Australian Government

Veterans’ Entitlements Act 1986

Military Rehabilitation and Compensation Act 2004

Veterans’ Affairs (Treatment Principles – Extend Eligibility for Allied Health Treatment to Residential Care Recipients) Determination 2020

Instrument 2020 No.R42/MRCC42 

1 Name

This instrument is the Veterans’ Affairs (Treatment Principles - Extend Eligibility for Allied Health Treatment to Residential Care Recipients) Determination 2020.

2 Commencement

This determination commences on 10 December 2020.

3 Authority

This determination is made under:

(a)   subsection 90(5) of the Veterans’ Entitlements Act 1986 in respect of the variations to the Treatment Principles in Schedule 1; and

(b)   subsection 286(5) of the Military Rehabilitation and Compensation Act 2004 in respect of the variations to the MRCA Treatment Principles in Schedule 2.

4 Schedules

Each instrument that is specified in a Schedule to this instrument is varied as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this determination has effect according to its terms.

Schedule 1 - Variations to the Treatment Principles (Instrument 2013 No. R52) [F2020C00775]

[1] Paragraph 7.1.3

After “Subject to”, insert “7.1C.1 (Extended Eligibility for Treatment by Allied Health Providers for Entitled Persons Receiving Residential Care),”.

[2] After Principle 7.1B, insert:

7.1C  Extended Eligibility for Treatment by Allied Health Providers for Entitled Persons Receiving Residential Care

 7.1C.1 For the period from 10 December 2020 until 30 June 2022 (both dates inclusive) the Commission will accept financial responsibility for services listed in paragraphs 7.1.2(a), (aa), (b), (c), (dd), (e), (h), (j), (k), (l). (m) and (n) in the following circumstances:

 (a) the entitled person must be receiving residential care as described in paragraph 7(6)(a) of the Quality of Care Principles 2014;

 (b) the services must be provided in accordance with the limits imposed in the relevant section of the Notes for Allied Providers and in the applicable Fee Schedule.

 Note (1): a person described in paragraph 7(6)(a) of the Quality of Care Principles 2014 is a care recipient in residential care whose classification level under the Classification Principles 2014 includes any of the following:

(i)                 high ADL domain category;

(ii)               high CHC domain category;

(iii)            high behaviour domain category;

(iv)             a medium domain category in at least 2 domains.

 These categories are worked out under the Classification Principles 2014.

 Note (2): a person described in paragraph 7(6)(a) of the Quality of Care Principles 2014 may be provided with care and services specified in Part 1, 2 or 3 of Schedule 1 of the Quality of Care Principles 2014.

 Note (3): the Notes for Allied Health Providers and the Fee Schedules can be found at: https://www.dva.gov.au/providers/notes-fee-schedules-and-guidelines.

[3] Paragraph 7.5.3

Omit “Prior approval is required”, substitute “Subject to paragraph 7.1C.1, prior approval is required”.

[4] After, paragraph 7.5.3, insert:

Note: paragraph 7.1C.1 provides that for the period from 10 December 2020 to 30 June 2022 Commission will accept financial responsibility for certain services listed in paragraph 7.1.2 (including physiotherapy) without the requirement for prior approval for an entitled person receiving residential care if the person is described in paragraph 7(6)(a) of the Quality of Care Principles 2014.

[5] Paragraph 7.6.2

Omit “Prior approval is required”, substitute “Subject to paragraph 7.1C.1, prior approval is required”.

[6] After, paragraph 7.6.2, insert:

Note: paragraph 7.1C.1 provides that for the period from 10 December 2020 to 30 June 2022 Commission will accept financial responsibility for certain services listed in paragraph 7.1.2 (including podiatry) without the requirement for prior approval for an entitled person receiving residential care if the person is described in paragraph 7(6)(a) of the Quality of Care Principles 2014.

[7] Paragraph 7.6A.2

Omit “Prior approval is required”, substitute “Subject to paragraph 7.1C.1, prior approval is required”.

[8] After, paragraph 7.6A.2, insert:

Note: paragraph 7.1C.1 provides that for the period from 10 December 2020 to 30 June 2022 Commission will accept financial responsibility for certain services listed in paragraph 7.1.2 (including diabetes educator services) without the requirement for prior approval for an entitled person receiving residential care if the person is described in paragraph 7(6)(a) of the Quality of Care Principles 2014.

Schedule 2 - Variations to the MRCA Treatment Principles (Instrument 2013 No. MRCC53) [F2020C00776]

[1] Paragraph 7.1.3

After “Subject to”, insert “7.1C.1 (Extended Eligibility for Treatment by Allied Health Providers for Entitled Persons Receiving Residential Care),”.

[2] After Principle 7.1B, insert:

 7.1C.1 For the period from 10 December 2020 until 30 June 2022 (both dates inclusive) the Commission will accept financial responsibility for services listed in paragraphs 7.1.2(a), (aa), (b), (c), (dd), (e), (h), (j), (k), (l). (m) and (n) in the following circumstances:

 (a) the entitled person must be receiving residential care as described in paragraph 7(6)(a) of the Quality of Care Principles 2014;

 (b) the services must be provided in accordance with the limits imposed in the relevant section of the Notes for Allied Providers and in the applicable Fee Schedule.

 Note (1): a person described in paragraph 7(6)(a) of the Quality of Care Principles 2014 is a care recipient in residential care whose classification level under the Classification Principles 2014 includes any of the following:

(i)     high ADL domain category;

(ii)  high CHC domain category;

(iii) high behaviour domain category;

(iv) a medium domain category in at least 2 domains.

 These categories are worked out under the Classification Principles 2014.

 Note (2): a person described in paragraph 7(6)(a) of the Quality of Care Principles 2014 may be provided with care and services specified in Part 1, 2 or 3 of Schedule 1 of the Quality of Care Principles 2014.

 Note (3): the Notes for Allied Health Providers and the Fee Schedules can be found at: https://www.dva.gov.au/providers/notes-fee-schedules-and-guidelines.

[3] Paragraph 7.5.3

Omit “Prior approval is required”, substitute “Subject to paragraph 7.1C.1, prior approval is required”.

[4] After, paragraph 7.5.3, insert:

Note: paragraph 7.1C.1 provides that for the period from 10 December 2020 to 30 June 2022 Commission will accept financial responsibility for certain services listed in paragraph 7.1.2 (including physiotherapy) without the requirement for prior approval for an entitled person receiving residential care if the person is described in paragraph 7(6)(a) of the Quality of Care Principles 2014.

[5] Paragraph 7.6.2

Omit “Prior approval is required”, substitute “Subject to paragraph 7.1C.1, prior approval is required”.

[6] After, paragraph 7.6.2, insert:

Note: paragraph 7.1C.1 provides that for the period from 10 December 2020 to 30 June 2022 Commission will accept financial responsibility for certain services listed in paragraph 7.1.2 (including podiatry) without the requirement for prior approval for an entitled person receiving residential care if the person is described in paragraph 7(6)(a) of the Quality of Care Principles 2014.

[7] Paragraph 7.6A.2

Omit “Prior approval is required”, substitute “Subject to paragraph 7.1C.1, prior approval is required”.

[8] After, paragraph 7.6A.2, insert:

Note: paragraph 7.1C.1 provides that for the period from 10 December 2020 to 30 June 2022 Commission will accept financial responsibility for certain services listed in paragraph 7.1.2 (including diabetes educator services) without the requirement for prior approval for an entitled person receiving residential care if the person is described in paragraph 7(6)(a) of the Quality of Care Principles 2014.