Private Health Insurance Act 2007
View history note
Hide history noteSubject to subsection (2) , the amount payable to the private health insurer in respect of the month is the sum of the amounts by which premiums in respect of that month under the [*]
To find definitions of asterisked terms, see the Dictionary in Schedule 1 .
complying health insurance policies issued by the private health insurer were reduced because of the operation of Division 23 .[ CCH Note: S 279-15(1) will be substituted by No 54 of 2025, s 3 and Sch 2 item 12, effective 4 May 2026 or a single day to be fixed by Proclamation. However, if the provisions do not commence within the period of 6 months beginning on the day this Act receives the Royal Assent, they commence on the day after the end of that period. For application, transitional and validation provisions, see note under s 279-1 . S 279-15(1) will read:
]
279-15(1)
The amount payable to the private health insurer in respect of a claim is the sum of the amounts that are included in the claim as amounts by which premiums under the * complying health insurance policies issued by the private health insurer have been reduced because of the operation of Division 23 .
[ CCH Note: S 279-15(1A) will be inserted by No 54 of 2025, s 3 and Sch 2 item 12, effective 4 May 2026 or a single day to be fixed by Proclamation. However, if the provisions do not commence within the period of 6 months beginning on the day this Act receives the Royal Assent, they commence on the day after the end of that period. For application, transitional and validation provisions, see note under s 279-1 . S 279-15(1A) will read:
]
279-15(1A)
However, if paragraph 279-11(2)(a) applies in relation to the claim, the amount payable to the private health insurer under subsection (1) of this section must not include any amounts included in the claim that do not meet the criteria specified for the purposes of paragraph 279-11(1)(b) .
The amount must be paid to the private health insurer within the period of 15 days starting on the first day of the following month.
[ CCH Note: S 279-15(2) will be substituted by No 54 of 2025, s 3 and Sch 2 item 12, effective 4 May 2026 or a single day to be fixed by Proclamation. However, if the provisions do not commence within the period of 6 months beginning on the day this Act receives the Royal Assent, they commence on the day after the end of that period. For application, transitional and validation provisions, see note under s 279-1 . S 279-15(2) will read:
]
279-15(2)
The amount must be paid to the private health insurer on or before the 15th day of the month in which the claim for reimbursement is made.
279-15(3)
The amount must be paid in the way determined, in writing, by the Chief Executive Medicare.
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