Document ID: chunk:federal_register_of_legislation:C2025C00090:section:99aaa:p1
Version: federal_register_of_legislation:C2025C00090
Segment Type: section
Provision Reference: s 99AAA (pt 1/2)
Character Range: 288873–291708

99AAA  Claim for payment relating to supply of benefits
 (1) In this section:
Claims Transmission System means the procedures defined in the rules made by the Minister under paragraph (8)(c).
manual system means the procedures defined in the rules made by the Minister under paragraph (8)(d).
 (2) An approved supplier who wants to receive payment from the Commonwealth in relation to the supply of a pharmaceutical benefit must make a claim for payment to the Secretary in accordance with the rules made by the Minister under paragraph (8)(a).
 (3) An approved supplier who makes, or proposes to make, a claim for payment in relation to the supply of a pharmaceutical benefit must give to the Secretary, in relation to the supply of that benefit, the information specified in the rules made by the Minister under paragraph (8)(b).
 (4) Except as provided by section 99AAB, an approved supplier must use the Claims Transmission System to give information to the Secretary in relation to the supply of pharmaceutical benefits.
 (5) If an approved supplier does not use the Claims Transmission System to provide information to the Secretary in relation to the supply of pharmaceutical benefits, the approved supplier must use the manual system to provide that information to the Secretary.
 (6) The Secretary must process and determine claims made under subsection (2), and make any payments relating to those claims, in accordance with the rules made by the Minister under paragraph (8)(e).
 (7) Where the Secretary decides not to approve a claim made by an approved supplier under subsection (2), the Secretary must, in writing, inform the approved supplier of the decision and give reasons for the decision.
 (8) The Minister must, by legislative instrument, make:
 (a) rules defining the procedures to be followed by approved suppliers in making claims for payment in relation to the supply of pharmaceutical benefits; and
 (b) rules specifying the information to be given to the Secretary by approved suppliers in relation to the supply by them of pharmaceutical benefits; and
 (c) rules defining the procedures to be followed by approved suppliers in providing information by electronic means to the Secretary in relation to the supply by them of pharmaceutical benefits; and
 (d) rules defining the procedures to be followed by approved suppliers in providing information otherwise than by electronic means to the Secretary in relation to the supply by them of pharmaceutical benefits; and
 (e) rules defining the procedures to be followed by the Secretary in:
 (i) processing and determining claims by approved suppliers for payment relating to the supply of pharmaceutical benefits; and
 (ii) making the payments.
 (10) In making rules for the purposes of paragraph (8)(a), the Minister may define different procedures:
 (a) for