Commonwealth Consolidated Acts

HEALTH AND OTHER SERVICES (COMPENSATION) ACT 1995 - SECT 18

             (1)  Subject to subsection (3), the claimant must give to the Medicare Australia CEO the statement required by the notice within the period of 28 days after being given the notice.

             (2)  The statement must be verified by statutory declaration.

             (3)  Subject to subsections (4) and (4A) and section 20, the Medicare Australia CEO may, by notice in writing, grant the claimant one or more extensions of the period.

             (4)  The period cannot be extended if:

                     (a)  the notice in question under subsection 17(1) was given in relation to a claim for compensation in respect of which an amount of compensation under a judgment or settlement had already been fixed; and

                     (b)  the Medicare Australia CEO had not given a notice under section 21, in respect of the claim for compensation, during the 6 months preceding the day on which an amount of compensation was fixed under the judgment or settlement; and

                     (c)  an advance payment has not been made in respect of the compensation payable under the judgment or settlement.

          (4A)  If an advance payment has been made under section 33B, the period cannot be extended:

                     (a)  if only one notice under section 17 has been given to the claimant in relation to the claim for compensation in question—beyond the period of 12 months after the claimant received that notice; or

                     (b)  in any other case—beyond the period of 12 months after the claimant received the last notice given to the claimant in relation to the claim for compensation.

             (5)  If the claimant does not give to the Medicare Australia CEO a statement as required by this section, all the professional services specified in the notice under subsection 17(2) are taken for the purposes of this Act and the Charges Act to have been rendered in the course of treatment of, or as a result of, the injury the claimant claims to have suffered.

             (6)  Subsection (5) does not operate, and is taken for the purposes of this Act and the Charges Act never to have operated, in relation to professional services specified in a notice under subsection 17(2) if the Medicare Australia CEO gives the claimant a notice under subsection (7).

             (7)  The Medicare Australia CEO must give the claimant a notice for the purposes of subsection (6) if:

                     (a)  apart from subsection (6), subsection (5) would operate so that all the services specified in a notice under subsection 17(2) would be taken for the purposes of this Act and the Charges Act to have been rendered in the course of treatment of, or as a result of, the injury the claimant claims to have suffered; and

                     (b)  an amount of compensation has been fixed under a judgment or settlement; and

                     (c)  the claimant, within the period of 2 years beginning on the day on which the amount of compensation was fixed under the judgment or settlement, satisfies the Medicare Australia CEO that:

                              (i)  not all of those services have been rendered in the course of treatment of, or as a result of, the injury the claimant claims to have suffered; and

                             (ii)  the claimant’s failure to give the Medicare Australia CEO a statement as required by this section was reasonable in the circumstances.

             (8)  To avoid doubt, if:

                     (a)  apart from subsection (6), an amount was payable to the Commonwealth under this Act in relation to the claim; and

                     (b)  a person paid that amount to the Commonwealth in relation to the claim; and

                     (c)  the Medicare Australia CEO gave the claimant a notice under subsection (7); and

                     (d)  because of subsection (6), the amount paid exceeds the amount properly payable under this Act;

the amount of the excess is payable by the Commonwealth to the person.

             (9)  The Consolidated Revenue Fund is appropriated for the purposes of payments by the Commonwealth under subsection (8).

Review of decision to refuse to give notice

          (9A)  Application may be made to the Medicare Australia CEO for reconsideration of a decision by the Medicare Australia CEO to refuse to give a notice under subsection (7).

          (9B)  The application must be made within 28 days after the claimant is notified of the decision to refuse to give the notice.

          (9C)  If an application for reconsideration is made, the decision must be reconsidered by the Medicare Australia CEO or a delegate of the Medicare Australia CEO.

          (9D)  The decision must not be reconsidered by the person who made the decision to refuse to give the notice.

           (9E)  The person reconsidering the decision must affirm or vary the decision within 28 days after the application for reconsideration is made.

           (10)  If a decision has been reconsidered, application may be made to the Administrative Appeals Tribunal for review of the decision as affirmed or varied at the reconsideration.

Note:          Section 27A of the Administrative Appeals Tribunal Act 1975 requires the decision‑maker to notify persons whose interests are affected by the decision of the making of the decision and their right to have the decision reviewed. In so notifying, the decision‑maker must have regard to the Code of Practice determined under section 27B of that Act.