Commonwealth Consolidated Acts Commonwealth Consolidated Acts(1) If the Chief Executive Medicare considers that a claim is incorrect, the Chief Executive Medicare may either refuse the claim or pay only such part of the claim as he or she is satisfied is correct.
(2) The Chief Executive Medicare must notify a private health insurer if the Chief Executive Medicare makes a decision mentioned in subsection (1).
(3) A notice under subsection (2) must include reasons for the decision.
(4) The Chief Executive Medicare is taken, for the purposes of this Part, to have decided that a claim is correct if the Chief Executive Medicare does not give notice of his or her decision that the claim is incorrect on or before the day under subsection 279 - 15(2) on or before which, if the claim were correct, it would have been required to have been paid.