MRCA Treatment Principles (Transition Care Co-Payment for Former Prisoners of War and Victoria Cross for Australia Recipients) Determination 2011 (Cth)

Australian Government

Military Rehabilitation and Compensation Act 2004

MRCA Treatment Principles (Transition Care Co-Payment for Former Prisoners of War and Victoria Cross for Australia Recipients) Determination 2011

Instrument No.M8/2011

I, Warren Snowdon, Minister for Veterans’ Affairs, pursuant to subsection 286(3) of the Military Rehabilitation and Compensation Act 2004, approve this determination made by the Military Rehabilitation and Compensation Commission.

Dated this       3rd       day of              March  2011

…Warren Snowdon………………………………………………….

WARREN SNOWDON

The Military Rehabilitation and Compensation Commission, pursuant to subsection 286(2) of the Military Rehabilitation and Compensation Act 2004, varies the MRCA Treatment Principles (Instrument No.M21 of 2004) in accordance with the Schedule.

Dated this       21st     day of  February   2011

The Seal of the   )
Military Rehabilitation   )

and Compensation Commission                   )                   SEAL

was affixed hereto in the   )

presence of:   )
Ian Campbell                          Major General Mark Kelly AO DSC

………………………………………………………………………………………....

IAN CAMPBELL                 MAJOR GENERAL MARK KELLY AO DSC

CHAIR     MEMBER

[1]     Name of Instrument

This instrument is the MRCA Treatment Principles (Transition Care Co-Payment for Former Prisoners of War and Victoria Cross for Australia Recipients) Determination 2011

[2]  Commencement

This instrument commences on the day after the day it is registered on the Federal Register of Legislative Instruments.

Schedule

1.      Paragraph 1.4.1

insert:

“approved provider”, in relation to transition care, has the meaning it has in the Aged Care Act 1997.

Note: the Aged Care Act 1997 can be found on COMLAW: care” has the meaning it has in section 49‑3 of the Aged Care Act 1997.

“prisoner of war” means an entitled member who was captured by the enemy (including a terrorist) while rendering defence service.

Note: defence service is defined in 6(1)(d) of the Act.

“transition care” has the meaning it has in section 15.28 of the Flexible Care Subsidy Principles 1997.

Note: the Flexible Care Subsidy Principles 1997 can be found on COMLAW: Heading to PART 10

substitute:

PART 10 – RESIDENTIAL CARE, CARE AT HOME PACKAGES AND TRANSITION CARE CO-PAYMENT

3.      Part 10 Part D

after this Part, insert:

Part E – TRANSITION CARE CO-PAYMENT

10.12           Financial Responsibility for Co-Payment

10.12.1       Subject to 10.12.2 the Commission may accept financial responsibility for transition care (care) provided by an approved provider to:

(a)     an entitled member who is former prisoner of war (POW); or

(b)     an entitled member awarded the Victoria Cross for Australia (VC recipient);

on condition that the care is provided on a day in respect of which flexible care subsidy is payable for the care under the Flexible Care Subsidy Principles 1997.

Note: as at December 2010 the maximum number of days for which flexible care subsidy was payable for transition care was 126 days.

10.12.2For 10.12.1, financial responsibility is limited to responsibility for the amount (co-payment) the POW or VC recipient paid, or is to pay, to an approved provider — to the extent:

(a) the co-payment does not exceed the amount the approved provider is permitted to charge the POW or VC recipient under section 56-3 of the Aged Care Act 1997; and

(b)     the co-payment does not exceed the amount the approved provider is permitted to charge the POW or VC recipient under any agreement between the Secretary of the Department that administers the Aged Care Act 1997 and the approved provider pursuant to section 15.33 of the Flexible Care Subsidy Principles 1997.

10.12.3In deciding whether to accept financial responsibility for transition care (care) provided to a POW or VC recipient the Commission should take into account:

(a)     whether the care was provided in accordance with the relevant provisions of the Aged Care Act 1997 and the relevant instruments thereunder;

Note 1: Part 3.3 of Chapter 3 of the Aged Care Act 1997 deals with transition care (flexible care)

Note 2:The Approval of Care Recipients Principles 1997, the Flexible Care Subsidy Principles 1997 and the User Rights Principles 1997 are relevant to transition care (flexible care).

(b)     whether the care complies with:

(i)      any agreement between the approved provider of the care and the Secretary of the Department that administers the Aged Care Act 1997 — under the Aged Care Act 1997 and under 15.33 of the Flexible Care      Subsidy Principles 1997; and

(c)      whether, if there is an agreement mentioned in (b)(i) and the agreement (Provider/Secretary Agreement) sets out requirements for agreements (client agreement) between an approved provider and a recipient of flexible care or flexible care that is transition care:

(i)      the client agreement satisfies any requirements in respect of it in the Provider/Secretary Agreement; and

(ii)     the provision of care complies with the client agreement.

(d)     whether the care essentially duplicates treatment the POW or VC recipient is receiving under other provisions of the Principles (double-dipping).

10.13          Billing

10.13.1An approved provider should bill Medicare Australia for the co-payment for transition care, rather than the POW or VC recipient (client) but if the client is billed, the Commission may, subject to 10.12.2 and 10.12.3, accept financial responsibility for the amount.