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HEALTH INSURANCE ACT 1973 - SECT 106KB Generic findings of inappropriate practice

HEALTH INSURANCE ACT 1973 - SECT 106KB

Generic findings of inappropriate practice

  (1)   This section applies in relation to services (the relevant services ) in respect of which:

  (a)   there are no clinical or practice records or some or all of the clinical or practice records are missing, inadequate, illegible or otherwise incomprehensible; and

  (b)   the Committee is unable, because of the matters mentioned in paragraph   (a), to make findings under section   106K or for the purposes of subsection   82(1A) or (1B).

  (2)   For the purpose of making a finding in respect of the relevant services, the Committee may use any information that it is able to obtain, including information supplied by the Chief Executive Medicare, contained in the report by the Director or given in evidence at hearings held by the Committee.

  (3)   If:

  (a)   the Committee is of the opinion, based on an evaluation by the Committee of the information obtained as mentioned in subsection   (2), that the person under review has engaged in inappropriate practice in the provision of some or all of the relevant services; but

  (b)   the Committee is not able to identify or determine the number of particular services in the provision of which the person engaged in inappropriate practice;

the Committee may nevertheless make a finding that the person engaged in inappropriate practice in the provision of some or all of the relevant services.

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