Document ID: chunk:federal_register_of_legislation:C2025C00156:section:129aad:p1
Version: federal_register_of_legislation:C2025C00156
Segment Type: section
Provision Reference: s 129AAD (pt 1/4)
Character Range: 724438–727116

129AAD  Notice to produce documents

When section applies
 (1) This section applies if the Chief Executive Medicare (the CEO):
 (a) has a reasonable concern that an amount paid, purportedly by way of benefit or payment under this Act, in respect of one or more professional services, may exceed the amount (if any) that should have been paid; and
 (b) has taken into account advice given to him or her by a medical practitioner who is a Departmental employee (within the meaning of the Human Services (Medicare) Act 1973) about the types of documents that contain information relevant to ascertaining whether amounts paid in respect of professional services of the same kind or kinds as the service or services referred to in paragraph (a) should have been paid.
Note: For the purposes of paragraph (a), the CEO may, for example, have a reasonable concern about benefits or payments made in respect of:
(a) professional services rendered by individual practitioners; or
(b) professional services rendered by particular kinds of practitioners; or
(c) the rendering of services to which specific items, or groups of items, relate.

CEO may require person to produce document etc.
 (2) If the CEO believes on reasonable grounds that:
 (a) a person:
 (i) who rendered a professional service in respect of which an amount has been paid that is the subject of the CEO's concern; or
 (ii) on whose behalf such a professional service was rendered; or
 (b) subject to subsection (7), another person;
has possession, custody or control of one or more documents relevant to ascertaining whether the amount paid in respect of the professional service should have been paid, or whether a determination under subsection 129ACA(2) should be made, the CEO may, by written notice given to the person, require the person to do any or all of the things mentioned in subsection (5) of this section.
 (3) The CEO may give a notice to a person under subsection (2) in respect of a professional service only if the CEO has given the person a reasonable opportunity to respond to a written request to produce to the CEO, or a Departmental employee (within the meaning of the Human Services (Medicare) Act 1973), documents relevant to either or both of the following:
 (a) ascertaining whether the amount paid, purportedly by way of benefit or payment under this Act, in respect of the service, should have been paid;
 (b) whether the CEO should make a determination under subsection 129ACA(2) 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