Medicare Compensation Recovery Notification Requirements

What to tell us

The notifiable person must tell the agency in writing of an injury or illness to a person where either:

a compensation amount of more than $5,000 was fixed by judgment or settlement under Australian law including legal costs for settlements
a reimbursement arrangement was made more than 6 months after a claim was lodged.

To do this, the payer needs to complete a Medicare Compensation Recovery Notice of judgment or settlement form. They have 28 days from the judgment or settlement date to send us this form. The form can be emailed to Compensation.Recovery@servicesaustralia.gov.au.

You don’t need to tell us if:

the claim has settled for an amount less than $5,000, including all costs
within 6 months of making your compensation claim, you have a reimbursement arrangement for medical expenses
the claim is not settled under Australian law.

When to tell us

You can tell us about a compensation claim before or after it’s settled.

Before settlement

While it is not a requirement to tell us before a claim reaches judgment or settlement, you can notify us in advance by completing a Medicare Compensation Recovery Notice of past benefits request form. It is preferred that you only tell us if the claim is expected to settle within the following 6-month period. Requests can be made earlier so long as the individual has made a claim for personal injury in writing to a compensation payer or insurer.

After settlement

The compensation payer, usually the insurer, must tell us about the compensation payment, within 28 days from when either a:

judgment ﬁxes the value of compensation awarded at more than $5,000, not including costs
settlement ﬁxes the value of compensation awarded at more than $5,000, including all costs
reimbursement arrangement is made more than 6 months from the date the claim was made and doesn’t include payments where there has been a ﬁxed amount awarded for damages exceeding $5,000.

Any payments that exceed $5,000 are to be notiﬁed under a judgment or settlement.

The date of judgment, settlement or reimbursement arrangement should be the last date the agreement is signed.

If you don’t tell us within 28 days from the date the claim reached judgment, settlement or a reimbursement arrangement, you may be liable for any outstanding amount owed to the Commonwealth. If you haven’t complied with your obligations we’ll send you a notice. We may also:

return any excess funds to the injured person
recover any amounts owing from you.

How to tell us about a judgment or settlement

Compensation payers or insurers can tell us an amount of compensation has been awarded by completing either a:

Remember to:

attach any relevant requested information on the form
sign and date the form and ensure all relevant fields are completed, particularly the date of injury and date of settlement
return the form to us within 28 days from the date the judgment, settlement or reimbursement arrangement was made by emailing us at compensation.recovery@servicesaustralia.gov.au.

You must not release the compensation payment to the injured person or claimant until you’ve paid us. You can choose to make an advance payment or pay the Notice of charge.

If you haven’t complied with your obligations, we’ll send you a notice. We may also:

send a copy of the notice to the injured person or claimant
return any excess funds to the injured person
recover any amounts owing from you.

Making a payment to us

We cannot accept payments made through foreign currency. We currently accept Australian issued cheques, however these are being phased out by banks.

Our preferred method for receiving payments is by Electronic Funds Transfer (EFT). If your organisation is not set up for EFT, please contact our Compensation Recovery line, or email us at Medicare.compensation.finance@servicesaustralia.gov.au for further information.

When making payments your organisation will have different vendor numbers for Centrelink, Medicare and Child Support business areas. Please ensure you are using the correct vendor number as payments made to the incorrect area will cause delays for the customer.

Notice of charge

When a Notice of past beneﬁts becomes a Notice of charge, the amount of past beneﬁts is known. You must pay us the amount speciﬁed within 28 days of either the date of:

judgment or settlement
reimbursement arrangement.

If you haven’t complied with your obligations we’ll send you a notice. We may also:

send a copy of the notice to the injured person or claimant
return any excess funds to the injured person
recover any amounts owing from you.

If there is no valid Notice of past benefits on the date of judgment or settlement, at the time of notiﬁcation you may either:

wait for the Notice of charge and pay us the amount speciﬁed within 28 days from the issue date
pay a 10% advance payment of the total compensation amount awarded within 28 days from the date of judgment or settlement.

Advance payment

You can choose to make an advance payment under a judgment or settlement when:

there is no valid Notice of past benefits at judgment or settlement
you’ve notiﬁed the injured person in writing prior to judgment or settlement, about your intention to make an advance payment, and that they are liable for any residual amounts not covered by the advance payment
you’ve notiﬁed us in writing of your intention to make an advance payment within 28 days of the date of judgment or settlement
the advance payment equals 10% of the total ﬁxed compensation amount and is received by us within 28 days from the date of judgment or settlement.

Once you have met the obligations of an advance payment you can release the remaining funds to the injured person or claimant.

If you haven’t complied with your obligations, we’ll send you a notice. We may also:

return any excess funds to the injured person
recover any amounts owing from you.

Notice of reimbursement arrangement

You may choose not to get a Notice of past beneﬁts within the 6 months before the reimbursement arrangement is made. If so, we’ll send a Notice of charge. You’ll need to pay us the amount speciﬁed, within 28 days from the date of issue.

Before you release payment to the injured person or claimant

It’s an offence to pay the injured person or claimant any part of the compensation awarded unless the following applies. You’ve sent us a complete Notiﬁcation of judgment or settlement form, or Notice of reimbursement arrangement form and either:

paid us the amount speciﬁed in the Notice of charge
paid us a valid advance payment.

When a Notice of past beneﬁts becomes a Notice of charge, the amount of past beneﬁts is known. You must pay us the amount speciﬁed within 28 days of either the date of:

judgment or settlement
reimbursement arrangement.

If there is no valid Notice of past benefits on the date of judgment or settlement, at the time of notiﬁcation you may either:

wait for the Notice of charge and pay us the amount speciﬁed within 28 days from the issue date
pay a 10% advance payment of the total compensation amount awarded within 28 days from the date of judgment or settlement.

You can then pay the balance of the compensation to the injured person.

We cannot accept payments made through foreign currency. Payments to us must be made in Australian currency.

If the amount owing is less than the advance payment, we’ll refund the balance to the injured person within 28 days. If the amount owing is more, the injured person needs to pay the difference to us within 28 days.

You cannot make an advance payment if there is a valid Notice of past beneﬁts.

If you haven’t complied with your obligations for an advance payment, we may recover any amounts owing from you. We may also return any excess funds to the injured person.

How to tell us about a payment you have made to us

It is important you advise of any payments you have made to us by providing a remittance advice.

To enable us to match the payment to the claimant the remittance advice must contain:

the injured person’s full name
the Medicare compensation case reference number if known
the injured person’s Medicare card number if known
the compensation payer’s name
the compensation payer’s claim reference number
the amount paid and date of deposit.

If you don’t know the Medicare compensation case reference number or Medicare card number, you will also need to include:

the injured person’s date of birth and current address
whether the injured person is an Australian resident or not
date of injury or illness, optional
the claim settlement date, optional.

Email the remittance advice to Medicare.compensation.finance@servicesaustralia.gov.au.

For all other matters relating to Medicare Compensation Recovery, including Notice of judgment/settlement documents, enquiries regarding claim processing, status or refunds, please send your forms, notifications or enquiries to Compensation.Recovery@servicesaustralia.gov.au.

Where possible, we ask that you email the remittance advice separately and do not attach the Notice of judgment or settlement documents.

Multiple compensation payers

When there are multiple compensation payers, it is your joint responsibility to pay the charge by the due date. You should nominate the primary compensation payer, as we won’t provide separate notices for a charge.

Contact us

If you’d like to talk to us please call our Compensation Recovery line.