
if the Dental Benefits Rules specify a class of persons to be dental providers in relation to the dental service—a person included in that class.
Despite subsection (1), a dental practitioner is not a dental provider in relation to a dental service, if:
the dental practitioner is included in a class of dental practitioners specified in the Dental Benefits Rules not to be dental providers in relation to the dental service; or
the Dental Benefits Rules specify that dental practitioners are not dental providers in relation to the dental service.
For the purposes of this Act, a dental service is taken to be rendered on behalf of a dental provider if, and only if:
the dental service is rendered by another person included in a class of persons specified in the Dental Benefits Rules for the purposes of this paragraph; and
the other person provides the dental service, in accordance with accepted dental practice, under the supervision of the dental provider.
This Act extends to every external Territory.
The following is a simplified outline of this Part:
• This Part creates a basic entitlement to dental benefit in respect of a dental service.
• Dental benefit is payable if dental expenses are incurred in respect of the dental service.
• The amount of dental benefit payable is the amount specified in, or determined in accordance with, the Dental Benefit Rules.
Basic entitlement
If dental expenses are incurred in respect of a dental service rendered in Australia to an eligible dental patient, dental benefit is payable under section 11 in respect of the dental service.
Amount payable
The amount of dental benefit payable in respect of a dental service is the amount specified in, or determined in accordance with, the Dental Benefits Rules.
See also sections 61 and 62.
The amount of dental benefit payable in respect of a dental service must not exceed the dental expenses incurred in respect of the dental service.
The following is a simplified outline of this Part:
• This Part deals with the payment of dental benefit in respect of a dental service.
• Dental benefit is payable by the Chief Executive Medicare to:
the person who incurs the dental expenses in respect of the dental service; or
the dental provider, if there has been an assignment of dental benefits or if there has been a request that the dental provider be paid.
• Claims for dental benefit must be lodged with the Chief Executive Medicare.
• Dental benefit is not payable in certain circumstances, including where a dental service is provided by a practitioner who has been disqualified under the Health Insurance Act 1973.
• The Minister may direct a disqualified practitioner to give notice of his or her disqualification.
Subject to this Part, dental benefit in respect of a dental service:
is payable by the Chief Executive Medicare on behalf of the Commonwealth to the person who incurs the dental expenses in respect of the dental service; and
is to be paid in such manner as the Chief Executive Medicare determines.
A determination under paragraph (1)(b) may provide for the amount of dental benefit to be paid to the credit of a bank account in such circumstances (if any), and subject to such conditions (if any), as are specified in the Dental Benefits Rules.
Subsection (2) does not limit paragraph (1)(b).
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