Document ID: chunk:federal_register_of_legislation:C2025C00097:section:5:p35
Version: federal_register_of_legislation:C2025C00097
Segment Type: section
Provision Reference: s 5 (pt 35/56)
Character Range: 171308–174218

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      Part 2‑2 provides for a premiums reduction scheme. This Part provides:

                (a) for private health insurers to be reimbursed for premiums that were reduced under the premiums reduction scheme in Division 23; and
                (b) for the Chief Executive Medicare to supervise that reimbursement and related matters; and
                (c) for recovery of amounts paid in error; and
                (d) for various other related administrative matters in relation to the scheme.

Division 279—Reimbursement of participating insurers and powers of Chief Executive Medicare

Subdivision 279‑A—Reimbursement of private health insurers for premiums reduced under scheme

279‑1  Participating insurers may claim reimbursement
  A private health insurer may claim reimbursement from the Chief Executive Medicare in accordance with section 279‑10 for each month during which it is a *participating insurer.

279‑5  Participating insurers
 (1) A private health insurer may apply to the Minister, in the *approved form, to become a *participating insurer for the purposes of this Part.
 (2) If the Minister approves the application, the private health insurer becomes a *participating insurer.
 (3) The Minister must approve the application, unless:
 (a) the insurer's status as a *participating insurer has previously been revoked under subsection 206‑1(1); and
 (b) the Minister is satisfied that the insurer is continuing, or will continue, to fail to comply with a provision or condition mentioned in that subsection.
Note: Rejections of applications are reviewable under Part 6‑9.
 (4) The Minister must notify the applicant, within 28 days after the date of the decision, whether the application has been approved or rejected.
 (5) If the application is rejected, the Minister must include his or her reasons for rejecting the application in the notice.

279‑10  Requirements for claims
 (1) A claim by a private health insurer in respect of a month must be made to the Chief Executive Medicare, in the *approved form, on or before the seventh day of the following month.
 (2) If the Chief Executive Medicare decides the claim is correct, the Chief Executive Medicare must pay the insurer, in accordance with section 279‑15, the amount payable under that section in respect of the month to which the claim relates.

279‑15  Amounts payable to the private health insurer
 (1) Subject to subsection (2), the amount payable to the private health insurer in respect of the month is the sum of the amounts by which premiums in respect of that month under the *complying health insurance policies issued by the private health insurer were reduced because of the operation of Division 23.
 (2) The amount must be paid to the private health insurer within the period of 15 days starting on the first day of the following month.
 (3) The amount must be paid in the way determined, in writing, by