Document ID: chunk:federal_register_of_legislation:C2024A00070:clause:1_127:p1
Version: federal_register_of_legislation:C2024A00070
Segment Type: clause
Provision Reference: sch 1 cl 127 (pt 1/2)
Character Range: 16459–19284

127  Assignor of medicare benefit to be given notifications etc.

Bulk billing assignments
 (1) A person contravenes this subsection if:
 (a) the person is a professional mentioned in paragraph 20A(1)(b); and
 (b) the professional and an eligible person (the assignor) enter into an agreement under subsection 20A(1); and
 (c) the assignor asks for a copy of the terms of the agreement; and
 (d) the professional does not give the assignor a copy of the terms of the agreement as soon as practicable after the assignor asks for it.
Civil penalty: 5 penalty units.
 (2) A person contravenes this subsection if:
 (a) the person is a professional mentioned in paragraph 20A(1)(b); and
 (b) the professional and an eligible person (the assignor) enter into an agreement under subsection 20A(1); and
 (c) under regulations made for the purposes of this paragraph, the professional is required to give a notification to the assignor relating to the agreement or to a right to payment of a medicare benefit assigned under the agreement; and
 (d) the professional contravenes those regulations; and
 (e) those regulations specify that this paragraph applies.
Civil penalty: 5 penalty units.

Simplified billing assignments
 (3) A person contravenes this subsection if:
 (a) the person is an insurer or approved billing agent; and
 (b) an eligible person (the assignor) is taken to have assigned a medicare benefit to the insurer or approved billing agent under subsection 20A(2); and
 (c) the medicare benefit is paid to the insurer or approved billing agent; and
 (d) the insurer or approved billing agent does not give the assignor a notification:
 (i) in accordance with any requirements specified in the regulations; and
 (ii) within 6 months of the payment.
Civil penalty: 5 penalty units.
 (4) A person contravenes this subsection if:
 (a) the person is a responsible provider mentioned in paragraph 20AAA(3)(a); and
 (b) an eligible person (the assignor) makes a request for the purposes of paragraph 20AAA(3)(a) to the responsible provider; and
 (c) the assignor asks the responsible provider for a copy of the terms of the request; and
 (d) the responsible provider does not ensure that the assignor is given a copy of the terms of the request as soon as practicable after the assignor asks for it.
Civil penalty: 5 penalty units.
 (5) A person contravenes this subsection if:
 (a) the person is a responsible provider mentioned in paragraph 20AAA(3)(b); and
 (b) an eligible person (the assignor) makes a request for the purposes of paragraph 20AAA(3)(a) to the responsible provider; and
 (c) the responsible provider, or a person authorised by the responsible provider, modifies the request as mentioned in paragraph 20AAA(3)(b); and
 (d) the responsible provider does not ensure that the assignor is given a notification: