Private Health Insurance Act 2007
(Repealed by No 54 of 2025)
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Pt 6-4 heading substituted by No 105 of 2013, s 3 and Sch 2 item 9, effective 1 July 2013. The heading formerly read:
PART 6-4 - ADMINISTRATION OF PREMIUMS REDUCTION AND INCENTIVE PAYMENTS SCHEMES
Div 279 heading substituted by No 105 of 2013, s 3 and Sch 2 item 12, effective 1 July 2013. The heading formerly read:
Division 279 - Provisions applying only to premiums reduction scheme
S 279-40 repealed by No 54 of 2025, s 3 and Sch 2 item 13, effective 1 April 2026. For application, transitional and validation provisions, see note under s
279-1
. S 279-40 formerly read:
S 279-40(1) amended by No 32 of 2011, s 3 and Sch 4 item 516, by substituting
"
Chief Executive Medicare
"
for
"
Medicare Australia CEO
"
(wherever occurring), effective 1 July 2011. S 279-40(2) amended by No 32 of 2011, s 3 and Sch 4 item 516, by substituting
"
Chief Executive Medicare
"
for
"
Medicare Australia CEO
"
(wherever occurring), effective 1 July 2011. S 279-40(3) amended by No 32 of 2011, s 3 and Sch 4 items 517 and 518, by substituting
"
Chief Executive Medicare
"
for
"
Medicare Australia CEO
"
and
"
Chief Executive Medicare
'
s
"
for
"
Medicare Australia CEO
'
s
"
, effective 1 July 2011. if the Chief Executive Medicare does not give notice of his or her decision that the additional amount sought is incorrect, or that it would not be reasonable to grant the application, within the period of 3 months after the application was received by the Chief Executive Medicare. S 279-40(5) amended by No 32 of 2011, s 3 and Sch 4 item 519, by substituting
"
Chief Executive Medicare
"
for
"
Medicare Australia CEO
"
(wherever occurring), effective 1 July 2011. S 279-40(6) amended by No 32 of 2011, s 3 and Sch 4 item 519, by substituting
"
Chief Executive Medicare
"
for
"
Medicare Australia CEO
"
(wherever occurring), effective 1 July 2011.
SECTION 279-40 DECISION ON APPLICATION
279-40(1)
If a private health insurer makes an application under section 279-25 or 279-30 for payment of an additional amount, the Chief Executive Medicare must pay the additional amount sought if the Chief Executive Medicare is satisfied:
(a)
that the additional amount sought is correct; and
(b)
that it would be reasonable to grant the application.
279-40(2)
The Chief Executive Medicare may refuse the application, or decide to pay only part of the additional amount sought, if the Chief Executive Medicare is satisfied:
(a)
that the additional amount sought is incorrect; or
(b)
that it would not be reasonable to grant the application.
279-40(3)
The Chief Executive Medicare must notify the private health insurer of the Chief Executive Medicare
'
s decision on the application.
279-40(4)
A notice under subsection (3) must include reasons for the decision.
279-40(5)
The Chief Executive Medicare is taken, for the purposes of this Part, to have decided that:
(a)
the additional amount sought is correct; and
(b)
that it would be reasonable to grant the application;
279-40(6)
If the Chief Executive Medicare is taken to have made a decision under subsection (5) in respect of a private health insurer, the Chief Executive Medicare is taken to have given notice of that decision to the private health insurer.
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