Document ID: chunk:federal_register_of_legislation:C2024C00580:section:32c:p2
Version: federal_register_of_legislation:C2024C00580
Segment Type: section
Provision Reference: s 32C (pt 2/3)
Character Range: 48927–51573

Medicare, or a Human Services employee, documents relevant to ascertaining whether the amount paid, purportedly by way of dental benefit, in respect of the service, should have been paid.

Limitations on power to give notice
 (5) A notice under subsection (1) can only be given in respect of a dental service for which an amount was claimed under this Act in the period of 2 years immediately before the day a written request under subsection (4) was first given to the person in relation to one or more dental services specified in the notice.

Content of notice
 (6) A notice under subsection (1) must:
 (a) specify details of each dental 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 Chief Executive Medicare's concern that an amount paid, purportedly by way of dental benefit, in respect of each such service may exceed the amount (if any) that should have been paid; and
 (c) specify the information relevant to ascertaining whether amounts paid in respect of each such service should have been paid; and
 (d) specify how the document, extract or copy is to be produced; and
 (e) contain a statement to the effect that the person to whom the notice is given is not expected to produce a document, extract or copy containing clinical details relating to an individual unless the document, extract or copy is necessary to ascertaining whether the amount paid in respect of the service should have been paid; and
 (f) specify the period within which, and place at which, the document, extract or copy is to be produced.
The period specified under paragraph (f) must be a period ending at least 21 days after the day on which the notice is given.
Note: For the purpose of paragraphs (b) and (c) the notice will include the reason for the Chief Executive Medicare's concern about the payment and explain the factual issue that the person is required to substantiate.

Health information within the meaning of the Privacy Act 1988
 (7) The power under this section to require a document, extract or copy to be produced includes the power to require the production of a document, extract or copy containing health information (within the meaning of the Privacy Act 1988) about an individual.
 (7A) If requested to do so under subsection (4), a person is authorised to produce any document relevant to the request, including a document containing health information (within the meaning of the Privacy Act 1988) about an individual.