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HEALTH INSURANCE ACT 1973 - SECT 129AAJ

Review of decisions to claim amounts as debts

  (1)   If the Chief Executive Medicare (the CEO ) makes a decision referred to in subsection   129AAI(1) (other than a decision mentioned in subsection   129AAI(1A)) about a person or an estate, the person or estate may apply in writing to the CEO, in the form approved in writing by the CEO, for a review of the decision.

  (1A)   Subsection   (1) does not apply if the person or estate has notified the CEO, in the form approved in writing by the CEO, that the person or estate waives the right to review of the decision to claim the amount as a debt.

  (2)   In making an application under subsection   (1), the person or estate may provide the CEO with additional information to substantiate (wholly or partly) that the amount paid, purportedly by way of benefit or payment under this Act in respect of the service, should have been paid.

  (3)   An application for review of a decision must be made within 28 days after the person or estate is notified of the decision.

  (4)   On receiving an application for review of a decision, the CEO must:

  (a)   review the decision; and

  (b)   confirm, vary or revoke the decision.

  (5)   The CEO must give to the applicant written notice of the decision (the reconsidered decision ) on the review within 28 days after receiving the application for review.

  (6)   A failure to comply with the requirements of subsection   (5) does not affect the validity of the review or of the reconsidered decision.

  (7)   Applications may be made to the Administrative Review Tribunal for review of reconsidered decisions.

  (8)   An application under subsection   (7) may be made only if:

  (a)   the applicant has been given notice of the reconsidered decision under subsection   (5); and

  (b)   one or more garnishee notices have been given under subsection   129AEG(1) in relation to the debt to which the reconsidered decision relates.

  (9)   Despite subsection   18(1) of the Administrative Review Tribunal Act 2024 , an application under subsection   (7) of this section must be made within the period of 28 days after the day the first garnishee notice is given.

  (10)   To avoid doubt:

  (a)   a decision to which subsection   (1) applies may be reviewed by the CEO under subsection   (4) once only; and

  (b)   a reconsidered decision takes effect:

  (i)   on the day specified in the reconsidered decision; or

  (ii)   if a day is not specified--on the day on which the reconsidered decision is made.



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