HEALTH INSURANCE ACT 1973 - SECT 124FC Determinations in relation to breach of undertaking by approved pathology authority

HEALTH INSURANCE ACT 1973 - SECT 124FC

  (1)   Subject to subsection   124J(8), where:

  (a)   a Committee is established under subsection   124E(3) in relation to an approved pathology authority; or

  (b)   a Committee has made a determination, under subsection   124FA(1), that the Committee should consider whether an approved pathology authority has breached an undertaking;

the Committee shall:

  (c)   determine whether the authority has breached the undertaking given by the authority;

  (d)   if the Committee determines that the authority has breached the undertaking given by the authority by reason of having permitted the rendering of excessive pathology services at an accredited pathology laboratory of which the authority is the proprietor--identify those services; and

  (e)   if the Committee determines that the authority has breached the undertaking given by the authority--make one or more of the following determinations:

  (i)   that no action should be taken against the authority;

  (ii)   that it should counsel one or more of the following persons:

  (A)   the authority;

  (B)   an employee of the authority;

  (C)   where the authority is a body corporate--an officer of the authority;

  (iii)   that it should reprimand one or more of the following persons:

  (A)   the authority;

  (B)   an employee of the authority;

  (C)   where the authority is a body corporate--an officer of the authority;

  (iv)   that the undertaking should be revoked;

  (v)   that no undertaking given by the authority should be accepted by the Minister under section   23DF during the period specified in the determination (being a period expiring not later than 5 years after the day on which the determination takes effect);

  (vi)   where a medicare benefit has been paid, or is payable, to a person other than the authority, in respect of a pathology service and the Committee is of the opinion that the authority failed to comply with the undertaking in relation to that service--that the amount of the medicare benefit or a specified part of that amount be payable by the authority to the Commonwealth.

  (2)   In making a determination under subsection   (1) in relation to an authority, the Committee shall comply with guidelines in force under section   124H.

  (3)   A determination under subsection   (1) shall be made in writing.