Health Insurance Act 1973

This section applies in relation to a purported payment of medicare benefit in respect of a service referred to in Schedule 1 to the Health Insurance (Dental Services) Determination 2007 if:

the service was provided by a dental practitioner; and

the payment exceeded the amount (if any) that should have been paid; and

there was a failure to comply with subsection 10(2) (quotation for dental services and reporting) of the Determination in relation to the service; and

the Chief Executive Medicare is satisfied that the excess is solely attributable to the failure to comply with subsection 10(2) of the Determination.

The Determination was made under subsection 3C(1) of this Act. It ceased at midnight 30 November 2012 (see section 2A of the Determination).

However, this section does not apply in relation to a purported payment of medicare benefit in respect of a service that was rendered on or after 1 April 2010 unless, before the end of 30 November 2014, the dental practitioner provides or has provided the Chief Executive Medicare with evidence that the documents that, under subsection 10(2) of the Determination, should have been given to the patient and general practitioner before the relevant course of treatment began have since been given to those persons.

If the excess, or part of the excess, is recoverable under section 129AAK or 129AC as a debt due to the Commonwealth, the Chief Executive Medicare must, on behalf of the Commonwealth, waive the debt.

If the excess, or part of the excess:

has been repaid to the Commonwealth by a person (or a person’s estate); or

has otherwise been recovered by the Commonwealth from a person (or a person’s estate), including by way of set‑off;

An amount payable under subsection (4) is reduced by any amount already paid by the Commonwealth in respect of the repaid or recovered amount.

A reference in subsection (3), (4) or (5) to an excess includes:

any amount of administrative penalty for which the dental practitioner is liable to the Commonwealth under section 129AEA in relation to the excess; and

any interest paid or payable in relation to the excess under subsection 129AC(2) or (3).