Document ID: chunk:federal_register_of_legislation:F2021C00040:reg:27
Version: federal_register_of_legislation:F2021C00040
Segment Type: reg
Provision Reference: reg 27
Character Range: 27564–29454

27  Inappropriate practices
 (1) The following are prescribed functions of the Chief Executive Medicare:
 (a) to devise and implement 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—to investigate 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) to investigate 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—to refer the case and the evidence to the Australian Federal Police or the Director of Public Prosecutions;
 (e) to take 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 section:
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.