Document ID: chunk:federal_register_of_legislation:C2025C00156:section:129aad:p2
Version: federal_register_of_legislation:C2025C00156
Segment Type: section
Provision Reference: s 129AAD (pt 2/4)
Character Range: 726907–729485

in relation to the amount paid, purportedly by way of benefit or payment under this Act, in respect of the service.
 (4) A notice may only be given in respect of a professional service for which a claim for an amount to be paid under this Act in respect of the service was made during the period mentioned in subsection (4A).
 (4A) The period is 2 years immediately before the day a written request under subsection (3) was first given to the person in relation to one or more professional services specified in the notice.
 (5) The CEO may require the person, in relation to each professional service specified in the notice:
 (a) subject to subsection (6), to produce to the CEO, or a Departmental employee (within the meaning of the Human Services (Medicare) Act 1973), any document, or extract of any document, that is relevant for a purpose set out in subsection (2); or
 (b) to make a copy of any such document or extract and to produce that copy to the CEO or employee.
Note: For a person referred to in paragraph (2)(a), failure to comply with a notice may lead to recovery action (see sections 129AC and 129ACA) and an administrative penalty may be applied (see sections 129AEA, 129AEB and 129AEC). For a person referred to in paragraph (2)(b), failure to comply with a notice may lead to a civil penalty (see section 129AAE).
 (6) If a document, extract or copy contains clinical details relating to an individual, the person to whom the notice is given is not required to produce the document, extract or copy to a person other than a Departmental employee (within the meaning of the Human Services (Medicare) Act 1973) who is a medical practitioner.

CEO not to give notice to certain persons
 (7) A person referred to in paragraph (2)(b) does not include:
 (a) the person in respect of whom the professional service was rendered; or
 (b) the person who incurred the medical expenses in respect of the service.

Content of notice
 (8) The notice must:
 (a) specify details of each professional service (including the item, date on which the service was rendered and medicare number of the person in respect of whom the service was rendered) in relation to which the document, extract or copy is to be produced; and
 (b) specify the reason or reasons for the CEO's concern that an amount paid, purportedly by way of benefit or payment under this Act, in respect of each such service may exceed the amount (if any) that should have been paid; and
 (ba) specify the circumstances in which a determination may be made under subsection 129ACA(2) in relation to an amount;