Recovering amounts by reducing future payments
58 Recovering amounts by reducing future payments
The Chief Executive Medicare may reduce one or more amounts of dental benefit payable to a person, or the estate of a person, if:
the following conditions are satisfied:
an amount or amounts have previously been paid under this Act to the person purportedly by way of dental benefit;
the amount or amounts referred to in subparagraph (i) exceed the amount (if any) that should have been paid to the person (whether or not the excess is recoverable as mentioned in paragraph (b)); or
an amount is recoverable from the person or from the estate of the person under section 56 or 56A or subsection 57(5).
The reduction limit is the excess referred to in subparagraph (1)(a)(ii), or the amount referred to in paragraph (1)(b), as the case requires.
Amount of reduction—no previous recovery or reduction
If subsection (4) does not apply, the amount of a reduction under subsection (1) must not exceed the reduction limit.
Amount of reduction—previous recovery or reduction
If either or both of the following have occurred:
the Chief Executive Medicare has previously reduced, under this section, one or more amounts (the reduced amounts) of dental benefit payable to the person;
one or more amounts (the recovered amounts) have been previously recovered from the person under section 56 or 56A or subsection 57(5);
the amount of a reduction under subsection (1) must not exceed the amount by which the reduction limit exceeds the sum of the reduced amounts (if any) and the recovered amounts (if any).
Reduction to nil
A reduction under subsection (1) may result in one or more amounts of dental benefit being reduced to nil.
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