National Health Amendment Act 1992 (Cth)
PART 1—PRELIMINARY
Section | |
| Short title etc. |
| Commencement |
PART 2—AMENDMENTS OF PARTS V AND VA OF THE PRINCIPAL ACT | |
| Interpretation |
| Repeal of section |
| Certain person to give notice on death of proprietor |
| Insertion of new heading in Part VA: |
| |
| Interpretation |
| Insertion of new sections: 46C. Secretary to determine accounting period in respect of certain approved nursing homes46D. Setting of notional fees
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| Insertion of new heading in Part VA: |
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| Benefits for patients in other approved nursing homes |
| Repeal of section |
| Benefit for nursing home care in transferred homes and adjusted fee Government nursing homes |
| Insertion of new section:
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TABLE OF PROVISIONS—
Section | |
| Insertion of new section:
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| Insertion of new heading in Part VA: |
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| Claims for benefit |
| Repeal and substitution of new sections: 51B. Treatment of money overpaid or underpaid by way of an advance 51C. Recovery of overpayments |
| Heading to Part VC |
| Insertion of new Part: |
PART VD—REQUIREMENTS IN RESPECT OF SALE OF APPROVED NURSING HOMES | |
64. Application and operation of Part 65. Interpretation | |
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65B. Purchaser to give notice of prospective purchase of approved nursing home65C. Investigation of accounts etc. of approved nursing home65D. Secretary may also determine certain matters 65E. Parties to a contract of sale to be informed of results of investigation etc.65F. Proprietor gives less than 90 days notice of settlement of contract of sale or settles in less than 90 days 65G. If no notice of sale given or vendor sells before notified date | |
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65J. If amount determined under paragraph 65F(1)(e)—direction to purchaser to pay amount to the Commonwealth65K. Certain moneys to be paid by proprietor of nursing home to the Commonwealth on or before sale of nursing home65L. Money paid in settlement of an overpayment outstanding—how to deal with it 65M. Treatment of amount paid in respect of overpayment outstanding to which subsection 65K(2) applies65N. Treatment of amount paid in respect of overpayment outstanding to which subsection 65K(3) applies65P. Treatment of amount paid in respect of overpayment outstanding to which subsection 65K(4) applies65Q. Treatment of amount paid in respect of overpayment outstanding to which subsection 65K(5) applies65R. Treatment of amount paid in respect of overpayment outstanding to which subsection 65K(6) applies—Step 1: first investigation amount65S. Treatment of amount paid in respect of overpayment outstanding to which subsection 65K(6) applies—Step 2: second investigation amount65T. Time when principles take effect 65U. Parties to a contract to be informed of certain matters after sale | |
| Application for review by Tribunal |
[
The Parliament of Australia enacts:
2.(1) Subject to subsection (2), this Act commences on 1 July 1993.
PART 2 —AMENDMENTS OF PARTS V AND VA OF THE PRINCIPAL ACT
3. Section 39 of the Principal Act is amended:
(a) by omitting from subparagraph (a)(i) of the definition of “reference fee” “fee determined in accordance with the scale of fees that would apply for the purposes of subparagraph 40AA(6)(c)(i) in its application” and substituting “notional fee that would apply”;
•
by omitting from subparagraph (a)(ii) of the definition of “reference fee” “fee determined for the purposes of subparagraph 40AA(6)(c)(i) in its application” and substituting “notional fee applying”;
(c) by inserting the following definition:
•
• “‘notional fee’ , in relation to the provision of nursing home care (other than care of a kind in respect of which benefit is paid under section 48B, 48C, 48D, 48E or 49) to an approved nursing home patient in an approved nursing home (other than a Government nursing home or a nursing home for disabled people) on a particular day, means the fee applicable in respect of the provision of nursing home care to the patient on that day in accordance with the scale of fees determined by the Secretary under section 46D;”.
4. Section 42A of the Principal Act is repealed.
“
7. Section 46 of the Principal Act is amended:
“(a) by omitting from subsection (1) the definition of “Commonwealth extensive care benefit” and substituting the following definition:
“‘accounting period’ , in relation to an approved nursing home other than a Government nursing home or a nursing home for disabled people, means:
(a) the period determined by the Secretary under subsection 46C(2); or
•
if that period has been varied under subsection 46C(5) or (6)—that period as so varied;
“46B.(1)
“(2) If the proprietor of an approved nursing home has received, by way of advance on account of Commonwealth benefit that may become payable in respect of an approved nursing home patient in the nursing home on a day, an amount that exceeds the amount payable to the
proprietor in respect of the nursing home patient on that day, the amount of that excess is an
“(3) If:
•
the proprietor of an approved nursing home has received an amount by way of advance on account of Commonwealth benefit that may become payable in respect of an approved nursing home patient in the nursing home on a day; and
(b) that benefit does not become payable;
the amount so received by the proprietor is an
“(4) If:
(a) an amount purporting to be Commonwealth benefit is paid to the proprietor of an approved nursing home in respect of an approved nursing home patient in the home; and
(b) Commonwealth benefit is not payable to the proprietor; that amount is an
“46C.(1) This section does not apply to a Government nursing home or a nursing home for disabled people.
“(2) The Secretary must, in relation to an approved nursing home, determine a period to be the accounting period in respect of that nursing home.
“(3) An accounting period in respect of an approved nursing home must not begin before the commencement of this Act.
“(4) The determination must:
(a) be in writing; and
•
set out the accounting period in respect of the nursing home.
“(5) The Secretary must provide a copy of the determination to the proprietor of the nursing home within 14 days after making it.
“(6) Subject to subsection (10), the Secretary may vary the accounting period in respect of the nursing home at any time.
“(7) If, before the day on which the sale of an approved nursing home is completed:
(a) the Secretary receives notice of the sale; or
•
is otherwise informed of the sale;
the Secretary must, within 14 days of receiving notice, or becoming informed, of the sale of the nursing home, vary the accounting period in respect of the home.
“(8) If:
(a) an approved nursing home has been sold and the Secretary did
not receive notice of the sale under section 65A or 65B, or was not otherwise informed of the sale, before the day of completion of the sale; or
(b) if the proprietor of an approved nursing home sells the nursing home before the notified day for completion of sale;
the Secretary must, within 14 days after first becoming aware of the sale, vary the accounting period in respect of the home.
“(9) The accounting period, as varied under subsection (7) or (8), must end on the day before the day of completion of the sale.
“(10) The Secretary must not vary the accounting period so that it begins on a day earlier than the last day of the previous accounting period.
“(11) If the Secretary varies the accounting period, he or she must notify the proprietor within 7 days of that variation.
“(12) A notice under subsection (11) must be in writing and set out the new accounting period in respect of the nursing home.
“46D.(1) The Secretary must, within 3 years after the end of an accounting period in respect of an approved nursing home, determine a notional scale of fees in respect of the nursing home.
“(2) A notional scale of fees, in respect of the nursing home is determined:
(a) in relation to the accounting period in respect of the home; and
•
•
(b) in respect of the provision of nursing home care (other than care of a kind in respect of which benefit is paid under section 48B, 48C, 48D, 48E or 49) to approved nursing home patients in the nursing home during the accounting period.
(a) must take into account the actual expenditure incurred by the proprietor in respect of the provision of that nursing home care to approved nursing home patients in the nursing home during the accounting period; and
•
may take into account such other things as the Secretary considers relevant.
“(4) The Secretary must, for the purposes of determining the notional scale of fees, order an investigation to be carried out in respect of an approved nursing home to find out the actual expenditure so incurred by the proprietor.
“(5) In determining the notional scale of fees, the Secretary must comply with the relevant principles formulated under subsection 40AA(7).
“(6) The proprietor affected by a decision of the Secretary under subsection (1) may apply, in writing, to the Minister for a reconsideration of that decision by the Minister.
“(7) The application must be made within 28 days after the proprietor receives notice of the decision.
“(8) If the proprietor applies for reconsideration of the decision, the Minister may affirm or revoke the decision or vary it as he or she thinks fit.
“(9) For the purposes of determining the notional scale of fees for the first accounting period in respect of a nursing home after the commencement of this Act, the accounting period is taken to have commenced on a day determined by the Secretary.
“(10) The day determined by the Secretary may be a day before the day this Act commences.
“46E.(1) If:
(a) during an accounting period in respect of an approved nursing home; or
•
after the end of an accounting period in respect of an approved nursing home and before the Secretary has determined a notional scale of fees in respect of the accounting period,
the Secretary reasonably believes that the proprietor of the nursing home will be found (on general care benefit becoming payable) to have, in respect of the accounting period:
(c) received an overpayment of general care benefit; or
•
been underpaid general care benefit;
the Secretary may determine, in writing, the amount that the Secretary believes to be the amount of the likely overpayment or underpayment.
“(2) If the Secretary determines an amount, the Secretary may, on the Commonwealth’s behalf, recover the amount from, or pay the amount to, the proprietor of the nursing home (as the case requires) in the manner specified in the principles formulated under subsection 40AA(7).
“(3) If the Secretary decides to recover the amount from, or pay the amount to, the proprietor of the nursing home under subsection (2), the Secretary must notify the proprietor, in writing, accordingly.
“(4) If steps have been taken to recover (by the manner specified in the principles) an amount determined under subsection (1) to be a likely overpayment then, for the purpose of establishing whether or not the proprietor of the nursing home has received an overpayment in respect of the accounting period, that amount is to be deducted from
the total amount of advances in respect of general care benefit paid in relation to the nursing home during the accounting period.
“(5) If steps have been taken to pay (by the manner specified in the principles) an amount determined under subsection (1) to be a likely underpayment then, for the purpose of establishing whether or not the proprietor of the nursing home has been underpaid in respect of the accounting period, the amount is to be added to the total amount of advances in respect of general care benefit paid in relation to the nursing home during the accounting period.
“(6) For the purpose of this section, the proprietor of an approved nursing home is
“
10. Section 47A of the Principal Act is amended:
(a) by inserting before subsection (1) the following subsection:
“(1A) This section applies to an approved nursing home other than a Government nursing home, an adjusted fee government nursing home, a transferred home or a nursing home for disabled people.”;
(b) by omitting from subsection (1), “Subject to this Part and Part VC, a Commonwealth benefit is payable to the proprietor of an approved nursing home (other than a Government nursing home, a transferred home or a nursing home for disabled people)” and substituting “Subject to this Part, Part VC and Part VD, the proprietor of an approved nursing home in respect of which this section applies is entitled to receive benefit”;
by omitting from subsection (2) “The benefit payable under subsection (1),” and substituting “The benefit that the proprietor of the nursing home is entitled to receive under subsection (1)”;
by omitting from paragraph (2)(a) “the fee payable to the proprietor for the provision of nursing home care for the patient on the relevant day” and substituting “the notional fee”;
by omitting from subsection (3) “The benefit payable” and substituting “The benefit that the proprietor is entitled to receive”.
11. Section 48 of the Principal Act is repealed.
12. Section 48A of the Principal Act is amended:
(a) by omitting from subsection (1) “Subject to this Part and Part VC, a Commonwealth benefit is payable to” and substituting “Subject to this Part, Part VC and Part VD”;
by inserting after “government nursing home” in subsection (1) “is entitled to receive benefit”;
by omitting from subsection (2) “the benefit payable” and substituting “the benefit that the proprietor of the nursing home is entitled to receive”;
by omitting from paragraph (2)(a) “the fee payable for the care of the patient in the nursing home on the relevant day” and substituting “the notional fee”;
by omitting from subsection (2A) “the benefit payable” and substituting “The benefit that the proprietor is entitled to receive”;
(f) by omitting from subsection (4) “the benefit payable” and substituting “the benefit that the proprietor is entitled to receive”.
“48AB. The general care benefit to which the proprietor of an approved nursing home is entitled in respect of an approved nursing home patient in the nursing home who receives nursing home care on a day in an accounting period becomes payable on the 30th day after a notional scale of fees has been determined under section 46D in relation to the accounting period.”.
“49B.(1) If:
(a) the proprietor of an approved nursing home charges fees in respect of the nursing home care provided to an approved nursing home patient during a period; and
•
the proprietor does not deduct from the fees Commonwealth benefit that is payable, or may become payable, to the proprietor in respect of the patient for the period;
the Secretary may direct that the Commonwealth benefit so payable, or the amount so paid in advance, be paid to the person to whom the fees were charged and not to the proprietor.
“(2) If:
(a) the proprietor of the nursing home has been paid, whether by way of advance on account of Commonwealth benefit or otherwise, an amount of Commonwealth benefit in respect of the patient for the period; and
•
the proprietor charges fees in respect of nursing home care provided to the patient during the period without deducting the amount of benefit so paid in respect of the patient;
the proprietor must, as the Secretary demands, repay to the Commonwealth that amount.
“(3) If the proprietor of the nursing home has not complied with the Secretary’s demand within 3 months, the amount to which the demand relates may be recovered by the Commonwealth as a debt.
“(4) The Commonwealth must pay an amount equal to the amount received under subsection (2) or (3) to the person to whom the fees concerned were charged.”.
“
Section 51 of the Principal Act is amended by omitting from paragraph (1)(a) “payable” and substituting “that is, or may become, payable”.
Sections 51A and 51B of the Principal Act are repealed and the following sections are substituted:
“51A. The Minister may, in his or her discretion, authorise the payment to the proprietor of an approved nursing home (other than a Government nursing home) of an advance or advances in respect of Commonwealth benefit that is or may become payable to the proprietor.
“51B.(1) The proprietor of an approved nursing home is liable to repay to the Commonwealth any overpayment of Commonwealth benefit.
“(2) If:
(a) an amount of Commonwealth benefit payable to the proprietor
of an approved nursing home in respect of an accounting period exceeds the total of the advances paid to the proprietor in respect of that amount; and
(b) the proprietor elects, in writing, that the amount of the excess be paid to him or her in the manner specified in the principles formulated under subsection 40AA(7);
the amount of the excess is payable to the proprietor of the nursing home in accordance with the election.
Note: See section 46B for the meaning of overpayment.
“51C.(1) An overpayment of Commonwealth benefit made to the proprietor of an approved nursing home may, in whole or in part, be:
(a) deducted from an amount (including an advance) payable, or to be paid, to that proprietor of the nursing home under this Part; or
recovered by the Commonwealth from that proprietor as a debt due to the Commonwealth; or
recovered from that proprietor, or a later proprietor of the nursing home, in a manner determined in accordance with the principles formulated under subsection 40AA(7).
(a) the proprietor of a nursing home receives an overpayment of Commonwealth benefit in respect of the nursing home; and
that proprietor (
part or all of the amount of that overpayment is recovered after the sale from the current proprietor of the nursing home under paragraph (1)(c); and
part or all of the overpayment is later recovered from the previous proprietor;
so much of the amount that has been recovered from the current proprietor as is equal to the amount recovered from the previous proprietor is to be paid to the current proprietor.
“(3) If the current proprietor of the nursing home elects, in writing, that the amount to which he or she is entitled under subsection (2) be paid to him or her in a manner specified in the principles formulated under subsection 40AA(7), the amount is payable to that proprietor in that manner.
“(4) Paragraphs (1)(a) and (b) do not affect the recovery or set-off of amounts that have not been paid under this Part.”.
Note: See section 46B for the meaning of overpayment.
The heading to Part VC of the Principal Act is amended by omitting “
19. After Part VC of the Principal Act the following Part is inserted:
•
•
• “
PART VD —REQUIREMENTS IN RESPECT OF SALE OF APPROVED NURSING HOMES
“
“63. The object of this Part is to provide, in relation to the sale of an approved nursing home, for:
(a) the giving of notices of sale and purchase; and
•
•
(b) the investigation of the nursing home’s accounts etc. prior to sale; and
•
(c) the giving of certain information about the nursing home to the vendor and purchaser before the completion of the contract of sale; and
•
(d) the recovery of any overpayment of Commonwealth benefit paid in respect of approved nursing home patients in the nursing home.
“64.(1) This Part applies to the sale of an approved nursing home (other than a Government nursing home or a nursing home for disabled people) whether or not that sale involves a transfer of nursing home beds under section 39B.
Note 1: For the meaning of ‘nursing home for disabled people’ see subsection 4(1).
Note 2: For the meaning of ‘Government nursing home’ see subsection 4(1).
“(2) If the vendor is selling the business or undertaking carried on at the nursing home to different purchasers, this Part applies to each of those sales as if each was a sale of an approved nursing home.
“(3) This Part does not apply if the contract of sale of an approved nursing home was entered into before this Part commenced.
“(4) This Part operates as follows:
•
notice of sale must be given in accordance with sections 65A and 65B;
(b) then:
If the Secretary receives 90 days or more notice of sale of nursing home and it is sold on or after the notified day for completion of sale | Section 65C Section 65D Section 65E | Section 65H (direction to purchaser) Subsections 65K(1), (5) and (6) (overpayment outstanding) Section 65Q Section 65R Section 65S |
If the Secretary receives less than 90 days notice of sale of nursing home and it is sold on or after the notified day for completion of sale | Section 65F | Section 65J (direction to purchaser) Subsections 65K(1), (3) and (4) Section 65N Section 65P |
If the Secretary does not become aware of sale until afterwards or it is sold before the notified day for completion of sale | Section 65G | Subsections 65K(1) and (2) Section 65M |
“65.(1) In this Part, unless the contrary intention appears:
(a) any notice given under the Act by the vendor to the Secretary; or
if the vendor has not given notice—any notice given under the Act by the purchaser to the Secretary; or
if neither the vendor nor the purchaser has given notice—the information (if any) received by the Secretary;
the sale of the nursing home is to be completed;
(a) the amount of money (if any) paid by the purchaser for the transfer of the ownership of the business or undertaking carried out at the nursing home to him or her; or
(b) if the vendor is also selling real or personal property used:
•
• (i) to accommodate the business or undertaking carried out at the nursing home; or
(ii) in the operation of the business or undertaking; the sum of the amount of money that the purchaser pays for that property and of the amount referred to in paragraph (a);
“(2) A
“(3) A
“(4) For the purposes of this Part, if:
(a) a proprietor of an approved nursing home has, before the commencement of this Act, received an amount of Commonwealth benefit in respect of the provision of nursing home care to an approved nursing home patient on a day; and
a reconciliation of the actual and estimated expenditure by the proprietor in respect of the provision of that care has been done in accordance with principles formulated under subsection 40AA(7); and
on the basis of the reconciliation it appears that the proprietor should have been entitled to receive, in respect of the provision of that care, an amount of Commonwealth benefit that is higher than the amount received by the proprietor;
the proprietor has
“(5) A reference in this Part to an
“
“65A.(1) The vendor of an approved nursing home who enters into a contract to sell the nursing home must, before the day of completion of the sale, give the Minister notice, in writing, of the following matters:
(a) the name and address of the nursing home;
the name and address of the other party to the contract;
the proposed day and time of completion of the sale;
the address at which completion will take place.
Penalty: $20,000.
“(2) The vendor must not complete the sale within:
(a) 90 days of giving notice; or
•
•
(b) such lesser period as the Secretary may determine at the request of the vendor.
Penalty: $20,000.
“(3) If the Secretary determines a period of less than 90 days, he or she must notify the vendor, in writing, of that lesser period.
“(4) If:
(a) the vendor has given notice under subsection (1); and
the particulars referred to in paragraphs (1)(c) or (d) change; the vendor must give the Secretary notice in writing (
(c) the date and time of completion of the sale;
•
the address at which completion will take place.
“(5) The vendor must give the amended notice at least 14 days before the day of completion of the sale.
Penalty: $5,000.
“(6) If:
(a) the vendor has given notice under subsection (1); and
•
•
(b) the notice does not contain particulars as to the proposed date and time of completion of the sale of the nursing home;
the notice is taken not to have been given.
“(7) If:
(a) the vendor has given notice under subsection (1) and the particulars referred to in paragraph (1)(c) or (d) change; and
(b) the vendor does not give an amended notice;
the notice is taken not to have been given.
“65B.(1) A person who contracts with the vendor of an approved nursing home to purchase the nursing home must give the Minister notice, in writing, of the following matters:
(a) that he or she has entered into a contract to purchase a nursing home;
•
the name of the vendor and the name and address of the nursing home;
(c) the proposed time and day of completion of the sale;
the address at which completion will take place;
his or her name and address.
“(2) The person must give notice at least 42 days before the day of completion of the sale.
“(3) If:
(a) the purchaser has given notice under subsection (1); and
•
the particulars referred to in paragraph (1)(c) or (d) change;
the purchaser must give the Secretary notice in writing (
(c) the date and time of completion of the sale;
•
the address at which completion will take place.
(a) the purchaser had given notice under subsection (1); and
•
•
(b) the notice does not contain particulars as to the proposed date and time of completion of the sale of the nursing home;
the notice is taken not to have been given.
“65C.(1) If the Secretary:
(a) has received notice of 90 days or more of the intended sale of an approved nursing home; or
•
been otherwise informed of the sale 90 days or more before the proposed day of sale;
the Secretary must order the following investigations to be carried out in respect of the nursing home:
(c) an investigation in respect of the period beginning on a day determined by the Secretary and ending on the last preceding 30 June; and
•
an investigation in respect of the period beginning on the immediately preceding 1 July and ending at the end of the day immediately before the day on which the contract of sale is completed.
(a) establish whether the vendor, or an earlier proprietor of that nursing home, has received an overpayment in respect of the nursing home, in respect of the investigation period; and
if there has been such an overpayment—allow the Secretary to work out the amount of the overpayment and how much of it (if any) has not been recovered as at the last day in the investigation period; and
if the investigation period began on a day earlier than the commencement of this Part—establish whether the vendor, or an earlier proprietor of that nursing home, has received, or missed out on receiving, a fee-determining benefit in respect of the investigation period; and
if the vendor, or an earlier proprietor of the nursing home, has received, or missed out on receiving (as the case may be), a fee-determining benefit—allow the Secretary to work out the amount of benefit.
“65D.(1) Before the second investigation in respect of the operation of an approved nursing home is completed, the Secretary must determine, in writing:
(a) whether, in the Secretary’s opinion, the vendor, or an earlier proprietor of the nursing home, has received an overpayment in respect of the nursing home, in respect of the second investigation period; and
•
the amount (if any) that, in the Secretary’s opinion, is a fair estimate of the total amount of any such overpayment.
“(2) In determining an amount under paragraph (1)(b) the Secretary must comply with any relevant principles in force under subsection (3).
“(3) The Minister may set out, in writing, principles to be complied with by the Secretary with respect to his or her powers under subsection (1).
Note: See section 65T for when the principles come into force.
“65E. If the Secretary has ordered an investigation to be carried out in respect of an approved nursing home under section 65C, the Secretary may, before the notified day for completion of sale of the nursing home, give to each of the parties to the contract of sale notice in writing of:
(a) the amount of any overpayment established by the investigation carried out under paragraph 65C(1)(c); and
(b) the means by which that amount was calculated; and
•
•
(c) the amount of any fee-determining benefit that the vendor, or an earlier proprietor of that nursing home, has received or missed out on receiving; and
•
(d) the means by which that amount of fee-determining benefit was calculated; and
•
(e) if the Secretary has determined an amount for the purposes of paragraph 65D(1)(b)—the amount and the means by which the amount was calculated; and
•
(f) the amount of any grant of Commonwealth benefit paid in respect of the nursing home; and
•
(g) any other information about a scale of fees or a notional scale of fees determined in respect of the nursing home that, in the Secretary’s opinion, the person purchasing the home should have.
“65F.(1) If less than 90 days before the proposed day for completion of the sale, the Secretary:
(a) receives notice of the sale of an approved nursing home under section 65A or 65B; or
(b) is otherwise informed of the intended sale of the nursing home; the Secretary must:
(c) order an investigation to be carried out in respect of the nursing home in respect of the period beginning on a day determined by the Secretary and ending on the day immediately before the day on which the contract of sale is to be completed; and
determine whether, in the Secretary’s opinion, the vendor or an earlier proprietor of that nursing home has received an overpayment in respect of the investigation period; and
if the Secretary determines that, in his or her opinion, the vendor or an earlier proprietor has received an overpayment in respect of the investigation period—determine:
• (i) the amount that, in the Secretary’s opinion, is an estimate of the overpayment so received; and
•
• (ii) how much of that amount, in the Secretary’s opinion, will not be recovered by the Commonwealth as at the notified day for completion of sale; and
if the investigation period began on a day earlier than the commencement of this Part—determine whether, in the Secretary’s opinion, the vendor, or an earlier proprietor of the nursing home, has received, or missed out on receiving, a fee-determining benefit in respect of the investigation period; and
if the Secretary determines that, in his or her opinion, the vendor or an earlier proprietor of the nursing home has received, or missed out on receiving (as the case may be), a fee-determining benefit—determine an amount that is, in the Secretary’s opinion, a fair estimate of that amount.
(a) establish whether the vendor, or an earlier proprietor of that nursing home, has received an overpayment in respect of the nursing home in respect of the investigation period; and
if there has been such an overpayment—allow the Secretary to work out the amount of the overpayment and how much of it (if any) is still owing on the last day in the investigation period; and
if the investigation period began on a day earlier than the commencement of this Part—establish whether the vendor, or an earlier proprietor of that nursing home, has received, or
missed out on receiving, a fee-determining benefit in respect of the investigation period; and(d) if the vendor, or an earlier proprietor of that nursing home, has received, or missed out on receiving (as the case may be), a fee-determining benefit—allow the Secretary to work out the amount of benefit.
(a) be in writing; and
state the amount determined by the Secretary; and
set out the means by which the amount is determined.
“(4) On or before the notified day of completion of the sale, a copy of the determination may be provided to both the vendor and the purchaser of the nursing home.
“(5) In determining an amount under paragraph (1)(e) the Secretary must comply with any relevant principles in force under subsection (6).
“(6) The Minister may set out, in writing, principles to be complied with by the Secretary with respect to his or her powers under paragraph (1)(e).
Note: See section 65T for when the principles come into force.
(a) if:“65G.(1) This section applies in the following cases:
(i) an approved nursing home has been sold; and (ii) the Secretary did not receive notice of the sale under section 65A or 65B or was not otherwise informed of the sale before the day of completion of sale;
(b) if the proprietor of an approved nursing home sells the nursing home before the notified day for completion of sale of the home.
“(2) On and from the day that the Secretary becomes aware that the nursing home has been so sold, any obligations imposed on the Secretary under sections 65C, 65D, 65E or 65F cease to operate.
“(3) The Secretary must order an investigation to be carried out in respect of the nursing home in respect of the period beginning on a day determined by the Secretary and ending on the day immediately before the day on which the contract of sale was completed for the purposes of:
(a) determining whether the vendor or an earlier proprietor of that nursing home has received an overpayment in respect of the investigation period; and
•
if the investigation period began on a day earlier than the commencement of this Part—determining whether the vendor
(a) determine whether the vendor or an earlier proprietor of that nursing home has received an overpayment in respect of the investigation period and, if there has been such an overpayment, determine:
(ii) how much of that amount will not be recovered as at the day before the day on which the contract of sale was completed; and(b) if the investigation period began on a day earlier than the commencement of this Part—determine whether the vendor or an earlier proprietor of that nursing home has received, or missed out on receiving, a fee-determining benefit in respect of the investigation period and, if the Secretary determines that there is such an amount of fee-determining benefit, determine the amount of it.“(5) A determination under paragraph (4)(a) or (b) must:(i) the amount of the overpayment so received; and
(a) be in writing; and
state the amount determined by the Secretary; and
set out the means by which the amount is determined.
“(6) In determining an amount under paragraph (4)(a) the Secretary must comply with any relevant principles in force under subsection (7).
“(7) The Minister may set out, in writing, principles to be complied with by the Secretary with respect to his or her powers under paragraph (4)(a).
Note: See section 65T for when the principles come into force.
“65H.(1) If investigations of the kind referred to in paragraphs 65C(1)(c) and (d) have been ordered in respect of an approved nursing home, the Secretary may, in writing, direct the purchaser of the nursing home to pay to the Commonwealth on or before the notified day for completion of sale of the nursing home:
(a) so much of the purchase price as is equal to the sum of:
(ii) the amount determined under paragraph 65D(1)(b) in respect of the nursing home; or(i) the amount of the overpayment established by the first investigation undertaken in respect of the operation of the nursing home; and
(b) if the purchase price is less than the sum of the amounts referred to in subparagraphs (a)(i) and (ii)—the purchase price.
“(2) If the purchaser payment is more than the overpayment established by the first investigation:
(a) so much of the purchaser payment as equals the overpayment is taken to have been paid in settlement of the amount due by the vendor to the Commonwealth in respect of the overpayment; and
•
the balance of the purchaser payment is taken to be money (
“(3) If the purchaser payment is equal to or less than the overpayment established by the first investigation, the whole of the purchaser payment is taken to be paid in settlement, or part settlement (as the case may be), of the amount due by the vendor to the Commonwealth in respect of the overpayment.
“(4) When the second investigation is completed:
(a) if the trust money is more than the overpayment (if any) established by the second investigation:
(ii) the remainder of the trust money is to be paid to the vendor; or(i) so much of it as is equal to the overpayment is taken to have been paid to the Commonwealth in settlement of the amount due to the Commonwealth by the vendor in respect of the overpayment; and
(b) if the trust money is equal to or less than the overpayment in respect of the second investigation period, it is taken to have been paid to the Commonwealth in settlement, or part settlement, of the amount due to the Commonwealth by the vendor in respect of the overpayment.
“(5) Money paid to the Commonwealth by the purchaser is taken to have been paid by the purchaser to the vendor as consideration, or part of the consideration, under the contract for the sale of the nursing home.
“65J.(1) If, in respect of the sale of an approved nursing home, the Secretary has determined an amount under paragraph 65F(1)(e), the Secretary may, in writing, direct the purchaser of the nursing home to
pay to the Commonwealth on or before the notified day for completion of sale of the nursing home:
(a) if the purchase price is equal to or less than the amount determined—the purchase price; or
•
if the purchase price is more than the amount determined—so much of the purchase price as is equal to the amount so determined.
“(2) The amount paid under subsection (1) is taken to be money (
“(3) When the investigation carried out under paragraph 65F(1)(c) is completed:
(a) if the trust money is more than the overpayment (if any) in respect of the period to which the investigation related:
(ii) the remainder of the trust money is to be paid to the vendor; or(i) so much of the trust money as is equal to the overpayment is taken to have been paid to the Commonwealth in settlement of the amount due to the Commonwealth by the vendor in respect of the overpayment; and
(b) if the trust money is equal to or less than the overpayment in respect of the period to which the investigation related—it is taken to have been paid to the Commonwealth in settlement, or part settlement, of the amount due to the Commonwealth by the vendor in respect of the overpayment.
“(4) Money paid to the Commonwealth by the purchaser is taken to have been paid by the purchaser to the vendor as consideration, or part of the consideration, under the contract for the sale of the nursing home.
“65K.(1) The vendor of an approved nursing home must, on or before the notified day for completion of sale of the nursing home, pay to the Commonwealth an amount equal to the amount that is, under subsection (2), (3), (4), (5) or (6), the overpayment outstanding in respect of the nursing home.
Penalty: $50,000.
“(2) If:
(a) the Secretary did not receive notice of the sale of the nursing home under section 65A or 65B or was not otherwise informed of the sale before the day of completion of the sale; or
(b) the vendor sells the nursing home before the notified day for completion of sale of the home;
the
Note: For the meaning of ‘notional scale of fees’ see section 46.
“(3) If:
(a) the Secretary has made a determination under paragraph 65F(1)(e) in respect of the nursing home; and
a copy of the determination has been given to the vendor on or before the day of completion of the sale; and
no purchaser payment has been made in respect of the sale of the nursing home; and
(d) subsection (2) does not apply;
the
“(4) If:
(a) the Secretary has made a determination under paragraph 65F(1)(e) in respect of the nursing home; and
a copy of the determination has been given to the vendor on or before the day of completion of the sale; and
a purchaser payment has been made in respect of the sale of the nursing home; and
(d) subsection (2) does not apply;
the
(e) the amount specified in the determination; and
•
the purchaser payment.
“(5) If:
(a) an investigation has been carried out under paragraph 65C(1)(c) in respect of the nursing home; and
an amount has been determined under paragraph 65D(1)(b); and
no purchaser payment has been made in respect of the sale of the nursing home; and
(d) subsection (2) does not apply;
the
(e) the amount of overpayment (if any) established by the first investigation; and
•
the amount specified in the determination.
“(6) If:
(a) investigations have been undertaken under paragraphs 65C(1)(c) and (d) in respect of the operation of the nursing home; and
an amount has been determined under paragraph 65D(1)(b); and
a purchaser payment has been made in respect of the sale of the nursing home; and
(d) subsection (2) does not apply;
the
(e) the sum of:
(ii) the amount specified in the determination; and(i) the overpayment (if any) established by the first investigation; and
(f) the purchaser payment.
“65L. A vendor payment in relation to an overpayment outstanding in respect of an approved nursing home is to be dealt with as set out in sections 65M, 65N, 65P, 65Q, 65R and 65S.
Note: For the meaning of ‘vendor payment’ see subsection 65(1).
“65M.(1) This section applies if the overpayment outstanding in respect of the approved nursing home has been determined under subsection 65K(2).
“(2) The vendor payment is held in trust for the vendor’s benefit until the investigation carried out under subsection 65G(3) in respect of the nursing home is completed.
“(3) If the investigation establishes that no overpayment is payable by the vendor, the vendor payment is paid to the vendor.
“(4) If the investigation establishes that there has been, in respect of the investigation period, an overpayment for which the vendor is liable, then:
(b) if the vendor payment is more than the overpayment:(a) if the vendor payment is equal to or less than the overpayment— the vendor payment is taken to have been paid to the Commonwealth in settlement or part settlement of the overpayment; or
(i) so much of the vendor payment as is equal to the overpayment is taken to have been paid to the Commonwealth in settlement of the overpayment; and
(ii) the balance is paid to the vendor.
“65N.(1) This section applies if the overpayment outstanding in respect of the approved nursing home has been determined under subsection 65K(3).
“(2) The vendor payment is held in trust for the vendor’s benefit until the investigation carried out under paragraph 65F(1)(c) in respect of the nursing home is completed.
“(3) If the investigation establishes that no overpayment is payable by the vendor, the vendor payment is paid to the vendor.
“(4) If the investigation establishes that there has been, in respect of the investigation period, an overpayment for which the vendor is liable, then:
(a) if the vendor payment is equal to or less than the overpayment— the vendor payment is taken to have been paid to the Commonwealth in settlement or part settlement of the overpayment; or
(b) if the vendor payment is more than the overpayment:
•
• (i) so much of the vendor payment as is equal to the overpayment is taken to have been paid to the Commonwealth in settlement of the overpayment; and
•
• (ii) the balance is paid to the vendor.
“65P.(1) This section applies if the overpayment outstanding in respect of the approved nursing home has been determined under subsection 65K(4).
“(2) The vendor payment is held in trust for the vendor’s benefit until the investigation carried out under paragraph 65F(1)(c) in respect of the nursing home is completed.
“(3) If the investigation establishes that no overpayment is payable by the vendor, the vendor payment is paid to the vendor.
“(4) If:
(a) the investigation establishes that there has been, in respect of the investigation period, an overpayment for which the vendor is liable; and
(b) the Commonwealth holds in trust a purchaser payment that is equal to, or higher than, the overpayment;
the vendor payment is paid to the vendor.
“(5) If:
(a) the investigation establishes that there has been, in respect of the investigation period, an overpayment for which the vendor is liable; and
•
the Commonwealth holds in trust a purchaser payment that is less than the overpayment;
then:
(c) if the vendor payment is equal to or less than the difference (
‘outstanding debt’ ) between the overpayment and the purchaser payment—the vendor payment is taken to have been paid to the Commonwealth in settlement or part settlement of the outstanding debt; or
(d) if the vendor payment is more than the outstanding debt:
•
• (i) so much of the vendor payment as is equal to the outstanding debt is taken to have been paid to the Commonwealth in settlement of that debt; and
•
• (ii) the balance is paid to the vendor.
“65Q.(1) This section applies if the overpayment outstanding in respect of the approved nursing home has been determined under subsection 65K(5).
“(2) If the first investigation has established that, in respect of the investigation period, an overpayment is payable by the vendor:
(a) so much of the vendor payment as is equal to the overpayment is taken to be paid in settlement, or part settlement, of the overpayment; and
•
the remainder of the vendor payment is held in trust for the benefit of the vendor until the second investigation is completed.
“(3) If the second investigation establishes that, in respect of that investigation period, no overpayment is payable by the vendor, the remainder of the vendor payment is paid to the vendor.
“(4) If the second investigation establishes that there has been, in respect of that investigation period, an overpayment for which the vendor is liable, then:
(b) if the remainder of the vendor payment is more than the overpayment:(a) if the remainder of the vendor payment is equal to or less than the overpayment—the remainder of the vendor payment is taken to have been paid to the Commonwealth in settlement or part settlement of the overpayment; or
(i) so much of the vendor payment as is equal to the overpayment is taken to have been paid to the Commonwealth in settlement of the overpayment; and
(ii) the balance is paid to the vendor.
“65R.(1) This section:
(a) applies if the overpayment outstanding in respect of the approved nursing home has been determined under subsection 65K(6); and
•
sets out how that part of the vendor payment as is equal to the overpayment established by the first investigation is to be dealt with.
Note: The treatment of so much of the vendor payment that relates to the amount (if any) established by the second investigation is dealt with under section 65S.
“(2) If the purchaser payment in respect of the nursing home was less than the amount of the overpayment in respect of the first investigation period, then:
(a) so much of the vendor payment as is equal to the difference between the overpayment and the purchaser payment is taken to have been paid in settlement, or part settlement, of the overpayment outstanding; and
•
the balance is held in trust for the vendor’s benefit until the second investigation is completed.
“(3) If the purchaser payment is equal to or more than the overpayment, the vendor payment is held in trust for the vendor’s benefit until the second investigation is completed.
“65S.(1) This section:
(a) applies if the overpayment outstanding in respect of the nursing home has been determined under subsection 65K(6); and
•
sets out how the balance of the vendor payment, held in trust, is to be dealt with when the second investigation is completed.
“(2) If the second investigation establishes that no overpayment in respect of that investigation period is payable by the vendor, the balance of the vendor payment is paid to the vendor.
“(3) If:
(a) the second investigation establishes that there has been, in
respect of that investigation period, an overpayment for which the vendor is liable; and
(b) the Commonwealth, under section 65H, holds in trust a part of the purchaser payment in respect of the overpayment that is equal to, or higher than, the overpayment;
the balance of the vendor payment is paid to the vendor.
“(4) If:
(a) the second investigation establishes that there has been, in respect of that investigation period, an overpayment for which the vendor is liable; and
•
the Commonwealth holds in trust a part of the purchaser payment in respect of the overpayment that is less than the overpayment;
then:
(c) if the balance of the vendor payment is equal to or less than the difference (
‘outstanding debt’ ) between the overpayment and the purchaser payment—the balance of the vendor payment is taken to have been paid to the Commonwealth in settlement or part settlement of the outstanding debt; or
if the balance of the vendor payment is more than the outstanding debt:
• (i) so much of the balance of the vendor payment as is equal to the outstanding debt is taken to have been paid to the Commonwealth in settlement of that debt; and
•
• (ii) the remainder is paid to the vendor.
Note: See examples in the following tables:
1. | The amount of the overpayment (OP) established by the second investigation is $65,000. |
2. | The purchaser payment held in trust (PP) is $30,000. |
3. | The balance of the vendor payment (VP) is $35,000. |
To work out how the vendor payment is treated under paragraphs 65S(4)(a), (b) and (c). | |
| |
| |
| |
| |
| |
| |
1. | $35,000 (VP) is taken is paid in settlement of the overpayment outstanding. |
2. | No money is paid to vendor. |
1. | The amount of the overpayment (OP) established by the second investigation is $65,000. |
2. | The purchaser payment held in trust (PP) is $30,000. |
3. | The balance of the vendor (VP) is $60,000. |
To work out how the vendor payment is treated under paragraphs 65S(4)(a), (b) and (d). | |
| |
| |
| |
| |
| |
| |
1. | $35.000 (VP) is taken to be paid in settlement of the overpayment outstanding. |
2. | $25,000 is paid to vendor. |
“(5) If:
(a) the second investigation establishes that there has been, in respect of the investigation period, an overpayment for which the vendor is liable; and
(b) no part of the purchaser payment is held in trust;
then:
(c) if the balance of the vendor payment is equal to or less than the overpayment—the balance of the vendor payment is taken to have been paid to the Commonwealth in settlement or part settlement of the overpayment; or
if the balance of the vendor payment is more than the overpayment:
• (i) so much of the balance of the vendor payment as is equal to the overpayment is taken to have been paid to the Commonwealth in settlement of the overpayment; and
•
• (ii) the remainder is paid to the vendor.
“65T.(1) Principles set out under subsections 65D(3), 65F(6) and 65G(8):
(a) are to be laid before each House of the Parliament within 15 sitting days of that House after they have been set out; and
•
take effect only as provided by the following provisions of this section.
(a) notice of a motion to amend the principles is given in either House of the Parliament within 15 sitting days after they have been laid before that House; and
the principles, whether or not as amended, are subsequently approved by that House; and
the other House approves the principles in the form approved by the first-mentioned House;
the principles take effect in the form so approved from the day on which that other House approves them in that form.
“(3) If no notice of motion to amend the principles is given in either House of the Parliament under paragraph (2)(a), the principles take effect from the day immediately after the last day on which the notice of motion could have been so given in either House.
“65U.(1) If:
(a) an investigation has been undertaken under paragraph 65C(1)(d) in respect of the operation of a nursing home; and
•
that investigation establishes that an overpayment in respect of the second investigation period is payable;
the Secretary may give the vendor and the purchaser of the nursing home information as to the amount of that overpayment.
“(2) If:
•
an investigation is carried out under paragraph 65F(1)(c) or subsection 65G(3) in respect of a nursing home; and
(b) the investigation establishes either:
•
• (i) that an overpayment has been made in respect of the operation of the nursing home during the investigation period; or
•
• (ii) that the vendor, or an earlier proprietor, has received, or missed out on receiving (as the case may be), a fee-determining benefit;
the Secretary may give the vendor and the purchaser information as to the amount of such overpayment or fee-determining benefit.
“(3) After the sale of a nursing home is completed, the Secretary may provide the purchaser of the home with any other information about a scale of fees or a notional scale of fees determined in respect of the home that, in the Secretary’s opinion, the purchaser should have.
“(4) The Secretary may provide the purchaser of the home with any information about a grant of Commonwealth benefit (if any) made in respect of the home.”.
“(1AA) An application may be made to the Tribunal for the review of a decision by the Minister under subsection 46D(8).”.
1. No. 95, 1953, as amended. For previous amendments, see No. 68, 1955; Nos. 55 and 95, 1956; No. 92, 1957; No. 68, 1958; No. 72, 1959; No. 16, 1961; No. 82, 1962; No. 77, 1963; No. 37, 1964; Nos. 100 and 146, 1965; No. 44, 1966; Nos. 14 and 100, 1967; No. 100, 1968; No. 102, 1969; No. 41, 1970; No. 85, 1971; No. 114, 1972; Nos. 49 and 202, 1973; No. 37, 1974; Nos. 1, 13 and 93, 1975; Nos. 1, 60, 91, 99, 108, 157 and 177, 1976; Nos. 98 and 100, 1977; Nos. 36, 88, 132 and 189, 1978; Nos. 54, 91 and 122, 1979; Nos. 117 and 131, 1980; Nos. 40, 74, 92, 118, 163 and 176, 1981; Nos. 49, 80 and 112, 1982; Nos. 35, 54 and 139, 1983; Nos. 46, 63, 72, 120, 135 and 165, 1984; Nos. 24, 53, 65, 70, 95, 127 and 167, 1985; Nos. 28, 75, 94 and 115, 1986; Nos. 22, 44, 72, 118, 131 and 132, 1987; Nos. 79, 87, 99 and 155, 1988; No. 95, 1989; Nos. 3, 84, 106 and 141, 1990; Nos. 6, 68, 70, 73, 83, 84, 115, 116, 119, 122, 141, 169, 175, 208 and 211, 1991; and Nos. 70, 81, 88 and 136, 1992.
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