Commonwealth Consolidated Acts

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NATIONAL HEALTH ACT 1953 - SECT 99AA

Unauthorised payments etc.

  (1)   Where:

  (a)   a pharmaceutical benefit has been supplied to a person (in this subsection referred to as the patient ) by an approved pharmacist, approved medical practitioner or approved hospital authority;

  (b)   the pharmacist, medical practitioner or authority is paid an amount (in this subsection referred to as the relevant amount ) by the Commonwealth in respect of the supply of the benefit to the patient; and

  (c)   the patient obtained the benefit on terms that were appropriate for the supply of the benefit to:

  (i)   a holder of a concession card; or

  (iii)   a holder of an entitlement card; or

  (iv)   a concessional beneficiary; or

  (v)   a person who was a dependant of a concessional beneficiary within the meaning of subsection   84(4) or (7);

    knowing, or in circumstances such that he or she ought reasonably to have known, that he or she was not entitled to receive the benefit on those terms;

the Secretary may, by notice in writing to the patient, require the patient to pay to the Commonwealth an amount equal to the relevant amount.

  (2)   Where:

  (a)   a pharmaceutical benefit is supplied, or purportedly supplied, to a person by an approved pharmacist, approved medical practitioner or approved hospital authority;

  (b)   the pharmacist, medical practitioner or authority is paid an amount (in this subsection referred to as the relevant amount ) by the Commonwealth in respect of the supply or purported supply of the benefit to that person; and

  (c)   the pharmacist, medical practitioner or authority obtained the relevant amount knowing, or in circumstances such that he or she ought reasonably to have known, that it was not payable;

the Secretary may, by notice in writing to the pharmacist, medical practitioner or authority, require the pharmacist, medical practitioner or authority to pay to the Commonwealth an amount equal to the relevant amount.

  (3)   Where:

  (a)   the conditions referred to in paragraphs   (1)(a), (b) and (c) or (2)(a), (b) and (c) are satisfied in relation to an amount paid by the Commonwealth; and

  (b)   the Secretary gives a person notice under subsection   (1) or (2) as the case may be, requiring the person to pay to the Commonwealth an amount equal to the amount referred to in paragraph   (a) of this subsection;

the Commonwealth may recover the amount referred to in the notice as a debt due to the Commonwealth by action in a court of competent jurisdiction.

  (4)   Where a person is liable to pay an amount to the Commonwealth under this section, an amount not exceeding that amount may be deducted from any other amount that is payable to the person under this Part and, where an amount is so deducted, the other amount shall, notwithstanding the deduction, be deemed to have been paid in full to the person.


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