Private Health Insurance Act 2007

CHAPTER 6 - ADMINISTRATION  

PART 6-10 - MISCELLANEOUS  

Division 333 - Miscellaneous  

SECTION 333-18   OVERSIGHT AND SAFEGUARDS FOR AUTOMATION OF ADMINISTRATIVE ACTION  
Chief Executive Medicare to ensure administrative action is action that could be validly taken

333-18(1)    
The Chief Executive Medicare must take all reasonable steps to ensure that administrative action taken by the operation of a computer program under an arrangement under subsection 333-17(1) is administrative action that the Chief Executive Medicare could validly take under this Act.

333-18(2)    
Without limiting subsection (1) , the Chief Executive Medicare must do the things (if any) prescribed by the Private Health Insurance (Incentives) Rules for the purposes of this subsection.

Note:

Administrative action may still be invalid even if subsections (1) and (2) are complied with.

333-18(3)    
A failure to comply with subsection (1) or (2) does not affect the validity of the administrative action taken by the operation of a computer program under an arrangement under subsection 333-17(1) .

Notification of substituted decisions

333-18(4)    
If, under subsection 333-17(5) , the Chief Executive Medicare makes a decision in substitution for a decision the Chief Executive Medicare is treated as having taken under subsection 333-17(4) , the Chief Executive Medicare must, within 14 days of the making of the substituted decision, cause the person who is the subject of the substituted decision to be notified in writing:

(a)    of the substituted decision and of the fact that the substituted decision was made by the Chief Executive Medicare; and

(b)    of the person ' s right (if any) to apply for reconsideration of the substituted decision.

333-18(5)    
A failure to comply with subsection (4) does not affect the validity of the substituted decision.

Publication

333-18(6)    
If the Chief Executive Medicare makes an arrangement under subsection 333-17(1) in relation to particular provisions of this Act, the Chief Executive Medicare must cause a statement to be published on Services Australia ' s website:

(a)    to the effect that the Chief Executive Medicare has made such an arrangement; and

(b)    setting out those particular provisions.

Details in annual report

333-18(7)    
The Chief Executive Officer of Services Australia, when preparing Services Australia ' s annual report under section 46 of the Public Governance, Performance and Accountability Act 2013 for a period, must include the following information in that report:

(a)    the total number of substituted actions taken by the Chief Executive Medicare under subsection 333-17(5) in that period;

(b)    the kind of substituted actions so taken;

(c)    the kind of administrative action taken by the operation of the computer program that the Chief Executive Medicare was satisfied was not correct.

333-18(8)    
The Chief Executive Officer of Services Australia may also include in the report any other information (other than personal information within the meaning of the Privacy Act 1988 ) about the operation of section 333-17 and this section in that period that the Chief Executive Officer of Services Australia considers appropriate.