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Dental Benefits Act 2008

Authoritative Version
  • - C2016C00756
  • In force - Superseded Version
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Act No. 41 of 2008 as amended, taking into account amendments up to Norfolk Island Legislation Amendment Act 2015
An Act to provide a framework for the provision of dental benefits, and for related purposes
Administered by: Health
Registered 08 Jul 2016
Start Date 01 Jul 2016
End Date 30 Jun 2018

Dental Benefits Act 2008

No. 41, 2008

Compilation No. 8

Compilation date:                              1 July 2016

Includes amendments up to:            Act No. 126, 2015

Registered:                                         8 July 2016

 

 

 

 

 

 

 

 

This compilation includes commenced amendments made by Act No. 59, 2015.

About this compilation

This compilation

This is a compilation of the Dental Benefits Act 2008 that shows the text of the law as amended and in force on 1 July 2016 (the compilation date).

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Editorial changes

For more information about any editorial changes made in this compilation, see the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.

Self‑repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

  

  

  


Contents

Part 1—Preliminary                                                                                                             1

1............ Short title............................................................................................. 1

2............ Commencement................................................................................... 1

3............ Simplified outline................................................................................ 1

4............ Definitions.......................................................................................... 2

5............ Meaning of eligible dental patient....................................................... 6

6............ Meaning of dental provider................................................................ 6

7............ Meaning of rendered on behalf of a dental provider.......................... 7

7A......... Extension to external Territories.......................................................... 7

Part 2—Entitlement to dental benefits                                                                      8

8............ Simplified outline................................................................................ 8

9............ Entitlement to dental benefits............................................................... 8

Part 3—Payment of dental benefits                                                                            9

Division 1—Introduction                                                                                            9

10.......... Simplified outline................................................................................ 9

Division 2—Payment of dental benefits                                                            10

11.......... Payment of dental benefits to persons who incur dental expenses.... 10

12.......... Assignment of dental benefits........................................................... 10

13.......... Payment of assigned dental benefits.................................................. 11

14.......... Payment of dental benefits to dental providers if a request is made... 11

Division 3—Claims for dental benefits                                                              13

15.......... Claims for dental benefits.................................................................. 13

16.......... Application for a longer period to lodge claims for assigned dental benefits            14

Division 4—When dental benefit is not payable                                           15

17.......... Dental benefit is not payable unless particulars are recorded on the account etc.      15

18.......... Dental benefit is not payable unless conditions specified in the Dental Benefits Rules are satisfied         15

19.......... Dental benefit is not payable if a benefit has been received etc. under a complying health insurance policy             16

20.......... Dental benefit is not payable in respect of a dental service rendered as part of an episode of hospital treatment etc........................................................................................................... 16

20A....... Dental benefit is not payable in respect of a dental service rendered by a disqualified practitioner           17

20B....... Minister may direct disqualified practitioner to give notice of disqualification         17

20C....... Strict liability offence—failure to comply with direction to give notice of disqualification       18

20D....... Minister may direct disqualified practitioner to display notice of disqualification     19

20E........ Strict liability offence—failure to comply with direction to display notice of disqualification  20

21.......... Dental Benefits Rules may provide that dental benefit is not payable 21

Part 4—Dental benefits vouchers                                                                               22

Division 1—Introduction                                                                                          22

22.......... Simplified outline.............................................................................. 22

Division 2—Qualification for vouchers                                                            23

23.......... Qualification for a voucher................................................................ 23

24.......... When a person satisfies the means test.............................................. 23

25.......... Dental Benefits Rules must specify certain matters........................... 26

26.......... Qualification for a voucher—other persons...................................... 26

Division 3—Issue of vouchers and other matters                                        27

27.......... Chief Executive Medicare must issue vouchers................................ 27

28.......... When voucher is not required to be issued—person dies.................. 28

29.......... When voucher is not required to be issued—circumstances specified in the Dental Benefit Rules           28

30.......... Voucher must specify dental service................................................. 28

31.......... Voucher remains in effect until the end of a calendar year................ 29

32.......... Dental Benefits Rules may provide for other matters........................ 29

Part 4A—Power to obtain documents etc. relevant to ascertaining whether amounts should have been paid                                                                                                                            30

32A....... Simplified outline.............................................................................. 30

32B....... When this Part applies....................................................................... 30

32C....... Chief Executive Medicare may require person to produce documents etc.               31

32D....... Civil penalty—failure to comply with requirement in notice............. 34

32E........ Self‑incrimination etc........................................................................ 35

32F........ Chief Executive Medicare or Human Services employee may deal with documents etc. produced          36

Part 5—Disclosure of protected information                                                      38

Division 1—Introduction                                                                                          38

33.......... Simplified outline.............................................................................. 38

Division 2—Disclosure of protected information                                        39

34.......... Prohibition on disclosure of protected information........................... 39

35.......... Authorised disclosure—official duties.............................................. 40

36.......... Authorised disclosure—public interest............................................. 40

37.......... Authorised disclosure—authorisation by affected person................. 41

38.......... Authorised disclosure—enforcement of the criminal law etc............ 41

39.......... Authorised disclosure—preventing or lessening a serious and imminent threat to the life or health of a person      41

40.......... Authorised disclosure—professional body....................................... 42

41.......... Authorised disclosure—administration of this Act........................... 43

42.......... Disclosure of protected information to courts or tribunals................ 43

Division 3—Offences relating to the disclosure etc. of protected information  45

43.......... Offence—disclosure of protected information obtained in the public interest           45

44.......... Offence—soliciting disclosure of protected information................... 45

45.......... Offence—use etc. of protected information....................................... 45

46.......... Offence—offering to supply protected information.......................... 46

Part 6—General offences and recovery provisions                                         47

Division 1—Introduction                                                                                          47

47.......... Simplified outline.............................................................................. 47

Division 2—Offences relating to assignment agreements                       48

48.......... Strict liability offence—particulars not set out in assignment agreement  48

49.......... Strict liability offence—copy of assignment agreement not given..... 48

Division 3—Offences relating to the giving of information                   50

50.......... Strict liability offence—false or misleading statements relating to dental benefit      50

51.......... Strict liability offence—false or misleading statements by employees etc.                50

52.......... Offence—statement that person knows is false or misleading.......... 51

53.......... Offence—statement based on statement that employee etc. knows is false or misleading        52

54.......... False statements etc........................................................................... 52

55.......... Prosecution of certain offences......................................................... 53

Division 4—Recovery of amounts paid under this Act                             54

56.......... Recovery of amounts paid: false or misleading statements................ 54

56A....... Recovery of amounts paid: requirements under Part 4A to produce documents       55

56B....... Notice of decision that document etc. produced substantiates that amount paid should have been paid    57

56C....... Notice of decision to claim amount as debt....................................... 58

56D....... Review of decision to claim amounts as debt.................................... 59

57.......... Interest payable on recoverable amounts........................................... 59

58.......... Recovering amounts by reducing future payments............................ 61

58A....... Amounts recoverable once only........................................................ 62

Part 7—Dental Benefits Rules                                                                                      63

59.......... Simplified outline.............................................................................. 63

60.......... Minister may make Dental Benefits Rules........................................ 63

61.......... Dental Benefits Schedule.................................................................. 64

62.......... Specification of items in Dental Benefits Schedule may be conditional 64

Part 8—Other matters                                                                                                       66

63.......... Simplified outline.............................................................................. 66

64.......... Additional functions of the Chief Executive Medicare...................... 66

65.......... Appropriation.................................................................................... 66

66.......... Delegation......................................................................................... 67

67.......... Regulations....................................................................................... 67

68.......... Review of operation of Act............................................................... 68

Endnotes                                                                                                                                    69

Endnote 1—About the endnotes                                                                            69

Endnote 2—Abbreviation key                                                                                71

Endnote 3—Legislation history                                                                             72

Endnote 4—Amendment history                                                                           73


An Act to provide a framework for the provision of dental benefits, and for related purposes

Part 1Preliminary

  

1  Short title

                   This Act may be cited as the Dental Benefits Act 2008.

2  Commencement

                   This Act commences on the day after it receives the Royal Assent.

3  Simplified outline

                   The following is a simplified outline of this Act:

•      This Act sets up a framework for the provision of dental benefits.

•      Dental benefit is payable if dental expenses are incurred in respect of a dental service rendered to an eligible dental patient.

•      The amount of dental benefit payable is the amount specified in, or determined in accordance with, the Dental Benefits Rules.

•      If dental benefit is payable, it is payable by the Chief Executive Medicare to the person who incurs the dental expenses in respect of the dental service. In some circumstances, dental benefit is payable to the dental provider.

•      Claims for dental benefit must be lodged with the Chief Executive Medicare.

•      The Chief Executive Medicare is to issue vouchers in relation to a dental service to persons who qualify for a voucher.

•      A person qualifies for a voucher if the person meets the requirements of this Act or if the Dental Benefits Rules provide that the person qualifies for a voucher.

•      A person in respect of whom a voucher is in effect is an eligible dental patient. The Dental Benefit Rules may also provide that certain eligible persons are eligible dental patients.

•      The Minister may make Dental Benefit Rules which may provide for a Dental Benefits Schedule.

•      This Act also makes provision in relation to the obtaining of documents relevant to ascertaining whether amounts should have been paid, the disclosure of information, offences against this Act and other matters.

4  Definitions

                   In this Act:

ABSTUDY scheme means the scheme known as ABSTUDY.

approved form means a form approved, in writing, by the Chief Executive Medicare.

                   associate, in relation to a corporation, means:

                     (a)  a director (within the meaning of the Corporations Act 2001), secretary or manager of the corporation; or

                     (b)  a receiver, or a receiver and manager, of any part of the undertaking of the corporation appointed under a power contained in any instrument; or

                     (c)  a liquidator of the corporation appointed in a voluntary winding up.

Australia, when used in a geographical sense, includes Norfolk Island, the Territory of Cocos (Keeling) Islands and the Territory of Christmas Island.

authorised disclosure has the meaning given by subsection 34(4).

bank includes, but is not limited to, a body corporate that is an ADI (authorised deposit‑taking institution) for the purposes of the Banking Act 1959.

Chief Executive Centrelink has the same meaning as in the Human Services (Centrelink) Act 1997.

Chief Executive Medicare has the same meaning as in the Human Services (Medicare) Act 1973.

clinically relevant service means a service that is generally accepted in the dental profession as being necessary for the appropriate care or treatment of the patient to whom it is rendered.

dental benefit means dental benefit payable under Part 3.

Dental Benefits Rules means the Dental Benefits Rules referred to in section 60.

Dental Benefits Schedule means the Dental Benefits Schedule referred to in section 61.

dental expenses means an amount payable in respect of a dental service.

dental practitioner has the same meaning as in the Health Insurance Act 1973.

dental provider has the meaning given by section 6.

dental service means a clinically relevant service specified in an item, being a service rendered by or on behalf of a dental provider.

disclose means divulge or communicate.

disqualified practitioner: a dental practitioner is a disqualified practitioner if:

                     (a)  the dental practitioner is fully disqualified under an agreement in effect under section 92 of the Health Insurance Act 1973; or

                     (b)  the dental practitioner is fully disqualified under section 105 of that Act; or

                     (c)  a final determination under section 106TA of that Act containing a direction under paragraph 106U(1)(h) of that Act that the dental practitioner be fully disqualified is in effect.

Note:          Under section 106ZPM of the Health Insurance Act 1973 (which deals with failure to produce certain documents or give certain information), a person may be taken to be a disqualified practitioner for the purposes of sections 20B to 20E of this Act.

eligible dental patient has the meaning given by section 5.

eligible person means:

                     (a)  a person who is an eligible person within the meaning of section 3 of the Health Insurance Act 1973; or

                     (b)  a person who is treated as such a person because of section 6, 6A or 7 of that Act.

entrusted public official has the meaning given by subsection 34(2).

FTB(A) person has the meaning given by subsection 24(2).

Human Services Department means the Department administered by the Human Services Minister.

Human Services employee means a Departmental employee, within the meaning of the Human Services (Medicare) Act 1973.

Human Services Minister means the Minister administering the Human Services (Medicare) Act 1973.

item means an item in the Dental Benefits Schedule.

making a statement, when used in Division 3 of Part 6, includes a reference to issuing or presenting a document.

medical practitioner has the same meaning as in the Health Insurance Act 1973.

medicare number has the same meaning as in subsection 84(1) of the National Health Act 1953.

medicare program has the same meaning as in the Human Services (Medicare) Act 1973.

partly disqualified practitioner: a dental practitioner is a partly disqualified practitioner in relation to a dental service if:

                     (a)  the dental practitioner is partly disqualified under an agreement in effect under section 92 of the Health Insurance Act 1973 in respect of the service; or

                     (b)  a final determination under section 106TA of that Act containing a direction under paragraph 106U(1)(g) of that Act that the dental practitioner be partly disqualified is in effect in respect of the service.

private health insurer has the same meaning as in the Private Health Insurance Act 2007.

protected information has the meaning given by subsection 34(3).

qualifies for a voucher has the meaning given by sections 23 and 26.

rendered on behalf of a dental provider has the meaning given by section 7.

satisfies the means test has the meaning given by section 24.

Secretary means the Secretary of the Department.

this Act includes:

                     (a)  the regulations; and

                     (b)  the Dental Benefits Rules.

voucher means a voucher issued under Part 4.

youth allowance means a payment under Part 2.11 of the Social Security Act 1991.

5  Meaning of eligible dental patient

             (1)  An eligible dental patient, in relation to a dental service, is:

                     (a)  a person in respect of whom a voucher in relation to the dental service is in effect; or

                     (b)  an eligible person included in a class of eligible persons specified in the Dental Benefits Rules to be eligible dental patients in relation to the dental service; or

                     (c)  if the Dental Benefits Rules provide that all eligible persons are eligible dental patients in relation to the dental service—an eligible person.

             (2)  Without limiting the way in which a class of eligible persons may be described for the purposes of paragraph (1)(b), the class may be described by reference to one or both of the following:

                     (a)  age;

                     (b)  receipt of a specified pension, benefit or allowance at a specified time or throughout a specified period.

6  Meaning of dental provider

             (1)  A dental provider, in relation to a dental service, means the following:

                     (a)  a dental practitioner who has general registration, or specialist registration, in the dentists division of the dental profession under a law of a State or Territory;

                     (b)  if the Dental Benefits Rules specify a class of persons to be dental providers in relation to the dental service—a person included in that class.

             (2)  Despite subsection (1), a dental practitioner is not a dental provider in relation to a dental service, if:

                     (a)  the dental practitioner is included in a class of dental practitioners specified in the Dental Benefits Rules not to be dental providers in relation to the dental service; or

                     (b)  the Dental Benefits Rules specify that dental practitioners are not dental providers in relation to the dental service.

7  Meaning of rendered on behalf of a dental provider

                   For the purposes of this Act, a dental service is taken to be rendered on behalf of a dental provider if, and only if:

                     (a)  the dental service is rendered by another person included in a class of persons specified in the Dental Benefits Rules for the purposes of this paragraph; and

                     (b)  the other person provides the dental service, in accordance with accepted dental practice, under the supervision of the dental provider.

7A  Extension to external Territories

                   This Act extends to every external Territory.

Part 2Entitlement to dental benefits

  

8  Simplified outline

                   The following is a simplified outline of this Part:

•      This Part creates a basic entitlement to dental benefit in respect of a dental service.

•      Dental benefit is payable if dental expenses are incurred in respect of the dental service.

•      The amount of dental benefit payable is the amount specified in, or determined in accordance with, the Dental Benefit Rules.

9  Entitlement to dental benefits

Basic entitlement

             (1)  If dental expenses are incurred in respect of a dental service rendered in Australia to an eligible dental patient, dental benefit is payable under section 11 in respect of the dental service.

Amount payable

             (2)  The amount of dental benefit payable in respect of a dental service is the amount specified in, or determined in accordance with, the Dental Benefits Rules.

Note:          See also sections 61 and 62.

             (3)  The amount of dental benefit payable in respect of a dental service must not exceed the dental expenses incurred in respect of the dental service.

Part 3Payment of dental benefits

Division 1Introduction

10  Simplified outline

                   The following is a simplified outline of this Part:

•      This Part deals with the payment of dental benefit in respect of a dental service.

•      Dental benefit is payable by the Chief Executive Medicare to:

               (a)     the person who incurs the dental expenses in respect of the dental service; or

              (b)     the dental provider, if there has been an assignment of dental benefits or if there has been a request that the dental provider be paid.

•      Claims for dental benefit must be lodged with the Chief Executive Medicare.

•      Dental benefit is not payable in certain circumstances, including where a dental service is provided by a practitioner who has been disqualified under the Health Insurance Act 1973.

•      The Minister may direct a disqualified practitioner to give notice of his or her disqualification.

Division 2Payment of dental benefits

11  Payment of dental benefits to persons who incur dental expenses

             (1)  Subject to this Part, dental benefit in respect of a dental service:

                     (a)  is payable by the Chief Executive Medicare on behalf of the Commonwealth to the person who incurs the dental expenses in respect of the dental service; and

                     (b)  is to be paid in such manner as the Chief Executive Medicare determines.

             (2)  A determination under paragraph (1)(b) may provide for the amount of dental benefit to be paid to the credit of a bank account in such circumstances (if any), and subject to such conditions (if any), as are specified in the Dental Benefits Rules.

             (3)  Subsection (2) does not limit paragraph (1)(b).

12  Assignment of dental benefits

Scope

             (1)  This section applies if dental benefit is payable under section 11 to a person in respect of a dental service.

Assignment of dental benefits

             (2)  The person and the dental provider by whom, or on whose behalf, the dental service is rendered may enter into an agreement, in accordance with the approved form, under which:

                     (a)  the person assigns his or her right to the payment of the dental benefit to the dental provider; and

                     (b)  the dental provider accepts the assignment in full payment of the dental expenses incurred by the person in respect of the dental service.

             (3)  An assignment of a dental benefit must not be made except in accordance with this section.

Agents

             (4)  If a person renders a dental service on behalf of a dental provider, the person may enter into an agreement under subsection (2) on behalf of the dental provider only if the person is authorised to do so by the dental provider.

13  Payment of assigned dental benefits

             (1)  If an assignment under section 12 takes effect with respect to a dental benefit, the dental benefit is, subject to section 15, payable in accordance with the assignment.

             (2)  Dental benefit payable under subsection (1) is to be paid in such manner as the Chief Executive Medicare determines.

             (3)  A determination under subsection (2) may provide for the amount of dental benefit to be paid to the credit of a bank account in such circumstances (if any), and subject to such conditions (if any), as are specified in the Dental Benefits Rules.

             (4)  Subsection (3) does not limit subsection (2).

14  Payment of dental benefits to dental providers if a request is made

Scope

             (1)  This section applies if:

                     (a)  dental benefit is payable under section 11 to a person in respect of a dental service; and

                     (b)  the person has not paid the dental expenses that the person incurred in respect of the dental service.

Dental benefit not to be paid to the person

             (2)  Dental benefit is not to be paid to the person.

Dental benefit to be paid to the dental provider if a request is made

             (3)  The person may request the Chief Executive Medicare to:

                     (a)  give the person personally; or

                     (b)  send by post to the address specified by the person;

a cheque for the amount of dental benefit payable in respect of the dental service in lieu of a payment to the person under section 11 in respect of the dental service.

             (4)  The Chief Executive Medicare must comply with a request under subsection (3).

             (5)  A cheque given or sent as requested under subsection (3) must be drawn in favour of the dental provider by whom, or on whose behalf, the dental service was rendered.

Division 3Claims for dental benefits

15  Claims for dental benefits

Claims for unassigned dental benefits

             (1)  A claim for a dental benefit (other than a dental benefit assigned under section 12) must be made in accordance with the approved form and:

                     (a)  lodged with the Chief Executive Medicare; or

                     (b)  sent, in such circumstances (if any), and subject to such conditions (if any), as are specified in the Dental Benefits Rules, to the Chief Executive Medicare in such manner as he or she determines.

Claims for assigned dental benefits

             (2)  A claim for a dental benefit assigned under section 12 must be made in accordance with the approved form and:

                     (a)  lodged with the Chief Executive Medicare; or

                     (b)  sent, in such circumstances (if any), and subject to such conditions (if any), as are specified in the Dental Benefits Rules, to the Chief Executive Medicare in such manner as he or she determines;

within the period of 2 years, or such longer period as is allowed under subsection 16(2), after the rendering of the dental service to which the dental benefit relates.

             (3)  A claim referred to in subsection (2) must not be paid unless the claimant satisfies the Chief Executive Medicare that, after signing the relevant agreement under subsection 12(2), the assignor retained in his or her possession a copy of the agreement.

             (4)  A determination under paragraph (2)(b) may provide for a claim for a dental benefit to be sent by electronic transmission.

             (5)  Subsection (4) does not limit paragraph (2)(b).

16  Application for a longer period to lodge claims for assigned dental benefits

             (1)  A person may, in accordance with the approved form, apply to the Chief Executive Medicare for a longer period within which to lodge a claim referred to in subsection 15(2).

             (2)  If an application under subsection (1) is made, the Chief Executive Medicare may, by notice in writing given to the person, allow a longer period for the lodgment of the claim.

             (3)  The Chief Executive Medicare must, in exercising his or her power under subsection (2), have regard to all matters that the Chief Executive Medicare considers relevant including, but not limited to, any hardship that might be caused to the person if a longer period is not allowed.

Division 4When dental benefit is not payable

17  Dental benefit is not payable unless particulars are recorded on the account etc.

             (1)  Dental benefit is not payable in respect of a dental service unless subsection (2) is satisfied.

             (2)  This subsection is satisfied if:

                     (a)  the dental provider by whom, or on whose behalf, the dental service was rendered; or

                     (b)  an employee of that dental provider;

has recorded on one or more of the following:

                     (c)  the account or receipt for fees in respect of the dental service;

                     (d)  the voucher that relates to the dental service;

                     (e)  if an assignment has been made in accordance with section 12 in relation to the dental benefit in respect of the dental service—on the form of the assignment;

such particulars (if any) as are specified in the Dental Benefits Rules in relation to dental services generally or in relation to a class of dental services in which the dental service is included.

18  Dental benefit is not payable unless conditions specified in the Dental Benefits Rules are satisfied

             (1)  The Dental Benefits Rules may provide that dental benefit is not payable in respect of a dental service unless the conditions specified in the Dental Benefits Rules are satisfied.

             (2)  Conditions specified in the Dental Benefits Rules for the purposes of subsection (1) may include, but are not limited to, conditions relating to:

                     (a)  the dental service; or

                     (b)  the circumstances in which the dental service is rendered; or

                     (c)  the dental provider by whom, or on whose behalf, the dental service is rendered; or

                     (d)  the eligible dental patient to whom the dental service is rendered; or

                     (e)  dental services rendered by, on behalf of or under an arrangement with:

                              (i)  the Commonwealth; or

                             (ii)  a State; or

                            (iii)  a Territory; or

                            (iv)  a local governing body; or

                             (v)  an authority established by a law of the Commonwealth, a law of a State or a law of a Territory.

Note:          For specification by class, see subsection 13(3) of the Legislation Act 2003.

19  Dental benefit is not payable if a benefit has been received etc. under a complying health insurance policy

             (1)  Dental benefit is not payable to a person in respect of a dental service if:

                     (a)  under a complying health insurance policy with a private health insurer, the person is covered, in whole or in part, for the liability to pay fees and charges in respect of the dental service; and

                     (b)  the person has received, or chooses to receive, a benefit from the private health insurer in respect of the dental service.

             (2)  In this section:

complying health insurance policy has the same meaning as in the Private Health Insurance Act 2007.

cover, in relation to a complying health insurance policy, has the same meaning as in the Private Health Insurance Act 2007.

20  Dental benefit is not payable in respect of a dental service rendered as part of an episode of hospital treatment etc.

             (1)  Dental benefit is not payable in respect of a dental service rendered to an eligible dental patient if the dental service is rendered:

                     (a)  as part of an episode of hospital treatment provided to the eligible dental patient; or

                     (b)  as part of hospital‑substitute treatment provided to the eligible dental patient in respect of which the eligible dental patient chooses to receive a benefit from a private health insurer.

             (2)  In this section:

hospital‑substitute treatment has the same meaning as in the Private Health Insurance Act 2007.

hospital treatment has the same meaning as in the Private Health Insurance Act 2007.

20A  Dental benefit is not payable in respect of a dental service rendered by a disqualified practitioner

                   Dental benefit is not payable in respect of a dental service if, at the time when the service was rendered, the person who rendered the service, or the dental provider on whose behalf the service was rendered, was:

                     (a)  a disqualified practitioner; or

                     (b)  a partly disqualified practitioner in relation to the service.

20B  Minister may direct disqualified practitioner to give notice of disqualification

             (1)  The Minister may, by written instrument served on a disqualified practitioner or a partly disqualified practitioner (the practitioner), direct the practitioner, and persons acting on behalf of the practitioner, not to render a specified dental service in respect of which, under section 20A of this Act or section 106ZPM of the Health Insurance Act 1973, dental benefit is not payable unless, before beginning to render the service, the practitioner or a person acting on behalf of the practitioner:

                     (a)  gives a copy of the notice under subsection (2) to the person (the service recipient) to whom the dental service is to be rendered; and

                     (b)  if the practitioner or person acting on behalf of the practitioner has reasonable grounds for believing that the service recipient is, or may be, unable to read and understand the notice—takes reasonable steps to explain the contents of the notice to the service recipient or to another person who has care of the service recipient.

Note:          Failure to comply with a direction given under this section is an offence (see section 20C).

             (2)  The instrument must:

                     (a)  be accompanied by a notice:

                              (i)  setting out particulars of the disqualification; and

                             (ii)  explaining such of the effects of the disqualification as the Minister considers appropriate; and

                     (b)  specify the day on which the direction comes into effect, which must not be before the instrument is served on the practitioner.

Period during which direction remains in force

             (3)  Unless sooner revoked, a direction under subsection (1) in relation to a disqualified practitioner, or a partly disqualified practitioner, remains in force until the practitioner ceases to be a disqualified practitioner or a partly disqualified practitioner.

Legislative instrument

             (4)  An instrument made under subsection (1), or a notice accompanying the instrument under subsection (2), is not a legislative instrument.

20C  Strict liability offence—failure to comply with direction to give notice of disqualification

             (1)  A person (the first person) commits an offence if:

                     (a)  the first person is a disqualified practitioner or a partly disqualified practitioner; and

                     (b)  an instrument is served on the first person under section 20B; and

                     (c)  the instrument contains a direction; and

                     (d)  the first person:

                              (i)  fails to comply with the direction; or

                             (ii)  causes or permits a person acting on his or her behalf to fail to comply with the direction.

Penalty:  1 penalty unit.

             (2)  An offence against subsection (1) is an offence of strict liability.

Note:          For strict liability, see section 6.1 of the Criminal Code.

             (3)  Subsection (1) does not apply if the first person has a reasonable excuse.

Note:          A defendant bears an evidential burden in relation to the matter in subsection (3): see subsection 13.3(3) of the Criminal Code.

20D  Minister may direct disqualified practitioner to display notice of disqualification

             (1)  The Minister may, by written instrument served on a disqualified practitioner or a partly disqualified practitioner (the practitioner), direct the practitioner to display one or more notices under subsection (2):

                     (a)  in a specified place or places; and

                     (b)  in a specified manner.

Note:          Failure to comply with a direction given under this subsection is an offence (see section 20E).

             (2)  The instrument must:

                     (a)  be accompanied by one or more notices:

                              (i)  setting out particulars of the disqualification; and

                             (ii)  explaining such of the effects of the disqualification as the Minister considers appropriate; and

                     (b)  specify the day on which the direction comes into effect, which must not be before the instrument is served on the practitioner.

             (3)  No more than one direction under subsection (1) may be in force in relation to the practitioner at any time.

Period during which direction remains in force

             (4)  Unless sooner revoked, a direction under subsection (1) in relation to a disqualified practitioner, or a partly disqualified practitioner, remains in force until the practitioner ceases to be a disqualified practitioner or a partly disqualified practitioner.

Legislative instrument

             (5)  An instrument made under subsection (1), or a notice accompanying the instrument under subsection (2), is not a legislative instrument.

20E  Strict liability offence—failure to comply with direction to display notice of disqualification

             (1)  A person commits an offence if:

                     (a)  the person is a disqualified practitioner or a partly disqualified practitioner; and

                     (b)  an instrument is served on the practitioner under section 20D; and

                     (c)  the instrument contains a direction; and

                     (d)  the person fails to comply with the direction.

Penalty:  1 penalty unit.

             (2)  An offence against subsection (1) is an offence of strict liability.

Note:          For strict liability, see section 6.1 of the Criminal Code.

             (3)  A person who commits an offence against subsection (1) commits a separate offence in respect of each day (including the day of a conviction under this section or any later day) during which the offence continues.

             (4)  Subsection (1) does not apply if the person has a reasonable excuse.

Note:          A defendant bears an evidential burden in relation to the matter in subsection (4): see subsection 13.3(3) of the Criminal Code.

21  Dental Benefits Rules may provide that dental benefit is not payable

             (1)  The Dental Benefits Rules may provide that dental benefit is not payable in respect of a dental service.

             (2)  Without limiting subsection (1), the Dental Benefits Rules may provide that:

                     (a)  dental benefit is not payable in respect of a specified dental service; or

                     (b)  dental benefit is not payable in respect of a dental service provided in specified circumstances; or

                     (c)  dental benefit is not payable in respect of a dental service rendered by, or on behalf of, a specified dental provider; or

                     (d)  dental benefit is not payable in respect of a dental service rendered to a specified eligible dental patient; or

                     (e)  dental benefit is not payable in respect of a dental service rendered by, on behalf of or under an arrangement with:

                              (i)  the Commonwealth; or

                             (ii)  a State; or

                            (iii)  a Territory; or

                            (iv)  a local governing body; or

                             (v)  an authority established by a law of the Commonwealth, a law of a State or a law of a Territory.

Note:          For specification by class, see subsection 13(3) of the Legislation Act 2003.

Part 4Dental benefits vouchers

Division 1Introduction

22  Simplified outline

                   The following is a simplified outline of this Part:

•      This Part sets up a framework for the issuing of vouchers in relation to a dental service to persons who qualify for a voucher.

•      A person qualifies for a voucher for a calendar year if he or she is aged between 2 and 18 years at any time during the calendar year, is an eligible person and satisfies the means test.

•      The Dental Benefit Rules may also provide that an eligible person qualifies for a voucher for a calendar year.

•      The Chief Executive Medicare must issue a voucher to a person if the person qualifies for the voucher on or before 31 October in a calendar year.

•      A person who qualifies for a voucher may request the Chief Executive Medicare to issue the voucher.

•      Unless the Dental Benefit Rules provide otherwise:

               (a)     only one voucher may be issued in relation to a dental service in respect of a person for a calendar year; and

              (b)     a voucher for a calendar year remains in effect until the end of the calendar year.

Division 2Qualification for vouchers

23  Qualification for a voucher

Persons to whom this section applies

             (1)  This section applies to a person, in relation to a calendar year, if:

                     (a)  the person is aged at least 2 years but is aged under 18 years on 1 January in the calendar year; or

                     (b)  the person will, in the ordinary course of events, reach the age of 2 years at any time during the calendar year.

Point in time at which person qualifies for a voucher

             (2)  The person qualifies for a voucher for the calendar year, in relation to a dental service specified in the Dental Benefits Rules for the purposes of this section, at the first time in the calendar year when:

                     (a)  the person is an eligible person; and

                     (b)  the person satisfies the means test set out in section 24.

24  When a person satisfies the means test

Basic rule

             (1)  For the purposes of section 23, a person satisfies the means test at a particular time if, at that time:

                     (a)  the person is receiving a payment under the ABSTUDY scheme, or another person is receiving such a payment in respect of the person; or

                     (b)  the person is receiving youth allowance; or

                     (c)  the person is an FTB(A) person; or

                     (d)  the person is included in a class of persons specified in the Dental Benefits Rules as satisfying the means test for the purposes of this paragraph.

When a person is an FTB(A) person

             (2)  A person is an FTB(A) person at a particular time if, at that time:

                     (a)  there is in force a section 16 determination that the person, or the person’s partner, is entitled to be paid family tax benefit at a Part A rate that is greater than nil; or

                     (b)  there is in force a section 16 determination that an FTB recipient in relation to the person is entitled to be paid family tax benefit in respect of the person at a Part A rate that is greater than nil; or

                     (c)  the person, or the person’s partner, has received an FTB lump sum payment in respect of the last income year ending before the start of the calendar year during which the time occurs; or

                     (d)  an FTB recipient in relation to the person has received an FTB lump sum payment that is:

                              (i)  in respect of the person; and

                             (ii)  in respect of the last income year ending before the start of the calendar year during which the time occurs; or

                     (e)  the person is included in a class of person specified in the Dental Benefits Rules to be an FTB(A) person for the purposes of this paragraph.

Definitions

             (3)  In this section:

approved care organisation has the same meaning as in the A New Tax System (Family Assistance) Act 1999.

FTB child, in relation to family tax benefit, has the same meaning as in the A New Tax System (Family Assistance) Act 1999.

FTB lump sum payment means a payment of family tax benefit under section 24 of the A New Tax System (Family Assistance) (Administration) Act 1999 that has a Part A rate that is greater than nil.

FTB recipient, in relation to a person (the child), means:

                     (a)  a person of whom the child is an FTB child in relation to family tax benefit; or

                     (b)  an approved care organisation of which the child is a client (within the meaning of the A New Tax System (Family Assistance) Act 1999).

income year has the same meaning as in subsection 3(1) of the A New Tax System (Family Assistance) Act 1999.

Part A rate means the Part A rate calculated under the A New Tax System (Family Assistance) Act 1999.

partner has the same meaning as in the A New Tax System (Family Assistance) Act 1999.

receive:

                     (a)  in relation to a payment under the ABSTUDY scheme—has the meaning given by subsection (4); and

                     (b)  in relation to youth allowance—has the same meaning as in section 23 of the Social Security Act 1991.

section 16 determination means a determination under section 16 of the A New Tax System (Family Assistance) (Administration) Act 1999.

When a person is receiving ABSTUDY

             (4)  For the purposes of this section, a person is taken to be receiving a payment under the ABSTUDY scheme:

                     (a)  from the earliest day on which the payment is payable to the person, even if an instalment of the payment, or the payment, it is not paid until a later day; and

                     (b)  until the latest day on which the payment is payable to the person, even if the last instalment of the payment, or the payment, is not paid until a later day.

25  Dental Benefits Rules must specify certain matters

             (1)  Dental Benefits Rules made for the purposes of paragraph 24(1)(d) must specify the time, or how to work out the time, at which a person satisfies the means test for the purposes of the paragraph.

             (2)  Dental Benefits Rules made for the purposes of paragraph 24(2)(e) must specify the time, or how to work out the time at which, a person is an FTB(A) person for the purposes of the paragraph.

26  Qualification for a voucher—other persons

                   The Dental Benefits Rules may provide that each eligible person included in a specified class of eligible persons qualifies for a voucher for a calendar year in relation to a specified dental service.

Division 3Issue of vouchers and other matters

27  Chief Executive Medicare must issue vouchers

Persons who qualify on or before 31 October

             (1)  The Chief Executive Medicare must issue a voucher for a calendar year in respect of a person, in relation to a dental service, if:

                     (a)  the person qualifies for the voucher on or before whichever of the following dates is applicable:

                              (i)  31 October in the calendar year;

                             (ii)  if an earlier or later date in the calendar year is specified in the Dental Benefits Rules for the purposes of this paragraph—the specified date; and

                     (b)  subject to subsection (5), the Chief Executive Medicare has not already issued a voucher for the calendar year in respect of the person in relation to the dental service.

Persons who request a voucher

             (2)  The Chief Executive Medicare must issue a voucher for a calendar year in respect of a person, in relation to a dental service, if:

                     (a)  the person qualifies for the voucher; and

                     (b)  the Chief Executive Medicare is requested by or on behalf of the person to issue the voucher; and

                     (c)  subject to subsection (5), the Chief Executive Medicare has not already issued a voucher for the calendar year in respect of the person in relation to the dental service.

Timing and form of a request

             (3)  A request under subsection (2):

                     (a)  must be made not later than 15 days, or such other number of days as is specified in the Dental Benefits Rules for the purposes of this paragraph, before the end of the calendar year; and

                     (b)  must be in the approved form.

Voucher to be issued as soon as reasonably practicable

             (4)  The Chief Executive Medicare must issue a voucher under subsection (1) or (2) as soon as reasonably practicable after the person qualifies for the voucher or the request for the voucher is made, as the case requires.

Exception to the one voucher per year rule

             (5)  The Dental Benefits Rules may specify circumstances in which more than one voucher in relation to a dental service, may be issued in respect of a person for a calendar year.

When voucher is not required to be issued

             (6)  This section has effect subject to sections 28 and 29.

28  When voucher is not required to be issued—person dies

                   Despite section 27, if:

                     (a)  a person qualifies for a voucher for a calendar year; and

                     (b)  the person dies before the Chief Executive Medicare issues the voucher for the calendar year in respect of the person;

the Chief Executive Medicare is not required to issue the voucher.

29  When voucher is not required to be issued—circumstances specified in the Dental Benefit Rules

                   The Dental Benefit Rules may specify circumstances in which the Chief Executive Medicare is not required to issue a voucher for a calendar year in respect of a person who qualifies for the voucher.

30  Voucher must specify dental service

                   A voucher must specify the dental service to which it relates.

31  Voucher remains in effect until the end of a calendar year

                   A voucher for a calendar year takes effect on the day on which it is issued and remains in effect until the end of the calendar year, unless the Dental Benefits Rules provide for a different period of effect.

32  Dental Benefits Rules may provide for other matters

                   The Dental Benefits Rules may provide for the following:

                     (a)  matters relating to requests for vouchers;

                     (b)  altering the period of effect of vouchers;

                     (c)  the persons to whom vouchers are to be issued;

                     (d)  lost vouchers.

Part 4APower to obtain documents etc. relevant to ascertaining whether amounts should have been paid

  

32A  Simplified outline

                   The following is a simplified outline of this Part:

•      The Chief Executive Medicare may require the production of documents etc. relevant to ascertaining whether amounts should have been paid.

•      A failure to comply may lead to debt recovery action or to a civil penalty.

•      The Chief Executive Medicare and Human Services employees may deal with documents etc. produced.

32B  When this Part applies

             (1)  This Part applies if the Chief Executive Medicare:

                     (a)  has a reasonable concern that an amount paid, purportedly by way of dental benefit, in respect of one or more dental services, may exceed the amount (if any) that should have been paid; and

                     (b)  has taken into account advice given to him or her by a dental practitioner, or a medical practitioner, who is a Human Services employee about the types of documents that contain information relevant to ascertaining whether amounts paid in respect of dental services of the same kind or kinds as the service or services referred to in paragraph (a) should have been paid; and

                     (c)  has taken reasonable steps to consult with a relevant professional body about the types of documents that contain information relevant to ascertaining whether amounts paid in respect of dental services of the same kind or kinds as the service or services referred to in paragraph (a) should have been paid.

Note:          For the purposes of paragraph (a), the Chief Executive Medicare may, for example, have a reasonable concern about payments made in respect of:

(a)    dental services rendered by or on behalf of individual dental providers; or

(b)    dental services rendered by or on behalf of particular kinds of dental providers; or

(c)    the rendering of dental services to which specific items, or groups of items, relate.

             (2)  In forming a reasonable concern for the purposes of subsection (1), the Chief Executive Medicare is not to take account of whether the service is clinically relevant.

Definition

             (3)  In this section:

relevant professional body means a body declared by the Minister under subsection (4) to be a relevant professional body.

             (4)  The Minister may, by legislative instrument, declare a body to be a relevant professional body for the purposes of this section.

32C  Chief Executive Medicare may require person to produce documents etc.

Power to give notice requiring production of documents etc.

             (1)  If the Chief Executive Medicare believes on reasonable grounds that:

                     (a)  a person:

                              (i)  who rendered a dental service in respect of which an amount has been paid that is the subject of the Chief Executive Medicare’s concern referred to in paragraph 32B(1)(a); or

                             (ii)  on whose behalf such a dental service was rendered; or

                     (b)  another person, not being:

                              (i)  the person in respect of whom the dental service was rendered; or

                             (ii)  the person who incurred the dental expenses in respect of the service;

has possession, custody or control of one or more documents relevant to ascertaining whether the amount paid in respect of the dental service should have been paid, the Chief Executive Medicare may, by written notice given to the person, require the person to do any or all of the things mentioned in subsection (2) within a period specified in the notice.

Note:          For a person referred to in paragraph (a), failure to comply with a notice may lead to debt recovery action (see section 56A). For a person referred to in paragraph (b), failure to comply with a notice may lead to a civil penalty (see section 32D).

             (2)  The Chief Executive Medicare may require the person, in relation to each dental service specified in the notice:

                     (a)  subject to subsection (3), to produce to the Chief Executive Medicare, or a Human Services employee, any document, or extract of any document, that is relevant for the purpose set out in subsection (1); or

                     (b)  to make a copy of any such document or extract and to produce that copy to the Chief Executive Medicare or a Human Services employee.

             (3)  If a document, extract or copy contains clinical details relating to an individual, the person to whom the notice is given is not required to produce the document, extract or copy to a person other than a Human Services employee who is a dental practitioner or a medical practitioner.

Limitations on power to give notice: person must first have been given opportunity to respond to a request

             (4)  The Chief Executive Medicare must not give a notice to a person under subsection (1) in respect of a dental service unless the Chief Executive Medicare has given the person a reasonable opportunity to respond to a written request (other than under this section) to produce to the Chief Executive Medicare, or a Human Services employee, documents relevant to ascertaining whether the amount paid, purportedly by way of dental benefit, in respect of the service, should have been paid.

Limitations on power to give notice: notice can only be given in respect of dental service rendered in the last 2 years

             (5)  A notice under subsection (1) can only be given in respect of a dental service that was rendered in the period of 2 years immediately before the notice is given.

Content of notice

             (6)  A notice under subsection (1) must:

                     (a)  specify details of each dental 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; and

                     (b)  specify the reason or reasons for the Chief Executive Medicare’s concern that an amount paid, purportedly by way of dental benefit, in respect of each such service may exceed the amount (if any) that should have been paid; and

                     (c)  specify the information relevant to ascertaining whether amounts paid in respect of each such service should have been paid; and

                     (d)  specify how the document, extract or copy is to be produced; and

                     (e)  contain a statement to the effect that the person to whom the notice is given is not expected to produce a document, extract or copy containing clinical details relating to an individual unless the document, extract or copy is necessary to ascertaining whether the amount paid in respect of the service should have been paid; and

                      (f)  specify the period within which, and place at which, the document, extract or copy is to be produced.

The period specified under paragraph (f) must be a period ending at least 21 days after the day on which the notice is given.

Note:          For the purpose of paragraphs (b) and (c) the notice will include the reason for the Chief Executive Medicare’s concern about the payment and explain the factual issue that the person is required to substantiate.

Health information within the meaning of the Privacy Act 1988

             (7)  The power under this section to require a document, extract or copy to be produced includes the power to require the production of a document, extract or copy containing health information (within the meaning of the Privacy Act 1988) about an individual.

Section is not limited by other provisions

             (8)  This section is not limited by:

                     (a)  any other provision of this Act; or

                     (b)  any provision of the Human Services (Medicare) Act 1973 or any other Act;

that relates to the powers of the Chief Executive Medicare to require the production of documents.

32D  Civil penalty—failure to comply with requirement in notice

             (1)  A person referred to in paragraph 32C(1)(b) contravenes this section if:

                     (a)  the person is given a notice under section 32C requiring the person to do something in respect of a dental service; and

                     (b)  the person fails to comply with the requirement within the period specified in the notice.

Civil penalty:

                     (a)  for an individual—20 penalty units; and

                     (b)  for a body corporate—100 penalty units.

             (2)  It is a defence in proceedings against a person for a contravention of subsection (1) if the person proves (on the balance of probabilities) that:

                     (a)  the failure to comply is brought about by another person over whom the person has no control or by a non‑human act or event over which the person has no control; and

                     (b)  the person could not reasonably be expected to guard against the failure.

             (3)  Part VIA of the Health Insurance Act 1973 applies in relation to this section as if subsection (1) of this section were a civil penalty provision as defined in section 125B of that Act.

Note:          Part VIA of the Health Insurance Act 1973 provides a regime for the obtaining of orders for a civil penalty.

32E  Self‑incrimination etc.

             (1)  A person is not excused from producing a document, extract or copy when required to do so under section 32C on the ground that doing so would tend to incriminate the person or expose the person to a penalty.

             (2)  However, in the case of an individual:

                     (a)  the document, extract or copy produced; and

                     (b)  producing the document, extract or copy; and

                     (c)  any information, document or thing obtained as a direct or indirect consequence of producing the document, extract or copy;

are not admissible in evidence against the individual in:

                     (d)  any criminal proceedings, other than:

                              (i)  proceedings for an offence against this Act dealing with false or misleading statements; and

                             (ii)  proceedings for an offence against section 137.1 or 137.2 of the Criminal Code (which deals with false or misleading information or documents) that relates to this Act; or

                     (e)  any civil proceedings, other than a civil proceeding arising under section 32D, or Division 4 of Part 6, of this Act.

32F  Chief Executive Medicare or Human Services employee may deal with documents etc. produced

Power to inspect, copy and retain document etc.

             (1)  If a document, extract or copy has been produced under section 32C in respect of a dental service, the Chief Executive Medicare, or a Human Services employee, may do all or any of the things mentioned in subsection (2) for the purpose of ascertaining whether the information contained in the document, extract or copy properly substantiates that an amount paid, purportedly by way of dental benefit, in respect of the service, should have been paid.

Note:          If the information does not properly substantiate the amount, debt recovery action may be taken (see section 56A).

             (2)  The Chief Executive Medicare or Human Services employee may:

                     (a)  inspect the document, extract or copy; and

                     (b)  make a copy of, or take an extract from, the document, extract or copy; and

                     (c)  retain the document, extract or copy in his or her possession for such reasonable period as he or she thinks fit.

Rights of person otherwise entitled to possession of document or extract

             (3)  The person otherwise entitled to possession of the document or extract is entitled to be supplied, as soon as practicable, with a copy certified by the Chief Executive Medicare, or a Human Services employee, to be a true copy.

             (4)  The certified copy must be received in all courts and tribunals as evidence as if it were the original.

             (5)  Until a certified copy is supplied, the Chief Executive Medicare, or a Human Services employee, must, at such times and places as he or she thinks appropriate, permit the person otherwise entitled to possession of the document or extract, or a person authorised by that person, to inspect and make copies of, or take extracts from, the document or extract.

Section is not limited by other provisions

             (6)  This section is not limited by:

                     (a)  any other provision of this Act; or

                     (b)  any provision of the Human Services (Medicare) Act 1973 or any other Act;

that relates to the powers of the Chief Executive Medicare, or a Human Services employee, to deal with a document, extract or copy as described in subsection (2) of this section.

Human Services employees

             (7)  A Human Services employee referred to in this section may be an employee other than the employee to whom the document, extract or copy was required to be produced.

Part 5Disclosure of protected information

Division 1Introduction

33  Simplified outline

                   The following is a simplified outline of this Part:

•      Except as authorised by this Part, an entrusted public official must not disclose protected information.

•      An entrusted public official must not, except for the purposes of this Act, be required:

               (a)     to disclose protected information to a court or tribunal; or

              (b)     produce documents that contain protected information in a court or tribunal.

•      This Part also sets out a number of offences relating to the disclosure etc. of protected information.

Division 2Disclosure of protected information

34  Prohibition on disclosure of protected information

Offence

             (1)  A person commits an offence if:

                     (a)  the person is, or was at any time, an entrusted public official; and

                     (b)  the person has, or has at any time had, a duty, function or power under this Act; and

                     (c)  the person discloses information to another person; and

                     (d)  the information is protected information; and

                     (e)  the disclosure is not an authorised disclosure.

Penalty:  Imprisonment for 2 years or 120 penalty units, or both.

Entrusted public official

             (2)  Each of the following persons is an entrusted public official:

                     (a)  the Chief Executive Medicare;

                     (b)  a Human Services employee;

                     (c)  a consultant to the Human Services Department;

                     (d)  the Secretary of the Department administered by the Minister who administers this Act;

                     (e)  an APS employee in that Department;

                      (f)  any other person employed or engaged by that Department.

Protected information

             (3)  Information is protected information if the information relates to a person other than the person who obtained it and:

                     (a)  the information is obtained by a person in the course of performing duties or functions, or exercising powers, under this Act; or

                     (b)  the information was information to which paragraph (a) applied and is obtained by a person by way of an authorised disclosure under section 36.

Authorised disclosure

             (4)  A disclosure of information is an authorised disclosure if the disclosure is one that a person may make under section 35, 36, 37, 38, 39, 40 or 41.

35  Authorised disclosure—official duties

                   For the purposes of subsection 34(4), a person may disclose protected information if the disclosure is made:

                     (a)  in the course of performing a duty or function, or exercising a power, under this Act or the Health Insurance Act 1973; or

                     (b)  for the purposes of enabling another person to perform duties or functions, or exercise powers, under this Act or the Health Insurance Act 1973; or

                     (c)  for the purposes of enabling a person to perform duties or functions, or exercise powers, in connection with a medicare program.

36  Authorised disclosure—public interest

             (1)  For the purposes of subsection 34(4), a person may disclose protected information if:

                     (a)  the disclosure is, or is a kind of disclosure, certified, in writing by the Secretary or the Chief Executive Medicare, to be in the public interest; and

                     (b)  the disclosure is made in accordance with any requirements specified in the Dental Benefit Rules.

             (2)  An instrument made under paragraph (1)(a) is not a legislative instrument.

37  Authorised disclosure—authorisation by affected person

                   For the purposes of subsection 34(4), the Secretary or the Chief Executive Medicare may disclose protected information to a person who is expressly or impliedly authorised by the person to whom the protected information relates to obtain it.

38  Authorised disclosure—enforcement of the criminal law etc.

             (1)  For the purposes of subsection 34(4), the Secretary or the Chief Executive Medicare may disclose protected information to an agency if:

                     (a)  the Secretary or the Chief Executive Medicare believes on reasonable grounds that the disclosure is reasonably necessary for:

                              (i)  the enforcement of the criminal law; or

                             (ii)  the enforcement of a law imposing a pecuniary penalty; or

                            (iii)  the protection of the public revenue; and

                     (b)  the functions of the agency include that enforcement or protection; and

                     (c)  the disclosure is for the purposes of that enforcement or protection.

             (2)  In this section:

agency includes:

                     (a)  a police force of a State or Territory; or

                     (b)  any other authority or person responsible for the enforcement of the laws of the State or Territory.

39  Authorised disclosure—preventing or lessening a serious and imminent threat to the life or health of a person

                   For the purposes of subsection 34(4), the Secretary or the Chief Executive Medicare may disclose protected information if:

                     (a)  the Secretary or the Chief Executive Medicare believes on reasonable grounds that the disclosure is necessary to prevent or lessen a serious and imminent threat to the life or health of a person; and

                     (b)  the disclosure is for the purposes of preventing or lessening that threat.

40  Authorised disclosure—professional body

             (1)  For the purposes of subsection 34(4), the Secretary or the Chief Executive Medicare may disclose to a professional body protected information that relates to:

                     (a)  a dental provider; or

                     (b)  the dental services rendered by or on behalf of a dental provider;

if the Secretary or the Chief Executive Medicare believes on reasonable grounds that the dental provider should be reported to the professional body.

             (2)  Subsection (1) does not apply to protected information:

                     (a)  that relates to a person who is a patient of the dental provider; and

                     (b)  from which the identity of the person is apparent or can reasonably be ascertained;

unless the Secretary or the Chief Executive Medicare believes on reasonable grounds that the disclosure of the protected information is necessary in connection with the reporting of the dental provider to the professional body.

             (3)  In this section:

professional body means a body responsible for the licensing, registration, accreditation or standards of professional conduct of dental providers generally or a class of dental providers.

41  Authorised disclosure—administration of this Act

             (1)  For the purposes of subsection 34(4), a person may disclose protected information to:

                     (a)  the Chief Executive Medicare; or

                     (b)  the Chief Executive Centrelink; or

                     (c)  the Minister who administers:

                              (i)  this Act; or

                             (ii)  the Human Services (Medicare) Act 1973; or

                            (iii)  the Social Security Act 1991 in so far as that Act relates to youth allowance; or

                            (iv)  the A New Tax System (Family Assistance) Act 1999 in so far as that Act relates to family tax benefit; or

                             (v)  the ABSTUDY scheme; or

                            (vi)  the Veterans’ Entitlements Act 1986; or

                     (d)  the Secretary of, or an APS employee in, the Department administered by a Minister mentioned in paragraph (c);

if the disclosure is for the purposes of administering this Act.

Note:          For the definition of APS employee, see section 2B of the Acts Interpretation Act 1901.

             (2)  In this section:

family tax benefit has the same meaning as in the A New Tax System (Family Assistance) Act 1999.

42  Disclosure of protected information to courts or tribunals

Scope

             (1)  This section applies if:

                     (a)  a person is, or was at any time, an entrusted public official; and

                     (b)  the person obtained:

                              (i)  protected information; or

                             (ii)  a document that contains protected information;

                            in the course of performing duties or functions, or exercising powers, under this Act.

Disclosure of protected information to a court or tribunal

             (2)  The person must not, except for the purposes of this Act, be required:

                     (a)  to disclose the protected information to a court or tribunal; or

                     (b)  to produce the document in a court or tribunal.

Division 3Offences relating to the disclosure etc. of protected information

43  Offence—disclosure of protected information obtained in the public interest

                   A person commits an offence if:

                     (a)  the person obtains protected information; and

                     (b)  the person does so by way of an authorised disclosure under section 36; and

                     (c)  the person discloses the protected information; and

                     (d)  the disclosure by the person is not an authorised disclosure.

Penalty:  Imprisonment for 2 years or 120 penalty units, or both.

44  Offence—soliciting disclosure of protected information

                   A person commits an offence if:

                     (a)  the person solicits the disclosure of information from another person; and

                     (b)  the information is protected information; and

                     (c)  the disclosure would constitute a contravention of section 34 or 43.

Penalty:  Imprisonment for 2 years or 120 penalty units, or both.

45  Offence—use etc. of protected information

                   A person commits an offence if:

                     (a)  information is disclosed to the person; and

                     (b)  the information is protected information; and

                     (c)  the disclosure to the person constitutes a contravention of section 34 or 43; and

                     (d)  any of the following apply:

                              (i)  the person solicited the disclosure of the information;

                             (ii)  the person subsequently discloses the information;

                            (iii)  the person uses the information.

Penalty:  Imprisonment for 2 years or 120 penalty units, or both.

46  Offence—offering to supply protected information

                   A person commits an offence if:

                     (a)  the person:

                              (i)  offers; or

                             (ii)  holds himself or herself out as being able;

                            to supply (whether or not to a particular person) information about another person; and

                     (b)  the person knows that the information is protected information; and

                     (c)  the supply would constitute a contravention of section 34 or 43.

Penalty:  Imprisonment for 2 years or 120 penalty units, or both.

Part 6General offences and recovery provisions

Division 1Introduction

47  Simplified outline

                   The following is a simplified outline of this Part:

•      Divisions 2 and 3 of this Part set out a number of offences relating to assignment agreements and the giving of information.

•      Division 4 of this Part deals with the recovery of amounts paid under this Act.

Division 2Offences relating to assignment agreements

48  Strict liability offence—particulars not set out in assignment agreement

             (1)  A dental provider commits an offence if:

                     (a)  the dental provider, or a person acting on his or her behalf, enters into an agreement under subsection 12(2) with another person; and

                     (b)  particulars relating to the dental service are required, by the approved form, to be set out in the agreement; and

                     (c)  the dental provider has not caused the particulars to be set out in the agreement before the other person signs the agreement.

Penalty:  10 penalty units.

             (2)  An offence under subsection (1) is an offence of strict liability.

Note:          For strict liability, see section 6.1 of the Criminal Code.

             (3)  In this section:

approved form means the form approved for the purposes of subsection 12(2).

49  Strict liability offence—copy of assignment agreement not given

             (1)  A dental provider commits an offence if:

                     (a)  the dental provider, or a person acting on his or her behalf, enters into an agreement under subsection 12(2) with another person; and

                     (b)  the dental provider does not cause a copy of the agreement to be given to the other person as soon as practicable after the other person signed the agreement.

Penalty:  10 penalty units.

             (2)  An offence under subsection (1) is an offence of strict liability.

Note:          For strict liability, see section 6.1 of the Criminal Code.

Division 3Offences relating to the giving of information

50  Strict liability offence—false or misleading statements relating to dental benefit

Offence

             (1)  A person commits an offence if:

                     (a)  the person makes, or authorises the making of, an oral or written statement; and

                     (b)  the statement is false or misleading in a material particular; and

                     (c)  the statement is capable of being used in connection with a claim for dental benefit.

Penalty:  20 penalty units.

Strict liability

             (2)  An offence under subsection (1) is an offence of strict liability.

Note:          For strict liability, see section 6.1 of the Criminal Code.

Prosecution—time limit

             (3)  Despite section 15B of the Crimes Act 1914, a prosecution for an offence under subsection (1) must be instituted within 3 years after the time at which the statement is alleged to have been made.

51  Strict liability offence—false or misleading statements by employees etc.

Offence

             (1)  A person (the first person) commits an offence if:

                     (a)  the first person is an employee, associate or agent of another person (the second person); and

                     (b)  the second person makes an oral or written statement (the claim statement); and

                     (c)  the claim statement is false or misleading in a material particular; and

                     (d)  the claim statement is capable of being used in connection with a claim for dental benefit; and

                     (e)  the material particular in respect of which the claim statement is false or misleading is substantially based upon another statement (the employee statement); and

                      (f)  the employee statement was made by the first person:

                              (i)  to the second person; or

                             (ii)  to an agent of the second person; and

                     (g)  the employee statement was false or misleading in a material particular.

Penalty:  20 penalty units.

Strict liability

             (2)  An offence under subsection (1) is an offence of strict liability.

Note:          For strict liability, see section 6.1 of the Criminal Code.

Prosecution—time limit

             (3)  Despite section 15B of the Crimes Act 1914, a prosecution for an offence under this section must be instituted within 3 years after the time at which the claim statement is alleged to have been made.

52  Offence—statement that person knows is false or misleading

                   A person commits an offence if:

                     (a)  the person makes, or authorises the making of, an oral or written statement; and

                     (b)  the person knows:

                              (i)  that the statement is false or misleading in a material particular; and

                             (ii)  that the statement is capable of being used in connection with a claim for dental benefit.

Penalty:  Imprisonment for 5 years or 100 penalty units, or both.

53  Offence—statement based on statement that employee etc. knows is false or misleading

                   A person (the first person) commits an offence if:

                     (a)  the first person is an employee, associate or agent of another person (the second person); and

                     (b)  the second person makes an oral or written statement (the claim statement); and

                     (c)  the claim statement is false or misleading in a material particular; and

                     (d)  the claim statement is capable of being used in connection with a claim for dental benefit; and

                     (e)  the material particular in respect of which the claim statement is false or misleading is substantially based upon another statement (the employee statement); and

                      (f)  the employee statement was made by the first person:

                              (i)  to the second person; or

                             (ii)  to an agent of the second person; and

                     (g)  the first person knew that the employee statement was false or misleading in a material particular; and

                     (h)  the first person knew that, or was reckless as to whether, the employee statement would be used in the preparation of the claim statement.

Penalty:  Imprisonment for 5 years or 100 penalty units, or both.

54  False statements etc.

                   A person commits an offence if:

                     (a)  the person gives information under or for the purposes of this Act; and

                     (b)  the person knows that the information is false or misleading in a material particular.

Penalty:  Imprisonment for 5 years or 100 penalty units.

55  Prosecution of certain offences

             (1)  An offence against section 52, 53 or 54 is an indictable offence.

             (2)  Despite subsection (1), a court of summary jurisdiction may hear and determine proceedings in respect of an offence referred to in that subsection if:

                     (a)  the court is satisfied that it is proper to do so; and

                     (b)  the defendant and the prosecutor consent.

             (3)  If, in accordance with subsection (2), a court of summary jurisdiction convicts a person of an offence referred to in subsection (1), the penalty that the court may impose is:

                     (a)  imprisonment for a period not exceeding 6 months; or

                     (b)  a fine not exceeding 10 penalty units.

Division 4Recovery of amounts paid under this Act

56  Recovery of amounts paid: false or misleading statements

Scope

             (1)  This section applies if:

                     (a)  an amount is paid purportedly by way of a payment of dental benefit; and

                     (b)  as a result of the making of a false or misleading statement, the amount paid exceeds the amount (if any) that should have been paid.

Debt due to the Commonwealth

             (2)  The amount of the excess is recoverable as a debt due to the Commonwealth from:

                     (a)  the person by or on behalf of whom the statement was made; or

                     (b)  the estate of that person.

Note:          See section 56D for review of decisions.

             (3)  Subsection (2) applies:

                     (a)  whether or not the amount was paid to the person by or on behalf of whom the statement was made; and

                     (b)  whether or not any person has been convicted of an offence in relation to the making of the statement.

56A  Recovery of amounts paid: requirements under Part 4A to produce documents

Failure to produce document: notice to person referred to in paragraph 32C(1)(a)

             (1)  If:

                     (a)  a person referred to in paragraph 32C(1)(a) is required, by a notice given under section 32C, to produce a document, extract or copy in respect of a dental service; and

                     (b)  the person does not comply with the requirement within the period specified in the notice;

the amount paid, purportedly by way of dental benefit, in respect of the service, is recoverable as a debt due to the Commonwealth from the person, or the estate of the person.

             (2)  Subsection (1) does not apply if the person concerned satisfies the Chief Executive Medicare that the person’s non‑compliance is due to circumstances beyond the person’s control.

Note:          See section 56D for review of decisions.

Amount not properly substantiated: notice to person referred to in paragraph 32C(1)(a)

             (3)  If:

                     (a)  a person referred to in paragraph 32C(1)(a) is required, by a notice given under section 32C, to produce a document, extract or copy in respect of a dental service; and

                     (b)  the person complies with the requirement within the period specified in the notice; and

                     (c)  the information contained in the document, extract or copy does not properly substantiate (wholly or partly) that the amount paid, purportedly by way of dental benefit, in respect of the service, should have been paid;

then, to the extent that the amount is not properly substantiated, the amount is recoverable as a debt due to the Commonwealth from the person, or the estate of the person.

             (4)  Subsection (3) does not apply if the person concerned satisfies the Chief Executive Medicare that the reason that the information contained in the document, extract or copy does not properly substantiate the amount is due to circumstances beyond the person’s control.

Note:          See section 56D for review of decisions.

Amount not properly substantiated: notice to person referred to in paragraph 32C(1)(b)

             (5)  If:

                     (a)  a person (the notice recipient) referred to in paragraph 32C(1)(b) is required, by a notice given under section 32C, to produce a document, extract or copy in respect of a dental service; and

                     (b)  the notice recipient complies with the requirement within the period specified in the notice; and

                     (c)  the information contained in the document, extract or copy does not properly substantiate (wholly or partly) that the amount paid, purportedly by way of dental benefit, in respect of the service, should have been paid;

then, to the extent that the amount is not properly substantiated, the amount is recoverable as a debt due to the Commonwealth from:

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

                     (e)  the estate of that person.

             (6)  Subsection (5) does not apply if the person from whom the amount concerned is recoverable satisfies the Chief Executive Medicare that the reason that the information contained in the document, extract or copy does not properly substantiate the amount is due to circumstances beyond the control of the person and the notice recipient.

Note:          See section 56D for review of decisions.

Amount is recoverable from a person under this section whether or not the amount was paid to that person

             (7)  An amount is recoverable from a person as mentioned in subsection (1), (3) or (5) whether or not the amount was paid to that person.

56B  Notice of decision that document etc. produced substantiates that amount paid should have been paid

Amount paid substantiated

             (1)  If:

                     (a)  a person produces to the Chief Executive Medicare, or to a Human Services employee, a document, extract or copy relating to a dental service after being requested, or required under section 32C, to do so; and

                     (b)  the Chief Executive Medicare decides that the information contained in the document, extract or copy properly substantiates that the amount paid, by way of dental benefit, in respect of the service, should have been paid;

the Chief Executive Medicare must give the person written notice of the decision.

Circumstances beyond control exist

             (2)  If the Chief Executive Medicare is satisfied, for the purposes of subsection 56A(2) or (4), that circumstances beyond a person’s control exist, the Chief Executive Medicare must give the person written notice of the decision.

             (3)  If the Chief Executive Medicare is satisfied, for the purposes of subsection 56A(6), that circumstances exist beyond the control of:

                     (a)  the person from whom the amount concerned is recoverable; and

                     (b)  the recipient of the notice concerned;

the Chief Executive Medicare must give written notice of the decision to the person from whom the amount concerned is recoverable.

Notice may include notice of other decisions

             (4)  The Chief Executive Medicare’s written notice to a person of a decision may include written notice of other decisions referred to in this section, or section 56C, that also are required to be given to the person.

56C  Notice of decision to claim amount as debt

             (1)  If an amount is recoverable under subsection 56(2), or 56A(1), (3) or (5), as a debt due to the Commonwealth from a person, or from an estate, the Chief Executive Medicare must give written notice to the person or estate of:

                     (a)  the decision to claim the amount as a debt; and

                     (b)  the reasons for the decision; and

                     (c)  the right of the person or estate to seek review of the decision under subsection 56D(1).

             (2)  The written notice may also include notice of other decisions referred to in this section, or section 56B, that also are required to be given to the person or estate. The notice may also, as appropriate, state that the Chief Executive Medicare was not satisfied, for the purposes of subsection 56A(2), (4) or (6), that circumstances beyond a person’s control existed.

             (3)  A failure to comply with the requirements of subsection (1) does not affect the validity of the decision.

             (4)  The Chief Executive Medicare must not serve a notice on a person or an estate claiming an amount as a debt before the end of the period of 28 days after written notice of the decision referred to in subsection (1) is given to the person or estate.

56D  Review of decision to claim amounts as debt

             (1)  If the Chief Executive Medicare makes a decision referred to in subsection 56C(1) about a person or an estate, the person or estate may apply in writing to the Chief Executive Medicare, in the form approved in writing by the Chief Executive Medicare, for a review of the decision.

             (2)  In making an application under subsection (1), the person or estate may provide the Chief Executive Medicare with additional information to substantiate (wholly or partly) that the amount paid, purportedly by way of dental benefit in respect of the service, should have been paid.

             (3)  An application for review of a decision must be made within 28 days after the person or estate is notified of the decision.

             (4)  On receiving an application for review of a decision, the Chief Executive Medicare must:

                     (a)  review the decision; and

                     (b)  confirm, vary or revoke the decision.

             (5)  The Chief Executive Medicare must give to the applicant written notice of the decision on the review within 28 days after receiving the application for review.

             (6)  To avoid doubt, a decision referred to in subsection 56C(1) (including such a decision varied under this section) may be reviewed under this section once only.

57  Interest payable on recoverable amounts

Scope

             (1)  This section applies if:

                     (a)  an amount (the principal sum) is recoverable as a debt due to the Commonwealth from a person or estate under section 56 or 56A; and

                     (b)  the Chief Executive Medicare has given a written notice to the person or estate claiming the amount as a debt due to the Commonwealth.

Interest payable

             (2)  Interest is payable on the amount of the principal sum that remains unpaid from time to time if:

                     (a)  a repayment arrangement in relation to the principal sum was entered into during the relevant period and there is a default (whether before or after the end of the relevant period) in repaying all or part of the principal sum as required by the arrangement; or

                     (b)  at the end of the relevant period, a repayment arrangement has not been entered into and all or part of the principal sum remains unpaid.

             (3)  For the purposes of subsection (2), the relevant period is:

                     (a)  the period of 3 months beginning on the day after the written notice is given to the person or estate under paragraph (1)(b); or

                     (b)  such longer period as the Chief Executive Medicare allows.

             (4)  Interest under subsection (2) is payable from:

                     (a)  the day after the end of the relevant period; or

                     (b)  such later day ordered by a court in any proceedings instituted by the Commonwealth to recover an amount due under this section.

             (5)  Interest under subsection (2):

                     (a)  is payable at the rate prescribed from time to time for the purposes of subsection 129AC(2) of the Health Insurance Act 1973; and

                     (b)  is recoverable as a debt due to the Commonwealth from the person or estate.

Definition

             (6)  In this section:

repayment arrangement, in relation to a principal sum, means an arrangement entered into by the Chief Executive Medicare and a person, or the person’s estate, for the repayment of the principal sum.

58  Recovering amounts by reducing future payments

             (1)  The Chief Executive Medicare may reduce one or more amounts of dental benefit payable to a person if:

                     (a)  the following conditions are satisfied:

                              (i)  an amount or amounts have previously been paid under this Act to the person purportedly by way of dental benefit;

                             (ii)  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

                     (b)  an amount is recoverable from the person under section 56 or 56A.

             (2)  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

             (3)  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

             (4)  If either or both of the following have occurred:

                     (a)  the Chief Executive Medicare has previously reduced, under this section, one or more amounts (the reduced amounts) of dental benefit payable to the person;

                     (b)  one or more amounts (the recovered amounts) have been previously recovered from the person under section 56 or 56A;

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

             (5)  A reduction under subsection (1) may result in one or more amounts of dental benefit being reduced to nil.

58A  Amounts recoverable once only

                   To avoid doubt, an amount paid purportedly by way of dental benefit is recoverable under this Division once only.

Part 7Dental Benefits Rules

  

59  Simplified outline

                   The following is a simplified outline of this Part:

•      The Minister may make Dental Benefits Rules.

•      The Dental Benefits Rules may provide for a Dental Benefits Schedule that sets out:

               (a)     items specifying dental services; and

              (b)     the amount of dental benefit payable, or a method for determining the amount of dental benefit payable, in respect of a dental service.

•      The specification of a dental service in an item in the Dental Benefits Schedule may be unconditional or subject to specified conditions, limitations or restrictions.

60  Minister may make Dental Benefits Rules

Dental Benefits Rules

             (1)  The Minister may, by legislative instrument, make Dental Benefits Rules providing for matters:

                     (a)  required or permitted by this Act to be provided; or

                     (b)  necessary or convenient to be provided in order to carry out or give effect to this Act.

Dental Benefits Rules may confer power

             (2)  The Dental Benefits Rules may make provision for or in relation to a matter by conferring a power on the Minister or on the Chief Executive Medicare.

Dental Benefits Rules may incorporate material

             (3)  The Dental Benefits Rules may make provision in relation to a matter by applying, adopting or incorporating, with or without modification, any matter contained in any other instrument or writing:

                     (a)  as in force or existing at a particular time; or

                     (b)  as in force or existing from time to time.

             (4)  Subsection (3) has effect despite anything in the Legislation Act 2003.

61  Dental Benefits Schedule

             (1)  The Dental Benefits Rules may provide for a Dental Benefits Schedule that sets out the following:

                     (a)  items specifying dental services;

                     (b)  the amount of dental benefit payable, or a method for the determining the amount of dental benefit payable, in respect of a dental service.

Note:          The amount of dental benefit payable in respect of a dental service must not exceed the dental expenses incurred in respect of the dental service: see subsection 9(3).

             (2)  The Dental Benefits Rules may sets out rules for interpretation of the Dental Benefits Schedule.

62  Specification of items in Dental Benefits Schedule may be conditional

             (1)  The specification of a dental service in an item in the Dental Benefits Schedule may be:

                     (a)  unconditional; or

                     (b)  subject to such conditions, limitations or restrictions as are specified in the Dental Benefits Rules (including the Dental Benefits Schedule).

             (2)  Conditions, limitations or restrictions specified in the Dental Benefits Rules may include, but are not limited to, imposing a specified monetary limit on the amount of dental benefit payable in respect of:

                     (a)  a specified dental service; or

                     (b)  specified dental services provided to specified eligible dental patients; or

                     (c)  specified dental services provided to specified eligible dental patients during specified periods.

Part 8Other matters

  

63  Simplified outline

                   The following is a simplified outline of this Part:

•      This Part makes provision in relation to:

               (a)     the functions of the Chief Executive Medicare; and

              (b)     the appropriation of the Consolidated Revenue Fund; and

               (c)     the delegation of the functions and powers of the Minister or the Secretary under this Act; and

              (d)     the making of regulations for the purposes of this Act.

64  Additional functions of the Chief Executive Medicare

             (1)  In addition to the functions of the Chief Executive Medicare under the Human Services (Medicare) Act 1973, the Chief Executive Medicare has such additional functions as are conferred on the Chief Executive Medicare by or under this Act.

             (2)  Anything done by or on behalf of the Chief Executive Medicare in the performance of such additional functions is taken, for all purposes, to have been done in the performance of his or her functions under the Human Services (Medicare) Act 1973.

65  Appropriation

                   Amounts of dental benefit payable under this Act are payable out of the Consolidated Revenue Fund, which is appropriated accordingly.

66  Delegation

Delegation by Minister

          (1A)  The Minister may, by writing, delegate any or all of his or her functions or powers under this Act to:

                     (a)  the Secretary; or

                     (b)  an SES employee, or acting SES employee, in the Department.

Note:          The expressions SES employee and acting SES employee are defined in section 2B of the Acts Interpretation Act 1901.

          (1B)  In exercising powers or performing functions delegated under subsection (1A), the delegate must comply with any directions of the Minister.

Delegation by Secretary

             (1)  The Secretary may, by writing, delegate any or all of his or her functions or powers under this Act to an SES employee, or acting SES employee, in the Department.

Note:          The expressions SES employee and acting SES employee are defined in section 2B of the Acts Interpretation Act 1901.

             (2)  In exercising powers or performing functions delegated under subsection (1), the delegate must comply with any directions of the Secretary.

67  Regulations

                   The Governor‑General may make regulations prescribing matters:

                     (a)  required or permitted by this Act to be prescribed; or

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

68  Review of operation of Act

             (1)  The Minister must cause an independent review of the operation of this Act to be undertaken as soon as possible after the first anniversary of the commencement of this Act.

             (2)  Further independent reviews of the operation of this Act must be made as soon as practicable after the third anniversary of the commencement of this Act and at three yearly intervals thereafter.

             (3)  The Minister must cause a copy of the report of each review mentioned in subsection (1) and (2) to be tabled in each House of the Parliament within 15 sitting days of the day on which the report is given to the Minister.

             (4)  The review must be conducted by a panel which must comprise not less than five persons, including:

                     (a)  a person occupying the position of Commonwealth Chief Medical Officer;

                     (b)  a person nominated by the Australian Dental Association;

                     (c)  a person nominated by the Consumers’ Health Forum of Australia;

                     (d)  two other persons nominated by the Minister, at least one of whom must have qualifications in medicine or dentistry.


Endnotes

Endnote 1—About the endnotes

The endnotes provide information about this compilation and the compiled law.

The following endnotes are included in every compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Abbreviation key—Endnote 2

The abbreviation key sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.

Editorial changes

The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.

If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.

Misdescribed amendments

A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.

If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.

 

Endnote 2—Abbreviation key

 

ad = added or inserted

o = order(s)

am = amended

Ord = Ordinance

amdt = amendment

orig = original

c = clause(s)

par = paragraph(s)/subparagraph(s)

C[x] = Compilation No. x

    /sub‑subparagraph(s)

Ch = Chapter(s)

pres = present

def = definition(s)

prev = previous

Dict = Dictionary

(prev…) = previously

disallowed = disallowed by Parliament

Pt = Part(s)

Div = Division(s)

r = regulation(s)/rule(s)

ed = editorial change

reloc = relocated

exp = expires/expired or ceases/ceased to have

renum = renumbered

    effect

rep = repealed

F = Federal Register of Legislation

rs = repealed and substituted

gaz = gazette

s = section(s)/subsection(s)

LA = Legislation Act 2003

Sch = Schedule(s)

LIA = Legislative Instruments Act 2003

Sdiv = Subdivision(s)

(md) = misdescribed amendment can be given

SLI = Select Legislative Instrument

    effect

SR = Statutory Rules

(md not incorp) = misdescribed amendment

Sub‑Ch = Sub‑Chapter(s)

    cannot be given effect

SubPt = Subpart(s)

mod = modified/modification

underlining = whole or part not

No. = Number(s)

    commenced or to be commenced

 

Endnote 3—Legislation history

 

Act

Number and year

Assent

Commencement

Application, saving and transitional provisions

Dental Benefits Act 2008

41, 2008

25 June 2008

26 June 2008 (s 2)

 

Human Services Legislation Amendment Act 2011

32, 2011

25 May 2011

Sch 4 (items 68–94): 1 July 2011 (s 2(1) item 3)

Acts Interpretation Amendment Act 2011

46, 2011

27 June 2011

Sch 2 (items 530, 531) and Sch 3 (items 10, 11): 27 Dec 2011 (s 2(1) items 3, 12)

Sch 3 (items 10, 11)

Dental Benefits Amendment Act 2012

183, 2012

10 Dec 2012

1 Jan 2014 (s 2)

Dental Benefits Legislation Amendment Act 2014

115, 2014

3 Nov 2014

Sch 1 (items 1–4, 27, 29–51): 4 Nov 2014 (s 2)

Sch 1 (items 27, 46

Norfolk Island Legislation Amendment Act 2015

59, 2015

26 May 2015

Sch 2 (items 122–125): 1 July 2016 (s 2(1) item 5)
Sch 2 (items 356–396): 18 June 2015 (s 2(1) item 6)

Sch 2 (items 356–396)

as amended by

 

 

 

 

Territories Legislation Amendment Act 2016

33, 2016

23 Mar 2016

Sch 2: 24 Mar 2016 (s 2(1) item 2)

Acts and Instruments (Framework Reform) (Consequential Provisions) Act 2015

126, 2015

10 Sept 2015

Sch 1 (items 170, 171): 5 Mar 2016 (s 2(1) item 2)

 

Endnote 4—Amendment history

 

Provision affected

How affected

Part 1

 

s 3........................................

am No 32, 2011; No 115, 2014

s 4........................................

am No 32, 2011; No 183, 2012; No 115, 2014; No 59, 2015

s 6........................................

am No 115, 2014

s 7A.....................................

ad No 59, 2015

Part 3

 

Division 1

 

s 10......................................

am No 32, 2011; No 115, 2014

Division 2

 

s 11......................................

am No 32, 2011

s 13......................................

am No 32, 2011

s 14......................................

am No 32, 2011

Division 3

 

s 15......................................

am No 32, 2011

s 16......................................

am No 32, 2011

Division 4

 

s 18......................................

am No 59, 2015; No 126, 2015

s 20A...................................

ad No 115, 2014

s 20B...................................

ad No 115, 2014

s 20C...................................

ad No 115, 2014

s 20D...................................

ad No 115, 2014

s 20E...................................

ad No 115, 2014

s 21......................................

am No 59, 2015; No 126, 2015

Part 4

 

Division 1

 

s 22......................................

am No 32, 2011; No 183, 2012

Division 2

 

s 23......................................

am No 183, 2012

s 24......................................

am No 183, 2012

s 25......................................

am No 183, 2012

Division 3

 

s 27......................................

am No 32, 2011

s 29......................................

am No 32, 2011

Part 4A

 

Part 4A.................................

ad No 115, 2014

s 32A...................................

ad No 115, 2014

s 32B...................................

ad No 115, 2014

s 32C...................................

ad No 115, 2014

s 32D...................................

ad No 115, 2014

s 32E...................................

ad No 115, 2014

s 32F....................................

ad No 115, 2014

Part 5

 

Division 2

 

s 34......................................

am No 32, 2011; No 115, 2014

s 35......................................

am No 115, 2014

s 41......................................

am No 32, 2011; No 46, 2011; No 115, 2014

Part 6

 

Division 1

 

s 47......................................

am No 115, 2014

Division 4

 

Division 4 heading...............

rs No 115, 2014

s 56......................................

am No 115, 2014

s 56A...................................

ad No 115, 2014

s 56B...................................

ad No 115, 2014

s 56C...................................

ad No 115, 2014

s 56D...................................

ad No 115, 2014

s 57......................................

am No 32, 2011; No 115, 2014

s 58......................................

am No 32, 2011; No 115, 2014

s 58A...................................

ad No 115, 2014

Part 7

 

s 60......................................

am No 32, 2011; No 126, 2015

s 62......................................

am No 183, 2012

Part 8

 

s 63......................................

am No 32, 2011; No 115, 2014

s 64......................................

am No 32, 2011

s 66......................................

am No 46, 2011; No 115, 2014