{"id":"C2004A04981","name":"Health and Other Services (Compensation) Care Charges Act 1995","slug":"health-and-other-services-compensation-care-charges-act-1995","collection":"act","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":"131 of 1995","makingDate":null,"administeringDepartment":null,"currentVersion":{"id":38903,"registerId":"commonwealth-C2004A04981-current","compilationNumber":null,"startDate":"2026-04-01","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Short title","content":"#### 1 Short title\n\n  This Act may be cited as the Health and Other Services (Compensation) Care Charges Act 1995.","sortOrder":0},{"sectionNumber":"2","sectionType":"section","heading":"Commencement","content":"#### 2 Commencement\n\n  This Act commences on the day on which the Health and Other Services (Compensation) Act 1995 commences.","sortOrder":1},{"sectionNumber":"3","sectionType":"section","heading":"Interpretation","content":"#### 3 Interpretation\n\n  Unless the contrary intention appears, expressions used in this Act have the same meanings as in the Health and Other Services (Compensation) Act 1995.","sortOrder":2},{"sectionNumber":"3A","sectionType":"section","heading":"Norfolk Island","content":"#### 3A Norfolk Island\n\n  This Act extends to Norfolk Island.","sortOrder":3},{"sectionNumber":"4","sectionType":"section","heading":"Application of this Act to events occurring before the commencement of the Health and Other Services (Compensation) Act 1995","content":"#### 4 Application of this Act to events occurring before the commencement of the Health and Other Services (Compensation) Act 1995\n\n  (1) This Act only applies in relation to an amount of compensation fixed by a judgment or settlement if the judgment or settlement is made on or after the day on which the Health and Other Services (Compensation) Act 1995 commences.\n  (2) This Act only applies in relation to an amount of compensation payable under a reimbursement arrangement if the reimbursement arrangement was made on or after the day on which the Health and Other Services (Compensation) Act 1995 commences.\n  (3) This Act applies in relation to such a judgment, settlement or reimbursement arrangement even if it is made in respect of an injury that occurred before that day.\n  (4) In its application in respect of an injury that occurred before that day, this Act is capable of applying in relation to a particular payment of an eligible benefit whether the payment was made before, on or after that day.","sortOrder":4},{"sectionNumber":"5","sectionType":"section","heading":"Charge on compensation in respect of reimbursements for professional services","content":"#### 5 Charge on compensation in respect of reimbursements for professional services\n\n  (1) This section applies if:\n    (a) a reimbursement arrangement has been made in respect of an injury to a compensable person; and\n    (b) the person is entitled, under the reimbursement arrangement, to compensation by way of reimbursement of expenses as those expenses are incurred, being expenses relating to the professional services rendered to the person in the course of treatment of, or as a result of, the injury.\n  (2) If:\n    (a) medicare benefit has been paid in respect of a professional service rendered to the person; and\n    (b) under the reimbursement arrangement, the person is entitled to reimbursement of the whole or any part of the amount payable for the service;\n  there is payable to the Commonwealth a charge, in respect of the compensation, of an amount equal to the medicare benefit.\n  (3) The charge is payable by the person entitled to the reimbursement.\n  (4) This section has effect only so far as it is a law imposing taxation or dealing with the imposition of taxation within the meaning of section 55 of the Constitution.\n\n> Note: So far as this section would not be a law imposing taxation or dealing with the imposition of taxation, see section 7 of the Health and Other Services (Compensation) Act 1995.","sortOrder":5},{"sectionNumber":"6","sectionType":"section","heading":"Charge on compensation amounts in respect of past payments of medicare benefit","content":"#### 6 Charge on compensation amounts in respect of past payments of medicare benefit\n\n  (1) Subject to subsections (2), (3), (6) and (9), if:\n    (a) an amount of compensation is fixed under a judgment or settlement made in respect of an injury to a compensable person; and\n    (b) medicare benefit has already been paid in respect of a professional service rendered to that person in the course of treatment of, or as a result of, the injury; and\n    (c) a liability has not already arisen under section 5 in respect of that payment of medicare benefit;\n  there is payable to the Commonwealth a charge, in respect of the compensation, of an amount equal to the medicare benefit.\n  (2) Subject to subsection (3), if:\n    (a) the judgment or settlement fixes the amount of compensation on the basis that liability for the injury should be apportioned between the compensable person and the compensation payer; and\n    (b) as a result, the amount of compensation is less than it would have been if liability had not been so apportioned;\n  the amount payable to the Commonwealth under subsection (1) is reduced by the proportion corresponding to the proportion of liability for the injury that is apportioned to the compensable person by the judgment or settlement.\n  (3) If:\n    (a) the amount of compensation is fixed by a judgment that specifies an amount (the past medical care component), being a portion of the amount of compensation, to be a component for the medical expenses already incurred relating to the injury; and\n    (b) the amount that, apart from this subsection, would be payable to the Commonwealth under this section exceeds the past medical care component;\n  the amount payable under subsection (1) is taken to be the past medical care component.\n  (4) The charge is payable by the compensable person.\n  (5) This section has effect only so far as it is a law imposing taxation or dealing with the imposition of taxation within the meaning of section 55 of the Constitution.\n\n> Note: So far as this section would not be a law imposing taxation or dealing with the imposition of taxation, see section 8 of the Health and Other Services (Compensation) Act 1995.\n\n  (6) Subject to subsections (7) and (8), and section 37 of the Health and Other Services (Compensation) Act 1995, this section does not apply if:\n    (a) the notifiable person in relation to the claim for compensation concerned has entered into a bulk payment agreement with the Chief Executive Medicare; and\n    (b) the notifiable person has complied with all the conditions of the bulk payment agreement; and\n    (c) an amount of compensation is fixed under the judgment or settlement during the period of the bulk payment agreement; and\n    (d) the judgment or settlement determines all the outstanding liability of the compensation payer in relation to the claim.\n  (7) Subsection (6) does not apply in relation to a judgment or settlement of a kind referred to in that subsection if:\n    (a) an amount of compensation was fixed under the judgment or settlement during the period of the bulk payment agreement; and\n    (b) at the time the judgment or settlement was made, it purported to determine all the outstanding liability of the compensation payer in relation to the claim; and\n    (c) another judgment or settlement in respect of the claim is made after the end of the period of the bulk payment agreement.\n  (8) Subsection (6) does not affect the validity of a payment of money pursuant to a notice under section 24 of the Health and Other Services (Compensation) Act 1995 if the payment occurred before the amount of compensation was fixed under the judgment or settlement referred to in that subsection.\n  (9) This section does not apply if:\n    (b) the amount of compensation fixed by the judgment or settlement is a small amount; and\n    (c) the amount of compensation so fixed is the entire amount of compensation for the injury to which the claim relates.\n\n> Note: For small amount see section 38 of the Health and Other Services (Compensation) Act 1995.","sortOrder":6},{"sectionNumber":"7","sectionType":"section","heading":"Charge on compensation in respect of reimbursements for nursing home care, residential care or home care","content":"#### 7 Charge on compensation in respect of reimbursements for nursing home care, residential care or home care\n\n  (1) This section applies if:\n    (a) a reimbursement arrangement has been made in respect of an injury to a compensable person; and\n    (b) the person is entitled, under the reimbursement arrangement, to compensation by way of reimbursement of expenses as those expenses are incurred, being expenses incurred in respect of nursing home care, residential care or home care provided to the person in the course of treatment of, or as a result of, the injury.\n  (2) If:\n    (a) nursing home care, residential care or home care has been provided to the person; and\n    (aa) nursing home benefit, residential care subsidy or home care subsidy has been paid in respect of the nursing home care, residential care or home care; and\n    (b) under the reimbursement arrangement, the person is entitled to reimbursement of the whole or any part of the amount payable for the nursing home care, residential care or home care;\n  on payment of the nursing home benefit, residential care subsidy or home care subsidy, there is payable to the Commonwealth, in respect of the compensation, a charge of an amount equal to the nursing home benefit, residential care subsidy or home care subsidy.\n  (3) The charge is payable by the person entitled to the reimbursement.\n  (4) This section has effect only so far as it is a law imposing taxation or dealing with the imposition of taxation within the meaning of section 55 of the Constitution.\n\n> Note: So far as this section would not be a law imposing taxation or dealing with the imposition of taxation, see section 9 of the Health and Other Services (Compensation) Act 1995.","sortOrder":7},{"sectionNumber":"8","sectionType":"section","heading":"Charge on compensation in respect of past payments of nursing home benefit, residential care subsidy or home care subsidy","content":"#### 8 Charge on compensation in respect of past payments of nursing home benefit, residential care subsidy or home care subsidy\n\n  (1) Subject to subsections (2), (3), (6) and (9), if:\n    (a) an amount of compensation is fixed under a judgment or settlement made in respect of an injury to a compensable person; and\n    (b) nursing home care, residential care or home care has been provided to that person in the course of treatment of, or as a result of, the injury; and\n    (ba) nursing home benefit, residential care subsidy or home care subsidy has already been paid in respect of that nursing home care, residential care or home care; and\n    (c) a liability has not already arisen under section 7 in respect of that payment of nursing home benefit, residential care subsidy or home care subsidy;\n  there is payable to the Commonwealth a charge, in respect of the compensation, of an amount equal to the nursing home benefit, residential care subsidy or home care subsidy.\n  (2) Subject to subsection (3), if:\n    (a) the judgment or settlement fixes the amount of compensation on the basis that liability for the injury should be apportioned between the compensable person and the compensation payer; and\n    (b) as a result, the amount of compensation is less than it would have been if liability had not been so apportioned;\n  the amount payable to the Commonwealth under subsection (1) is reduced by the proportion corresponding to the proportion of liability for the injury that is apportioned to the compensable person by the judgment or settlement.\n  (3) If:\n    (a) the amount of compensation is fixed by a judgment that specifies an amount (the past care component), being a portion of the amount of compensation, to be a component for the nursing home care expenses, residential care expenses or home care expenses already incurred relating to the injury; and\n    (b) the amount that, apart from this subsection, would be payable to the Commonwealth under this section exceeds the past care component;\n  the amount payable under subsection (1) is taken to be the past care component.\n  (4) The charge is payable by the compensable person.\n  (5) This section has effect only so far as it is a law imposing taxation or dealing with the imposition of taxation within the meaning of section 55 of the Constitution.\n\n> Note: So far as this section would not be a law imposing taxation or dealing with the imposition of taxation, see section 10 of the Health and Other Services (Compensation) Act 1995.\n\n  (6) Subject to subsections (7) and (8), and section 37 of the Health and Other Services (Compensation) Act 1995, this section does not apply if:\n    (a) the notifiable person in relation to the claim for compensation concerned has entered into a bulk payment agreement with the Chief Executive Medicare; and\n    (b) the notifiable person has complied with all the conditions of the bulk payment agreement; and\n    (c) an amount of compensation is fixed under the judgment or settlement during the period of the bulk payment agreement; and\n    (d) the judgment or settlement determines all the outstanding liability of the compensation payer in relation to the claim.\n  (7) Subsection (6) does not apply in relation to a judgment or settlement of a kind referred to in that subsection if:\n    (a) an amount of compensation was fixed under the judgment or settlement during the period of the bulk payment agreement; and\n    (b) at the time the judgment or settlement was made, it purported to determine all the outstanding liability of the compensation payer in relation to the claim; and\n    (c) another judgment or settlement in respect of the claim is made after the end of the period of the bulk payment agreement.\n  (8) Subsection (6) does not affect the validity of a payment of money pursuant to a notice under section 24 of the Health and Other Services (Compensation) Act 1995 if the payment occurred before the amount of compensation was fixed under the judgment or settlement referred to in that subsection.\n  (9) This section does not apply if:\n    (b) the amount of compensation fixed by the judgment or settlement is a small amount; and\n    (c) the amount of compensation so fixed is the entire amount of compensation for the injury to which the claim relates.\n\n> Note: For small amount see section 38 of the Health and Other Services (Compensation) Act 1995.","sortOrder":8}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"The legislation appears to maintain its original scope as enacted in 1995. It was designed to recover Medicare and aged care benefits from compensation payments, and the current text reflects that core purpose without significant expansion into unrelated areas. The aged care components (nursing home benefit, residential care subsidy, home care subsidy) appear to be part of the original legislative design rather than later additions, given the Act's 1995 vintage and the historical context of aged care funding structures."},"complexity_factors":["Heavy reliance on defined terms from a companion Act (Health and Other Services (Compensation) Act 1995) rather than defining terms internally","Nested conditional logic with multiple subsections and cross-references (e.g., section 6 has 9 subsections with exceptions to exceptions)","Constitutional safety provisions requiring the law to operate 'only so far as' it imposes taxation, with fallback references to companion legislation","Parallel structure between sections 5-6 (medical) and 7-8 (aged care) creating duplication but with slight variations","Complex temporal application rules in section 4 distinguishing between when injuries occurred, when judgments were made, and when Medicare benefits were paid","Multiple exception categories: contributory negligence reductions (ss 6(2), 8(2)), past medical care component caps (ss 6(3), 8(3)), bulk payment agreements (ss 6(6)-(8), 8(6)-(8)), and small amount exemptions (ss 6(9), 8(9))","Cross-references to specific sections of the companion Act (ss 7, 8, 9, 10, 24, 37, 38) necessary to understand full operation"],"plain_english_summary":"This law ensures that when someone receives compensation for an injury (through a court judgment or settlement), the Australian Government can recover money it previously spent on that person's medical and care costs through Medicare and aged care subsidies.\n\n**Who it affects:**\n- **Injured people** who receive compensation payments\n- **Compensation payers** (usually insurance companies or employers who pay compensation)\n- **The Commonwealth** (Australian Government), which recovers costs\n\n**How it works:**\n\nWhen someone is injured and later gets compensation, the government essentially says: \"We already paid for your medical treatment and care through Medicare or aged care subsidies. Now that you're getting money from the person who caused your injury, we want that money back.\"\n\nThe law creates **charges** (amounts payable to the Commonwealth) in two main situations:\n\n1. **Ongoing reimbursements** (Sections 5 and 7): If the injured person has an arrangement where they get reimbursed for medical or care expenses as they incur them, and Medicare or aged care subsidies have already covered those costs, the person must pay the government back the subsidy amount.\n\n2. **Lump sum compensation** (Sections 6 and 8): If the injured person receives a lump sum judgment or settlement, and Medicare or aged care subsidies were previously paid for their treatment, the government charges them for those past payments.\n\n**Key protections and limits:**\n- If the injured person was partly at fault for their injury (contributory negligence), the charge is reduced proportionally\n- If the compensation is small, no charge applies\n- If the parties enter a \"bulk payment agreement\" with Medicare, the charges may not apply\n- The charge cannot exceed the specific portion of compensation allocated to past medical expenses\n\n**Why the strange tax note?**\nThe Constitution says only certain types of laws can impose taxes. This law includes careful wording to ensure it qualifies as a tax law, otherwise it might be unconstitutional. If it doesn't qualify as tax law, the companion Act (the Health and Other Services (Compensation) Act 1995) picks up the slack.\n\n**Why it matters:**\nThis prevents \"double dipping\"—where an injured person gets their medical costs covered by Medicare AND gets compensation for those same medical costs from the responsible party. It protects the public purse by ensuring compensation goes toward actual losses, not costs already covered by taxpayers."},"summary":{"complexity_score":7,"scope_assessment":{"changed":false,"description":"The Act remains focused on its original intent: creating a taxation charge mechanism to recover Commonwealth expenditure on Medicare and care subsidies from compensation recipients. The inclusion of residential care and home care subsidies (alongside the original nursing home benefit) reflects expansion of aged care funding models over time, but this is consistent with the original policy purpose rather than a departure from it."},"complexity_factors":["Multiple interlocking charge types (4 distinct charging mechanisms) requiring cross-referencing to understand the full picture","Heavy reliance on definitions and mechanisms in a companion Act (Health and Other Services (Compensation) Act 1995), meaning this Act cannot be understood in isolation","Constitutional framing required — sections explicitly limit their own operation to 'laws imposing taxation' under s.55 of the Constitution, with the non-taxation aspects dealt with elsewhere","Complex exceptions and carve-outs including bulk payment agreements, contributory negligence apportionment, past care components, and small amount exemptions","Temporal complexity — the Act applies to pre-commencement injuries but only post-commencement judgments, with nuanced rules about when payments were made","Subsection interdependencies — multiple subsections modify or switch off other subsections depending on factual circumstances (e.g. ss.(6), (7), (8) in sections 6 and 8)","Specialised terminology (compensable person, notifiable person, bulk payment agreement, reimbursement arrangement) that laypeople would not readily understand"],"plain_english_summary":"## Health and Other Services (Compensation) Care Charges Act 1995\n\n### What does this law do?\n\nThis Act requires people who receive **compensation payouts** (for example, from a personal injury claim, workers' compensation, or a car accident claim) to **repay the Commonwealth** for any Medicare benefits, nursing home benefits, or aged/home care subsidies that the government paid for their treatment *because of that injury*.\n\nIn plain terms: **if the government paid your medical or care bills while you were waiting for your compensation case to settle, you must pay that money back to the government once you receive your payout.**\n\n### Who does this affect?\n\n- **Injured people** who received Medicare-funded healthcare or government-subsidised nursing home, residential, or home care as a result of their injury, AND who later receive a compensation payment (e.g. a court judgment or out-of-court settlement)\n- **People with ongoing reimbursement arrangements** — where a compensation payer reimburses costs as they arise, rather than as a lump sum\n\n### How does the charge work?\n\nThere are **four types of charges** created by this Act:\n\n1. **Ongoing Medicare repayment** (s.5): If your compensation arrangement reimburses you for medical costs as you go, and Medicare paid for those services, you owe the Commonwealth the Medicare amount.\n2. **Lump sum Medicare repayment** (s.6): If you receive a lump sum compensation payment and Medicare previously paid for your treatment, you owe the Commonwealth those Medicare amounts — *unless* the payout is a small amount, or a valid bulk payment agreement applies.\n3. **Ongoing care repayment** (s.7): Same as #1, but for nursing home, residential, or home care subsidies.\n4. **Lump sum care repayment** (s.8): Same as #2, but for nursing home, residential, or home care subsidies.\n\n### Important protections and reductions\n\n- **Shared fault (contributory negligence):** If the court finds you were partly at fault for your injury, the repayment amount is reduced proportionally — so you're not penalised for the share of blame attributed to you.\n- **Judgment specifies past care costs:** If a court judgment separately identifies the portion of your payout that covers past medical/care costs, the repayment is capped at that amount — you won't owe more than the court said was for those expenses.\n- **Bulk payment agreements:** Compensation payers (e.g. insurers) can enter into agreements with Medicare to pay a flat rate instead of tracking individual claims — this can reduce or eliminate the charge in some situations.\n- **Small amounts:** Very small compensation payouts (as defined elsewhere in the related legislation) are exempt.\n\n### Why does this law exist?\n\nThe government's logic is straightforward: Medicare and aged care subsidies are meant to help people who need medical care — not to subsidise compensation payouts received by people who are being compensated for exactly those costs by someone else (like an insurer). This law prevents **double-dipping**, ensuring the Commonwealth gets back what it spent when a third party is ultimately responsible for covering those costs.\n\n### Coverage\n\nThis Act applies across Australia, **including Norfolk Island**. It applies to judgments and settlements made after the Act commenced, even if the original injury happened earlier."},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":false,"description":"Based on the text provided, the Act’s scope is internally consistent: it applies to reimbursement arrangements and to judgments/settlements made on or after commencement (even if the injury pre‑dates commencement) (s2; s4(1)–(4)), extends to Norfolk Island (s3A), and limits each charge provision to the extent it is a law imposing taxation under section 55 of the Constitution (s5(4); s6(5); s7(4); s8(5)). There is no textual indication in the supplied material that the Act’s scope has been altered from an earlier stated intent."},"complexity_factors":["Multiple triggering pathways: reimbursement arrangements (ss5,7) versus judgments/settlements (ss6,8).","Different benefit types covered (Medicare benefits; nursing home benefit; residential care subsidy; home care subsidy) with parallel but separate rules (ss5–8).","Reductions, caps and apportionment rules for judgments/settlements (s6(2)–(3); s8(2)–(3)).","Bulk payment agreement exception with multiple conditions and follow‑up exceptions (s6(6)–(8); s8(6)–(8)).","Timing and retrospective limits: Act applies only to arrangements/judgments made on or after commencement but can apply to earlier injuries (s2; s4(1)–(4)).","Constitutional qualification: each charge provision operates only to the extent it is a law imposing taxation under s55, requiring cross‑reference to companion Act provisions for non‑tax treatment (s5(4); s6(5); s7(4); s8(5)).","Cross‑references and dependence on definitions and procedures in the Health and Other Services (Compensation) Act 1995 (s3 and notes).","Administrative complexity: need to check Medicare payment records, settlement/judgment components, and compliance with bulk payment agreements (ss6(1)(b); s8(1)(ba); s6(6); s8(6))."],"plain_english_summary":"The Act lets the Commonwealth recover from compensation payments amounts it has already paid as Medicare benefits or nursing/residential/home‑care subsidies. It creates a recoverable charge that applies when benefits are paid under reimbursement arrangements or when compensation is fixed by judgment or settlement, affecting injured persons, reimbursement recipients and compensation payers.\n\nThis matters because it changes settlement and reimbursement incentives—apportionment, specified past‑care components and bulk payment agreements with Medicare can materially alter how much the Commonwealth recovers."},"issue_detection":{"absurdities":[],"contradictions":[]}},"importantCases":[],"_links":{"self":"/api/acts/health-and-other-services-compensation-care-charges-act-1995","history":"/api/acts/health-and-other-services-compensation-care-charges-act-1995/history","analysis":"/api/acts/health-and-other-services-compensation-care-charges-act-1995/analysis","conflicts":"/api/acts/health-and-other-services-compensation-care-charges-act-1995/conflicts","importantCases":"/api/acts/health-and-other-services-compensation-care-charges-act-1995/important-cases","documents":"/api/acts/health-and-other-services-compensation-care-charges-act-1995/documents"}}