Health Insurance Amendment (Compliance) Act 2011 (Cth)

Health Insurance Amendment (Compliance) Act 2011

No. 10, 2011

An Act to amend the Health Insurance Act 1973, and for related purposes

Contents 1 Short title 2 Commencement 3 Schedule(s) Schedule 1—Amendment of the Health Insurance Act 1973

Health Insurance Amendment (Compliance) Act 2011 No. 10, 2011

An Act to amend the Health Insurance Act 1973, and for related purposes

[Assented to 8 April 2011]

The Parliament of Australia enacts:

1 Short title This Act may be cited as the Health Insurance Amendment (Compliance) Act 2011.

2 Commencement This Act commences on the day after this Act receives the Royal Assent.

3 Schedule(s) Each Act that is specified in a Schedule to this Act is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this Act has effect according to its terms.

Schedule 1—Amendment of the Health Insurance Act 1973

1 Subsection 3(1) Insert: medicare number has the same meaning as in subsection 84(1) of the National Health Act 1953.

2 After section 129AAC Insert:

129AAD Notice to produce documents

When section applies (1) This section applies if the Medicare Australia CEO: (a) has a reasonable concern that an amount paid, purportedly by way of benefit or payment under this Act, in respect of one or more professional services, may exceed the amount (if any) that should have been paid; and (b) has taken into account advice given to him or her by a medical practitioner who is an employee of Medicare Australia about the types of documents that contain information relevant to ascertaining whether amounts paid in respect of professional services of the same kind or kinds as the service or services referred to in paragraph (a) should have been paid; and (c) has taken reasonable steps to consult with a relevant professional body about the types of documents that contain information relevant to ascertaining whether amounts paid in respect of professional services of the same kind or kinds as the service or services referred to in paragraph (a) should have been paid. Note: For the purposes of paragraph (a), the CEO may, for example, have a reasonable concern about benefits or payments made in respect of: (a) professional services rendered by individual practitioners; or (b) professional services rendered by particular kinds of practitioners; or (c) the rendering of services to which specific items, or groups of items, relate.