Commonwealth Consolidated Acts

HEALTH AND OTHER SERVICES (COMPENSATION) ACT 1995 - SECT 23B

             (1)  If the Medicare Australia CEO is satisfied that a statement given to the Medicare Australia CEO under section 18 or 23A or this section is not substantially correct, the Medicare Australia CEO must give to the claimant a written notice:

                     (a)  specifying that the statement is not substantially correct; and

                     (b)  requiring the claimant to give an amended statement that is substantially correct; and

                     (c)  stating the period within which the claimant is required to give the amended statement to the Medicare Australia CEO.

             (2)  The notice must be given:

                     (a)  unless paragraph (b) applies—within 28 days after the statement under section 18 or 23A or this section was given to the Medicare Australia CEO; or

                     (b)  if an advance payment has been made to the Commonwealth under section 33B in relation to a judgment or settlement in respect of the claim—before the last day on which the Medicare Australia CEO could give the compensable person a notice under section 33C in relation to the payment.

             (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.

             (4)  In deciding whether a statement is substantially correct, the Medicare Australia CEO may have regard to:

                     (a)  the date on which the compensable person suffered the injury; and

                     (b)  the nature of the injury that the compensable person suffered; and

                     (c)  the treatment of the injury; and

                     (d)  statistical information about claims for eligible benefits in relation to injuries of substantially the same kind as the injury in respect of which the claim was made; and

                     (e)  expert medical opinion about the treatment that is usual or may reasonably be expected in relation to injuries of that kind; and

                      (f)  any other matter that the Medicare Australia CEO considers relevant.

             (5)  A reference in subsection (4) to the treatment of the injury includes a reference to the provision of nursing home care or residential care as a result of the injury.

             (6)  Sections 18 and 19 apply to an amended statement under this section as if it were a statement under section 18. Section 23A applies to an amended statement under this section as if it were a statement under section 23A.