Commonwealth Consolidated Acts

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Requests by Chief Executive Medicare to Director to review provision of services

  (1)   Subject to subsection   (1A), the Chief Executive Medicare may, in writing, request the Director to review the provision of services by a person during the period specified in the request if it appears to the Chief Executive Medicare that there is a possibility that the person may have:

  (a)   provided services during the period; and

  (b)   engaged in inappropriate practice in the provision of the services.

Note 1:   For provides services , see subsection   81(2).

Note 2:   Reviewing the provision of services by a person during a period may include reviewing whether particular services were provided during the period by the person or another person.

  (1A)   If the Chief Executive Medicare becomes aware that the circumstances in which services were rendered or initiated by a person constitute a prescribed pattern of services, the Chief Executive Medicare must make a request under subsection   (1) in relation to the services.

  (2)   The period specified in the request must fall within the 2 year period immediately preceding the request.

  (3)   The request must include reasons for the request.

Note:   If the request is made because of subsection   (1A), it may include reasons other than the prescribed pattern of services.

  (4)   The content and form of the request must comply with any guidelines made under subsection   (5).

  (5)   The Minister may, by legislative instrument, make guidelines about the content and form of requests for review.

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