24Functions in relation to inappropriate practices

24 Functions in relation to inappropriate practices

(1) The following are prescribed functions: (a) devising and implementing measures to: (i) prevent practitioners and other persons from engaging in inappropriate practice; and (ii) detect cases where practitioners or other persons have engaged in inappropriate practice in relation to rendering or initiating services; and (iii) prevent or detect activities relating to claims for medicare benefits, or receipt of medicare benefits, that may constitute an offence under the Health Insurance Act, the Crimes Act 1914 or the Criminal Code; (b) if there are reasonable grounds to suspect that a person has engaged in inappropriate practice, investigating the conduct of the person to decide whether to make a request under subsection 86(1) of the Health Insurance Act for the provision of services by the person to be reviewed; (c) investigating cases where there are reasonable grounds to suspect that: (i) an act in relation to a claim for medicare benefits, or receipt of medicare benefits, may constitute an offence under the Health Insurance Act, the Crimes Act 1914 or the Criminal Code; or (ii) a person may have committed an offence against section 23DP, 106D or 106EA, or subsection 19D(2), 19D(7), 106E(1) or 106E(2), of the Health Insurance Act; (d) if an investigation under paragraph (c) discloses enough evidence for a prosecution, referring the case and the evidence to the Australian Federal Police or the Director of Public Prosecutions; (e) undertaking action (including starting legal proceedings) to recover from a person an amount of medicare benefit that is recoverable by the Commonwealth, including under the Health Insurance Act. (2) In this regulation:

inappropriate practice has the meanings given by section 82 of the Health Insurance Act.

practitioner has the meaning given by section 81 of the Health Insurance Act.

service has the meaning given by section 81 of the Health Insurance Act.