PRIVATE HEALTH INSURANCE INCENTIVES ACT 1998

CHAPTER 4 - PROVISIONS APPLYING BOTH TO INCENTIVE PAYMENTS SCHEME AND TO PREMIUMS REDUCTION SCHEME  

PART 7 - GENERAL  

Division 18 - When and how payments can be recovered  

SECTION 18-5   RECOVERY OF PAYMENTS  

18-5(1)   [Debts due to Commonwealth]  

The following amounts are recoverable as debts due to the Commonwealth:

(a) a payment made to a person under Part 3 to which the person was not entitled;

(b) a payment made to a person under Part 3 in respect of a premium that was afterwards refunded;

(ba) a payment made to a person under Part 3 in respect of a claim that has been withdrawn under section 6-15 ;

(c) so much of a payment made under section 15-5 or 15-24 as relates to an * appropriate private health insurance policy that covers a person who was:

(i) a * participant in the premiums reduction scheme for the financial year concerned in respect of the policy; and

(ii) not eligible to participate in that scheme in respect of that policy;

(ca) so much of a payment made under section 15-5 or 15-24 as relates to a premium for which a reduction was not allowable under section 12-5 ;

(d) 150% of so much of a payment made under section 15-5 or 15-24 as:

(i) is not reflected in reductions in premiums payable under *appropriate private health insurance policies issued by the * health fund concerned; or

(ii) relates to a person whose application under section 11-15 has not been retained by the health fund as required by section 11-50 ; or

(iii) relates to a person whose application under section 11-15 has been so retained, but has not been produced to the Medicare Australia CEO by the health fund in accordance with a requirement made by the Medicare Australia CEO under section 16-10 ;

(e) so much of a payment purportedly made under section 15-5 or 15-24 as was not payable under that section;

(f) interest payable under subsection 18-10(2) .

18-5(2)   [Who owes debt]  

The amounts are recoverable from:

(a) if paragraph (1)(a), (b) or (ba) applies - the person referred to in that paragraph or that person's estate; or

(b) if paragraph (1)(c), (ca), (d) or (e) applies - the * health fund to which the payment concerned was made; or

(c) if paragraph (1)(f) applies:

(i) if the payment was made to a health fund - that fund; or

(ii) if the payment was made to an individual - the individual or his or her estate.

18-5(3)   [Where there is a convention]  

An amount recoverable under subsection (1) is recoverable whether or not any person has been convicted of an offence relating to the payment.