Document ID: chunk:federal_register_of_legislation:C2011A00010:clause:1_129aad:p1
Version: federal_register_of_legislation:C2011A00010
Segment Type: clause
Provision Reference: sch 1 cl 129AAD (pt 1/3)
Character Range: 1095–3768

129AAD  Notice to produce documents

When section applies
 (1) This section applies if the Medicare Australia 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 an employee of Medicare Australia 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; and
 (c) has taken reasonable steps to consult with a relevant professional body 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, 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).
 (3) The CEO may only give a notice to a person under subsection (2) in respect of a professional service if the CEO has given the person a reasonable opportunity to respond to a written request (other than under this section) to produce to the CEO, or an employee of Medicare Australia, documents relevant to ascertaining whether the amount paid, purportedly by way of benefit or payment under this Act, in respect of the service, should have been paid.
 (4) A notice may only be given in respect of a professional service that was rendered in the period of 2 years immediately before the notice is given.
 (5) The CEO may