Provision of Information (Bulk Payment Agreements) Determination 2017

Administered by Department of Health, Disability and Ageing

Legislation au F2017L00901 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

Health and Other Services (Compensation) Act 1995

 

Provision of Information (Bulk Payment Agreements) Determination 2017

 

The Health and Other Services (Compensation) Act 1995 (“the Act”) establishes a scheme for the recovery of medicare benefits and nursing home, residential care and home care subsidies paid in respect of an injury for which compensation becomes payable under a judgment, settlement or reimbursement arrangement.   Under the Act, the compensation payer or insurer is prohibited from paying the compensable person any part of the compensation until specified requirements of the Act are met.   

 

Subsection 34(1) of the Act allows the Chief Executive Medicare (the CEM) to enter into a bulk payment agreement (BPA) on behalf of the Commonwealth with a compensation payer or insurer who is, or may become, liable to make payments to the Commonwealth under the Act.

 

The effect of entry into a BPA is to exempt the person with whom the BPA is made, and any compensable person concerned, from some of the obligations under the Act. The BPA becomes the primary mechanism for regulating and administering the obligations of compensation payers or insurers and compensable persons under the Act.

 

Entering into a BPA is entirely voluntary and designed to streamline and facilitate compliance with the Act in cases where there are large numbers of claims.

 

Subsection 34(1) of the Act requires that a BPA contain certain provisions.   Those provisions include an obligation for the person with whom the BPA is made to give the CEM information of a kind, and in a way, specified in a determination made by the CEM under subsection 34(2) of the Act.   Subsection 34(3) of the Act provides that the determination may require the giving of information about settlements, judgments and reimbursement arrangements that occur within the period in which the BPA applies.

 

The new determination (Provision of Information (Bulk Payment Agreements) Determination 2017) specifies the information about judgments, settlements and reimbursement arrangements to be provided to the CEM under a BPA, specifically:

 

  • the date of the judgment, settlement or reimbursement arrangement;
  • the full names and addresses, dates of birth and medicare numbers (if known) of all the compensable persons to whom the judgment, settlement or reimbursement arrangement  relates;
  • the amount of compensation to be paid under the judgment or settlement;
  • a description of the injury;
  • the date of injury; and
  • a copy of the relevant order or agreement.

 

The Determination also specifies the ways in which this information must be provided.  The information must be given to the CEM in writing and sent by the post or electronic communication.

 

 

The Provision of Information (Bulk Payment Agreement) Determination 2017 continues the requirements of the Provision of Information (Bulk Payment Agreement) Determination 2006 which sunsetted on 1 October 2016 under section 50 of the Legislation Act 2003.  The kinds of information specified in this Determination is required by the Department of Human Services to enable it to administer the Act and  is consistent with the information which is normally obtained in compensation cases where a BPA is not in place.  This Determination ensures that the requirement to provide this information is included in a BPA.

 

The commencement date for the Determination is the day after it is registered. 

 

Subsection 34(4) of the Act provides that determinations under subsection 34(2) are disallowable instruments for the purposes of section 46A of the Acts Interpretation Act 1901.  This Determination is therefore a legislative instrument for the purposes of the Legislation Act 2003 (subsection 8(5) of the Legislation Act 2003 refers).

 

No consultation was undertaken under section 17 of the Legislative Instruments Act 2003 before the Provision of Information (Bulk Payment Agreement) Determination 2017 was made as the Determination is of a minor or machinery nature and does not substantially alter existing arrangements.

 

The Act specifies no conditions that must be satisfied before the power to make this Determination is exercised.

 

 

Statement of Compatibility with Human Rights

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

 

This Determination is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Overview of the Disallowable Legislative Instrument

The Health and Other Services (Compensation) Act 1995 (“the Act”) establishes a scheme for the recovery of medicare benefits and nursing home, residential care and home care subsidies paid in respect of an injury for which compensation becomes payable under a judgment, settlement or reimbursement arrangement.   Under the Act, the compensation payer or insurer is prohibited from paying the compensable person any part of the compensation until specified requirements of the Act are met.   

 

Subsection 34(1) of the Act allows the Chief Executive Medicare (the CEM) to enter into a bulk payment agreement (BPA) on behalf of the Commonwealth with a compensation payer or insurer who is, or may become, liable to make payments to the Commonwealth under the Act.

 

The effect of entry into a BPA is to exempt the person with whom the BPA is made, and any compensable person concerned, from some of the obligations under the Act. The BPA becomes the primary mechanism for regulating and administering the obligations of compensation payers or insurers and compensable persons under the Act.

Entering into a BPA is entirely voluntary and designed to streamline and facilitate compliance with the Act in cases where there are large numbers of claims.

Subsection 34(1) of the Act requires that a BPA contain certain provisions.   Those provisions include an obligation for the person with whom a BPA is made to give the CEM information of a kind, and in a way, specified in a determination made by the CEM under subsection 34(2) of the Act.   Subsection 34(3) of the Act provides that the determination may require the giving of information about settlements, judgments and reimbursement arrangements that occur within the period in which the BPA applies.

The purpose of the Determination is to specify the kinds of information that must be provided under BPA and the way in which the information is to be provided.  This information is required by the Department of Human Services to enable it to administer the Act.  This Determination ensures that the requirement to provide this information is included in a BPA.

 

Human Rights Implications

This Determination does not engage any of the applicable rights or freedoms.

Conclusion

This Determination is compatible with human rights as it does not raise any human rights issues.

 

Caroline Edwards

Chief Executive Medicare

Overview

The Health and Other Services (Compensation) Act 1995 aims to establish a scheme for the recovery of medicare benefits and subsidies paid for injuries for which compensation becomes payable. The Act prevents compensation payers or insurers from making payments until certain requirements are met. One of the mechanisms under the Act is the bulk payment agreement (BPA), which streamlines compliance with the Act for compensation payers or insurers involved in numerous claims. The Provision of Information (Bulk Payment Agreements) Determination 2017 was introduced to specify the kinds of information that must be provided under a BPA and the manner in which this information should be delivered to the Chief Executive Medicare (CEM). This determination ensures that the necessary information, including details of judgments, settlements, and reimbursement arrangements, is included in BPAs to facilitate the administration of the Act by the Department of Human Services. The determination is a legislative instrument under the Legislation Act 2003 and is compatible with human rights as it does not raise any issues.

Scope and Application

The Health and Other Services (Compensation) Act 1995, which pertains to the recovery of Medicare benefits and other subsidies paid in respect of an injury for which compensation becomes payable, applies to compensation payers and insurers in Australia. These entities are prohibited from paying any part of the compensation until certain requirements of the Act are met. The Act allows the Chief Executive Medicare (CEM) to enter into bulk payment agreements (BPA) with compensation payers or insurers, which streamlines and facilitates compliance with the Act by exempting the involved parties from some of the obligations under the Act. The Provision of Information (Bulk Payment Agreements) Determination 2017 specifies the information about judgments, settlements, and reimbursement arrangements that must be provided to the CEM under a BPA, including the date of the judgment or settlement, the full names and addresses, dates of birth and Medicare numbers (if known) of all the compensable persons, the amount of compensation, a description of the injury, the date of injury, and a copy of the relevant order or agreement. The information must be provided in writing and sent by post or electronic communication. The Determination is a legislative instrument for the purposes of the Legislation Act 2003 and is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Key Provisions

The main operative sections of the Provision of Information (Bulk Payment Agreements) Determination 2017 (the Determination) are sections 34(2) and 34(3) of the Health and Other Services (Compensation) Act 1995 (the Act). Section 34(2) allows the Chief Executive Medicare (CEM) to make a determination specifying the kind of information to be provided under a Bulk Payment Agreement (BPA), while section 34(3) allows the determination to include requirements about settlements, judgments, and reimbursement arrangements within the period the BPA applies. This Determination specifies the information to be provided under a BPA, such as the date of the judgment or settlement, the names and personal details of the compensable persons, the amount of compensation, a description of the injury, and the date of the injury, along with a copy of the relevant order or agreement. The Determination imposes specific obligations on compensation payers or insurers who enter into a BPA. These parties must provide detailed information about any settlements, judgments, or reimbursement arrangements to the CEM, in accordance with the Determination's specifications. This information must be sent in writing either by post or electronic communication. The obligations are designed to facilitate compliance with the Act by streamlining the process for large numbers of claims, ensuring that the CEM has all necessary details to administer the Act effectively. Any failure to comply with the requirements of the Determination may lead to consequences under the Act. While the Determination itself does not specify penalties, non-compliance with the Act can lead to enforcement actions. Subsection 34(4) of the Act states that determinations under subsection 34(2) are disallowable instruments, meaning they can be subject to parliamentary scrutiny and disallowance. Additionally, the Act prohibits compensation payers or insurers from paying any part of the compensation to the compensable person until the requirements of the Act are met, which includes adhering to the provisions of any BPA and the associated determinations. This prohibition underscores the importance of compliance and highlights the potential legal repercussions for non-compliance.

Legal classification tags

Area of Law
Health Law
Instrument
Determination
Concepts
Definitions & Interpretation
Licensing & Registration
Reporting & Disclosure Obligations
Catchwords
bulk payment agreement
compensation payer
Medicare benefits

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.