19AHMy Health Record—recovery of payments

#### 19AH My Health Record—recovery of payments Scope (1) This section applies in relation to: (a) an amount (a relevant amount) paid under section 19AG on account of an amount that would but for section 19AD be payable under section 10 in respect of a professional service rendered by or on behalf of a person (the service provider); and (b) an amount (a relevant amount) of medicare benefit paid in respect of a professional service specified in the upload rules for the purposes of subsection 19AD(1) rendered by or on behalf of a person (the service provider) specified for the service in the upload rules for the purposes of that subsection. (2) Subsections (3), (4), (6) and (8) apply whether the relevant amount was paid to the service provider or another person. Amounts not payable (3) If, at the end of the period specified in the upload rules for the purposes of subsection 19AD(1), medicare benefit is not payable in respect of the professional service under section 19AD, an amount equal to the relevant amount is recoverable as a debt due to the Commonwealth from the service provider or from the estate of the service provider. Amounts not evidenced (4) If: (a) the service provider is required, by a notice given under subsection 19AF(3), to produce evidence in relation to the professional service; and (b) the service provider does not comply with the requirement within the period set out in the notice; an amount equal to the relevant amount is recoverable as a debt due to the Commonwealth from the service provider or from the estate of the service provider. (5) Subsection (4) does not apply if the service provider satisfies the Chief Executive Medicare that the service provider’s non‑compliance is due to circumstances beyond the service provider’s control. (6) If: (a) the service provider is required, by a notice given under subsection 19AF(3), to produce evidence in relation to the professional service; and (b) the service provider complies with the requirement within the period set out in the notice; and (c) the evidence produced does not properly substantiate (wholly or partly) that the relevant amount is payable in accordance with section 19AD; then, to the extent that the relevant amount is not properly substantiated, that amount is recoverable as a debt due to the Commonwealth from the service provider or from the estate of the service provider. (7) Subsection (6) does not apply if the service provider satisfies the Chief Executive Medicare that the reason that the evidence produced does not properly substantiate that the relevant amount is payable in accordance with section 19AD is due to circumstances beyond the service provider’s control. (8) If: (a) a person (the notice recipient) other than the service provider is required, by a notice given under subsection 19AF(3), to produce evidence in relation to the professional service; and (b) the notice recipient complies with the requirement within the period set out in the notice; and (c) the evidence produced does not properly substantiate (wholly or partly) that the relevant amount is payable in accordance with section 19AD; then, to the extent that the relevant amount is not properly substantiated, that amount is recoverable as a debt due to the Commonwealth from the service provider or from the estate of the service provider. (9) Subsection (8) does not apply if the service provider satisfies the Chief Executive Medicare that the reason that the evidence produced does not properly substantiate that the relevant amount is payable in accordance with section 19AD is due to circumstances beyond the control of the service provider and the notice recipient. General (10) To avoid doubt, for the purposes of this section and sections 129AAH and 129AAJ, the relevant amount is payable in accordance with section 19AD if section 19AD does not prevent payment of medicare benefit in respect of the professional service. (11) To avoid doubt, an amount paid purportedly by way of benefit or payment under this Act is recoverable under this section once only. (12) This section does not limit, and is not limited by, any other provision of this Act that relates to payment of amounts to the Commonwealth.