Document ID: chunk:federal_register_of_legislation:F2024C00744:front:0:p44
Version: federal_register_of_legislation:F2024C00744
Segment Type: other
Provision Reference: 
Character Range: 117375–120256

for the purpose of lodging claims.

             Note 4: a claim may be lodged by means of an electronic transmission.

3.5.2A  Upon application in writing, by a claimant, to the Commission, the Commission may, in its discretion, by notice in writing served on the claimant, allow a longer period for lodging a claim than the period of 2 years referred to in subparagraph 3.5.2(c).

Note: 'claimant' means an appropriate category of health provider seeking payment in respect of treatment provided under the Principles.

3.5.2B  In exercising its power under paragraph 3.5.2A to allow a longer period for lodging a claim, the Commission shall have regard to all matters that it considers relevant, including, but without limiting the generality of the foregoing, any hardship that might be caused to the claimant if a longer period is not allowed.

Note: 'claimant' means an appropriate category of health provider seeking payment in respect of treatment provided under the Principles.

3.5.3 Subject to paragraph 3.5.3A, the Commission will not accept financial responsibility for the cost of the following treatment by health care providers, including treatment by dentists, physiotherapists and podiatrists:

(a) services that have been paid for, wholly or partly, by the Department of Human Services, as a medicare benefit, or by a health insurance fund; or

(b) services where the cost is otherwise recoverable, wholly or partly, by way of a legal claim; or

(c) examination for employment purposes; or

(d) examination for a medical certificate for membership of a friendly society.

3.5.3A  Paragraph 3.5.3(a) does not apply to treatment that is private accommodation provided to an entitled person as a private patient in a hospital where a private health insurer of the person agrees to pay the difference between the cost of shared accommodation for the person at the hospital and the cost of the private accommodation for the person — the RPPPs covers such treatment.

Note 1: "private patient" is defined in s.90A(8) of the Act.

Note 2: this provision ensures paragraph 3.5.3(a) does not prohibit the Commission from accepting responsibility for part of the cost of private accommodation in a hospital where a private health insurer pays for the remainder of the cost.

The Commission's responsibility in this area is regulated by the RPPPs i.e. cost‑sharing between the Commission and the entitled person or a private health insurer is worked out under the RPPPs.

3.5.4 Where the Commission accepts financial responsibility under these Treatment Principles, it does so on behalf of the Commonwealth.

PART 4 — MEDICAL PRACTITIONER SERVICES
     4.1 General Practitioners

4.1.2 Outline

    4.1.3 The aim of the medical services program is to ensure that as far as practicable entitled persons have access to free, safe and cost‑effective treatment.

    To