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HEALTH INSURANCE ACT 1973 - SECT 23DZZIK

Requester civil penalty provisions--asking for or accepting prohibited benefits

Requester asks for or accepts a prohibited benefit

  (1)   A person contravenes this subsection if:

  (a)   the person is a requester of one or more kinds of pathology services or diagnostic imaging services; and

  (b)   the requester:

  (i)   asks for a benefit from a second person; or

  (ii)   accepts a benefit from a second person; and

  (c)   the second person is, or is connected to, a provider of any of those kinds of services; and

  (d)   the benefit:

  (i)   would be reasonably likely to induce a requester to request any of those kinds of services from a provider; or

  (ii)   is related to the business of rendering pathology services or diagnostic imaging services, as the case requires; and

  (e)   the benefit is not a permitted benefit.

Civil penalty:

  (a)   for an individual--600 penalty units; and

  (b)   for a body corporate--6,000 penalty units.

Requester knows that a person connected to a requester asks for or accepts a prohibited benefit

  (2)   A person contravenes this subsection if:

  (a)   the person is a requester of one or more kinds of pathology services or diagnostic imaging services; and

  (b)   a second person:

  (i)   asks for a benefit from a third person; or

  (ii)   accepts a benefit from a third person; and

  (c)   the second person is connected to the requester; and

  (d)   the third person is, or is connected to, a provider of any of those kinds of services; and

  (e)   the requester knows (either at the time of asking for or accepting the benefit or at any later time) that:

  (i)   the second person asks for or accepts the benefit from the third person; and

  (ii)   the second person is connected to the requester; and

  (iii)   the third person is, or is connected to, the provider; and

  (f)   the benefit:

  (i)   would be reasonably likely to induce a requester to request any of those kinds of services from a provider; or

  (ii)   is related to the business of rendering pathology services or diagnostic imaging services, as the case requires; and

  (g)   the benefit is not a permitted benefit.

Civil penalty:

  (a)   for an individual--600 penalty units; and

  (b)   for a body corporate--6,000 penalty units.

  (3)   Subsection   (2) does not apply if:

  (a)   within 30 days after the requester first becomes aware as mentioned in paragraph   (2)(e), the requester reports the benefit to the Chief Executive Medicare, in the form approved in writing by the Chief Executive Medicare; or

  (b)   that 30 day period has not elapsed.


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