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PRIVATE HEALTH INSURANCE ACT 2007 (NO. 31, 2007) - SECT 279.45

Reconsideration of decisions

             (1)  A private health insurer that has been given a notice under subsection 279‑20(2) or 279‑40(3) may request the Medicare Australia CEO to reconsider the decision.

             (2)  The request must:

                     (a)  set out the reasons for the request; and

                     (b)  be made within the period of 28 days after the day on which the Medicare Australia CEO gave the notice.

             (3)  As soon as practicable after receiving the request, the Medicare Australia CEO must reconsider the decision and:

                     (a)  affirm it; or

                     (b)  vary it; or

                     (c)  revoke it and make a fresh decision.

Note:          Decisions on reconsideration are reviewable under Part 6‑9.

             (4)  If the Medicare Australia CEO varies the decision or revokes the decision and makes a fresh decision, the decision as varied, or the fresh decision, as the case may be, has effect according to its terms and is taken always to have had that effect from the time when the original decision was made.

             (5)  The Medicare Australia CEO must notify the private health insurer stating the Medicare Australia CEO's decision on the reconsideration together with a statement of his or her reasons for the decision.

             (6)  The Medicare Australia CEO is taken, for the purposes of this Part, to have revoked the decision if the Medicare Australia CEO does not notify the private health insurer of his or her decision on the reconsideration within 28 days after receiving the request.



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