Private Health Insurance Act 2007

CHAPTER 6 - ADMINISTRATION  

PART 6-4 - ADMINISTRATION OF PREMIUMS REDUCTION SCHEME  

Division 279 - Reimbursement of participating insurers and powers of Chief Executive Medicare  

Subdivision 279-A - Reimbursement of private health insurers for premiums reduced under scheme  

SECTION 279-10   REQUIREMENTS RELATING TO REIMBURSEMENT CLAIMS  

279-10(1)    
A private health insurer may only make one claim each month for reimbursement from the Chief Executive Medicare of amounts by which premiums under a * complying health insurance policy issued by the private health insurer are reduced.

279-10(2)    
The claim must:

(a)    be made within 7 days after the end of a month; and

(b)    be given to the Chief Executive Medicare electronically in accordance with the electronic system approved by the Chief Executive Medicare under section 333-16 for the purposes of this paragraph; and

(c)    include the information required by that system to be included in the claim; and

(d)    be accompanied by any documents required by that system to accompany the claim.

279-10(3)    
Before making a claim, a private health insurer must be satisfied that:

(a)    the claim only includes amounts by which premiums under a * complying health insurance policy issued by the private health insurer have been reduced because of the operation of Division 23 ; and

(b)    the private health insurer was a * participating insurer when the premiums were reduced; and

(c)    the premiums were reduced in the 36 month period ending before the month in which the claim for reimbursement is made; and

(d)    the amounts have not previously been reimbursed to the private health insurer under this Division.