Commonwealth Consolidated Acts

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

  (1)   If the Chief Executive Medicare is satisfied that a statement given to the Chief Executive Medicare under section   18 or 23A or this section is not substantially correct, the Chief Executive Medicare 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 Chief Executive Medicare.

  (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 Chief Executive Medicare; 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 Chief Executive Medicare could give the compensable person a notice under section   33C in relation to the payment.

  (3)   The claimant must give to the Chief Executive Medicare the statement required by the notice within the period of 28 days after being given the notice.

Note:   Sections   137.1 and 137.2 of the Criminal Code create offences for providing false or misleading information or documents.

  (4)   In deciding whether a statement is substantially correct, the Chief Executive Medicare 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 Chief Executive Medicare considers relevant.

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