PART 2Direct Payments
Repayment of direct payments15
1
A health body may require that part or all of a direct payment must be repaid to the health body, if satisfied that it is appropriate to require repayment having regard in particular to whether—
a
the care plan has changed substantially;
b
the patient’s circumstances have changed substantially;
c
a substantial proportion of the direct payments received by a patient, representative or nominee have not been used to secure services specified in the care plan and have accumulated;
d
the direct payments have been used otherwise than for a service specified in the care plan;
e
theft, fraud or another offence may have occurred in connection with the direct payments; or
f
the patient has died.
2
Where a health body decides under paragraph (1) that a sum must be repaid, the health body must give reasonable notice in writing to the patient and any representative or nominee, stating—
a
the reasons for the decision;
b
the amount to be repaid;
c
the time within which the sum must be repaid; and
d
the person who must repay.
3
In the case of a patient who has died, the notice mentioned in paragraph (2) must be given to the personal representatives of the patient.
4
On receipt of a notice under paragraph (2), a patient, personal representative, representative or nominee may require a health body to re-consider the decision, and may provide evidence or relevant information for the health body to consider as part of that deliberation.
5
A health body must inform the patient and any personal representative, representative or nominee in writing of the decision on a re-consideration, stating the reasons for the decision, the amount to be repaid, if any, the time within which any sum must be repaid and the person who must repay, if any.
6
A health body may not be required to undertake more than one re-consideration following a decision under paragraph (1).