meeting part of the costs of large settlements or awards paid by eligible insurers that indemnify eligible midwives (other than in the circumstances set out in paragraph (aa)); and

meeting the full cost of settlements or awards paid by eligible insurers that indemnify eligible midwives (or in certain circumstances eligible entities) in relation to intrapartum care outside of a hospital; and

meeting the amounts by which settlements and awards exceed insurance contract limits, if those contract limits meet the Commonwealth’s threshold requirements; and

meeting the amounts payable in relation to certain claims against eligible midwives who are no longer in private practice.

Level 1 and Level 2 Commonwealth contributions; and

run-off cover Commonwealth contributions.

an Aboriginal person; or

a Torres Strait Islander.

Aboriginal or Torres Strait Islander person means:

an Aboriginal person; or

a Torres Strait Islander.

Aboriginal person has the same meaning as in the Aboriginal and Torres Strait Islander Act 2005.

Actuary means the Australian Government Actuary.

administrative action has the meaning given by subsection 87A(4).

affected eligible midwife has the meaning given by section 42.

apportionment certificate means an apportionment certificate issued by the Chief Executive Medicare under subsection 51(1).

Birthing on Country model means a model designed to provide continuous, culturally safe care to: an Aboriginal or Torres Strait Islander person who is pregnant; or a person who is pregnant with an Aboriginal or Torres Strait Islander child.

an Aboriginal or Torres Strait Islander person who is pregnant; or

a person who is pregnant with an Aboriginal or Torres Strait Islander child.

Birthing on Country out-of-hospital incident means an out-of-hospital incident that occurs in relation to intrapartum care provided under a Birthing on Country model.

Chief Executive Medicare has the same meaning as in the Human Services (Medicare) Act 1973.

claim:

means a claim or demand of any kind (whether or not involving legal proceedings); and

includes proceedings of any kind including:

proceedings before an administrative tribunal or of an administrative nature; and

disciplinary proceedings (including disciplinary proceedings conducted by or on behalf of a professional body); and

an inquiry or investigation;

and claim against a person includes an inquiry into, or an investigation of, the person’s conduct.

Commonwealth contribution means:

a Level 1 Commonwealth contribution; or

a Level 2 Commonwealth contribution; or

a run-off cover Commonwealth contribution.

contribution year has the same meaning as in the Midwife Professional Indemnity (Run-off Cover Support Payment) Act 2010.

eligible entity, for a midwife, means a person:

specified in the Rules; and

that employs or engages the midwife to provide intrapartum care under a Birthing on Country model; and

to which any circumstances prescribed by the rules do not apply.

eligible insurer means an insurer included in a class of insurers specified in the Rules.

eligible midwife means a person who: is licensed, registered or authorised to practice midwifery by or under a law of the Commonwealth, a State or a Territory; and meets such other requirements (if any) as are specified in the Rules for the purposes of this paragraph; and is not included in a class of persons specified in the Rules for the purposes of this paragraph.

is licensed, registered or authorised to practice midwifery by or under a law of the Commonwealth, a State or a Territory; and

meets such other requirements (if any) as are specified in the Rules for the purposes of this paragraph; and

is not included in a class of persons specified in the Rules for the purposes of this paragraph.

eligible run-off claim has the meaning given by section 31.

Federal Register of Legislation means the Federal Register of Legislation established under the Legislation Act 2003.

health service means any service, care, treatment, advice or goods provided in respect of the physical or mental health of a person.

hospital has the same meaning as in the Private Health Insurance Act 2007.

incident means any incident (including any act, omission or circumstance) that occurs, or that is claimed to have occurred, in the course of, or in connection with, the provision of a health service.

indemnify has a meaning affected by subsection (3).

insurance business has the same meaning as in the Insurance Act 1973.

insurer means a person who carries on insurance business.

insurer-to-insurer payment means a payment that: is made by an insurer to an insurer; and is not made by the insurer on behalf of another person.

is made by an insurer to an insurer; and

is not made by the insurer on behalf of another person.

intrapartum care means care provided: at any time during the period from the onset of labour to delivery of the placenta; and in the course of a person’s practice as an eligible midwife; and in accordance with any other requirements prescribed by the Rules.

at any time during the period from the onset of labour to delivery of the placenta; and

in the course of a person’s practice as an eligible midwife; and

in accordance with any other requirements prescribed by the Rules.

invoice includes any document issued by an eligible insurer to a person (whether or not the eligible insurer already provides midwife professional indemnity cover to the person) that contains a quote for the amount of premium that is or would be payable by that person for provision of such cover.

late payment penalty:

in relation to a debt owed under section 25—means a penalty payable under section 28; and

in relation to a debt owed under section 37—means a penalty payable under section 40.

legal practitioner means a person who is enrolled as a barrister, a solicitor, a barrister and solicitor, or a legal practitioner, of: a federal court; or a court of a State or Territory.

a federal court; or

a court of a State or Territory.

Level 1 claim threshold has the meaning given by subsection 10(1).

Level 1 Commonwealth contribution means a Level 1 Commonwealth contribution paid or payable under Subdivision A of Division 3 of Part 2 of Chapter 2.

Level 1 qualifying claim certificate means a Level 1 qualifying claim certificate issued by the Chief Executive Medicare under subsection 11(1).

Level 1 termination date means the date specified in Rules made under subsection 7(1).

Level 2 claim threshold has the meaning given by subsection 10(2).

Level 2 Commonwealth contribution means a Level 2 Commonwealth contribution paid or payable under Subdivision B of Division 3 of Part 2 of Chapter 2.

Level 2 qualifying claim certificate means a Level 2 qualifying claim certificate issued by the Chief Executive Medicare under subsection 11(2).

Level 2 termination date means the date specified in Rules made under subsection 7(2).

medical practitioner means a person registered or licensed as a medical practitioner under a State or Territory law that provides for the registration or licensing of medical practitioners.

midwife professional indemnity cover: a contract of insurance provides midwife professional indemnity cover for a person if:

the insurance cover provided by the contract is cover (other than midwife professional indemnity run-off cover) that an eligible insurer is required, under an arrangement in force between the eligible insurer and the Commonwealth, to provide; and

the person is specified or referred to in the contract, whether by name or otherwise, as a person to whom the insurance cover extends; and

the insurance cover indemnifies the person (subject to the terms and conditions of the contract) in relation to claims that may be made against the person in relation to incidents that occur or occurred in the course of, or in connection with, the practice by the person of the profession of midwifery.

midwife professional indemnity run-off cover means cover in the nature of midwife professional indemnity run-off cover that an eligible insurer is required, under an arrangement in force between the eligible insurer and the Commonwealth, to provide to persons referred to in subsection 31(2).

out-of-hospital incident means an incident that occurs or occurred in the course of an eligible midwife providing intrapartum care outside of a hospital.

payment made in relation to a claim (other than in Subdivisions B and C of Division 3 of Part 2 of Chapter 2 (which deal with Level 2 Commonwealth contributions)) has the meaning given by subsections (4) and (5).

public patient has the same meaning as in the Health Insurance Act 1973.

qualifying claim certificate means a Level 1 or Level 2 qualifying claim certificate.

qualifying liability, in relation to a claim, has the meaning given by section 19.

Rules means the rules made under section 90.

run-off cover Commonwealth contribution means a run-off cover Commonwealth contribution paid or payable under Division 2 of Part 3 of Chapter 2.

run-off cover support payment means a run-off cover support payment payable under Part 2 of Chapter 3.

run-off cover termination date means the date specified in Rules made under subsection 7(3).

Secretary means the Secretary of the Department.

subject to appeal: a judgment or order is subject to appeal until:

any applicable time limits for lodging an appeal (however described) against the judgment or order have expired; and

if there is such an appeal against the judgment or order—the appeal (and any subsequent appeals) have been finally disposed of.

Torres Strait Islander has the same meaning as in the Aboriginal and Torres Strait Islander Act 2005.

total run-off cover credit has the meaning given by section 44.

Notifications by midwives may constitute claims

at the time of the incident, the person was an eligible midwife; and

the notification is to an eligible insurer; and

at the time of the notification:

a contract of insurance with the eligible insurer provided the person with midwife professional indemnity cover; and

the cover would have indemnified the person in relation to any claim relating to the incident if the claim had been made at the time of the notification.

The notification is taken, for the purposes of Part 3, to be a claim against the person.

Indemnifying

making a payment; or

agreeing to make a payment.

Payments in relation to claims

a payment is made or is payable in relation to a claim against a person if and only if the payment is made or is payable to:

satisfy or settle the claim; or

meet legal and other expenses that are directly attributable to any negotiations, arbitration or proceedings in relation to the claim; and

a payment is made or is payable in relation to a claim by a person if and only if the payment is made or is payable to meet legal and other expenses that are directly attributable to any negotiations, arbitration or proceedings in relation to the claim.

is made to reimburse the person for a payment the person has made to satisfy or settle the claim; or

is made to the person so that the person can make a payment to satisfy or settle the claim.

Eligible midwives

relate to an incident that occurs in the course of, or in connection with, the practice by the person as an eligible midwife; and

have been certified as a qualifying claim; and

for a claim that relates to an incident that is not an out-of-hospital incident—exceed the Level 1 claim threshold.

is in relation to a claim that:

relates to an incident that occurs in the course of, or in connection with, the midwife’s practice as an eligible midwife; and

has been certified as a qualifying claim; and

(b) exceeds the amount payable under an insurance contract that limits the eligible insurer’s liability under the contract for a particular claim in relation to the midwife, where the limit equals or exceeds the Level 2 claim threshold.

$100,000; or

such other amount as is specified in the Rules for the purposes of this paragraph.

No Level 1 claim threshold for out-of-hospital claims

$2 million; or

such other amount as is specified in the Rules for the purposes of this paragraph.

the claim meets the common requirements set out in subsection (3); and

a person has applied for a Level 1 qualifying claim certificate in relation to the claim in accordance with section 12.

Criteria for certification—Level 2

the claim meets the common requirements set out in subsection (3); and

the claim meets the additional Level 2 requirements set out in subsection (4); and

a person has applied for a Level 2 qualifying claim certificate in relation to the claim in accordance with section 12.

Common requirements for both Level 1 and Level 2 qualifying claim certificates

(a) for a claim that relates to an incident that is not a Birthing on Country out-of-hospital incident—the claim is or was made against a person (the midwife); or

for a claim that relates to a Birthing on Country out-of-hospital incident—the claim is or was made against:

(i) a person (also the midwife); or

(ii) the eligible entity for a person (also the midwife); and

the claim relates to an incident that occurs or occurred in the course of, or in connection with, the midwife’s practice as an eligible midwife; and

there is a contract of insurance entered into by an eligible insurer that provides midwife professional indemnity cover in relation to the claim; and

except in the circumstances specified in Rules made for the purposes of this paragraph, the incident occurs or occurred in Australia or an external Territory; and

if the claim relates to an incident that is not an out-of-hospital incident—the claim does not relate to an incident that occurs or occurred in the course of, or in connection with, the provision of treatment of a public patient of a hospital; and

the claim does not relate to an incident that occurs or occurred in the course of, or in connection with, practice of a kind for which:

the Commonwealth, a State or a Territory; or

a local governing body; or

an authority established under a law of the Commonwealth, a State or a Territory;

indemnifies eligible midwives from liability relating to compensation; and

if the application is for a Level 1 qualifying claim certificate for a claim that relates to an incident that is not an out-of-hospital incident, the incident occurs or occurred:

on or after 1 July 2010; and

on or before the Level 1 termination date (if any); and

if the application is for a Level 1 qualifying certificate for a claim that relates to an out-of-hospital incident, the incident occurs or occurred:

on or after 1 July 2025; and

(ii) on or before the Level 1 termination date for claims in relation to out-of-hospital incidents (if any); and

if the application is for a Level 2 qualifying claim certificate for a claim that relates to an incident that is not an out-of-hospital incident, the incident occurs or occurred:

on or after 1 July 2010; and

on or before the Level 2 termination date (if any); and

if the application is for a Level 2 qualifying certificate for a claim that relates to an out-of-hospital incident, the incident occurs or occurred:

on or after 1 July 2025; and

(ii) on or before the Level 2 termination date for claims in relation to out-of-hospital incidents (if any); and

the claim is not in substance an aggregation of:

two or more separate claims against the midwife; or

for a claim made against the eligible entity—two or more separate claims against the entity in relation to the midwife; and

the claim is not a claim included in a class specified in Rules made for the purposes of this paragraph; and

the claim does not relate to an incident of a kind specified in Rules made for the purposes of this paragraph; and

the claim does not relate to a type of midwifery practice specified in Rules made for the purposes of this paragraph.

Additional requirements for Level 2 qualifying claim certificates

there is a contract of insurance entered into by an eligible insurer in relation to which the following requirements are satisfied:

the contract provides midwife professional indemnity cover for the eligible midwife in relation to the claim, or would, but for the limit of the eligible insurer’s liability under the contract in relation to a particular claim against the eligible midwife, provide such cover for the midwife in relation to the claim;

the limit of the eligible insurer’s liability under the contract, in relation to each claim against the midwife, equals or exceeds the Level 2 claim threshold;

(iii) the eligible insurer is a general insurer, within the meaning of the Insurance Act 1973;

the eligible insurer entered into the contract in the ordinary course of the eligible insurer’s business; and

the contract of insurance is not a contract included in a class specified in Rules made for the purposes of this paragraph.

When a certificate is in force

identify:

the midwife; and

the claim; and

if the certificate is a Level 1 qualifying claim certificate in relation to an out-of-hospital incident or a Level 2 qualifying claim certificate—the contract of insurance that provides midwife professional indemnity cover for the midwife; and

if the claim is made against the eligible entity—the entity; and

if the certificate is a Level 1 qualifying claim certificate for a claim that relates to an incident that is not an out-of-hospital incident—specify the Level 1 claim threshold; and

if the certificate is a Level 2 qualifying claim certificate—specify the Level 2 claim threshold.

The certificate may also contain other material.

ART review of decision to refuse

an eligible insurer; or

the person against whom the claim is or was made or a person acting on that person’s behalf.

be made in writing using a form approved by the Chief Executive Medicare; and

specify whether it is an application for a Level 1 qualifying claim certificate or a Level 2 qualifying claim certificate; and

if the application relates to an out-of-hospital incident—specify that fact; and

specify whether the application relates to a claim that is or was made against:

if the claim relates to an incident that is not a Birthing on Country out-of-hospital incident—the midwife concerned; or

if the claim relates to a Birthing on Country out-of-hospital incident—the eligible entity concerned for the midwife concerned, or the midwife concerned; and

specify each person, other than the midwife concerned or, in the case of an application in relation to a claim against the eligible entity, the entity concerned, against whom a claim has been or is reasonably likely to be made, in relation to the incident to which the claim relates; and

be accompanied by the documents and other information required by the form approved by the Chief Executive Medicare.

a qualifying claim certificate is in force in relation to a claim; and

a person becomes aware that the information provided to the Chief Executive Medicare in connection with the application for the certificate was incorrect or incomplete, or is no longer correct or complete; and

the person is:

the person who applied for the certificate; or

another person who has applied for a payment of a Level 2 Commonwealth contribution in relation to the claim;

the person must notify the Chief Executive Medicare of the respect in which the information was incorrect or incomplete, or is no longer correct or complete.

be made in writing; and

be given to the Chief Executive Medicare within 28 days after the person becomes aware as mentioned in subsection (1).

the making of Rules for the purpose of paragraph 11(3)(k),(l) or (m) or (4)(b); or

changes to the terms and conditions of the contract of insurance identified in the certificate.

Variation

the Chief Executive Medicare revokes a qualifying claim certificate; and

an amount of Level 1 or Level 2 Commonwealth contribution has already been paid in relation to the claim;

the amount is an amount overpaid to which section 64 applies.

Effect of variation

the Chief Executive Medicare varies a qualifying claim certificate; and

an amount of Level 1 or Level 2 Commonwealth contribution has already been paid in relation to the claim, and that amount exceeds the amount that would have been paid if the amount of Level 1 or Level 2 Commonwealth contribution had been determined having regard to the certificate as varied;

the amount of the excess is an amount overpaid to which section 64 applies.

ART review of decision to revoke or vary

(a) a claim (the current claim) is, or was, made against:

(i) for a claim that relates to an incident that is not a Birthing on Country out-of-hospital incident—a person (the midwife); or

(ii) for a claim that relates to a Birthing on Country out-of-hospital incident—a person (also the midwife), or the eligible entity for a person (also the midwife); and

a Level 1 qualifying claim certificate is in force in relation to the current claim; and

in a case where there is a person, other than the midwife (in the case of a claim made against the midwife) or the eligible entity (in the case of a claim made against the entity), against whom a claim has been, or could reasonably be made in relation to the incident to which the current claim relates—either:

an apportionment certificate in relation to the current claim is in force; or

the Chief Executive Medicare has not issued an apportionment certificate because of the operation of section 52 (which deals with claims for which there is a final judgment or order of a court); and

the eligible insurer has a qualifying payment in relation to the current claim (see subsection (3)); and

if the current claim relates to an incident that is not an out-of-hospital incident—the amount of the qualifying payment exceeds what was the Level 1 claim threshold at the time the eligible insurer was first notified of the current claim or the incident to which the current claim relates; and

a person has applied for the Level 1 Commonwealth contribution in accordance with section 58; and

any other requirements (however described) that are specified in the Rules have been met; and

the current claim is not a claim included in a class specified in Rules made for the purposes of this paragraph.

the eligible insurer:

pays an amount in relation to the current claim; or

is liable to pay an amount in relation to a payment or payments that someone makes, or is liable to make, in relation to the current claim under a written agreement between the parties to the current claim; or

is liable to pay an amount in relation to a payment or payments that someone makes, or is liable to make, in relation to the current claim under a judgment or order of a court that is not stayed and is not subject to appeal; and

the eligible insurer pays, or is liable to pay, the amount under an insurance contract between the eligible insurer and the midwife or, in the case of a claim against the eligible entity, the entity; and

the eligible insurer pays, or becomes liable to pay, the amount in the ordinary course of the eligible insurer’s business; and

if an apportionment certificate is in force in relation to the current claim—the amount paid or payable in relation to the current claim is consistent with the proportion of the overall liability specified in the apportionment certificate as the proportion that is to be attributed to the midwife or, in the case of a claim against the eligible entity, the entity, against whom the claim was made.

80%; or

such other percentage as is specified in the Rules;

of the amount by which the amount of the eligible insurer’s qualifying payment, or the sum of the eligible insurer’s qualifying payments (see subsection 16(3)), in relation to the claim, exceeds the Level 1 claim threshold but does not exceed the Level 2 claim threshold.

Claims for out-of-hospital incidents

(a) a claim (the current claim) is, or was, made against the following person by another person:

for a claim that relates to an incident that is not a Birthing on Country out-of-hospital incident—the midwife;

for a claim that relates to a Birthing on Country out-of-hospital incident—the eligible entity for the midwife, or the midwife; and

a Level 2 qualifying claim certificate is in force in relation to the current claim; and

the liability is a qualifying liability in relation to the claim (see section 19); and

in a case where there is a person, other than the midwife (in the case of a claim made against the midwife) or the eligible entity (in the case of a claim made against the entity), against whom a claim has been, or could reasonably be made in relation to the incident to which the current claim relates—either:

an apportionment certificate in relation to the current claim is in force; or

the Chief Executive Medicare has not issued an apportionment certificate because of the operation of section 52 (which deals with claims for which there is a final judgment or order of a court); and

because of the limit of the eligible insurer’s liability under the contract of insurance identified in the qualifying claim certificate, the contract does not cover, or does not fully cover, the liability; and

the amount that, if the limit had been high enough to cover the whole of the liability, the eligible insurer would (subject to the other terms and conditions of the contract) have been liable to pay under the contract of insurance in relation to the liability exceeds the actual amount (if any) that the eligible insurer has paid or is liable to pay under the contract in relation to the liability; and

the aggregate of:

the amount (if any) the insurer has paid, or is liable to pay, in relation to the liability under the contract of insurance; and

the other amounts (if any) that the insurer has already paid, or has already become liable to pay, under the contract in relation to the current claim; and

equals or exceeds the Level 2 claim threshold identified in the qualifying claim certificate; and

a person has applied for the Level 2 Commonwealth contribution in accordance with section 60; and

the claim is not a claim included in a class specified in Rules made for the purposes of this paragraph.

Who the contribution is payable to

one of the following applies:

the liability is under a judgment or order of a court in relation to the claim, being a judgment or order that is not stayed and is not subject to appeal;

the liability is under a settlement of the claim that takes the form of a written agreement between the parties to the claim;

the liability is some other kind of liability (for example, a liability to legal costs) that relates to the claim; and

the defence of the claim was conducted appropriately (see subsection (2)) up to the time when:

if the liability is under a judgment or order of a court—the date on which the judgment or order became a judgment or order that is not stayed and is not subject to appeal; or

if the liability is under a settlement of the claim—the date on which the settlement agreement was entered into; or

if the liability is some other kind of liability—the date on which the liability was incurred; and

if the liability is under a settlement of the claim, or is under a consent order made by a court—a legal practitioner has given a statutory declaration certifying that the amount of the liability is reasonable; and

if an apportionment certificate is in force in relation to the current claim—the amount paid or payable in relation to the current claim is consistent with the proportion of the overall liability specified in the apportionment certificate as the proportion that is to be attributed to the midwife or entity against whom the claim was made.

to the extent it is conducted on the midwife or entity’s behalf by an insurer, or by a legal practitioner engaged by the insurer—the defence is conducted to a standard that is consistent with the insurer’s usual standard for the conduct of the defence of claims; and

to the extent it is conducted by the midwife or entity, or by a legal practitioner engaged by the midwife or entity—the defence is conducted prudently.

apply so much of the contribution as equals the undischarged amount of the liability towards the discharge of the liability; and

if the recipient is not the midwife—deal with the balance of the contribution in accordance with the directions of the midwife.

Time by which recipient must comply with obligation

by the time specified in a written direction (whether contained in the payment notice or otherwise) given to the recipient by the Chief Executive Medicare; or

if no such direction is given to the recipient—as soon as practicable after the Commonwealth contribution is received by the recipient.

To avoid doubt, the Chief Executive Medicare may vary a direction under paragraph (a) to specify a different time.

Debt to Commonwealth if recipient does not comply with obligation on time

by action by the Chief Executive Medicare against the recipient in a court of competent jurisdiction; or

under section 65.

if the contribution has not yet been dealt with in accordance with whichever of subsections 22(3) and (4) applies—the recipient referred to in subsection 22(1); or

if the contribution has been dealt with in accordance with whichever of those subsections applies—the midwife referred to in subsection 22(1).

the recipient and the midwife referred to in subsection 22(1) are not the same person; and

when the overpayment is recovered as a debt, the liable person is the recipient;

the fact that the recipient may later deal with the remainder of the contribution in accordance with subsection 22(3) or (4) does not mean that the overpayment should instead have been recovered from the midwife.

Subdivision C—Payments that would have reduced the amount paid out under the contract of insurance

(a) an amount (the insurance payment) has been paid under a contract of insurance that provides midwife professional indemnity cover for a person (the midwife) in relation to a liability of the midwife; and

another amount (not being an amount referred to in subsection (2)) has been paid in relation to the incident to which the liability relates:

if the incident is not a Birthing on Country out-of-hospital incident—to a person covered by subsection (3); or

if the incident is a Birthing on Country out-of-hospital incident—to a person covered by subsection (4); and

the other amount was not taken into account in working out the amount of the insurance payment; and

if the other amount had been taken into account in working out the amount of the insurance payment, a lesser amount would have been paid under the contract of insurance in relation to the liability;

then, for the purpose of calculating the amount of Level 2 Commonwealth contribution (if any) that is payable in relation to a liability of the midwife, the lesser amount is taken to have been the amount of the insurance payment.

an amount paid to an eligible insurer by another insurer under a right of contribution;

a payment of Level 1 Commonwealth contribution;

a payment of run-off cover Commonwealth contribution;

an amount of a kind specified in the Rules for the purposes of this paragraph.

Recipients of amounts—incidents that are not Birthing on Country out-of-hospital incidents

the midwife; or

the eligible insurer; or

another person.

Recipients of amounts—Birthing on Country out-of-hospital incidents

the midwife; or

the eligible insurer; or

the eligible entity for a midwife; or

another person.

(a) an amount (the actual contribution amount) of Level 2 Commonwealth contribution has been paid in relation to a qualifying liability that relates to a claim made against a person (the midwife) or an eligible entity; and

another amount (not being an amount referred to in subsection (5)) has been paid in relation to the incident to which the claim relates:

if the incident is not a Birthing on Country out-of-hospital incident—to a person covered by subsection 24(3); or

if the incident is a Birthing on Country out-of-hospital incident—to a person covered by subsection 24(4); and

the other amount was not taken into account in calculating the actual contribution amount; and

(d) if the other amount had been so taken into account, a lesser amount (the reduced contribution amount, which could be zero) of Level 2 Commonwealth contribution would have been paid in relation to the liability.

the recipient and the midwife referred to in subsection 22(1) are not the same person; and

the midwife becomes the liable person;

then (subject to subsection 23(3)), the recipient ceases to be the liable person, and the amount overpaid must instead be recovered from the midwife.

by action by the Chief Executive Medicare against the liable person in a court of competent jurisdiction; or

under section 65.

an amount paid to an eligible insurer by another insurer under a right of contribution;

a payment of Level 1 Commonwealth contribution;

a payment of run-off cover Commonwealth contribution;

an amount of a kind specified in the Rules for the purposes of this paragraph.

(a) an amount of Level 2 Commonwealth contribution has been paid in relation to a qualifying liability that relates to a claim made against a person (the midwife) or an eligible entity; and

(b) the person (the applicant) who applied for the Level 2 Commonwealth contribution becomes aware that another amount has been paid in relation to the incident to which the claim relates:

if the incident is not a Birthing on Country out-of-hospital incident—to a person covered by subsection 24(3); or

if the incident is a Birthing on Country out-of-hospital incident—to a person covered by subsection 24(4); and

because of the payment of the other amount, there is an amount overpaid as described in subsection 25(2);

the applicant must notify the Chief Executive Medicare that the other amount has been paid.

be in writing; and

be given to the Chief Executive Medicare within 28 days after the applicant becomes aware that the other amount has been paid.

an amount of Level 2 Commonwealth contribution has been paid in relation to a qualifying liability that relates to a claim made against:

(i) for a claim that relates to an incident that is not a Birthing on Country out-of-hospital incident—a person (the midwife); or

(ii) for a claim that relates to a Birthing on Country out-of-hospital incident—a person (also the midwife) or the eligible entity for a person (also the midwife); and

another amount is paid in relation to the incident to which the claim relates:

if the incident is not a Birthing on Country out-of-hospital incident—to a person covered by subsection 24(3); or

if the incident is a Birthing on Country out-of-hospital incident—to a person covered by subsection 24(4); and

because of the payment of the other amount, there is an amount overpaid as described in subsection 25(2);

the Chief Executive Medicare may give the liable person (see subsection 23(2)) a written notice that specifies:

the amount overpaid, and that it is a debt owed to the Commonwealth under subsection 25(3); and

the day before which the amount must be paid to the Commonwealth; and

the effect of section 28.

The day specified under paragraph (e) must be at least 28 days after the day on which the notice is given.

a person owes a debt to the Commonwealth under subsection 25(3); and

the debt remains wholly or partly unpaid after it becomes due and payable;

the person is liable to pay a late payment penalty under this section.

at the rate specified in the Rules for the purposes of this paragraph; and

on the unpaid amount; and

for the period:

starting when the amount becomes due and payable; and

ending when the amount, and the penalty payable under this section in relation to the amount, have been paid in full.

the recipient and the midwife referred to in subsection 22(1) are not the same person; and

the midwife becomes the liable person; and

the recipient has or had a liability under this section to pay late payment penalty;

the recipient’s liability to the late payment penalty is not affected by the fact that the recipient is no longer the person who owes the debt to the Commonwealth under subsection 25(3), except that the period referred to in paragraph (2)(c) ends when the midwife becomes the liable person.

it is a claim made against a person who, at the time the claim is made, is a person to whom subsection (2) applies; and

for an incident that is not an out-of-hospital incident—it relates to an incident that occurred on or after 1 July 2010 and on or before the run-off cover termination date in the course of, or in connection with, the person’s practice as an eligible midwife; and

for an incident that is an out-of-hospital incident—it relates to an incident that occurred:

on or after 1 July 2025; and

on or before the run-off cover termination date (if any); and

if there is a run-off cover termination date, the person:

was, immediately before the run-off cover termination date, a person to whom subsection (2) applies; and

continued to be such a person for the whole of the period between the run-off cover termination date and the time when an eligible insurer was first notified of the claim, or of facts that might give rise to the claim; and

the person has midwife professional indemnity run-off cover that indemnifies the person in relation to the claim.

a person who has retired permanently from private practice as an eligible midwife;

a person who has not engaged in private practice as an eligible midwife at any time during the preceding period of 3 years;

a person who has ceased (temporarily or permanently) the person’s practice as an eligible midwife because of maternity (see subsection (3));

a person who has ceased the person’s practice as an eligible midwife because of permanent disability (see subsection (4));

a person who is the legal personal representative of a deceased person who had been an eligible midwife;

a person who is included in a class of persons that the Rules specify as persons to whom this subsection applies.

However, a person is not a person to whom this subsection applies if the person is included in a class of persons that the Rules specify as a class of persons to whom this subsection does not apply.

the person:

is pregnant; or

has given birth; or

is recovering from a pregnancy (including a miscarriage or a stillbirth); and

another person who is a medical practitioner has certified, in the form approved by the Chief Executive Medicare, that the person is pregnant, has given birth or is recovering from a pregnancy, as the case requires; and

the person has ceased all practice as an eligible midwife:

because she is pregnant; or

in order to care for one or more children to whom she has given birth; or

in order to recover from the pregnancy; and

any other requirements specified in the Rules have been met.

the person has incurred an injury, or suffers from an illness, that is permanent, or is likely to be permanent; and

as a result of the injury or illness, the person can no longer practise the profession of midwifery; and

another person who is a medical practitioner has certified, in the form approved by the Chief Executive Medicare, that the person:

has incurred an injury, or suffers from an illness, that is permanent, or is likely to be permanent; and

can no longer practice the profession of midwifery; and

the person has permanently ceased all practice as an eligible midwife.

practice consisting of treatment of public patients of a hospital; or

practice for which:

the Commonwealth, a State or a Territory; or

a local governing body; or

an authority established under a law of the Commonwealth, a State or a Territory;

indemnifies eligible midwives from liability relating to compensation; or

practice conducted outside both Australia and the external Territories; or

practice of a kind specified in the Rules.

(a) an eligible run-off claim (the current claim) is made that relates to an incident that occurred in the course of, or in connection with, a person’s practice as an eligible midwife; and

at the time the claim is first notified to the eligible insurer, the person is a person to whom subsection 31(2) applies; and

in a case where there is a person, other than the eligible midwife, against whom a claim has been, or could reasonably be made in relation to the incident to which the current claim relates—either:

an apportionment certificate in relation to the current claim is in force; or

the Chief Executive Medicare has not issued an apportionment certificate because of the operation of section 52 (which deals with claims for which there is a final judgment or order of a court); and

the eligible insurer makes, or is liable to make, a payment in relation to the claim under a contract of insurance under which the insurer is liable to indemnify the person in relation to claims made by or against the person while he or she is a person to whom subsection 31(2) applies; and

for an incident that is not an out-of-hospital incident—either the incident occurs or occurred on or after 1 July 2010 and on or before the run-off cover termination date; and

for an incident that is an out-of-hospital incident—either the incident occurs or occurred:

on or after 1 July 2025; and

on or before the run-off cover termination date (if any); and

the eligible insurer applies to the Chief Executive Medicare for the run-off cover Commonwealth contribution in accordance with section 58; and

if an apportionment certificate is in force in relation to the current claim—the amount paid or payable in relation to the current claim is consistent with the proportion of the overall liability specified in the apportionment certificate as the proportion that is to be attributed to the eligible midwife against whom the claim was made.

in relation to a claim made in relation to which the eligible midwife concerned has midwife professional indemnity run-off cover; and

in the eligible insurer’s ordinary course of business.

in relation to a claim for which the midwife has midwife professional indemnity run-off cover; and

in the eligible insurer’s ordinary course of business.

(a) an amount (the relevant payment) has been paid, in relation to a liability of an eligible midwife (the midwife), under a contract of insurance with an eligible insurer that provides midwife professional indemnity run-off cover for the midwife; and

another amount (not being an amount referred to in subsection (2)) has been paid to the midwife, eligible insurer or another person in relation to the incident to which the liability relates; and

the other amount was not taken into account in working out the amount of the relevant payment; and

if the other amount had been taken into account in working out the amount of the relevant payment, a lesser amount would have been paid under the contract of insurance, in relation to the liability;

then, for the purpose of calculating the amount of run-off cover Commonwealth contribution (if any) that is payable in relation to a liability of the midwife, the lesser amount is taken to have been the amount of the relevant payment.

an amount paid to an eligible insurer by another insurer under a right of contribution;

a payment of Level 1 Commonwealth contribution;

a payment of Level 2 Commonwealth contribution;

an amount of a kind specified in the Rules for the purposes of this paragraph.

(a) an amount (the actual run-off cover amount) of run-off cover Commonwealth contribution has been paid in relation to an eligible run-off claim made against an eligible midwife (the midwife); and

another amount (not being an amount referred to in subsection (5)) is paid to the midwife, an eligible insurer or another person in relation to the incident to which the claim relates; and

the other amount was not taken into account in calculating the actual run-off cover amount; and

(d) if the other amount had been so taken into account, a lesser amount (the reduced run-off cover amount, which could be zero) of run-off cover Commonwealth contribution would have been paid in relation to the liability.

by action by the Chief Executive Medicare against the eligible insurer in a court of competent jurisdiction; or

under section 65.

an amount paid to an eligible insurer by another insurer under a right of contribution;

a payment of Level 1 Commonwealth contribution;

a payment of Level 2 Commonwealth contribution;

an amount of a kind specified in the Rules for the purposes of this paragraph.

(a) a run-off cover Commonwealth contribution has been paid to an eligible insurer in relation to a liability that relates to a claim made against an eligible midwife (the midwife); and

the eligible insurer becomes aware that another amount has been paid to the midwife, eligible insurer or another person in relation to the incident to which the claim relates; and

because of the payment of the other amount, there is an amount overpaid as described in subsection 37(2);

the eligible insurer must notify the Chief Executive Medicare that the other amount has been paid.

be in writing; and

be given to the Chief Executive Medicare within 28 days after the applicant becomes aware that the other amount has been paid.

a run-off cover Commonwealth contribution has been paid to an eligible insurer in relation to a liability that relates to a claim made against an eligible midwife; and

another amount is paid to the midwife, eligible insurer or another person in relation to the incident to which the claim relates; and

because of the payment of the other amount, there is an amount overpaid as described in subsection 37(2);

the Chief Executive Medicare may give the eligible insurer a written notice that specifies:

the amount overpaid, and that it is a debt owed to the Commonwealth under subsection 37(3); and

the day before which the amount must be paid to the Commonwealth; and

the effect of section 40.

The day specified under paragraph (e) must be at least 28 days after the day on which the notice is given.

a person owes a debt to the Commonwealth under subsection 37(3); and

the debt remains wholly or partly unpaid after it becomes due and payable;

the person is liable to pay a late payment penalty under this section.

at the rate specified in the Rules for the purposes of this paragraph; and

on the unpaid amount; and

for the period:

starting when the amount becomes due and payable; and

ending when the amount, and the penalty payable under this section in relation to the amount, have been paid in full.

must be paid to a person who:

is nominated by the eligible midwife; and

has, on or after the run-off cover termination date, provided midwife professional indemnity cover for the eligible midwife under a contract of insurance; and

must be paid as all or part of the premium payable for the provision of that cover; and

must be paid within 12 months after that date; and

must not exceed the eligible midwife’s total run-off cover credit.

the eligible midwife’s run-off cover credit for the financial year; by

the interest rate adjustment for the financial year (see subsection (4)).

Step 2. For each subsequent financial year (if any) until the financial year in which the termination date occurs, multiply:

the sum of the eligible midwife’s run-off cover credit for the financial year and the amount worked out, under step 1 or this step, for the immediately preceding financial year; by

the interest rate adjustment for the financial year (see subsection (4)).

Step 3. Add together:

the eligible midwife’s run-off cover credit for the financial year in which the run-off cover termination date occurs; and

the last of the amounts worked out under step 1 or step 2.

The result is the practitioner’s total run-off cover credit.

each eligible midwife to whom the payment is attributable; and

for each such eligible midwife, each financial year in relation to which the payment is attributable; and

for each such eligible midwife and financial year, the extent to which the payment is attributable to the practitioner in relation to the financial year.

be made in writing; and

must be given to the Chief Executive Medicare on or before the payment day under section 75 for the run-off cover support payment.

a person ceases to be a person to whom subsection 31(2) applies; and

immediately before the cessation, an eligible insurer was providing midwife professional indemnity run-off cover to the person;

the eligible insurer must notify the Chief Executive Medicare of the cessation.

be in writing; and

set out details of the cessation; and

be given to the Chief Executive Medicare within a period, starting on the day after the day on which the person becomes aware of the cessation, of:

61 days; or

such greater number of days specified in the Rules for the purposes of this subparagraph.

an eligible insurer gives to a person an invoice stating the premium that is or will be payable for midwife professional indemnity cover provided by a contract of insurance with the eligible insurer; and

payment of the premium would increase the eligible insurer’s liability to pay run-off cover support payment;

the eligible insurer must ensure that the invoice states:

the amount of the eligible insurer’s premium income, for the contribution year in question, that represents the premium that is or will be payable for midwife professional indemnity cover provided by the contract of insurance; and

the applicable percentage relating to that contribution year; and

the amount of the run-off cover support payment imposed on the eligible insurer, for that contribution year, that relates to the premium that is or will be payable for midwife professional indemnity cover provided by the contract of insurance.

a statement of the number of persons who were, at the end of the financial year, persons to whom subsection 31(2) applies; and

a statement of the total of all the amounts of run-off cover Commonwealth contribution paid by the Commonwealth during the financial year; and

a statement of the total of all the amounts of run-off cover support payments paid to the Commonwealth during the financial year; and

estimates by the Actuary of the Commonwealth’s liabilities in relation to amounts of run-off Commonwealth contributions in future financial years.

a specified class of claims; or

a specified class of contracts of insurance; or

a specified class of situations in which a liability is, whether wholly or partly, covered by more than one contract of insurance.

to deal with what happens if, as a result of the appeal or another appeal, the amount paid later becomes wholly or partly repayable; and

to deal with what happens if the amount paid is later applied towards a liability that is confirmed as a result of the appeal or another appeal.

either:

a qualifying claim certificate has been issued by the Chief Executive Medicare in relation to the claim; or

for a claim against a midwife—the claim is an eligible run-off claim; and

for a claim against a midwife—the Chief Executive Medicare is satisfied that there is a person, other than the midwife, against whom a claim has been or is reasonably likely to be made, in relation to the incident to which the claim relates; and

for a claim against an eligible entity—the Chief Executive Medicare is satisfied that there is a person, other than the entity, against whom a claim has been or is reasonably likely to be made, in relation to the incident to which the claim relates; and

an application for the certificate has been made in accordance with section 53.

the midwife or eligible entity; and

the other person or persons against whom the Chief Executive Medicare is satisfied a claim has been, or is reasonably likely to be, made in relation to the incident.

each of those persons individually; or

those persons taken as a group.

the information provided with the application; and

any other information that the Chief Executive Medicare considers appropriate.

a judgment or order of a court has been made in relation to the claim; and

the judgment or order specifies the liability of the eligible midwife or eligible entity in relation to the claim; and

the judgment or order is not stayed and is not subject to appeal; and

the defence of the claim against the midwife or entity was conducted appropriately (see subsection (2)) up to the date on which the judgment or order became a judgment or order that is not stayed and is not subject to appeal.

to the extent it is conducted on the midwife or entity’s behalf by an insurer, or by a legal practitioner engaged by the insurer—the defence is conducted to a standard that is consistent with the insurer’s usual standard for the conduct of the defence of claims; and

to the extent it is conducted by the midwife or entity, or by a legal practitioner engaged by the midwife or entity—the defence is conducted prudently.

for a claim made against a midwife—there is a person other than the midwife against whom a claim has been, or is reasonably likely to be, made in relation to the incident to which the claim relates; or

for a claim made against an eligible entity—there is a person other than the entity against whom a claim has been, or is reasonably likely to be, made in relation to the incident to which the claim relates.

be made in writing using a form approved by the Chief Executive Medicare; and

must specify the proportion of the overall liability in relation to the incident to which the claim relates that the applicant proposes be attributed to:

the midwife or entity; and

the other person or persons against whom a claim has been, or is reasonably likely to be made in relation to the incident to which the claim relates; and

be accompanied by the documents and other information required by the form approved by the Chief Executive Medicare.

each of those persons individually; or

those persons taken as a group.

an apportionment certificate is in force in relation to a claim; and

a person becomes aware that the information provided to the Chief Executive Medicare in connection with the application for the certificate was incorrect or incomplete, or is no longer correct or complete; and

the person is:

the person who applied for the certificate; or

another person who has applied for a payment of Commonwealth contribution in relation to the claim;

the person must notify the Chief Executive Medicare of the respect in which the information was incorrect or incomplete, or is no longer correct or complete.

be made in writing; and

be given to the Chief Executive Medicare within 28 days after the person becomes aware as mentioned in subsection (1).

a judgment or order of a court is made; and

the judgment or order is of a kind that would have prevented the Chief Executive Medicare issuing an apportionment certificate under section 52, had it been made before the certificate was issued.

Variation

the Chief Executive Medicare revokes an apportionment certificate; and

an amount of Commonwealth contribution has already been paid in relation to the claim;

the amount is an amount overpaid to which section 64 applies.

Effect of variation

the Chief Executive Medicare varies an apportionment certificate; and

an amount of Commonwealth contribution has already been paid in relation to the claim, and that amount exceeds the amount that would have been paid if the amount of Commonwealth contribution had been determined having regard to the certificate as varied;

the amount of the excess is an amount overpaid to which section 64 applies.

Chief Executive Medicare to give applicant copy of varied certificate

an insurer applies for a Level 1 Commonwealth contribution or a run-off cover Commonwealth contribution; and

the Chief Executive Medicare requests a person to give information under section 62 in relation to the application; and

the person does not give the Chief Executive Medicare the information requested before the end of the month that immediately follows the month in which the insurer applies for the contribution; and

a Level 1 Commonwealth contribution or a run-off cover Commonwealth contribution is payable to the insurer;

the Chief Executive Medicare must pay the Level 1 Commonwealth contribution or a run-off cover Commonwealth contribution to the insurer before the end of the month that immediately follows the month in which the person gives the Chief Executive Medicare the requested information.

an application for the issue of a qualifying claim certificate in relation to a claim; and

an application for a Level 1 Commonwealth contribution in relation to the same claim;

the Chief Executive Medicare does not have to decide the application for payment of a Level 1 Commonwealth contribution until the Chief Executive Medicare has decided the application for the issue of a qualifying claim certificate.

be made in writing using a form approved by the Chief Executive Medicare; and

be accompanied by the documents and other information required by the form approved by the Chief Executive Medicare.

if the liability is under a judgment or order of a court—the date on which the judgment or order became or becomes a judgment or order that is not stayed and is not subject to appeal; or

if the liability is under a settlement of the claim—the date on which the settlement agreement was entered into; or

if the liability is some other kind of liability—the date on which the liability was incurred.

an application for the issue of a qualifying claim certificate in relation to a claim; and

an application for a Level 2 Commonwealth contribution in relation to the same claim;

the Chief Executive Medicare does not have to decide the application for payment of a Level 2 Commonwealth contribution until the Chief Executive Medicare has decided the application for the issue of a qualifying claim certificate.

Time by which payment must be made

whether a Commonwealth contribution is payable; or

the amount of the Commonwealth contribution that is payable; or

whether a qualifying claim certificate or an apportionment certificate should be issued, varied or revoked; or

the Commonwealth’s possible future liability to make Commonwealth contributions, or a particular kind of Commonwealth contribution;

the Chief Executive Medicare may request the person to give the Chief Executive Medicare the information.

an insurer;

a person who practises, or used to practise, as an eligible midwife;

a person who is acting, or has acted, on behalf of a person covered by paragraph (b);

the legal personal representative of a person covered by paragraph (b) or (c).

must be made in writing; and

must state what information must be given to the Chief Executive Medicare; and

may require the information to be verified by statutory declaration; and

must specify the day on or before which the information must be given; and

must contain a statement to the effect that a failure to comply with the request is an offence.

The day specified under paragraph (d) must be at least 28 days after the day on which the request is made.

the payability of the contribution;

the amount of the contribution payable;

any amount paid to the person that results in a person being liable to pay an amount under section 25 or 37;

any other matter determined by the Chief Executive Medicare.

Records to be kept by person who applies for a qualifying claim certificate

matters related to whether the criteria specified in subsection 11(1) or (2) are satisfied in relation to the claim;

any other matter determined by the Chief Executive Medicare.

Records to be retained for certain period

the day on which the records were created; or

the day on which this Act commenced.

Determination of additional matters to be gazetted

be published in the Gazette; and

not take effect earlier than 14 days after the day on which it is published in the Gazette.

Retrospective effect not intended

the amount of Commonwealth contribution is not payable; or

the amount paid is greater than the amount of the Commonwealth contribution that was payable.

the whole of the amount paid if paragraph (1)(a) applies; or

the difference between the amount that was paid and the amount that was payable if paragraph (1)(b) applies.

if the Commonwealth contribution was a Level 1 Commonwealth contribution or a run-off cover Commonwealth contribution—the insurer to which the payment was made; or

if the Commonwealth contribution was a Level 2 Commonwealth contribution—the person who is the liable person under subsection 23(2).

the recipient and the midwife referred to in subsection 22(1) are not the same person; and

the midwife becomes the liable person;

then (subject to subsection 23(3)), the recipient ceases to be the liable person, and the amount overpaid must instead be recovered from the midwife.

by action by the Chief Executive Medicare against the liable person in a court of competent jurisdiction; or

by deduction from the amount of a Level 1 Commonwealth contribution, a Level 2 Commonwealth contribution or a run-off cover Commonwealth contribution payable to the liable person; or

under section 65.

The total amount recovered must not exceed the amount overpaid.

not require an amount to be paid to the Chief Executive Medicare at a time before it becomes owing by the third party to the liable person; and

specify a period of not less than 14 days within which the third party must comply with the direction.

the repayment or overpayment debt relates to a Level 2 Commonwealth contribution; and

the recipient and the midwife referred to in subsection 22(1) are not the same person; and

the midwife becomes the liable person; and

the direction was given to the recipient;

the direction ceases to have effect when the midwife becomes the liable person.

Third party to comply

immediately give notice to the third party of that fact; and

make an appropriate variation to the direction; and

give a copy of the varied direction to the liable person.

When third party is taken to owe money

money is due or accruing by the third party to the liable person; or

the third party holds money for or on account of the liable person; or

the third party holds money on account of some other person for payment to the liable person; or

the third party has authority from some other person to pay money to the liable person;

whether or not the payment of the money to the liable person is dependent on a pre-condition that has not been fulfilled.

the person is an eligible insurer; and

the person gives such an invoice to another person; and

the invoice does not state the matters required by section 47.

a contract is a contract of insurance between 2 insurers; and

the contract is governed by the laws of a State or Territory;

the contract has effect as if the contract provided, and had at all times provided, that:

Commonwealth contributions; and

insurers’ rights to Commonwealth contributions;

were to be disregarded for all purposes and, without limiting this, were to have no effect on the amounts payable under the contract by the insurer providing the insurance.