{"id":"F2019L00503","name":"Health Insurance (Medicare Compliance Shared Debt) Instrument 2019","slug":"health-insurance-medicare-compliance-shared-debt-instrument-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440020,"registerId":"F2019L00503-fast-fetch-1775955817421","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Health Insurance (Medicare Compliance Shared Debt) Instrument 2019","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n![Commonwealth Coat of Arms of Australia](image.001.jpeg)\n\n \n\nHealth Insurance (Medicare Compliance Shared Debt) Instrument 2019\n\n \n\nI, GREG HUNT, Minister for Health, make the following legislative instrument.\n\nDated 26 March 2019   \n\nGreg Hunt\n\nMinister for Health\n\n \n\n \n\n \n\nContents\n\n1  Name\n\n2  Commencement\n\n3  Authority\n\n4  Definition\n\n5  Percentage\n\n \n\n \n\n1  Name\n\n  This instrument is the Health Insurance (Medicare Compliance Shared Debt) Instrument 2019.\n\n2  Commencement\n\n  This instrument commences on 1 July 2019.\n\n3  Authority\n\n  This instrument is made under paragraph 129ACA(9)(c) of the Health Insurance Act 1973.\n\n4  Definition\n\n  In this instrument:\n\nAct means the Health Insurance Act 1973.\n\n5  Percentage\n\n  For the purposes of paragraph 129ACA(9)(c) of the Act, the prescribed percentage is 35%.\n\n \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":1,"scope_assessment":{"changed":false,"description":"This instrument does exactly what its enabling provision (paragraph 129ACA(9)(c) of the Health Insurance Act 1973) authorises: it specifies a percentage for shared debt recovery. The scope remains tightly confined to this single numerical determination."},"complexity_factors":["Only 5 sections total","Single substantive provision (section 5) containing one number","No defined terms beyond a single acronym ('Act')","No cross-references to other legislation beyond the enabling provision","No conditional logic, exceptions, or procedural requirements","Total length: approximately 200 words"],"plain_english_summary":"This is a very short piece of legislation that sets a specific number: **35%**.\n\n**What it does:**\nWhen Medicare finds that a doctor or practice has overcharged or incorrectly claimed Medicare benefits, they can issue a \"shared debt\" notice. This means both the individual practitioner AND the practice they work for can be held responsible for paying back the money. This instrument decides how much of that debt each party pays.\n\n**The rule:**\nThe practice must pay **35%** of the shared debt, and the individual practitioner pays the remaining 65%.\n\n**Who it affects:**\n- **Medical practices** (clinics, surgeries, health centres) that employ or contract doctors\n- **Individual doctors** who bill Medicare through a practice\n\n**Why it matters:**\nThis creates a clear, fixed split for who pays what when Medicare compliance goes wrong. Before this, there may have been uncertainty or negotiation about how much each party owed. Now it's locked in: the practice pays just over one-third, the doctor pays just under two-thirds. This gives both parties certainty about their financial exposure if Medicare billing errors are found."},"flash_summary":{"complexity_score":2,"scope_assessment":{"changed":false,"description":"This instrument does not expand or narrow the coverage of the Health Insurance Act 1973; it supplies a numeric parameter (35%) to be used in paragraph 129ACA(9)(c) of the Act (section 5). It therefore changes the quantitative split used in that existing statutory mechanism but does not, by itself, change who or what is within the scope of the Act or paragraph 129ACA(9)(c)."},"complexity_factors":["Single, narrow substantive change: prescribes one numeric parameter (section 5).","Reliance on an external statutory provision (paragraph 129ACA(9)(c) of the Health Insurance Act 1973) for substantive effect; full impact requires reading that paragraph.","Low administrative complexity to implement (update calculations/systems to apply 35%), but potential for meaningful financial redistribution depending on the underlying Act.","Clear delegated-authority basis (ministerial instrument) with limited legal drafting complexity (sections 1–5).","Timing element: fixed commencement date (section 2) creates a discrete operational cutover."],"plain_english_summary":"This instrument fixes the “prescribed percentage” used in paragraph 129ACA(9)(c) of the Health Insurance Act 1973 at 35%, commencing 1 July 2019. It doesn’t change who is covered by the Act but requires any party or agency applying that paragraph to use 35% in calculations, reallocating financial burdens and requiring operational updates to billing or reconciliation systems."}},"importantCases":[],"_links":{"self":"/api/acts/health-insurance-medicare-compliance-shared-debt-instrument-2019","history":"/api/acts/health-insurance-medicare-compliance-shared-debt-instrument-2019/history","analysis":"/api/acts/health-insurance-medicare-compliance-shared-debt-instrument-2019/analysis","conflicts":"/api/acts/health-insurance-medicare-compliance-shared-debt-instrument-2019/conflicts","importantCases":"/api/acts/health-insurance-medicare-compliance-shared-debt-instrument-2019/important-cases","documents":"/api/acts/health-insurance-medicare-compliance-shared-debt-instrument-2019/documents"}}