Document ID: chunk:federal_register_of_legislation:C2025C00097:section:5:p36
Version: federal_register_of_legislation:C2025C00097
Segment Type: section
Provision Reference: s 5 (pt 36/56)
Character Range: 174010–176627

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 the Chief Executive Medicare.

279‑20  Notifying private health insurers if amount is not payable
 (1) If the Chief Executive Medicare considers that a claim is incorrect, the Chief Executive Medicare may either refuse the claim or pay only such part of the claim as he or she is satisfied is correct.
 (2) The Chief Executive Medicare must notify a private health insurer if the Chief Executive Medicare makes a decision mentioned in subsection (1).
 (3) A notice under subsection (2) must include reasons for the decision.
 (4) The Chief Executive Medicare is taken, for the purposes of this Part, to have decided that a claim is correct if the Chief Executive Medicare does not give notice of his or her decision that the claim is incorrect on or before the day under subsection 279‑15(2) on or before which, if the claim were correct, it would have been required to have been paid.

279‑25  Additional payment if insurer claims less than entitlement
 (1) This section applies to a private health insurer in respect of a month if:
 (a) the private health insurer is a *participating insurer in respect of the month; and
 (b) the private health insurer made a claim in respect of the month under section 279‑1; and
 (c) the amount claimed by the private health insurer was less than the sum of the amounts by which premiums in respect of the month under the *complying health insurance policies issued by the private health insurer were reduced because of the operation of this Division.
 (2) The private health insurer may apply to the Chief Executive Medicare for payment of an amount (the additional amount) not exceeding the difference between:
 (a) the sum of the amounts by which premiums in respect of the month under the *complying health insurance policies issued by the private health insurer were reduced because of the operation of this Division; and
 (b) the amount already paid to the private health insurer under section 279‑1 in respect of the month.
 (3) An application under subsection (2) may relate to more than one month.

279‑30  Additional payment if insurer makes a late claim
 (1) This section applies to a private health insurer in respect of a month if:
 (a) the private health insurer did not make a claim in respect of the month on or before the seventh day of the following month; and
 (b) premiums in respect of the month under the *complying health insurance policies issued