28. Adjustments of advance subsidy

(1) Where a contractor has received an advance subsidy on behalf of a member for a premium period and:

(a) there has been a change in the member’s circumstances during any part of that premium period; or

(b) the information on which the amount of advance subsidy was calculated was not correct or has changed,

the contractor must recalculate the amount of advance subsidy based on the new information and apply to the Chief Executive Medicare for an adjustment in accordance with the conditions and requirements of the PSS contract.

(2) An application for an adjustment under this section must be in a form, or in another manner, approved by the Chief Executive Medicare.

(3) If the amount calculated in accordance with this section is less than the amount of advance subsidy to which the adjustment relates, the difference is a debt due to the Commonwealth from the contractor.

(4) If the amount calculated in accordance with this section is more than the amount of advance subsidy to which the adjustment relates, the Chief Executive Medicare must pay the difference to the contractor as an advance subsidy, but the Chief Executive Medicare may offset that amount against other amounts due from the contractor to the Chief Executive Medicare under this Scheme.

(5) Notwithstanding anything in the PSS contract, applications for adjustment must be made as soon as practicable or otherwise within the timeframe notified in writing by the Chief Executive Medicare to the contracted insurer.