Health Insurance Amendment (Incentive Payments and Other Measures) Act 2026

Contents

1Short title#

This Act is the Health Insurance Amendment (Incentive Payments and Other Measures) Act 2026.

2Commencement#

(1)Each provision of this Act specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

Commencement information
Column 1	Column 2	Column 3
Provisions	Commencement	Date/Details
1. Sections 1 to 3 and anything in this Act not elsewhere covered by this table	The day this Act receives the Royal Assent.	16 October 2026
2. Schedule 1	The day after this Act receives the Royal Assent.	17 October 2026
3. Schedule 2, Parts 1 and 2	A single day to be fixed by Proclamation.However, if the provisions do not commence within the period of 24 months beginning on the day this Act receives the Royal Assent, they commence on the day after the end of that period.
4. Schedule 2, Part 3, Division 1	The later of:(a) the commencement of the provisions covered by table item 3; and(b) immediately after the commencement of Schedule 1 to the Health Legislation Amendment (Miscellaneous Measures No. 1) Act 2025.
5. Schedule 2, Part 3, Division 2	The later of:(a) the commencement of the provisions covered by table item 3; and(b) immediately after the commencement of Part 4 of the Commonwealth Parole Board Act 2026.

Note: This table relates only to the provisions of this Act as originally enacted. It will not be amended to deal with any later amendments of this Act.

(2)Any information in column 3 of the table is not part of this Act. Information may be inserted in this column, or information in it may be edited, in any published version of this Act.

3Schedules#

Legislation that is specified in a Schedule to this Act is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this Act has effect according to its terms.

Schedule 1 · Main amendments

Health Insurance Act 1973 #

1 Title

Omit “and Payments for Hospital Services”, substitute “, Payments for Hospital Services and Payments to incentivise health care”.

2 Subsection 3(1)

Insert:

Aboriginal person means a person of the Aboriginal race of Australia.

Commonwealth entity has the same meaning as in the Public Governance, Performance and Accountability Act 2013.

designated provision: see subsection 66(2).

eligible provider has the meaning given by section 49.

incentive payment program means a program prescribed under subsection 48(1).

incentive payment programs administrative action: see subsection 66(3).

incentive payment programs participant means an eligible provider approved to participate in an incentive payment program under subsection 52(1), 54(1) or 55(1).

incentive payment programs rules: see section 71.

reviewable incentive payment programs decision: see section 61.

Torres Strait Islander means a descendant of an Indigenous inhabitant of the Torres Strait Islands.

3 After subsection 19(2)

Insert:

(2A)Subsection (2) does not apply in relation to a professional service if:

(a)the professional service is rendered under, or for the purposes of, an incentive payment program; and

(b)apart from the incentive payment program, subsection (2) would not apply in relation to the professional service.

(2B)To avoid doubt, subsection (2) continues to apply in relation to a professional service to the extent that it would apply apart from subsection (2A).

(2C)The incentive payment program rules may provide that subsection (2) applies (despite subsection (2A)) in relation to:

(a)a specified incentive payment program; or

(b)a class of professional service rendered under, or for the purposes of, a specified incentive payment program.

4 After Part IVAA

Insert:

Part V · Incentive payment programs

Division 1 · Simplified outline of this Part

47Simplified outline#

This Part provides for incentive payment programs under which the Commonwealth may make payments to participants.

An incentive payment program may be prescribed by the incentive payment programs rules only if it relates to one or more matters set out in subsection 48(2).

The incentive payment programs rules may provide for matters relating to the administration of the program, including eligibility and participation requirements, the kinds of payments and conditions that apply to payments.

Eligible providers may apply for approval to participate in an incentive payment program, may be approved on the initiative of the Secretary or the Chief Executive Medicare or, if certain circumstances specified in the incentive payment programs rules apply in relation to the eligible provider, will automatically be approved to be a participant in an incentive payment program. Approvals may be subject to conditions and may be revoked.

Participants are subject to compliance requirements, including record-keeping obligations. Civil penalties apply for certain contraventions. The Secretary or the Chief Executive Medicare may also take other compliance action, including making banning orders.

This Part also deals with other matters such as review of decisions and other administrative matters.

Division 2 · Incentive payment programs

48Incentive payment programs#

(1)The incentive payment programs rules may prescribe one or more programs (incentive payment programs) under which the Commonwealth may make payments to participants in those programs.

(2)An incentive payment program may only be prescribed under subsection (1) if the program relates to one or more of the following:

(a)encouraging the provision of quality health care and enhanced health service capacity;

(b)improving affordability, access and health outcomes, particularly in rural and remote locations;

(c)supporting quality improvement activities to improve health outcomes and deliver best practice care;

(d)providing incentives to support appropriate access to after-hours care;

(e)encouraging digital health uptake and adoption of new health technology that supports improved administration processes and individual care;

(f)supporting health services to undertake quality improvement activities for the purposes of providing better health care for Aboriginal persons and Torres Strait Islanders;

(g)encouraging healthcare providers in rural and remote areas to deliver quality primary care services and support local access to specialist health services;

(h)supporting quality education and training in health care, including encouraging the provision of teaching sessions to undergraduate and graduate medical students preparing to enter the Australian medical profession;

(i)supporting individuals to attain the highest attainable standard of physical and mental health;

(j)any other matters prescribed by the incentive payment programs rules for the purposes of this paragraph.

(3)An incentive payment program may only be prescribed under subsection (1) to the extent that the program is with respect to one or more legislative powers of the Parliament.

(4)The incentive payment programs rules must specify the legislative power or powers of the Parliament in respect of which the rules are made.

(5)Without limiting subsection (1), the incentive payment programs rules may provide for the following:

(a)eligibility criteria and participation requirements;

(b)the kinds of payments that may be payable to participants;

(c)the amounts of payments, or methods for working out the amounts of payments;

(d)the manner in which payments may be paid to participants;

(e)conditions that apply to payments;

(f)the waiver of eligibility criteria or participation requirements by the Secretary or the Chief Executive Medicare;

(g)requirements for participants to notify specified matters, including requirements for ongoing or periodic notification;

(h)requirements for when a participant can no longer participate in a program;

(i)investigations to be conducted to ensure that participants are eligible to participate in programs or receive payments;

(j)processes for reconsideration of decisions;

(k)the functions and powers of the Secretary and the Chief Executive Medicare in relation to the programs.

Division 3 · Participation in incentive payment programs

49Meaning of eligible provider#

Each of the following is an eligible provider:

(a)an individual healthcare provider (within the meaning of the My Health Records Act 2012);

(b)a healthcare provider organisation (within the meaning of the My Health Records Act 2012);

(c)a person or entity prescribed by the incentive payment programs rules.

50Application to participate in an incentive payment program#

(1)An eligible provider may apply to the Secretary or the Chief Executive Medicare for approval to participate in an incentive payment program.

(2)The application must:

(a)be in writing; and

(b)be in a form approved, in writing, by the Secretary or the Chief Executive Medicare; and

(c)comply with the requirements (if any) prescribed by the incentive payment programs rules.

51Secretary or Chief Executive Medicare may request further information#

(1)The Secretary or the Chief Executive Medicare may, by written notice, request an applicant under section 50 to give further information about the application to the Secretary or the Chief Executive Medicare within a specified period.

(2)The specified period must not be less than 28 days after the notice is given.

(3)Before the specified period ends:

(a)the applicant may request, in writing, that the Secretary or the Chief Executive Medicare extend the specified period; and

(b)the Secretary or the Chief Executive Medicare may extend the specified period (the extended period).

(4)The application is taken to be withdrawn at the end of the specified period if the person does not give the requested information within:

(a)in a case in which the specified period has been extended under paragraph (3)(b)—the extended period; or

(b)otherwise—the specified period.

(5)A notice given under subsection (1) must set out the effect of subsection (4).

52Approval to participate in an incentive payment program on application#

(1)The Secretary or the Chief Executive Medicare must approve an application under section 50 if:

(a)any eligibility criteria for the program prescribed by the incentive payment programs rules are met in relation to the applicant; and

(b)any other matter prescribed by the incentive payment programs rules in relation to the program is satisfied.

(2)The incentive payment programs rules may prescribe conditions to which approvals under this section are subject.

(3)The Secretary or the Chief Executive Medicare must notify the applicant of the approval and the conditions (if any) that apply to the approval.

53Refusal of application#

If the Secretary or the Chief Executive Medicare refuses an application under section 50, the Secretary or the Chief Executive Medicare must notify the applicant, in writing, of the refusal and the reasons for the refusal.

Note: Section 266 of the Administrative Review Tribunal Act 2024 requires the applicant to be notified of the applicant’s review rights.

54Approval to participate in an incentive payment program on Secretary’s or Chief Executive Medicare’s own initiative#

(1)The Secretary or the Chief Executive Medicare may, on the Secretary’s or the Chief Executive Medicare’s own initiative, approve an eligible provider to participate in an incentive payment program.

(2)The Secretary or the Chief Executive Medicare must not approve an eligible provider under subsection (1) unless:

(a)any eligibility criteria for the program prescribed by the incentive payment programs rules are met in relation to the eligible provider; and

(b)any other matter prescribed by the incentive payment programs rules in relation to the program is satisfied.

(3)The incentive payment programs rules may prescribe conditions to which approvals under this section are subject.

(4)The Secretary or the Chief Executive Medicare must notify the eligible provider of the approval and the conditions (if any) that apply to the approval.

55Approval to participate in an incentive payment program where prescribed circumstances apply#

(1)The Secretary or the Chief Executive Medicare must approve an eligible provider to participate in an incentive payment program if circumstances prescribed by the incentive payment programs rules for the purposes of this subsection apply in relation to the eligible provider.

(2)The incentive payment programs rules may prescribe conditions to which the approvals under this section are subject.

(3)The Secretary or the Chief Executive Medicare must notify the eligible provider of the approval and the conditions (if any) that apply to the approval.

56Secretary or Chief Executive Medicare may revoke approval to participate in an incentive payment program#

(1)The Secretary or the Chief Executive Medicare may revoke an approval under subsection 52(1), 54(1) or 55(1) if:

(a)the incentive payment programs participant that is the subject of the approval:

(i)does not meet the eligibility criteria (if any) for the incentive payment program; or

(ii)has breached a condition (if any) to which the approval is subject under subsection 52(2), 54(3) or 55(2); or

(iii)has been given a notice under subsection 129AACA(1) or 129AAD(2) and has failed to comply with a requirement of the notice; or

(b)circumstances prescribed by the incentive payment programs rules for the purposes of this paragraph apply in relation to the participant.

(2)The Secretary or the Chief Executive Medicare must give to the incentive payment program participant written notice of the decision and the reasons for the decision.

Note: Section 266 of the Administrative Review Tribunal Act 2024 requires the participant to be notified of the participant’s review rights.

(3)A notice given under subsection (2) must specify the day the revocation takes effect (which must not be earlier than the day the notice is given).

57Revocation on request of an incentive payment programs participant#

(1)An incentive payment programs participant may, by written notice given to the Secretary or the Chief Executive Medicare, request the Secretary or the Chief Executive Medicare to revoke the participant’s approval under subsection 52(1), 54(1) or 55(1).

(2)The Secretary or the Chief Executive Medicare must revoke an approval for which a request is given under subsection (1) and give written notice to the participant of the revocation.

(3)A notice given under subsection (2) must specify the day the revocation takes effect (which must not be earlier than the day the notice is given).

Division 4 · Compliance

58Keeping records#

(1)An incentive payment programs participant must keep any records prescribed by the incentive payment programs rules.

(2)The incentive payment programs rules may prescribe:

(a)the kinds of records that must be kept; and

(b)the manner and form in which the records must be kept.

(3)Records kept under subsection (1) must be retained for the period prescribed by the incentive payment programs rules.

Civil penalty provision

(4)A person contravenes this subsection if:

(a)the person is subject to a requirement under this section; and

(b)the person fails to comply with the requirement.

Civil penalty: 10 penalty units.

59Falsely claiming to be an incentive payment programs participant#

(1)A person contravenes this subsection if:

(a)the person advertises or otherwise holds themselves out as an incentive payment programs participant; and

(b)the person is not an incentive payment programs participant.

Civil penalty: 50 penalty units.

(2)A person contravenes this subsection if:

(a)the person advertises or otherwise holds themselves out as participating in a particular incentive payment program; and

(b)the person is not an incentive payment programs participant in that program.

Civil penalty: 50 penalty units.

(3)A person contravenes this subsection if:

(a)the person makes a representation about:

(i)being an incentive payment programs participant; or

(ii)participating in an incentive payment program; and

(b)the representation is false or misleading in a material particular.

Civil penalty: 50 penalty units.

60Banning orders#

(1)The Secretary or the Chief Executive Medicare may, by written notice, make an order (a banning order) prohibiting an eligible provider from participating in an incentive payment program.

(2)The Secretary or the Chief Executive Medicare may make an order under subsection (1) only if:

(a)the Secretary or the Chief Executive Medicare has revoked the eligible provider’s approval to participate in an incentive payment program under section 56; or

(b)the Secretary or the Chief Executive Medicare reasonably believes that the eligible provider has contravened, is contravening, or is likely to contravene this Act or a provision of the incentive payment programs rules; or

(c)the eligible provider is convicted of an offence involving fraud or dishonesty.

Application of banning order

(3)A banning order may:

(a)apply generally or be of limited application; and

(b)be permanent or for a specified period; and

(c)be made subject to specified conditions.

(4)A banning order takes effect from the day specified in the order.

(5)A banning order is not a legislative instrument.

Process

(6)The Secretary or the Chief Executive Medicare may only make a banning order against an eligible provider after giving the eligible provider an opportunity to make submissions to the Secretary or the Chief Executive Medicare on the matter.

(7)However, subsection (6) does not apply if the Secretary or the Chief Executive Medicare has revoked the eligible provider’s approval to participate in an incentive payment program under section 56.

(8)The Secretary or the Chief Executive Medicare must:

(a)give the banning order to the eligible provider against whom the order is made; and

(b)include in the banning order a statement of reasons for the order.

Revocation of banning order

(9)The Secretary or the Chief Executive Medicare may, by written notice, revoke a banning order.

(10)The Secretary or the Chief Executive Medicare must give written notice of a revocation to the eligible provider.

Division 5 · Reconsideration and review of decisions

61Reviewable decisions#

Each of the following decisions is a reviewable incentive payment programs decision:

(a)a decision to refuse an application for approval to participate in an incentive payment program under section 53;

(b)a decision to revoke an incentive payment programs participant’s approval to participate in an incentive payment program under section 56;

(c)a decision to make a banning order under section 60;

(d)a decision made under subsection 66(8) in substitution for a decision the Secretary or the Chief Executive Medicare is treated as having taken under subsection 66(6);

(e)a decision made under the incentive payment programs rules so long as the incentive payment programs rules provide that the decision is a reviewable decision for the purposes of this paragraph.

62Secretary and Chief Executive Medicare may reconsider decisions on own initiative#

(1)The Secretary or the Chief Executive Medicare may, on the Secretary’s or the Chief Executive Medicare’s own initiative, reconsider a reviewable incentive payment programs decision if the Secretary or the Chief Executive Medicare is satisfied that there is sufficient reason to reconsider the decision.

(2)The Secretary or the Chief Executive Medicare may reconsider a reviewable incentive payment programs decision:

(a)whether or not any person has applied for review of the decision; or

(b)even though an application has been made to the Administrative Review Tribunal for review of the decision.

Decision on reconsideration

(3)After reconsidering the decision, the Secretary or the Chief Executive Medicare must do one of the following:

(a)affirm the reviewable incentive payment programs decision;

(b)vary the reviewable incentive payment programs decision;

(c)set aside the reviewable incentive payment programs decision;

(d)set aside the reviewable incentive payment programs decision and make a new decision in substitution for the reviewable incentive payment programs decision.

(4)The incentive payment programs rules may prescribe:

(a)matters that the Secretary or the Chief Executive Medicare must have regard to when making the decision on reconsideration; and

(b)matters that the Secretary or the Chief Executive Medicare may disregard when making the decision on reconsideration.

(5)The Secretary or the Chief Executive Medicare must give written notice of:

(a)the decision on reconsideration to the person to whom it relates; and

(b)the reasons for the decision; and

(c)the person’s review rights under section 64 or 65 (as applicable).

When decision on reconsideration takes effect

(6)The Secretary’s or the Chief Executive Medicare’s decision on reconsideration takes effect on:

(a)the day specified in the notice; or

(b)if a day is not specified—the day on which the decision is made.

63Initial reconsideration of decision#

(1)A person (the affected person) whose interests are affected by a reviewable incentive payment programs decision may request the Secretary or the Chief Executive Medicare to reconsider the decision.

(2)Subsection (1) does not apply to a reviewable incentive payment programs decision if the decision was made by the Secretary or the Chief Executive Medicare personally.

Note 1: See section 65 for review of a reviewable incentive payment programs decision that is made by the Secretary or the Chief Executive Medicare personally.

Note 2: For the purposes of this subsection, incentive payment programs administrative action taken to have been taken by the Secretary or the Chief Executive Medicare under subsection 66(6) is not, to the extent that it is a decision, taken to be made personally by the Secretary or the Chief Executive Medicare.

Form and timing of request

(3)The affected person must make the request in writing:

(a)before the end of the period of 28 days beginning on the day on which the affected person is notified of the reviewable incentive payment programs decision, unless paragraph (b) applies; or

(b)if the Secretary or the Chief Executive Medicare allows a longer period for making the request—before the end of that longer period.

Reasons for request

(4)The affected person must set out in the request the reasons for the request.

Further information may be required

(5)If an affected person makes a request under subsection (1), the Secretary or the Chief Executive Medicare may, by notice in writing, require the affected person to give the Secretary or the Chief Executive Medicare, within the period specified in the notice, such further information in relation to the request as the Secretary or the Chief Executive Medicare requires.

(6)The Secretary or the Chief Executive Medicare is not required to decide the request, and may cease considering the request, if the affected person does not provide the required information within the period specified in the notice.

Reconsideration of decision

(7)The Secretary or the Chief Executive Medicare:

(a)on receiving a request made in accordance with subsections (3) and (4); or

(b)if subsection (5) applies—after receiving the required information under subsection (5);

must:

(c)reconsider the reviewable incentive payment programs decision personally; or

(d)cause the reviewable incentive payment programs decision to be reconsidered by a person (the internal reviewer) who:

(i)was not involved in making that decision; and

(ii)occupies a position specified in the incentive payment programs rules for the purposes of this subparagraph; and

(iii)meets any requirements prescribed by the incentive payment programs rules for the purposes of this subparagraph.

Decision on reconsideration

(8)The Secretary, the Chief Executive Medicare or the internal reviewer must do one of the following:

(a)affirm the reviewable incentive payment programs decision;

(b)vary the reviewable incentive payment programs decision;

(c)set aside the reviewable incentive payment programs decision;

(d)set aside the reviewable incentive payment programs decision and make a new decision in substitution for the reviewable incentive payment programs decision.

(9)The incentive payment programs rules may prescribe:

(a)matters that the Secretary, the Chief Executive Medicare or the internal reviewer must have regard to when making the decision on reconsideration; and

(b)matters that the Secretary, the Chief Executive Medicare or the internal reviewer may disregard when making the decision on reconsideration.

(10)The Secretary, the Chief Executive Medicare or the internal reviewer must make the decision on reconsideration before the end of the period of 28 days beginning on the day:

(a)the request for reconsideration is received under subsection (1); or

(b)if further information was required to be provided under subsection (5) in relation to the request—the required information is received.

(11)The Secretary, the Chief Executive Medicare or the internal reviewer must give the affected person written notice of:

(a)the Secretary’s, Chief Executive Medicare’s or internal reviewer’s decision on reconsideration; and

(b)the reasons for that decision; and

(c)the person’s review rights under section 64 or 65 (as applicable).

When decision on reconsideration takes effect

(12)The Secretary’s, the Chief Executive Medicare’s or the internal reviewer’s decision on reconsideration takes effect on:

(a)the day specified in the notice; or

(b)if a day is not specified—the day on which that decision is made.

Secretary, Chief Executive Medicare or internal reviewer may be taken to have affirmed reviewable incentive payment programs decisions

(13)The Secretary, the Chief Executive Medicare or the internal reviewer is taken to have made a decision affirming the reviewable incentive payment programs decision if the Secretary, the Chief Executive Medicare or the internal reviewer has not notified the affected person of the Secretary’s, the Chief Executive Medicare’s or the internal reviewer’s decision on reconsideration before the end of the period applicable under subsection (10).

When a healthcare provider organisation is also an affected person

(14)If:

(a)an individual healthcare provider (within the meaning of the My Health Records Act 2012) is an affected person; and

(b)the provider is an employee (within the meaning of the My Health Records Act 2012) of a healthcare provider organisation (within the meaning of that Act);

this section applies as if the healthcare provider organisation is also an affected person whose interests are affected by the reviewable incentive payment programs decision.

64Subsequent internal reconsideration of decision#

(1)A person (the affected person) whose interests are affected by a decision (the reconsideration decision) of the following kind may request the Secretary or the Chief Executive Medicare to reconsider the reconsideration decision:

(a)a decision that is made under subsection 62(3);

(b)a decision made by an internal reviewer under subsection 63(8);

(c)a decision that is taken to have been made under subsection 63(13).

(2)Subsection (1) does not apply to a reconsideration decision that is made by the Secretary or the Chief Executive Medicare personally.

Note: See section 65 for review of a reviewable incentive payment programs decision that is made by the Secretary or the Chief Executive Medicare personally.

Form and timing of request

(3)The affected person must make the request in writing:

(a)before the end of the period of 28 days beginning on:

(i)the day on which the affected person is notified of the reconsideration decision; or

(ii)if subsection 63(13) applies—the day on which the decision is taken to have been affirmed; or

(b)if the Secretary or the Chief Executive Medicare allows a longer period for making the request—before the end of that longer period.

Reasons for request

(4)The affected person must set out in the request the reasons for the request.

Further information may be required

Reconsideration of decision

(7)The Secretary or the Chief Executive Medicare:

(a)on receiving a request made in accordance with subsections (3) and (4); or

(b)if subsection (5) applies—after receiving the required information under subsection (5);

must:

(c)reconsider the reconsideration decision personally; or

(d)cause the reconsideration decision to be reconsidered by a person (the second internal reviewer) who:

(i)was not involved in making that decision; and

(ii)is an APS employee in the Department or Services Australia; and

(iii)occupies a position that is senior to that occupied by any person involved in making that decision.

Decision on reconsideration

(8)The Secretary, the Chief Executive Medicare or the second internal reviewer must do one of the following:

(a)affirm the reconsideration decision;

(b)vary the reconsideration decision;

(c)set aside the reconsideration decision;

(d)set aside the reconsideration decision and make a new decision in substitution for the reconsideration decision.

(9)The incentive payment programs rules may prescribe:

(a)matters that the Secretary, the Chief Executive Medicare or the second internal reviewer must have regard to when making the decision on reconsideration; and

(b)matters that the Secretary, the Chief Executive Medicare or the second internal reviewer may disregard when making the decision on reconsideration.

(10)The Secretary, the Chief Executive Medicare or the second internal reviewer must make the decision on reconsideration before the end of the period of 45 days beginning on the day:

(a)the request for reconsideration is received under subsection (1); or

(b)if further information was required to be provided under subsection (5) in relation to the request—the required information is received.

Notice of decision on reconsideration

(11)The Secretary, the Chief Executive Medicare or the second internal reviewer must give the affected person written notice of:

(a)the Secretary’s, the Chief Executive Medicare’s or the second internal reviewer’s decision on reconsideration; and

(b)the reasons for that decision; and

(c)the person’s review rights under section 65.

When decision on reconsideration takes effect

(12)The Secretary’s, the Chief Executive Medicare’s or the second internal reviewer’s decision on reconsideration takes effect on:

(a)the day specified in the notice; or

(b)if a day is not specified—the day on which that decision is made.

Secretary, Chief Executive Medicare or second internal reviewer may be taken to have affirmed reconsideration decision

(13)The Secretary, the Chief Executive Medicare or the second internal reviewer is taken to have made a decision affirming the reconsideration decision if the Secretary, the Chief Executive Medicare or the second internal reviewer has not notified the affected person of the Secretary’s, the Chief Executive Medicare’s or the second internal reviewer’s decision on reconsideration before the end of the period applicable under subsection (10).

When a healthcare provider organisation is also an affected person

(14)If:

(a)an individual healthcare provider (within the meaning of the My Health Records Act 2012) is an affected person; and

(b)the provider is an employee (within the meaning of the My Health Records Act 2012) of a healthcare provider organisation (within the meaning of that Act);

this section applies as if the healthcare provider organisation is also an affected person whose interests are affected by the reconsideration decision.

65Administrative Review Tribunal review of decisions#

(1)An application may be made to the Administrative Review Tribunal for review of the following decisions:

(a)a reviewable incentive payment programs decision that is made by the Secretary or the Chief Executive Medicare personally;

(b)a decision that is made under subsection 62(3) or 63(8) by the Secretary or the Chief Executive Medicare personally;

(c)a decision that is made under subsection 64(8) or a decision that is taken to have been made under subsection 64(13).

(2)Subsection 12(2) of the Administrative Review Tribunal Act 2024 does not apply to a decision covered by paragraph (1)(a) or (b) of this section.

Division 6 · Miscellaneous

Subdivision A · Automation of incentive payment programs administration action

66Automation of incentive payment programs administrative action#

(1)The Secretary or the Chief Executive Medicare may, in writing, arrange for the use, under the Secretary’s or the Chief Executive Medicare’s oversight, of computer programs to take incentive payment programs administrative action that may or must be taken by the Secretary or the Chief Executive Medicare under a provision that is one of the following:

(a)a provision of this Act that is specified in the incentive payment programs rules for the purposes of this paragraph;

(b)a provision of the incentive payment programs rules that is specified in those rules for the purposes of this paragraph.

Note: This subsection is not intended to imply that the making of an arrangement is the only means by which a computer program may be used to take incentive payment programs administrative action if that action would otherwise not require statutory authorisation in order to be validly taken. For example, statutory authorisation would not generally be needed if a computer program is only being used to assist a decision-maker to make a decision. Statutory authorisation would also not be needed in order to implement a provision that creates an outcome through the operation of law and does not involve an administrative decision being made.

(1A)Rules for the purposes of paragraph (1)(a) or (b) must only specify a provision that is a section, subsection, paragraph or subparagraph.

Note: Rules for the purposes of paragraph (1)(a) and (b) specify provisions under which computer programs may take incentive payment programs administrative action for the Secretary or the Chief Executive Medicare. Specifying such provisions at the section level or lower makes easier to identify which kinds of actions are to be taken by a computer program.

(2)A provision covered by subsection (1) is a designated provision.

(3)Incentive payment programs administrative action is any of the following:

(a)making, or refusing or failing to make, a decision, or a part of a decision, under a designated provision;

(b)exercising, or refusing or failing to exercise, a power under a designated provision;

(c)performing, or refusing or failing to perform, a function or duty under a designated provision;

(d)doing, or refusing or failing to do, anything (including giving a notice) related to making a decision or part of a decision, exercising a power or performing a function or duty under a designated provision.

Note: A number of administrative actions may be covered by a particular designated provision. For example, a designated provision might provide for multiple decisions to be made as a part of making a broader overarching decision. In this case, any of those administrative actions can be automated in accordance with an arrangement under subsection (1).

Evaluative administrative action

(4)Subsection (1) includes incentive payment programs administrative action that involves one or more of the following:

(a)a discretion being exercised;

(b)an evaluative judgement being made;

(c)a state of mind being formed.

Note: Section 67 provides for the making of a standard operating procedure instrument in relation to this kind of incentive payment programs administrative action.

(5)If incentive payment programs administrative action under a provision involves one or more of the matters mentioned in paragraph (4)(a), (b) or (c), then before a provision is specified for the purposes of paragraph (1)(a) or (b), the Minister must be satisfied that it is appropriate to do so.

Person responsible for incentive payment programs administrative action taken by computer

(6)Incentive payment programs administrative action taken by the operation of a computer program under an arrangement under subsection (1) is treated, for all purposes, as incentive payment programs administrative action taken by the following person (the attributed decision-maker):

(a)if the designated provision to which the incentive payment programs administrative action relates confers a power, function or duty on either the Secretary or the Chief Executive Medicare, but not both—that person; or

(b)otherwise—the Secretary or the Chief Executive Medicare, as specified in, or worked out in accordance with, the incentive payment programs rules for the purposes of this paragraph.

(7)In determining, for the purposes of paragraph (6)(a), whether a designated provision confers a power, function or duty on either the Secretary or the Chief Executive Medicare, but not both, disregard any instrument of delegation.

Substituted incentive payment programs administrative actions

(8)The attributed decision-maker may take incentive payment programs administrative action (the substituted action) in substitution for earlier incentive payment programs administrative action that the attributed decision-maker is treated as having taken under subsection (6) if the attributed decision-maker is satisfied that the incentive payment programs administrative action taken by the operation of the computer program is not correct or preferable.

When substituted action takes effect

(9)The substituted action takes effect on:

(a)if the attributed decision-maker specifies the day on which the substituted action takes effect—that specified day; or

(b)otherwise—the day of the incentive payment programs administrative action taken by the operation of the computer program.

(10)The day specified under paragraph (9)(a) may be earlier than the day the substituted action is taken but not earlier than the day of the incentive payment programs administrative action taken by the operation of the computer program.

Notification of substituted decision

(11)The attributed decision-maker must, if the substituted action is a decision made in substitution for an earlier decision (the original decision) that the person is treated as having taken under subsection (6), cause the person who is the subject of the substituted decision to be notified in writing, within 14 days of the making of the substituted decision, of:

(a)the substituted decision; and

(b)the fact that the substituted decision was made by the attributed decision-maker.

(12)A failure to comply with subsection (11) does not affect the validity of the substituted decision.

Secretary or Chief Executive Medicare may still take incentive payment programs administrative action

(13)An arrangement under subsection (1) does not prevent the Secretary or the Chief Executive Medicare from taking incentive payment programs administrative action.

Substituted action does not limit right to review or reconsideration of incentive payment programs administrative action

(14)If the original decision is the subject of a right of merits review (however described) by the Administrative Review Tribunal or another body or person, the person who is the subject of the substituted decision may apply for review of the substituted decision under the provision conferring that right.

(15)Subsection (8) does not limit any other provision of this Act or the incentive payment programs rules that provides for the review or reconsideration of incentive payment programs administrative action.

Arrangement not a legislative instrument

(16)An arrangement under subsection (1) is not a legislative instrument.

67Secretary or Chief Executive Medicare must make standard operating procedure instrument#

(1)The Secretary or the Chief Executive Medicare must make a written instrument (a standard operating procedure instrument) if:

(a)particular incentive payment programs administrative action is proposed to be taken under a designated provision by the operation of a computer program (as authorised by section 66); and

(b)the administrative action involves one or more of the following (each of which is an evaluative determination):

(i)a discretion being exercised;

(ii)an evaluative judgement being made;

(iii)a state of mind being formed.

Content of instrument etc.

(2)If the Secretary or the Chief Executive Medicare makes a standard operating procedure instrument:

(a)the instrument must not deal with matters other than evaluative determinations; and

(b)the Secretary or the Chief Executive Medicare must, in relation to each evaluative determination, specify in the instrument particular circumstances in which the Secretary or the Chief Executive Medicare is satisfied, if those circumstances exist or do not exist, that evaluative determination should always be made in a way specified in the instrument; and

(c)the Secretary or the Chief Executive Medicare must, in specifying those circumstances, be satisfied that the instrument is consistent with how the evaluative determination may be made by the Secretary or the Chief Executive Medicare.

Objective circumstances

(3)The Secretary or the Chief Executive Medicare must be satisfied that the circumstances covered by paragraph (2)(b) are sufficiently objective in nature, such that their existence, or non-existence, can be ascertained by the operation of the computer program.

Computer program to be programmed consistently with instrument

(4)If the Secretary or the Chief Executive Medicare makes a standard operating procedure instrument, the Secretary or the Chief Executive Medicare must ensure that the arrangement under subsection 66(1) provides for the making of each evaluative determination in a way that is consistent with the standard operating procedure instrument.

Instrument may deal with more than one administrative action

(5)A standard operating procedure instrument may deal with more than one incentive payment programs administrative action.

Instrument is a notifiable instrument

(6)A standard operating procedure instrument is a notifiable instrument.

68Oversight and safeguards for automation of incentive payment programs administrative action#

Secretary or Chief Executive Medicare to ensure incentive payment programs administrative action is action that could be validly taken

(1)The Secretary or the Chief Executive Medicare must take all reasonable steps to ensure that incentive payment programs administrative action taken by the operation of a computer program under an arrangement made under subsection 66(1) by the Secretary or the Chief Executive Medicare (as applicable) is incentive payment programs administrative action that the Secretary or the Chief Executive Medicare could validly take under a designated provision.

(2)Without limiting subsection (1), the Secretary or the Chief Executive Medicare must do the things (if any) prescribed by the incentive payment programs rules for the purposes of this subsection.

Note: Incentive payment programs administrative action may still be invalid even if subsections (1) and (2) are complied with.

(3)A failure to comply with subsection (1) or (2) does not affect the validity of the incentive payment programs administrative action taken by the operation of a computer program under an arrangement under subsection 66(1).

Notification of decisions made by the operation of computer programs

(4)If:

(a)in accordance with section 66, incentive payment programs administrative action is taken by the operation of a computer program under an arrangement under subsection (1) of that section; and

(b)another provision of this Act or the incentive payment programs rules requires a notice of the incentive payment programs administrative action to be given to a person;

the notice must inform the person of the fact that the incentive payment programs administrative action was taken by the operation of a computer program.

(5)A failure to comply with subsection (4) does not affect the validity of the incentive payment programs administrative action taken by the operation of the computer program.

Publication

(6)If the Secretary makes an arrangement under subsection 66(1) in relation to particular designated provisions, the Secretary must cause a statement to be published on the Department’s website:

(a)to the effect that the Secretary has made such an arrangement; and

(b)setting out those particular designated provisions.

(7)If the Chief Executive Medicare makes an arrangement under subsection 66(1) in relation to particular designated provisions, the Chief Executive Medicare must cause a statement to be published on Services Australia’s website:

(a)to the effect that the Chief Executive Medicare has made such an arrangement; and

(b)setting out those particular designated provisions.

Details in annual report

(8)The Secretary, when preparing the Department’s annual report under section 46 of the Public Governance, Performance and Accountability Act 2013 for a period, and the Chief Executive Officer of Services Australia, when preparing Services Australia’s annual report under that section for a period, must include the following information in the report:

(a)the kinds of substituted actions taken in that period under subsection 66(8) of this Act;

(b)the kinds of incentive payment programs administrative actions taken by the operation of computer programs in that period that the Secretary or the Chief Executive Medicare was satisfied were not correct or preferable.

(9)The Secretary and the Chief Executive Officer of Services Australia may also include in their respective reports any other information (other than personal information within the meaning of the Privacy Act 1988) about the operation of sections 66, 67 and this section in that period that they consider appropriate.

Subdivision B · Other matters

69Partnerships#

(1)This Part, the incentive payment programs rules and any other provision of this Act or any other instrument as far as it relates to this Part or the incentive payment programs rules (the relevant provisions), apply to a partnership as if it were a person, but with the changes set out in this section.

(2)A right that would otherwise be exercisable by the partnership is exercisable by each partner instead and, if exercised by one of the partners in the partnership, is taken to have been exercised on behalf of all of them.

(3)An obligation that would otherwise be imposed on the partnership is imposed on each partner instead, but may be discharged by any partner.

Offences and civil penalties

(4)An offence against the relevant provisions that would otherwise be committed by a partnership is taken to have been committed by each partner in the partnership, at the time the offence is committed, who:

(a)did the relevant act or made the relevant omission; or

(b)aided, abetted, counselled or procured the relevant act or omission; or

(c)was in any way knowingly concerned in, or party to, the relevant act or omission (whether directly or indirectly and whether by any act or omission of the partner).

(5)A civil penalty provision of the relevant provisions that would otherwise be contravened by a partnership is taken to have been contravened by each partner in the partnership, at the time of the conduct constituting the contravention, who:

(a)engaged in the conduct; or

(b)aided, abetted, counselled or procured the conduct; or

(c)was in any way knowingly concerned in, or party to, the conduct (whether directly or indirectly or whether by any act or omission of the partner).

Partnership ceases to exist

(6)If a partnership ceases to exist, subsections (1) to (3) apply as if:

(a)references to a partnership were to a partnership that ceases to exist; and

(b)references to partners of the partnership were to the persons who were partners immediately before the cessation.

Incentive payment programs rules

(7)The incentive payment programs rules may make provision in relation to the application of the relevant provisions to a partnership, to the extent to which this section does not do so.

70Unincorporated associations#

(1)This Part, the incentive payment programs rules and any other provision of this Act or any other instrument as far as it relates to this Part or the incentive payment programs rules (the relevant provisions), apply to an unincorporated association as if it were a person, but with the changes set out in this section.

(2)A right that would otherwise be exercisable by the unincorporated association is exercisable by each member of the association’s committee of management instead and, if exercised by one of the members, is taken to have been exercised on behalf of all of them.

(3)An obligation that would otherwise be imposed on the unincorporated association by the relevant provisions is imposed on each member of the association’s committee of management instead, but may be discharged by any of those members.

Offences and civil penalties

(4)An offence against the relevant provisions that would otherwise be committed by an unincorporated association is taken to have been committed by each member of the association’s committee of management, at the time the offence is committed, who:

(a)did the relevant act or made the relevant omission; or

(b)aided, abetted, counselled or procured the relevant act or omission; or

(c)was in any way knowingly concerned in, or party to, the relevant act or omission (whether directly or indirectly and whether by any act or omission of the member).

(5)A civil penalty provision of the relevant provisions that would otherwise be contravened by an unincorporated association is taken to have been contravened by each member of the association’s committee of management, at the time of the conduct constituting the contravention, who:

(a)engaged in the conduct; or

(b)aided, abetted, counselled or procured the conduct; or

(c)was in any way knowingly concerned in, or party to, the conduct (whether directly or indirectly or whether by any act or omission of the member).

Unincorporated association ceases to exist

(6)If an unincorporated association ceases to exist, subsections (1) to (3) apply as if:

(a)references to an unincorporated association were to an unincorporated association that ceases to exist; and

(b)references to members of the association’s committee of management were to the persons who were members immediately before the cessation.

Incentive payment programs rules

(7)The incentive payment programs rules may make provision in relation to the application of the relevant provisions to an unincorporated association, to the extent to which this section does not do so.

71Incentive payment programs rules#

(1)The Minister may, by legislative instrument, make rules (the incentive payment programs rules) prescribing matters:

(a)required or permitted by this Act to be prescribed by the incentive payment programs rules; or

(b)necessary or convenient to be prescribed for carrying out or giving effect to this Act.

(2)To avoid doubt, the incentive payment programs rules may not do the following:

(a)create an offence or civil penalty;

(b)provide powers of:

(i)arrest or detention; or

(ii)entry, search or seizure;

(c)impose a tax;

(d)set an amount to be appropriated from the Consolidated Revenue Fund under an appropriation in this Act;

(e)directly amend the text of this Act.

5 Section 129AAD (heading)

After “professional services”, insert “or incentive payment programs”.

6 After subsection 129AAD(1)

Insert:

(1A)This section applies if the CEO has a reasonable concern that an amount paid, purportedly by way of payment under this Act, in respect of an incentive payment program, may exceed the amount (if any) that should have been paid.

7 After paragraph 129AAD(2)(a)

Insert:

(aa)a person that is an incentive payment programs participant who has been paid an amount that is the subject of the CEO’s concern; or

8 Subsection 129AAD(2)

After “in respect of the professional service”, insert “or incentive payment program”.

9 Subsection 129AAD(3)

Omit “in respect of a professional service”.

10 Paragraphs 129AAD(3)(a) and (b)

After “in respect of the service”, insert “or the incentive payment program”.

11 Subsection 129AAD(5)

Repeal the subsection, substitute:

(5)The CEO may require the person:

(a)to produce to the CEO, or a Departmental employee (within the meaning of the Human Services (Medicare) Act 1973), any document, or extract of any document, that is relevant for a purpose set out in subsection (2); or

(b)to make a copy of any such document or extract and to produce that copy to the CEO or employee.

Note: For a person referred to in paragraph (2)(a) or (aa), failure to comply with a notice may lead to recovery action (see sections 129AC and 129ACA) and an administrative penalty may be applied (see sections 129AEA, 129AEB and 129AEC). For a person referred to in paragraph (2)(b), failure to comply with a notice may lead to a civil penalty (see section 129AAE).

12 Paragraph 129AAD(8)(a)

Repeal the paragraph, substitute:

(a)specify:

(i)details of each professional service (including the item, date on which the service was rendered and medicare number of the person in respect of whom the service was rendered) in relation to which the document, extract or copy is to be produced; or

(ii)details of each incentive payment program in relation to which the document, extract or copy is to be produced; and

13 Paragraph 129AAD(8)(b)

After “, in respect of each such service”, insert “or incentive payment program”.

14 Paragraph 129AAD(8)(c)

Omit “in respect of each such service”.

15 Paragraph 129AAD(8)(e)

Before “contain a”, insert “if the notice relates to professional services—”.

16 Subsection 129AADA(1)

After “a professional service”, insert “or an incentive payment program”.

17 Subsection 129AADA(1)

After “the service”, insert “or the incentive payment program”.

18 Subparagraphs 129AADA(2)(b)(i) and (ii)

After “in respect of the service”, insert “or the incentive payment program”.

19 Paragraph 129AAE(1)(a)

After “a professional service”, insert “or an incentive payment program”.

20 Subsection 129AAG(1)

After “a professional service,”, insert “or an incentive payment program,”.

21 Subsection 129AAG(1)

After “the service”, insert “or the incentive payment program”.

22 Paragraph 129AAH(1)(a)

After “a professional service”, insert “or an incentive payment program”.

23 Paragraph 129AAH(1)(b)

After “the service”, insert “or the incentive payment program”.

24 Subsection 129AAJ(2)

After “of the service”, insert “or the incentive payment program”.

25 After paragraph 129AAK(1)(a)

Insert:

(aa)the amount was paid purportedly under this Act in respect of an incentive payment program to a person who was not entitled to be paid the amount under this Act in respect of that incentive payment program; or

(ab)the amount was paid in a circumstance prescribed by the incentive payment program rules for the purposes of this paragraph; or

26 Paragraph 129AC(1A)(a)

After “paragraph 129AAD(2)(a)”, insert “or (aa)”.

27 Paragraph 129AC(1A)(a)

After “a professional service”, insert “or an incentive payment program”.

28 Subsection 129AC(1A)

After “in respect of the service”, insert “or the incentive payment program”.

29 Paragraph 129AC(1C)(a)

After “a professional service”, insert “or an incentive payment program”.

30 Paragraph 129AC(1C)(c)

After “the service”, insert “or the incentive payment program”.

31 Paragraph 129AC(1E)(a)

After “a professional service”, insert “or an incentive payment program”.

32 Paragraph 129AC(1E)(c)

After “the service”, insert “or the incentive payment program”.

33 Paragraphs 129AC(1E)(d) and (e)

Repeal the paragraphs, substitute:

(d)for a debt relating to a benefit or payment under this Act in respect of a professional service—either:

(i)the person who rendered the service, or on whose behalf the service was rendered; or

(ii)the estate of that person; and

(e)for a debt relating to a payment under this Act in respect of an incentive payment program—either:

(i)the person who is the incentive payment programs participant under the incentive payment program; or

(ii)the estate of that person;

34 Paragraph 129ACA(1)(a)

Repeal the paragraph, substitute:

(a)as a result of giving of false or misleading information, an amount paid, purportedly by way of benefit or payment under this Act, exceeds the amount (if any) that should have been paid:

(i)in respect of a professional service rendered, or purportedly rendered by a person; or

(ii)under an incentive payment program; and

35 Subparagraph 129ACA(2)(b)(i)

Omit “paragraph (1)(a)”, substitute “subparagraph (1)(a)(i)”.

36 Subparagraph 129ACA(2)(b)(ii)

Omit “of that kind”, substitute “of the kind mentioned in subparagraph (1)(a)(i)”.

37 After subsection 129AEA(1)

Insert:

(1A)A person is liable for an administrative penalty if:

(a)the CEO has served a notice (as mentioned in subsection 129AAI(4)) on the person claiming an amount (the total amount) as a debt due to the Commonwealth under subsection 129AC(1); and

(b)the total amount consists of, or includes, an amount (the recoverable amount) in respect of an incentive payment program; and

(c)the total amount is more than the amount prescribed by the incentive payment programs rules.

38 After subsection 129AEA(2)

Insert:

(2A)A person is liable for an administrative penalty in respect of a particular incentive payment program if:

(a)a notice was given to the person under section 129AAD requiring the person to produce a document, extract or copy relevant to the particular incentive payment program; and

(b)subsection 129AC(1A) or (1C) applies in respect of the person and the particular incentive payment program; and

(c)if the notice specifies one or more other incentive payment programs—either or both of subsections 129AC(1A) and (1C) apply in respect of the person and any other incentive payment program specified in the notice; and

(d)the sum of the amounts that may be recovered from the person under those subsections in respect of the particular incentive payment program, and any other incentive payment program specified in the notice, is more than the amount prescribed by the incentive payment programs rules; and

(e)the CEO has served a notice on the person claiming as a debt due to the Commonwealth the amount (the recoverable amount) that may be recovered from the person under whichever of subsection 129AC(1A) or (1C) applies in respect of the person and the particular incentive payment program.

39 After subsection 129AEA(3)

Insert:

(3A)A person (the participant) is liable for an administrative penalty in respect of an incentive payment program if:

(a)a notice was given to another person under section 129AAD requiring the person to produce a document, extract or copy relevant to the particular incentive payment program; and

(b)subsection 129AC(1E) applies in respect of the participant and the particular incentive payment program; and

(c)if the notice specifies one or more other incentive payment programs—subsection 129AC(1E) applies in respect of the participant and any other incentive payment program specified in the notice; and

(d)the sum of the amounts that may be recovered from the participant under that subsection in respect of the particular incentive payment program, and any other incentive payment program specified in the notice, is more than the amount prescribed by the incentive payment programs rules; and

(e)the CEO has served a notice on the participant claiming as a debt due to the Commonwealth the amount (the recoverable amount) that may be recovered from the participant under subsection 129AC(1E) in respect of the particular incentive payment program.

40 At the end of section 129AEA

Add:

(4A)A person is liable for an administrative penalty in respect of an incentive payment program if:

(a)the CEO has made a determination under subsection 129ACA(2) in relation to a recoverable amount in respect of the incentive payment program; and

(b)a notice has been served on the person (as mentioned in subsection 129ACA(5)) in respect of the incentive payment program; and

(c)if the determination relates to one or more other incentive payment programs—the person is the primary debtor or secondary debtor for any other incentive payment program to which the determination relates; and

(d)the sum of the recoverable amounts for the particular incentive payment program, and any other incentive payment program to which the determination relates, is more than the amount prescribed by the incentive payment programs rules.

41 Subsection 129AEB(1)

After “professional service”, insert “or an incentive payment program”.

42 Subsection 129AEB(2)

After “the professional service”, insert “or the incentive payment program”.

43 After paragraph 129AEB(2)(a)

Insert:

(aa)the recoverable amount referred to in paragraph 129AEA(1A)(b);

44 After paragraph 129AEB(2)(b)

Insert:

(ba)the recoverable amount referred to in paragraph 129AEA(2A)(e);

45 After paragraph 129AEB(2)(c)

Insert:

(ca)the recoverable amount referred to in paragraph 129AEA(3A)(e);

46 At the end of subsection 129AEB(2)

Add:

; (e) the recoverable amount referred to in paragraph 129AEA(4A)(a).

47 Subsection 129AEB(3)

After “a professional service” (first occurring), insert “or an incentive payment program”.

48 Subsection 129AEB(3) (table item 1)

After “the professional service”, insert “or the incentive payment program”.

49 Subsection 129AEB(3) (table item 1)

After “the service”, insert “or the incentive payment program”.

50 Subsection 129AEB(3) (table items 2 and 3)

After “the service” (wherever occurring), insert “or the incentive payment program”.

51 Subsection 129AEB(4)

After “a professional service”, insert “or an incentive payment program”.

52 Paragraphs 129AEB(4)(a) and (b)

After “the service”, insert “or the incentive payment program”.

53 Paragraph 129AEB(4)(b)

After “any other professional service”, insert “or incentive payment program”.

54 Subsection 129AEB(5)

After “a professional service”, insert “or an incentive payment program”.

55 Paragraph 129AEB(5)(b)

After “the professional service”, insert “or the incentive payment program”.

56 Paragraphs 129AEC(1)(a) to (c)

Repeal the paragraphs, substitute:

(a)if the liability to pay an administrative penalty is in respect of one or more professional services:

(i)the person’s liability to pay an administrative penalty in respect of the professional service; and

(ii)the professional service to which each administrative penalty relates; and

(iii)if there is more than one professional service—the total of the administrative penalties;

(b)if the liability to pay an administrative penalty is in respect of one or more incentive payment programs:

(i)the person’s liability to pay an administrative penalty in respect of the incentive payment program; and

(ii)the incentive payment program to which each administrative penalty relates; and

(iii)if there is more than one incentive payment program—the total of the administrative penalties;

57 Subsection 129AEC(1)

After “arising in relation to the professional service”, insert “or the incentive payment program”.

58 Subsection 129AEF(3)

After “under subsection (2)”, insert “(other than an amount set off in relation to an incentive payment program)”.

59 Section 129B (heading)

Omit “benefits for”.

60 At the end of paragraph 129B(1)(c)

Add:

; (iv) information obtained by the agency, or any other agency, in connection with an incentive payment program;

(v)information relating to a person’s eligibility or purported eligibility to participate in an incentive payment program or receive a payment under an incentive payment program.

61 After section 129F

Insert:

129GUse or disclosure authorised by incentive payment programs rules#

(1)A person may use relevant information if:

(a)the person is included in a class of persons prescribed by the incentive payment programs rules for the purposes of this paragraph; and

(b)the use is for a purpose prescribed by the incentive payment programs rules for the purposes of this paragraph; and

(c)the information is of a kind prescribed by the incentive payment programs rules for the purposes of this paragraph; and

(d)the use complies with any conditions prescribed by the incentive payment programs rules for the purposes of this paragraph.

Note: This subsection constitutes an authorisation for the purposes of the Privacy Act 1988 and other laws.

(2)A person may disclose relevant information if:

(a)the person is included in a class of persons prescribed by the incentive payment programs rules for the purposes of this paragraph; and

(b)the disclosure is for a purpose prescribed by the incentive payment programs rules for the purposes of this paragraph; and

(c)the information is of a kind prescribed by the incentive payment programs rules for the purposes of this paragraph; and

(d)the disclosure complies with any conditions prescribed by the incentive payment programs rules for the purposes of this paragraph.

Note: This subsection constitutes an authorisation for the purposes of the Privacy Act 1988 and other laws.

(3)Incentive payment programs rules may be made for the purposes of this section only to the extent that they are with respect to one or more legislative powers of the Parliament.

(4)Incentive payment programs rules made for the purposes of this section must specify the legislative power or powers of the Parliament in respect of which the incentive payment programs rules are made.

(5)In this section, relevant information means information obtained or generated by a person in the course of or for the purposes of:

(a)performing functions or duties, or exercising powers, under Part V or the incentive payment programs rules; or

(b)assisting another person to perform functions or duties, or exercise powers, under Part V or the incentive payment programs rules.

62 Section 130AAA

After “129F”, insert “, 129G”.

63 Section 131 (at the end of the heading)

Add “—delegation to officers”.

64 Subsection 131(1)

After “other than”, insert “a power under Subdivision A of Division 6 of Part V or”.

65 After subsection 131(1)

Insert:

(1A)The Secretary or the Chief Executive Medicare may, in writing, delegate to an SES employee, or acting SES employee, in the Department or in Services Australia one or more of the Secretary’s or the Chief Executive Medicare’s functions or powers under Subdivision A of Division 6 of Part V.

66 After section 131

Insert:

131ADelegation to other persons#

(1)The Secretary or the Chief Executive Medicare may, in writing, delegate one or more of their functions or powers under Part V or the incentive payment programs rules to a person engaged (whether as an employee or otherwise) by an organisation that performs services for a Commonwealth entity.

Note: Sections 34AA to 34A of the Acts Interpretation Act 1901 contain provisions relating to delegations.

(2)However, the Secretary or the Chief Executive Medicare must not delegate their functions or powers under the following provisions of this Act:

(a)section 56;

(b)section 60;

(c)a provision of Subdivision A of Division 6 of Part V.

(3)To avoid doubt, an organisation performs services for a Commonwealth entity even if that organisation performs those services in accordance with a contract or other arrangement with another organisation that performs services for the Commonwealth entity.

(4)Before delegating a function or power under subsection (1) to a person who is not an APS employee, the Secretary or the Chief Executive Medicare must have regard to whether the person has appropriate qualifications or expertise to perform the function or exercise the power.

(5)A person performing functions or exercising powers under a delegation under subsection (1) must comply with any written directions of the Secretary or the Chief Executive Medicare under subsection (6).

(6)The Secretary or the Chief Executive Medicare may, in writing, give directions for the purposes of subsection (5).

67 Application provision—use and disclosure of information

Section 129G of the Health Insurance Act 1973, as inserted by this Schedule, applies to the use or disclosure of information on or after the commencement of this item, whether the information was obtained before, on or after that commencement.

68 Transitional rules

(1) The Minister may, by legislative instrument, make rules prescribing matters of a transitional nature (including prescribing any saving or application provisions) relating to the amendments or repeals made by this Act.

(2) To avoid doubt, the rules may not do the following:

(a)create an offence or civil penalty;

(b)provide powers of:

(i)arrest or detention; or

(ii)entry, search or seizure;

(c)impose a tax;

(d)set an amount to be appropriated from the Consolidated Revenue Fund under an appropriation in this Act;

(e)directly amend the text of this Act.