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Notice of past benefits (NOPB) and Notice of charge (NOC) - Medicare Compensation Recovery 011-15030010

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Difference between NOPB, NOC and NOPB-AP

All notices contain information about recoverable Medicare benefits and care costs in addition to other information listed in the table.

Table 1

Notice of past benefits (NOPB)

Notice of Charge (NOC)

Notice of past benefits – advance payment (NOPB-AP)

Sent to the compensation payer (copy sent to the injured person/claimant/ authorised third party)

Sent to the compensation payer (copy sent to the injured person/claimant/authorised third party)

Sent to the injured person or claimant (the compensation payer does not get a copy)

Not payable

See note below

Payable within 28 days from the date of judgment or settlement (DOJS) or the date of the notice, whichever is the latter

Payable within 28 days from the date of the notice

Expires after 6 months

Never expires

Never expires

Issued before judgment or settlement is reached and may be issued multiple times

Issued after DOJS, and only once

See note below

Issued after DOJS, and only once

Does not advise of any ad-hoc payments received

Advises of all ad-hoc payments received

Advises of advance payment (AP) amount received

Advises total recoverable amount (if still current at DOJS)

Advises total recoverable amount or refund payable

Advises total recoverable amount or refund payable

Note: a NOPB becomes a NOC if it is still current on the date of judgment or settlement (DOJS). An advance payment (AP) cannot be made if a current NOPB exists.

Time frames for issue of notices

Table 2

Notice type

Agency has received

Time by which notice must be issued by the agency

Notice of past benefits (Z2807)
  • statement by claimant (Z2801 for MCRS claims or Z2245 and MO028 for legacy CCMS claims), or
  • notification from MCRS that a statement has not been returned by the due date

Sections 21, 23B applies:

  • 28 days after date of receipt or statement due date where statement was not returned (includes if an extension was granted), or
  • if s23B had been applied, 28 days after the statement was accepted as being substantially correct

Notice of charge (Z2811)
  • notice of judgment or settlement (MO022), or
  • notice of reimbursement arrangement (MO027)

Section 24(4) or 25(4) applies:

  • within 3 months after date of receipt of complete documents, or
  • for Notice of reimbursement arrangements (NORA), extension to lodge the SBC has been granted, the above 3 months or 60 days after receipt of the statement, whichever is later

Notice of past benefits – advance payment (Z2811)
  • notice judgment or settlement (MO22), and
  • advance payment

Section 33D applies

Within 3 months after date of receipt of the later of the two, or

Where an extension has been granted (Z2804 issued) with a new due date later than the original 3 month window:

  • within 28 days after the date of expiry for the period of the extension, or

Where a not substantially correct notice (Z2805) has been issued the later of:

  • the end of the 3 month period referred to above, or
  • within 28 days after an amended statement under s23B was accepted as substantially correct, or
  • within 28 days after the due date, where an amended statement under s23B was not submitted, see Note below

See Extensions, not substantially correct, decisions and reviews.

Note: if both a Z2805 and Z2804 were issued, the later date of the 2 applies.

If the timeframe is not met under:

  • Section 24(4) or section 25(4):
    • a Notice of charge cannot be issued, and
    • it will be considered lost revenue by the Australian government
    • any amounts paid are refundable to the notifiable party unless express permission from them has been received to make that payment to the injured person/claimant
  • Section 33D
    • a Notice of charge cannot be issued and no amount is recoverable under the HOSC Act
    • s33K applies and the whole advance payment (AP) is payable to the injured person or claimant
    • the injured person’s liability to pay any amounts owed in relation to the claim is discharged
    • it will be considered lost revenue by the Australian government

In either case a Past benefits and subsidies will not be recovered letter (Z2812) is issued.

Forms

Notice of past benefits request (MO026)

Notice of judgment or settlement (MO022)

Notice of reimbursement arrangement (MO027)

Letters

Services Australia has endorsed the letter or electronic message for use. It is the latest version. Do not use locally produced letters or electronic message.

Medicare Compensation Recovery

System generated letters from MCRS.