Medical Indemnity (Run-off Cover Claims and Administration) Protocol 2006

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      Medical Indemnity (Run-off Cover Claims and Administration) Protocol 2006 Medical Indemnity Act 2002                                                 I, TONY ABBOTT, Minister for Health and Ageing, determine this Protocol under section 34ZN of the Medical Indemnity Act 2002.                                                       [signed] Tony Abbott Minister for Health and Ageing                                                                                           Dated               19     June  2006   Part 1              Preliminary 1              Name of Protocol This Protocol is the Medical Indemnity (Run-off Cover Claims and Administration) Protocol 2006. 2              Commencement                 This Protocol commences on the day after it is registered. 3              Revocation The Medical Indemnity (Run-off Cover Claims and Administration) Protocol 2004 is revoked.   4              Definitions          (1)  In this Protocol:                 Act means the Medical Indemnity Act 2002. Prudential Supervision and Product Standards Act means the Medical Indemnity (Prudential Supervision and Product Standards) Act 2003. (2)  A reference to costs incurred or to a medical indemnity insurer having incurred a cost refers to costs that the medical indemnity insurer has paid or has a legal liability to pay. (3)  A reference to legal, administrative or other costs does not include legal costs, administrative costs or other costs incurred by a medical indemnity insurer in complying with a request by the Medicare Australia CEO under sections 34ZO, 38 or 71 of the Act. Note:  Except as expressed in this Protocol, the words and phrases used in this Protocol have the same meaning those words and phrases are given in the Act.  Examples of the words and phrases that have the same meaning as in the Act are: claim contribution year Medicare Australia CEO medical indemnity cover medical indemnity insurer Part 2              Payment of implementation and compliance costs (under paragraph 34ZN(1)(c) of the Act) 5              Implementation costs (1)  A payment under this Protocol is payable to a medical indemnity insurer for reimbursement of certain costs where the insurer: (a)            has provided medical indemnity cover to practitioners before 1 July 2004; and (b)            has incurred legal, administrative or other costs (whether on its own behalf or otherwise); and (c)             incurred those costs in respect of implementing a system or part of a system or making modifications to an existing system for the provision of medical indemnity cover for the sole purpose of complying with Division 2A of Part 3 of the Prudential Supervision and Product Standards Act; and (d)            incurred those costs prior to 1 July 2006; and (e)            has incurred those costs in the ordinary course of business; and (f)              has applied to the Medicare Australia CEO in accordance with section 7 of this Protocol for payment of those costs.              Note:    Examples of implementation costs: ·        Costs incurred in relation to the collection of data ·        Costs incurred in relation to product design ·        Costs incurred in relation to staff training ·        Costs incurred in relation to system development 6              Payments in respect of annual compliance costs (1)  A payment under this Protocol is payable to a medical indemnity insurer where the medical indemnity insurer: (a)            has incurred legal, administrative or other costs (whether on its own behalf or otherwise); and (b)            incurred those costs in respect of administering a system or administering part of a system for the provision of medical indemnity cover for the sole purpose of complying with Division 2A of Part 3 of the Prudential Supervision and Product Standards Act; and (c)             those costs have been incurred in the ordinary course of business; and (d)            those costs have been incurred in the financial year starting on 1 July 2004 or the financial year starting on 1 July 2005; and (e)            the medical indemnity insurer has applied to the Medicare Australia CEO in accordance with section 7 of this Protocol for payment of the costs incurred. (2)  The amount of the ongoing compliance costs payable to a medical indemnity insurer will be paid calculated in accordance with this section.  (3)   For each of the financial years starting on 1 July 2004 and 1 July 2005, the amount of the ongoing compliance costs payable to a medical indemnity insurer is calculated using the following formula:                                          ATNP x $23.00 = amount of ongoing compliance costs payable                 Where:                 ATNP is the Annual Total Number of Practitioners for whom the medical indemnity insurer provided medical indemnity cover in respect of which a Run-off Cover Support Payment was payable in the first contribution year for that insurer which started on or after 1 July 2004.  If the ATNP for a medical indemnity insurer is less than 1,000 then, for the purposes of the calculation under this subsection, the ATNP is taken to be 1,000.                      Note:  The amounts calculated using the formulae do not include GST.   Part 3                             General 7              Application for payment (1)  An application by an insurer for a payment under this Protocol must: (a)         be made in writing using a form approved by the Medicare Australia CEO; and (b)         be accompanied by the documents and other information required by the form approved by the Medicare Australia CEO. 8              Payment date (1)  Subject to subsection (2), the Medicare Australia CEO must make a payment under this Protocol before the end of the month immediately following the month in which the medical indemnity insurer applied to the Medicare Australia CEO for the payment. (2)  If a medical indemnity insurer applies for a payment under this Protocol; and (a)         the insurer has not complied with the requirements of the application form; or (b)         the Medicare Australia CEO has requested further information under section 34ZO of the Act in relation to the application; and (c)         the insurer has not given the Medicare Australia CEO the information that was requested under section 34ZO in relation to the application for payment; the payment date for the payment must be before the end of the month immediately following the month in which the insurer complies with the requirements of the application form or provides the information requested by the Medicare Australia CEO under section 34ZO, as the case may be. 9              Recovery of overpayments          (1)   If an amount is paid to a medical indemnity insurer under this Protocol, and the         amount is not payable:                  (a)    that amount; or                  (b)    part of that amount;                    is a debt due to the Commonwealth.            (2)   The amount overpaid to the medical indemnity insurer may be recovered:                     (a)    by action by the Medicare Australia CEO in a court of competent jurisdiction; or                   (b)    by deduction from any future amount payable to the medical indemnity insurer under this Protocol.    

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