Commonwealth Consolidated Acts

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HEALTH INSURANCE ACT 1973 - SECT 14

Medicare benefit not to exceed medical expenses incurred

  (1)   A medicare benefit payable in respect of a professional service shall not exceed the medical expenses incurred in respect of the professional service.

  (2)   Subsection   (1) does not apply if:

  (a)   the rendering of the professional service is covered by an agreement between a private health insurer and another person; and

  (b)   the amount payable under the agreement for the professional service is not determined on a fee for service basis.


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