Health Insurance Act 1973
92Agreement entered into between Director and person under review
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92 Agreement entered into between Director and person under review
(1) A person under review and the Director may enter into a written agreement under which: (a) the person under review acknowledges that the person engaged in inappropriate practice in connection with the provision of specified services during the review period (whether rendered or initiated by the person or an associated person); and (b) specified action in relation to the person under review (being action of a kind mentioned in subsection (2)) is to take effect.
Note: The effect of paragraph (b) and subsection (2) is that action may be specified in the agreement only in relation to the person under review, even if the inappropriate practice is in connection with the rendering or initiating of services by an associated person of the person under review.
(2) The action that may be specified under paragraph (1)(b) in the agreement includes any one or more of the following: (a) that the Director, or the Director’s nominee, is to reprimand the person under review; (aa) that the Director, or the Director’s nominee, is to counsel the person under review; (b) if any medicare benefit or dental benefit has been paid (whether or not to the person under review) for services referred to in paragraph (1)(a)—that the person under review is to repay to the Commonwealth an amount equal to the whole or a specified part of that medicare benefit or dental benefit; (c) that any medicare benefit or dental benefit that would otherwise be payable for services referred to in paragraph (1)(a) is to cease to be payable; (ca) if an amount has been paid (whether or not to the person under review) for treatment under a relevant DVA law relating to services referred to in paragraph (1)(a)—that the person under review is to repay to the Commonwealth an amount equal to the whole or a specified part of the amount paid for the treatment; (cb) that any amount for treatment under a relevant DVA law that would otherwise be payable for services referred to in paragraph (1)(a) is to cease to be payable; (d) if any of the services referred to in paragraph (1)(a) were rendered or initiated by an associated person—that the person under review is to: (i) give specified classes of associated persons specified information about the appropriate provision of services, or that is relevant to preventing inappropriate practice in the provision of services, in a specified form (if any) within a specified period; and (ii) give the Chief Executive Medicare, within a specified period, specified evidence that the person under review has taken the action mentioned in subparagraph (i); (da) if the person under review is a midwife and there is in force in respect of the person an undertaking under section 21B—that the Minister’s acceptance of the undertaking is to be taken to be revoked; (db) if the person under review is a nurse practitioner and there is in force in respect of the person an undertaking under section 22A—that the Minister’s acceptance of the undertaking is to be taken to be revoked; (e) if the person under review is a person in respect of whom a Part VII authority is in force and a service referred to in paragraph (1)(a) involves prescribing or supplying a pharmaceutical benefit—that the Part VII authority is to be taken, for the purposes of the National Health Act 1953, to be suspended for a period of not more than 3 years starting when the agreement takes effect; (f) if the person under review is a practitioner—that the person is to be disqualified, for a specified period starting when the agreement takes effect, in respect of one or more of the following: (i) provision of specified services, or provision of services other than specified services; (ii) provision of services to a specified class of persons, or provision of services to persons other than persons included in a specified class of persons; (iii) provision of services within a specified location, or provision of services otherwise than in a specified location; (g) if the person under review is a practitioner—that the person is to be fully disqualified for a specified period starting when the agreement takes effect.