Health Insurance Act 1973

Subject to subsection 124J(8), where:

a Committee is established under subsection 124E(3) in relation to an approved pathology practitioner; or

a Committee has made a determination, under subsection 124FA(2), that the Committee should consider whether an approved pathology practitioner has breached an undertaking;

determine whether the practitioner has breached the undertaking given by the practitioner;

if the Committee determines that the practitioner has breached the undertaking given by the practitioner by reason of having rendered excessive pathology services—identify those services; and

if the Committee determines that the practitioner has breached the undertaking given by the practitioner—make one or more of the following determinations:

that no action should be taken against the practitioner;

that it should counsel the practitioner;

that it should reprimand the practitioner;

that the undertaking given by the practitioner should be revoked;

that no undertaking given by the practitioner should be accepted by the Minister under section 23DC during the period specified in the determination (being a period expiring not later than 5 years after the day on which the determination takes effect);

that medicare benefits should not be payable, during the period specified in the determination (being a period expiring not later than 5 years after the day on which the determination takes effect), in respect of pathology services, being pathology services of a kind specified in the determination, that are rendered by or on behalf of the practitioner;

where a medicare benefit is payable, but has not been paid, to the practitioner in respect of a pathology service and the Committee is of the opinion that the practitioner failed to comply with the undertaking in relation to that service—that the medicare benefit or a specified part of the medicare benefit cease to be payable;

where a medicare benefit has been paid to the practitioner, or has been paid, or is payable, to a person other than the practitioner, in respect of a pathology service and the Committee is of the opinion that the practitioner failed to comply with the undertaking in relation to that service—that the amount of the medicare benefit or a specified part of that amount be payable by the practitioner to the Commonwealth.

In making a determination under subsection (1) in relation to a practitioner, the Committee shall comply with guidelines in force under section 124H.

A determination under subsection (1) shall be made in writing.