Health (Repayment Scheme) Act 2006

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Determination of application.

6.— (1) Subject to subsection (2), the scheme administrator shall determine an application—

(a) if the scheme administrator is satisfied—

(i) that the applicant is entitled under this Act to make the application,

(ii) that the purported recoverable health charge to which the application relates is a recoverable health charge, whether in whole or in part, and

(iii) as to the amount (“eligible amount”) of that purported recoverable health charge which is a recoverable health charge,

by causing a payment, equivalent to the sum of the eligible amount and the interest, if any, payable by virtue of regulations made under section 20 (1)(b) which are applicable to this paragraph, to be made as soon as is practicable,

(b) if the scheme administrator is—

(i) satisfied that the applicant is entitled under this Act to make the application,

(ii) satisfied that the purported recoverable health charge to which the application relates is a recoverable health charge, whether in whole or in part, and

(iii) not satisfied, for whatever reason, as to the amount of that purported recoverable health charge which is a recoverable health charge,

by causing a payment to be made, as soon as is practicable—

(I) subject to subparagraph (II), by reference to the income the relevant person had, the type of in-patient the relevant person was or the type of institutional assistance the relevant person received, as the case may be, and the nature of the charge imposed on, or the contribution required of, the relevant person, during the period in which the relevant person was an in-patient for the purposes of the regulations referred to in paragraph (a) or (b) of the definition of “recoverable health charge”,

(II) if the information referred to in subparagraph (I) is not available and subject to subparagraph (III), that does not exceed 80 per cent of the maximum of the weekly rate of the old age (non-contributory) pension, within the meaning of the Social Welfare Acts, as applicable during the period to which the recoverable health charge relates,

(III) that takes into account the interest, if any, payable by virtue of regulations made under section 20 (1)(b) which are applicable to this paragraph,

(c) if neither paragraph (a) nor (b) applies, by refusing the application.

(2) Where the scheme administrator, not being the Executive, determines an application pursuant to subsection (1)(a) or (b), then, subject to section 16 (12), the Executive shall make the prescribed repayment concerned as soon as is practicable.