Private Health Insurance Act 2007
CHAPTER 6
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ADMINISTRATION
PART 6-4
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ADMINISTRATION OF PREMIUMS REDUCTION SCHEME
Division 279
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Reimbursement of participating insurers and powers of Chief Executive Medicare
Subdivision 279-A
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Reimbursement of private health insurers for premiums reduced under scheme
SECTION 279-20
NOTIFYING PRIVATE HEALTH INSURERS IF AMOUNT IS NOT PAYABLE
279-20(1)
If the Chief Executive Medicare considers that a claim is incorrect, the Chief Executive Medicare may either refuse the claim or pay only such part of the claim as he or she is satisfied is correct.
279-20(2)
The Chief Executive Medicare must notify a private health insurer if the Chief Executive Medicare makes a decision mentioned in subsection (1) .
279-20(3)
A notice under subsection (2) must include reasons for the decision.
279-20(4)
The Chief Executive Medicare is taken, for the purposes of this Part, to have decided that a claim is correct if the Chief Executive Medicare does not give notice of his or her decision that the claim is incorrect on or before the day under subsection 279-15(2) on or before which, if the claim were correct, it would have been required to have been paid.
View history note
Hide history noteIf the Chief Executive Medicare considers that a claim is incorrect, the Chief Executive Medicare may either refuse the claim or pay only such part of the claim as he or she is satisfied is correct.
279-20(2)
The Chief Executive Medicare must notify a private health insurer if the Chief Executive Medicare makes a decision mentioned in subsection (1) .
279-20(3)
A notice under subsection (2) must include reasons for the decision.
279-20(4)
The Chief Executive Medicare is taken, for the purposes of this Part, to have decided that a claim is correct if the Chief Executive Medicare does not give notice of his or her decision that the claim is incorrect on or before the day under subsection 279-15(2) on or before which, if the claim were correct, it would have been required to have been paid.