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Veterans' Affairs Legislation Amendment (2001 Budget Measures) Bill 2001
Schedule 1 Extension of the Repatriation Pharmaceutical Benefits Scheme

   

Veterans’ Entitlements Act 1986

1  Subsection 7A(1)

Omit “Part III”, substitute “Parts III and VA”.

2  After Part V

Insert:

Part VA Extension of Repatriation Pharmaceutical Benefits Scheme

Division 1 Definitions

93K   Definitions

             (1)  In this Part:

pharmaceutical benefits has the same meaning as in subsection 91(9).

pharmaceutical benefits scheme means an approved scheme within the meaning of subsection 91(9).

             (2)  In this Part, a person is the holder of a pharmaceutical benefits card under this Part while there is in force under section 93X a determination that the person is entitled to a pharmaceutical benefits card under this Part.

Division 2 Pharmaceutical benefits may be obtained

93L   Certain veterans and mariners may obtain pharmaceutical benefits

             (1)  If a Commonwealth veteran, allied veteran or allied mariner is the holder of a pharmaceutical benefits card under this Part, then the veteran or mariner may obtain pharmaceutical benefits under the pharmaceutical benefits scheme as if the veteran or mariner were a person who is eligible to be provided with treatment under Part V.

Note 1:       For the meanings of Commonwealth veteran , allied veteran and allied mariner , see subsection 5C(1).

Note 2:       Apart from enabling the obtaining of pharmaceutical benefits, subsection 93L(1) has the effect of applying provisions of Part V such as section 93 (Recovery of costs of treatment), section 93B (False statements relating to treatment) and section 93C (Knowingly making false statements relating to treatment) to the veteran or mariner in respect of pharmaceutical benefits provided to the veteran or mariner.

             (2)  Nothing in this section entitles a Commonwealth veteran, allied veteran or allied mariner to be provided with a form of treatment, other than pharmaceutical benefits, under Part V.

Division 3 Eligibility for, and entitlement to, pharmaceutical benefits card

Subdivision A Eligibility

93M   Who is eligible?

             (1)  A Commonwealth veteran, an allied veteran or an allied mariner is eligible for a pharmaceutical benefits card under this Part if the veteran or mariner:

                     (a)  is 70 years of age or older; and

                     (b)  has rendered qualifying service during a period covered by paragraph (a) or (b) of the definition of period of hostilities in subsection 5B(1); and

                     (c)  has been an Australian resident for a continuous period of at least 10 years.

Note 1:       For qualifying service see section 7A and Division II of Part III.

Note 2:       For Australian resident see section 5G.

             (2)  If:

                     (a)  a Commonwealth veteran, allied veteran or allied mariner has been an Australian resident during more than one period; and

                     (b)  the longer or longest of those periods is less than 10 years but is not less than 5 years; and

                     (c)  the aggregate of those periods is more than 10 years;

then, in the application of paragraph (1)(c) to the veteran, the period of 10 years specified in that paragraph is to be reduced by a period equal to the period by which the aggregate is more than 10 years.

Subdivision B Entitlement

93N   Entitlement to a pharmaceutical benefits card under this Part

                   Even though a person is eligible for a pharmaceutical benefits card under this Part, it is only if the person is the holder of a pharmaceutical benefits card under this Part that pharmaceutical benefits under the pharmaceutical benefits scheme may be provided to the person by the Commonwealth.

Note:          For holder of a pharmaceutical benefits card under this Part see subsection 93K(2).

Division 4 Claim for pharmaceutical benefits card under this Part

93P   Need for a claim

                   A person who wants to be granted a pharmaceutical benefits card under this Part must make a proper claim.

Note:          For proper claim see section 93R (form), section 93S (manner of lodgment) and section 93T (residence/presence in Australia).

93Q   Who can claim?

             (1)  Subject to subsection (2), a claim must be made by:

                     (a)  the person who wants to be granted a pharmaceutical benefits card under this Part; or

                     (b)  with the approval of the person—another person on the person’s behalf.

             (2)  If the person is unable, because of physical or mental incapacity, to approve another person to make the claim on his or her behalf, the Commission may approve another person to make the claim.

93R   Form of claim

                   To be a proper claim, the claim must be:

                     (a)  made in writing; and

                     (b)  in accordance with a form approved by the Commission; and

                     (c)  accompanied by any evidence available to the claimant that the claimant considers may be relevant to the claim.

93S   Lodgment of claim

             (1)  To be a proper claim, a claim must be lodged:

                     (a)  at an office of the Department in Australia; or

                     (b)  at a place approved for this purpose by the Commission; or

                     (c)  with a person approved for this purpose by the Commission.

             (2)  A place or person approved under subsection (1) must be a place or person in Australia.

             (3)  A claim for a pharmaceutical benefits card under this Part is taken to have been lodged on the day it is received:

                     (a)  at an office of the Department in Australia; or

                     (b)  at a place approved under subsection (1); or

                     (c)  by a person approved under subsection (1).

93T   Claimant must be an Australian resident and in Australia

                   A claim is not a proper claim unless the person making the claim, or on whose behalf the claim is being made, is:

                     (a)  an Australian resident; and

                     (b)  in Australia;

on the day on which the claim is lodged.

Note:          For Australian resident see section 5G.

93U   Claim may be withdrawn

             (1)  A claimant for a pharmaceutical benefits card under this Part or a person on behalf of a claimant may withdraw a claim that has not been determined.

             (2)  A claim that is withdrawn is taken to have not been made.

             (3)  A withdrawal may be made orally or in writing.

Written withdrawal of a claim

             (4)  A written withdrawal of a claim must be lodged at an office of the Department in Australia.

Oral withdrawal of a claim

             (5)  An oral withdrawal of a claim must be made to a person in an office of the Department in Australia.

Acknowledgment of oral withdrawal of a claim

             (6)  As soon as practicable after receiving an oral withdrawal of a claim, the Secretary must give the claimant an acknowledgment notice in writing stating that:

                     (a)  an oral withdrawal of the claim was made; and

                     (b)  the claimant, or a person on behalf of the claimant, may, within 28 days from the day the acknowledgment notice is given, request the Secretary to treat the withdrawal as if it had not been made.

Reactivating the withdrawn claim

             (7)  If, within 28 days from the day on which the Secretary gave the acknowledgment notice, a claimant, or a person on behalf of a claimant, requests the Secretary to treat the oral withdrawal of the claim as if it had not been made, the oral withdrawal is taken not to have been made.

Note:          A request made under paragraph (6)(b) has the effect of reactivating the claim. In particular, the commencement day of the claim stays the same.

Division 5 Investigation of claim

93V   Secretary to investigate claim and submit it to Commission

             (1)  If a person makes a proper claim for a pharmaceutical benefits card under this Part, the Secretary must investigate the matters to which the claim relates.

             (2)  When the investigation is completed, the Secretary must submit the claim to the Commission for consideration and determination.

             (3)  When the claim is submitted to the Commission it must be accompanied by:

                     (a)  any evidence supplied by the claimant in support of the claim; and

                     (b)  any documents or other evidence obtained by the Department in the course of the investigation that are relevant to the claim; and

                     (c)  any other documents or other evidence under the control of the Department that are relevant to the claim.

Division 6 Consideration and determination of claim

93W   Duties of Commission in relation to claim

             (1)  When the claim is submitted to the Commission, the Commission must consider all matters that are, in the Commission’s opinion, relevant to the claim and must then determine the claim.

             (2)  In considering the claim, the Commission must:

                     (a)  satisfy itself with respect to; or

                     (b)  determine;

(as the case requires) all matters relevant to the determination of the claim.

             (3)  Without limiting subsection (1), the Commission, in considering the claim, must consider:

                     (a)  the evidence submitted with the claim under section 93V; and

                     (b)  any further evidence subsequently submitted to the Commission in relation to the claim.

Note:          A claimant may apply to the Commission for review of a determination made under this section (see section 93Z).

93X   Entitlement determination

                   The Commission must determine that a person is entitled to a pharmaceutical benefits card under this Part if the Commission is satisfied that the person is eligible for the card.

93Y   Date of effect of determination

             (1)  A determination under section 93X takes effect:

                     (a)  if the determination is made before 1 January 2002—on 1 January 2002 or on such later day as is specified in the determination; or

                     (b)  if the determination is made after 1 January 2002—on the day that the determination is made or on such later day or earlier day as is specified in the determination.

             (2)  For the purposes of paragraph (1)(b), a day before 1 January 2002 may not be specified as an earlier day.

Division 7 Review of decisions

93Z   Review of certain decisions

                   A claimant who is dissatisfied with a decision of the Commission in relation to a claim for a pharmaceutical benefits card under this Part may request the Commission to review the decision.

93ZA   Application for review

             (1)  A request for review of a decision under section 93Z must:

                     (a)  be made within 3 months after the person seeking review was notified of the decision; and

                     (b)  set out the grounds on which the request is made; and

                     (c)  be in writing.

             (2)  If a request for review of a decision is made in accordance with subsection (1), the Commission must review the decision.

93ZB   Commission’s powers where request for review

             (1)  If the Commission reviews a decision under this Division, the Commission must affirm the decision or set it aside.

             (2)  If the Commission sets the decision aside it must substitute a new decision in accordance with this Act.

Note:          For the Commission’s evidence gathering powers see section 93ZF.

93ZC   Date of effect of certain review decisions

             (1)  If the Commission sets aside a decision and substitutes for it a decision that a person is entitled to a pharmaceutical benefits card under this Part, the substituted decision takes effect from a date specified by the Commission.

             (2)  The date specified by the Commission must not be earlier than the date from which, had the Commission determined that the person is entitled to a pharmaceutical benefits card under this Part, such a determination could have taken effect.

93ZD   Commission must make written record of review decision and reasons

             (1)  When the Commission reviews a decision under this Division it must make a written record of its decision upon review.

             (2)  The written record must include a statement that:

                     (a)  sets out the Commission’s findings on material questions of fact; and

                     (b)  refers to the evidence or other material on which those findings are based; and

                     (c)  provides reasons for the Commission’s decision.

93ZE   Person who requested review to be notified of decision

             (1)  If the Commission affirms or sets aside a decision under this Division, it must give the person who requested the review of the decision:

                     (a)  a copy of the Commission’s decision; and

                     (b)  subject to subsection (2), a copy of the statement about the decision referred to in subsection 93ZD(2); and

                     (c)  if the person has a right to apply to the Administrative Appeals Tribunal for a review of the Commission’s decision—a statement giving the person particulars of that right.

             (2)  If the statement referred to in paragraph (1)(b) contains any matter that, in the opinion of the Commission:

                     (a)  is of a confidential nature; or

                     (b)  might, if communicated to the person who requested review, be prejudicial to his or her physical or mental health or well-being;

then the copy given to the person must not contain that matter.

93ZF   Powers of Commission to gather evidence

             (1)  The Commission or the Commission’s delegate may, in reviewing a decision under this Division:

                     (a)  take evidence on oath or affirmation for the purposes of the review; and

                     (b)  adjourn a hearing of the review from time to time.

             (2)  The presiding member of the Commission or the Commission’s delegate may, for the purposes of the review:

                     (a)  summon a person to appear at a hearing of the review to give evidence and to produce such documents (if any) as are referred to in the summons; and

                     (b)  require a person appearing at a hearing of the review for the purpose of giving evidence either to take an oath or to make an affirmation; and

                     (c)  administer an oath or affirmation to a person so appearing.

             (3)  The person who applied for the review under this Division is a competent and compellable witness upon the hearing of the review.

             (4)  The oath or affirmation to be taken or made by a person for the purposes of this section is an oath or affirmation that the evidence that the person will give will be true.

             (5)  The Commission’s power under paragraph (1)(a) to take evidence on oath or affirmation:

                     (a)  may be exercised on behalf of the Commission by:

                              (i)  the presiding member or the Commission’s delegate; or

                             (ii)  by another person (whether a member or not) authorised by the presiding member or the Commission’s delegate; and

                     (b)  may be exercised within or outside Australia; and

                     (c)  must be exercised subject to any limitations specified by the Commission.

             (6)  Where a person is authorised under subparagraph (5)(a)(ii) to take evidence for the purposes of a review, the person has:

                     (a)  all the powers of the Commission under subsection (1); and

                     (b)  all the powers of the presiding member under subsection (2);

for the purposes of taking that evidence.

             (7)  In this section:

Commission’s delegate means a person to whom the Commission has delegated its powers under section 93ZA and who is conducting the review in question.

93ZG   Withdrawal of request for review

             (1)  A person who requests a review under section 93Z may withdraw the request at any time before it is determined by the Commission.

             (2)  To withdraw the request, the person must give written notice of withdrawal to the Secretary and the notice must be lodged at an office of the Department in Australia.

             (3)  Subject to section 93ZA, a person who withdraws a request for review may subsequently make another request for review of the same decision.

Note:          Section 93ZA provides that a person who wants to request a review of a decision must do so within 3 months after the person has received notice of the decision.

3  After subsection 175(2AAA)

Insert:

  (2AAAA)  If the Commission, under section 93ZB, affirms a decision of the Commission referred to in section 93Z or sets it aside and substitutes another decision, a person may apply to the Administrative Appeals Tribunal for a review of the decision so affirmed or substituted.

4  Subsection 175(2A)

After “(2),”, insert “(2AAAA),”.