Commonwealth Consolidated Acts

HEALTH INSURANCE ACT 1973 - SECT 129AED

When this section applies

  (1)   This section applies in relation to a purported payment of medicare benefit in respect of a service referred to in Schedule   1 to the Health Insurance (Dental Services) Determination   2007 if:

  (a)   the service was provided by a dental practitioner; and

  (b)   the payment exceeded the amount (if any) that should have been paid; and

  (c)   there was a failure to comply with subsection   10(2) (quotation for dental services and reporting) of the Determination in relation to the service; and

  (d)   the Chief Executive Medicare is satisfied that the excess is solely attributable to the failure to comply with subsection   10(2) of the Determination.

Note:   The Determination was made under subsection   3C(1) of this Act. It ceased at midnight 30   November 2012 (see section   2A of the Determination).

  (2)   However, this section does not apply in relation to a purported payment of medicare benefit in respect of a service that was rendered on or after 1   April 2010 unless, before the end of 30   November 2014, the dental practitioner provides or has provided the Chief Executive Medicare with evidence that the documents that, under subsection   10(2) of the Determination, should have been given to the patient and general practitioner before the relevant course of treatment began have since been given to those persons.

Waiver and repayment of debts

  (3)   If the excess, or part of the excess, is recoverable under section   129AC as a debt due to the Commonwealth, the Chief Executive Medicare must, on behalf of the Commonwealth, waive the debt.

  (4)   If the excess, or part of the excess:

  (a)   has been repaid to the Commonwealth by a person (or a person's estate); or

  (b)   has otherwise been recovered by the Commonwealth from a person (or a person's estate), including by way of set - off;

the Chief Executive Medicare must, on behalf of the Commonwealth, pay to the person (or to the person's estate) the amount paid or recovered.

  (5)   An amount payable under subsection   (4) is reduced by any amount already paid by the Commonwealth in respect of the repaid or recovered amount.

  (6)   A reference in subsection   (3), (4) or (5) to an excess includes:

  (a)   any amount of administrative penalty for which the dental practitioner is liable to the Commonwealth under section   129AEA in relation to the excess; and

  (b)   any interest paid or payable in relation to the excess under subsection   129AC(2) or (3).