Australian Government

Veterans’ Entitlements Act 1986

Veterans’ Entitlements (Treatment Principles – Removal of Prior Approval/New Dental Providers/Coordinated Care Adjustment) Instrument 2012

Instrument No. R27/2012

[1] Name of Instrument

This instrument is the Veterans’ Entitlements (Treatment Principles – Removal of Prior Approval/New Dental Providers/Coordinated Care Adjustment) Instrument 2012.

[2] Commencement

This instrument commences, or is taken to have commenced, on 31 August 2012.

   Schedule

1. Paragraph 1.4.1

insert:

“dental hygienist” means a person registered under the National Law that provides for the registration of dental practitioners but does not include a person:

(a) whose registration to practise as a dental hygienist has been suspended, or cancelled, following an inquiry relating to his or her conduct; and

(b) who has not, after that suspension or cancellation, again been authorised to practise as a dental hygienist.

“dental therapist” means a person registered under the National Law that provides for the registration of dental practitioners but does not include a person:

(a) whose registration to practise as a dental therapist has been suspended, or cancelled, following an inquiry relating to his or her conduct; and

(b) who has not, after that suspension or cancellation, again been authorised to practise as a dental therapist.

“National Law” means a law of the Commonwealth, a State, or Territory, enacted pursuant to the Intergovernmental Agreement for a National Registration and Accreditation Scheme for the Health Professions made on 26 March 2008:

http://www.ahwo.gov.au/documents/National%20Registration%20and%20Accreditation/NATREG%20-%20Intergovernmental%20Agreement.pdf

“Notes for Providers” means a DVA document approved by the Secretary to the Department, or by the Commission or a member thereof, with the word ‘Notes’ in its title, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which, a health care provider is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

“oral health therapist” means a person registered under the National Law that provides for the registration of dental practitioners but does not include a person:

(a) whose registration to practice as an oral health therapist has been suspended, or cancelled, following an inquiry relating to his or her conduct: and

(b) who has not, after that suspension or cancellation, again been authorised to practice as an oral health therapist.

Note: oral health therapists are practitioners who are dually qualified as dental therapists and dental hygienists.

2. Paragraph 3.2.1(a)

omit.

3. Paragraph 3.2.1(f)(the Note)

omit:

paragraph 9.1.8

substitute:

paragraph 9.1.9

4. Paragraph 3.2.1(n)

omit:

in Part 5

substitute:

in Part 5 or in a DVA document incorporated into the Principles

5. Paragraphs 3.2.1(u) and (v)

omit.

6. Paragraph 3.2.1(z)

substitute:

(z) psychiatric inpatient care or psychiatric day patient program care;

(za) treatment specified in any Notes for Providers (however described) and in any Fee Schedule as requiring prior approval.

7. Paragraphs 3.3.2(c) and (d)

omit:

in Part 5

substitute:

in Part 5 or in a DVA document incorporated into the Principles

8. Paragraph 3.3.2(o)

omit:

, except where otherwise indicated in principle 7.7

9. Paragraph 3.5.1(1)(b)

after:

(Local Dental Officer)

insert:

, including for dental services provided by a dental hygienist, dental therapist or oral health therapist on behalf of the dentist

10. Paragraph 3.5.1(1)(d)

after (first occurring):

dental specialist

insert:

, including for dental services provided by a dental hygienist, dental therapist or oral health therapist on behalf of the dental specialist

11. Paragraph 4.6

omit.

12. Paragraph 4.7.1

omit:

principle 4.6 and paragraph 4.7.3

substitute:

paragraph 4.7.3 and the Repatriation Private Patient Principles 2004

13. Paragraph 4.8.1(a) and the Note

after:

with the exception of

insert:

elective surgery in a public hospital,

omit the Note.

14. Paragraph 5.1.1

after the paragraph, insert:

5.1.1A For paragraph 5.1.1, dental treatment provided by a dentist or dental specialist includes dental treatment provided by a dental hygienist, dental therapist or oral health therapist on behalf of the dentist or dental specialist, as the case may be.

15. Paragraph 5.4.1

omit:

but the Commission’s

substitute:

but if prior approval is required for the treatment then the Commission’s

16. Paragraph 6A.4.6

after the paragraph, insert:

6A.4A Arrangements with Service Providers

6A.4A.1 For the purpose of facilitating the provision of Coordinated Veterans' Care Program treatment to entitled persons, the Commission or the Department may enter into an arrangement with a person to:

(a) assist in identification of possible participants in the Coordinated Veterans' Care Program and provide general support to the Commission or Department in respect of the program including:

(i) data analysis to identify and notify potential participants and their usual LMO or medical practitioner;

(ii) undertaking ongoing analysis and reporting to support program evaluation and monitoring;

(iii) promoting the program and providing supplementary support materials for LMOs and participants in the Program; or

(b) deliver training modules and resources in Chronic Disease Management to LMOs, medical practitioners, Practice Nurses and Community Nurses; or

(c) undertake ongoing and independent monitoring and evaluation of the Coordinated Veterans' Care Program Program.

17. Paragraph 6A.6.1(c)(iii)

substitute:

(iii) “Transition Care”;

18. Paragraph 6A.6.1(c)(iv)

omit.

19. Paragraph 6A.6.1(c)

omit:

(i) –(iv)

substitute:

(i) – (iii)

20. Paragraph 7.1.1

substitute:

7.1.1 Except where provided in:

(1) the Principles;

(2) the Notes for Allied Health Providers; or

(3) a Fee Schedule;

the Commission’s prior approval for a treatment under this Part is not required.

21. Schedule 1

substitute:

The date for :

 1. Notes for Local Medical Officers (paragraph 1.4.1);

2. Department of Veterans’ Affairs Fee Schedules for Medical Services (paragraph 3.5.1);

3. Notes for Allied Health Providers (paragraphs 3.5.1 and 7.1A.1);

4. Optometrist Fees for Consultation (paragraph 3.5.1);

5. DVA Schedule of Fees Orthoptists (paragraph 3.5.1);

6. Pricing Schedule for visual aids (paragraph 3.5.1);

7. The fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (commonly known as DSM-IV) (paragraph 2.4.2A);

8. Fee Schedule of Dental Services for Dentists and Dental Specialists (paragraph 3.5.1);

9. Fee Schedule of Dental Services for Dental Prosthetists (paragraph 3.5.1);

 10. Chiropractors Schedule of Fees (paragraph 3.5.1);

11. Diabetes Educators Schedule of Fees (paragraph 3.5.1);

12. Dietitians Schedule of Fees (paragraph 3.5.1);

13. Exercise Physiologists Schedule of Fees (paragraph 3.5.1);

14. Occupational Therapists Schedule of Fees (paragraph 3.5.1);

15. Osteopaths Schedule of Fees (paragraph 3.5.1);

16. Physiotherapists Schedule of Fees (paragraph 3.5.1);

17. Psychologists Schedule of Fees (paragraph 3.5.1);

18. Podiatrists Schedule of Fees (paragraph 3.5.1);

19. Social Workers Schedule of Fees (paragraph 3.5.1);

20. Clinical Counsellors Schedule of Fees (paragraph 3.5.1);

21. Speech Pathologists Schedule of Fees (paragraph 3.5.1);

22. Australian Government Department of Veterans’ Affairs  Classification System and Schedule of Item Numbers and               Fees — Community Nursing Services;

23. Notes for Coordinated Veterans' Care Program Providers;

24. Rehabilitation Appliances Program (RAP) National Guidelines (paragraph 11.2A.1);

25. RAP National Schedule of Equipment (paragraph 11.2A.1);

is 31 August 2012.

22. The Treatment Principles

ensure for provisions that numerals and letters run, respectively, in chronological and alphabetical order.