Document ID: chunk:federal_register_of_legislation:C2004A00666:clause:1_1
Version: federal_register_of_legislation:C2004A00666
Segment Type: clause
Provision Reference: sch 1 cl 1
Character Range: 2409–3749

1  After subsection 20A(2A)
Insert:

 (2AA) If:
 (a) a medicare benefit would, apart from this section, be payable to an eligible person in respect of a professional service rendered to a patient while hospital treatment is provided to the patient; and
 (b) the eligible person has entered into an applicable benefits arrangement with a registered organization under which he or she is covered (wholly or partly) for liability to pay fees and charges in respect of that professional service; and
 (c) the professional service is a service in respect of which there applies a gap cover scheme in respect of which an approval by the Minister under section 73BDD of the National Health Act 1953 is in force;
the eligible person is taken, for the purposes of this Act, to have assigned his or her right to the payment of the medicare benefit:
 (d) unless paragraph (e) applies—to the organization; or
 (e) if the gap cover scheme makes express provision for the assignment of the right to payment of the medicare benefit to an approved billing agent, to a hospital or day hospital facility or to some other person prescribed for the purposes of this paragraph as an appropriate assignee—to that approved billing agent, to that hospital or day hospital facility or to that other person, as provided for under the terms of the gap cover scheme.