Document ID: chunk:federal_register_of_legislation:C2025C00156:section:19b:p1
Version: federal_register_of_legislation:C2025C00156
Segment Type: section
Provision Reference: s 19B (pt 1/2)
Character Range: 196242–199057

19B  Medicare benefit not payable in respect of services rendered by disqualified practitioners
 (1) In this section:
partly disqualified means disqualified (other than fully disqualified), or taken to be disqualified (other than fully disqualified), under an agreement that was in effect under section 92 or under a final determination under section 106TA or a determination under Part VB.
practitioner has the same meaning as in section 124B.
 (2) A medicare benefit is not payable in respect of a professional service (including a pathology service) if:
 (a) at the time when the service was rendered, the person who rendered the service, or the practitioner on whose behalf the service was rendered, was a practitioner:
 (iaa) who was fully disqualified under an agreement that was in effect under section 92; or
 (ia) who was fully disqualified under section 105; or
 (ib) in relation to whom a final determination under section 106TA containing a direction under paragraph 106U(1)(h) that the practitioner be fully disqualified was in effect; or
 (i) in relation to whom a determination under paragraph 124F(2)(e) or 124FF(2)(d) that the practitioner be fully disqualified was in effect; or
 (ii) who was taken to be fully disqualified because a determination under paragraph 124F(2)(f) or 124FF(2)(e) or (f) in relation to another person was in effect; or
 (b) at the time when the service was rendered, the person who rendered the service, or the practitioner on whose behalf the service was rendered, was a practitioner:
 (ia) who was partly disqualified under an agreement that was in effect under section 92 in respect of that service; or
 (ib) in relation to whom a final determination under section 106TA containing a direction under paragraph 106U(1)(g) that the practitioner be partly disqualified was in effect in respect of that service; or
 (i) in relation to whom a determination under paragraph 124F(2)(d) or 124FF(2)(d) that the practitioner be partly disqualified was in effect in respect of that service; or
 (ii) who was taken to be partly disqualified because a determination under paragraph 124F(2)(f) or 124FF(2)(e) or (f) in relation to another person was in effect in respect of that service; or
 (c) the service was initiated by a person other than the person who rendered the service, and the person who initiated the service, or the practitioner on whose behalf the service was initiated, was a practitioner:
 (ia) who was fully disqualified under an agreement that was in effect under section 92; or
 (i) who was fully disqualified under section 105; or
 (ii) in relation to whom a final determination under section 106TA containing a direction under paragraph 106U(1)(h) that the practitioner be fully disqualified was in effect; or
 (iii) in relation to whom a determination under