Private Health Insurance Act 2007

CHAPTER 6 - ADMINISTRATION  

PART 6-4 - ADMINISTRATION OF PREMIUMS REDUCTION SCHEME  

Division 279 - Reimbursement of participating insurers and powers of Chief Executive Medicare  

Subdivision 279-B - Powers of Chief Executive Medicare in relation to participating insurers  

SECTION 279-50   AUDITS BY CHIEF EXECUTIVE MEDICARE  

279-50(1)    
The Chief Executive Medicare may, at any time, audit the accounts and records of a private health insurer that is, or has been, a ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

participating insurer.

279-50(2)    
An audit under subsection (1) must relate only to the accounts and records of the private health insurer to the extent that they deal with:

(a)    participation by persons in the ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

premiums reduction scheme; or

(b)    reductions of premium payable under ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

complying health insurance policies under the premiums reduction scheme; or

(c)    receipt of money from the Chief Executive Medicare under this Division.

279-50(3)    
The Chief Executive Medicare must not carry out an audit unless he or she has given notice to the private health insurer concerned stating that an audit is to be carried out.

279-50(4)    
The private health insurer must ensure that the Chief Executive Medicare has full and free access to all accounts, records, documents and papers of the private health insurer that are relevant to the audit.

279-50(5)    
The person carrying out the audit may make copies of, or take extracts from, such accounts, records, documents or papers for use in the audit.

279-50(6)    
Without limiting the powers of the Chief Executive Medicare under this section, the Chief Executive Medicare may, by notice given to a private health insurer, require the insurer to give to the Chief Executive Medicare, within a period specified in the notice beginning at the end of a financial year, a certificate in writing by a registered company auditor as to the correctness of the accounts and records of the insurer for that year to the extent that those accounts and records deal with matters mentioned in paragraphs (2)(a) , (b) and (c) .