Letters
Health services administration Occupational diseases
Volume 177 - Issue 7

In reply: Work-related stress: care and compensation

Authors:  Ian D Steven and Michael Shanahan

Med J Aust 2002; 177 (7): 398. || doi: 10.5694/j.1326-5377.2002.tb04856.x
Published online: 7 October 2002
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In reply: What Carroll says is correct, but Section 3.6 of the general explanatory notes of the Medicare benefits schedule book also states that "The only exception to this is where a person has entered into a reimbursement arrangement with a compensation insurer. In such cases a Medicare benefit is not payable".1

While it may be arguable as to what actually constitutes a reimbursement arrangement, the situation is further clarified by Section 13.2.1 of the same schedule, which states:

"Medicare benefits are not payable in respect of a professional service in the following circumstance:

(b) where the medical expenses for the services are in relation to a compensable injury or illness for which the patient's insurer or compensation payer has accepted liability. However, if medical expenses relate to a compensable injury or illness and the insurer or compensation payer is disputing liability, Medicare benefits are payable until liability is accepted".

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