Medicare Provider Numbers and How Private Health Insurers Get Paid Back
Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025
House of Representatives
Senate
Assent
Links to official parliament websites
Effects of this bill
If this bill passes, it means that:
Chief Executive Medicare must notify applicants in writing if a provider number is revoked; the notice must include the reasons and the date the revocation starts.
Chief Executive Medicare must notify people in writing when they are allocated a provider number.
Chief Executive Medicare must notify people within 14 days if a substituted decision is made regarding the premiums reduction scheme.
Chief Executive Medicare must provide a copy of modified request terms if asked.
Private health insurers must ensure reimbursement claims only include specific premium reductions.
The Minister can set the criteria for allocating or unsuspending provider numbers.
The CEO of Services Australia can include information about automated provider number actions in reports; this must not include personal information.
Responsible providers must give a copy of the request terms to the person assigning Medicare benefits if that person asks for them.
The Minister can set the rules for how provider numbers are handed out and when a suspended provider number can be used again.
Chief Executive Medicare must notify people in writing about decisions regarding their provider numbers. If a provider number is taken away, the notice must include the reasons why and the date it ends.
Chief Executive Medicare must give a written notice to anyone who asks for a provider number decision to be reconsidered.
Actions taken by a computer program under specific arrangements are treated as if Chief Executive Medicare took those actions personally.
Private health insurers must check that a claim only includes the actual amount premiums were reduced before claiming a reimbursement under the premiums reduction scheme.