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WORKPLACE INJURY REHABILITATION AND COMPENSATION ACT 2013 - SECT 570

Conduct of service providers

    (1)     This section applies if the Authority is concerned about the adequacy, appropriateness or frequency of any professional service provided by a person ( the relevant service ).

    (2)     If there is a relevant body responsible for regulating conduct of persons in the trade or profession of the person who provided the relevant service, the Authority—

        (a)     may notify the relevant body of, or refer to the relevant body for investigation or review, the conduct of the person in accordance with the relevant law and its rules and regulations, together with relevant matters of which the Authority is aware pertaining to that conduct; and

        (b)     until the relevant body has investigated or reviewed the conduct, may, by notice in writing given to the person, determine to suspend the payment of costs of the relevant services provided by that person, including the payment of costs of the relevant services provided before the notice is given; and

        (c)     if it gives a notice under paragraph (b), must give a copy of the notice to each self-insurer.

    (3)     If there is not a body responsible for regulating conduct of a person in the trade or profession of the person who provided the relevant services the Authority, by notice in writing given to the person, may do any one or more of the following—

        (a)     warn the person that the Authority is concerned about the person's conduct and, if it continues, the Authority may, by further notice in writing given to the person, suspend payment of costs of the relevant services provided by that person;

        (b)     determine to review the person's conduct;

        (c)     suspend payment of costs of professional services provided by the person until it has completed its review.

    (4)     A suspension of payment of costs under subsection (2) or (3) continues in force until—

        (a)     the conduct of the person has been reviewed under subsection (2) or (3); or

        (b)     the expiry of—

              (i)     in the case of a suspension under subsection (2), the period of 6 months after the notice of suspension is given or, if that period is extended, that period as so extended; or

              (ii)     in the case of a suspension under subsection (3), the period of 6 months after the notice of suspension is given under that subsection—

whichever first occurs.

    (5)     If, following a review of which notice is given under subsection (3)(b), the Authority considers—

        (a)     that the person, in providing the relevant service, has acted in an unreasonable or unprofessional manner; or

        (b)     that the ability of the person to practise is affected because of the person's physical or mental health or the person's incapacity; or

        (c)     that the person is not of good character or is otherwise not a fit and proper person—

the Authority, by notice in writing to the person, may do any one or more of the following—

        (d)     suspend the person's approval as a provider of the relevant services for a period specified in the notice;

        (e)     determine that the costs of any relevant services provided during the suspension are not payable by the Authority or a self-insurer;

        (f)     revoke the person's approval as a provider of the relevant services.

    (6)     If, under subsection (2), the Authority—

        (a)     has referred the conduct of a person to a relevant body; and

        (b)     has given a notice of suspension to that person; and

        (c)     forms the view that the relevant body's review of the conduct will not be completed within the period of 6 months—

the Authority may, by notice given to that person, extend the period of the suspension by one further period not exceeding 6 months.

    (7)     If a person to whom a notice is given under subsection (2)(b), (3), (5) or (6) is a practitioner within the meaning of Part VAA of the Health Insurance Act 1973 of the Commonwealth, the Authority—

        (a)     must give a copy of the notice to each self‑insurer; and

        (b)     may give a copy of the notice to Medicare Australia.

    (8)     The Authority is not subject to any civil or criminal liability for a decision to refer the conduct of a person to a relevant body under subsection (2)(a) or giving notice to Medicare Australia under subsection (7).

    (9)     Section 21A of the Evidence (Miscellaneous Provisions) Act 1958 applies to a review by the Authority under this section as if the Authority or a delegate of the Authority were a commission appointed by the Governor in Council to conduct the review.

    (10)     Section 552 applies in respect of any liability or entitlement under this section.

    (11)     In this section, "relevant body" means the following—

        (a)     a National Board within the meaning of the Health Practitioner Regulation National Law;

        (b)     the Authority, Committee, Director or Panel within the meaning of section 81 of the Health Insurance Act 1973 of the Commonwealth;

        (c)     a body responsible for regulating conduct of persons in the trade or profession of a person providing professional services;

        (d)     Medicare Australia;

        (e)     a tribunal.



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