Untitled document
MRCA Treatment Principles
Instrument 2013 No. MRCC53
made under subsection 286(2) of the
Military Rehabilitation and Compensation Act 2004
Compilation No. 19
Compilation date: 1 October 2019
Includes amendments up to: F2019L01171
Registered: 23 December 2019
About this compilation
This compilation
This is a compilation of the MRCA Treatment Principles that shows the text of the law as amended and in force on 1 October 2019 (the compilation date).
The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.
Uncommenced amendments
The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register ( The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.
Application, saving and transitional provisions for provisions and amendments
If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.
Editorial changes
For more information about any editorial changes made in this compilation, see the endnotes.
Modifications
If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.
Self‑repealing provisions
If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.
Table of provisions
PART 1 — INTRODUCTION 1
1.2Application of MRCA Private Patient Principles 2
1.3Delegation 2
1.4Interpretation 2
PART 2 — ENTITLEMENT TO TREATMENT 37
2.1Treatment for entitled persons in Australia 37
2.2Treatment for entitled persons residing or travelling overseas 37
2.3Treatment of associated non‑service injury or disease injuries or diseases 39
2.6Referrals by the Veterans and Veterans Families Counselling Service 39
2.8Loss of eligibility for treatment 40
PART 3 — COMMISSION APPROVAL FOR TREATMENT 41
3.1Approval for treatment 41
3.2Circumstances in which prior approval is required 41
3.3Circumstances in which prior approval is not required 43
3.4Other retrospective approval 45
3.5Financial responsibility 47
PART 4 — MEDICAL PRACTITIONER SERVICES 54
4.2Providers of services 55
4.3Financial responsibility 56
4.4Referrals 58
4.5Referrals by medical specialists 58
4.7Referrals: prior approval 58
4.8Other matters 59
PART 5 — DENTAL TREATMENT 60
5.1Providers of services 60
5.2Financial responsibility 61
5.3Entitlement 62
5.4Emergency dental treatment 63
5.5Orthodontic treatment for children 64
5.6General anaesthesia 64
5.7Prescribing of pharmaceutical benefits by dentists 64
5.8Other dental services 65
PART 6 — PHARMACEUTICAL BENEFITS 65
6.1MRCA Pharmaceutical Benefits Scheme 65
6.2Entitlement under the MRCA Pharmaceutical Benefits Scheme 66
PART 6A — COORDINATED VETERANS' CARE PROGRAM 66
PART 7 — TREATMENT GENERALLY FROM OTHER HEALTH PROVIDERS 80
7.1Prior approval and financial responsibility for health services 80
7.2Registration or enrolment of providers 83
7.3Community nursing 84
7.3A MRCA Home Care Program 85
7.4Optometrical services 94
7.5Physiotherapy 95
7.6Podiatry 95
7.7Chiropractic and osteopathic services 97
7.8Other services 99
PART 9 — TREATMENT OF ENTITLED PERSONS AT HOSPITALS AND INSTITUTIONS 99
9.1Admission to a hospital or institution 99
9.2Financial Responsibility For Treatment In Hospital 101
9.3Nursing‑home‑type care 102
9.5Convalescent care 103
9.6Other matters 103
PART 10 — RESIDENTIAL CARE, HOME CARE AND TRANSITION CARE CO‑PAYMENT 104
10.1Residential care arrangements 104
10.2Payment of daily care fee for certain entitled members with dependants 105
PART 11 — THE PROVISION OF REHABILITATION APPLIANCES 115
11.1Rehabilitation Appliances Program 115
11.2Supply of rehabilitation appliances 117
11.3Restrictions on the supply of certain items 117
11.4Visual aids 124
11.5Hearing aids 126
11.6Other rehabilitation appliances 126
11.7Repair and replacement 127
11.8Treatment aids from hospitals 128
PART 12 — OTHER TREATMENT MATTERS 130
12.1Ambulance transport 130
12.2 Treatment under Medicare Program 130
12.4Prejudicial or unsafe acts or omissions by patients 131
12.6Recovery of moneys 131
Transitional Provisions 132
SCHEDULE 1 DATES FOR INCORPORATED DOCUMENTS 133
Endnotes136
Endnote 1—About the endnotes 136
Endnote 2—Abbreviation key 137
Endnote 3—Legislation history 138
Endnote 4—Amendment history 141
Endnote 5—Editorial changes 147
Australian Government
MILITARY REHABILITATION AND COMPENSATION COMMISSION
Military Rehabilitation and Compensation Act 2004
Section 286
MRCA Treatment Principles
Instrument 2013 No. MRCC 53
PART 1 — INTRODUCTION
1.1.1 This Instrument is known as the MRCA Treatment Principles and is prepared by the Military Rehabilitation and Compensation Commission (Commission) under section 286 of the Act.
1.1.2 The MRCA Treatment Principles set out the places at which, the circumstances in which, and the conditions subject to which, a particular kind or class of treatment may be provided for entitled persons under Part 3 of Chapter 6 of the Act and are to be read subject to the Act. The MRCA Treatment Principles also set out:
(a) the places at which, the circumstances in which, and the conditions subject to which, a particular kind or class of treatment may be provided under Part 3 of Chapter 6 of the Act;
(b) the kinds or classes of treatment that will not be provided under Part 3 of Chapter 6 of the Act;
(c) the places at which, the circumstances in which, and the conditions subject to which, treatment will not be provided under Part 3 of Chapter 6 of the Act;
(d) whether the Commission’s prior approval of a particular kind or class of treatment is required under Part 3 of Chapter 6 of the Act;
(e) if the Commission’s prior approval is required:
(i) the circumstances in which the Commission may exercise its power to give prior approval; and
(ii) the circumstances in which the Commission may exercise its power to give approval if the treatment was obtained without prior approval.
1.1.3 The MRCA Treatment Principles state the policies under which the Commission may accept financial responsibility for the cost of treatment for persons entitled to treatment under the Act.
Note: Consistent with the Act, treatment extends beyond medical treatment and encompasses social and domestic assistance.
1.2 Application of MRCA Private Patient Principles
1.2.1 The MRCA Private Patient Principles (the MPPPs), determined by the Commission under paragraph 286(1)(b) of the Act, apply in all States and Territories
1.2.2 A provision of the MRCA Treatment Principles does not apply if it is inconsistent with the MPPPs.
1.2.3 Nothing in these Principles is to be taken to require prior approval for admission at a public hospital in a State or Territory.
1.3 Delegation
1.3.1 The Commission may delegate all or any of its powers under the Principles (except this power of delegation) in the same manner, and subject to the same conditions, that it may delegate all or any of its powers under the Act.
Note: section 384 of the Actsets out the circumstances in which the Commission may delegate its powers.
1.4 Interpretation
1.4.1 In these Principles, unless a contrary intention appears:
“ABN (Australian Business Number)” has the meaning given by the A New Tax System (Australian Business Number) Act 1999.
“aboriginal health worker” means a person who is qualified as an aboriginal health worker after undertaking a course in Aboriginal and Torres Strait Islander Health, provided by an institution recognised by the Department of Prime Minister and Cabinet as suitable for providing a course of that nature, and who obtained a Certificate Level III (or higher) under the course.
“Aboriginal Health Worker Care Co‑ordination treatment” means treatment provided by an aboriginal health worker to an entitled person under the Coordinated Veterans' Care Program, comprised of:
(a) implementing the GPMP for the person under the Program — in particular co‑ordinating treatment services under the GPMP;
(b) liaising, in relation to the GPMP, with the general practitioner who manages the GPMP for the person;
(c) performing such other functions under the program that the aboriginal health worker has under the Notes for Coordinated Veterans' Care Program Providers.
“ACPMH treatment” means action taken with a view to maintaining an entitled member in mental health and includes:
(a) training members of the Defence Force or staff made available under section 382 of the Act, or both, in the mental health care disciplines that could benefit the mental health of an entitled member; and
(b) conducting research into mental injuries or diseases suffered by members of the Defence Force or into the mental state generally of such members with the resulting knowledge being applied to the benefit of the health of an entitled member; and
(c) improving communication on mental injury or disease health care matters between:
(i)members of the Defence Force who are staff‑managers; and
(ii)staff made available under section 382 of the Act; and
(iii)an entitled member; and
(d) conducting mental injury or disease health care policy research with the outcomes of that research being applied to the benefit of the health of an entitled member.
Note (1): under section 13 of the Acttreatment can be action taken with a view to maintaining a person in physical or mental health.
Note (2): the term “member” is defined in these Principles so as to include “former member“ and the term “Defence Force” is defined in s.5 of the Act.
“Act” means the Military Rehabilitation and Compensation Act 2004.
“admission date” means the date on which a general practitioner records in writing (including in electronic form) that the general practitioner has decided an entitled person may participate in the Coordinated Veterans' Care Program.
“admitting general practitioner”, in relation to an entitled person in the Coordinated Veterans' Care Program, means the general practitioner who decided an entitled person may participate in the Coordinated Veterans' Care Program.
“allied health provider” means a category of provider mentioned in the Table in 7.1A.1.
"approved provider" means a State, Territory or Local Government, or incorporated organisation, or person, that has entered into an arrangement with the Commission for the provision of:
(a)a Home Care service (category A); or
(b)a Home Care service (category B); or
(c)a Home Care service (category C); or
(d)a limited MHC‑type service;
to an entitled person, whether by the approved provider or a sub‑contractor engaged by it.
“approved provider”, in relation to short‑term restorative care, has the meaning it has in the Aged Care Act 1997.
“assistive communication device” means an object that enhances the ability of a person with complex communication needs to communicate and includes items such as:
·communication books or boards
·speech generating devices
·modified personal computers
·computerised devices, which may include a keyboard and screen display and which may incorporate synthetic speech, memory functions, and word prediction facilities
·devices commonly known as computer tablets and smart `phones.
“Australian Government’s Better Access initiative” means the mental health initiative described in the document entitled “Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (Better Access) initiative” referred to in Schedule 1.
“Australian Centre for Posttraumatic Mental Health” and “ACPMH” mean the Australian Centre for Posttraumatic Mental Health Incorporated.
“authorised nurse practitioner” has the meaning it has in subsection 84(1) of the National Health Act 1953.
“acute care certificate” means a certificate given by a medical practitioner in similar form to the acute care certificate provided for in section 3B of the Health Insurance Act 1973 to the extent that the provisions of that section are applicable.
“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: means a person who provides ongoing care, attention and support for a severely incapacitated or frail person to enable that person to continue to reside in his or her home, and is not limited to a person who is receiving a carer service pension.
“Chief Executive Medicare” has the meaning it has in the Human Services (Medicare) Act 1973.
“Classification Principles 2014” means the legislative instrument of that name made under section 96‑1 of the Aged Care Act 1997.
“clinical psychologist” means a psychologist:
(a) who has been given a provider number in respect of being a psychologist; and
(b) who, in the opinion of an employee of, or consultant to, the Department or the Department of Human Services, has appropriate qualifications in clinical psychology and practises as a clinical psychologist.
“Commission” means the Military Rehabilitation and Compensation Commission.
"Commission‑funded treatment" means treatment for which the Commission may accept financial responsibility.
Note: although the Commission may accept financial responsibility for treatment, actual payment for that treatment is made by the Commonwealth. See paragraph 423(c) of the Act.
“Commonwealth Home Support Programme service” means a service provided to a person under the programme administered by the Department of Social Services called the “Commonwealth Home Support Programme” and includes any service provided under that programme as the name of the programme may change from time to time.
“community nurse” means a registered nurse or enrolled nurse who works in a community nursing setting and who is employed or engaged by a community nursing provider.
“Community Nurse Care Co‑ordination treatment” means
treatment provided by a community nurse to an entitled person under the Coordinated Veterans' Care Program, comprised of:
(a) implementing the GPMP for the person under the Program — in particular co‑ordinating treatment services under the GPMP; and
(b) liaising, in relation to the GPMP, with the general practitioner who manages the GPMP for the person.
“community nursing provider” means a community nursing provider who has entered into an agreement with the Commission to provide community nursing services to entitled persons.
"community nursing services" means the community nursing services provided to an entitled person, in respect of which the Commission will accept financial responsibility for under Part 7 of the Principles.
“Contracted Day Procedure Centre” means premises:
(a) at which any patient is admitted and discharged on the same day for medical, surgical or other treatment; and
(b) operated by a person contracted to the Commission, the Repatriation Commission or the Department in respect of treatment provided at the premises to entitled persons;
but does not include any of the following premises:
(c) premises conducted by or on behalf of the State;
(d) a public hospital or health service under the control of a public health organisation;
(e) a private hospital;
(f) a nursing home;
(g) a residential rehabilitation establishment.
“contracted private hospital” means a private hospital with which the Commission has entered into arrangements for the care and welfare of entitled persons.
“convalescent care” means a period of medically prescribed convalescence for an entitled person who is recovering from an acute illness or an operation.
“Coordinated Veterans’ Care Program” means the treatment program of that name set out in Part 6A of these Principles and in the Notes for Coordinated Veterans' Care Program Providers that aims to reduce the need for hospitalisation among Gold Card members of the veteran and defence force community and improve their social well-being. In particular the program has the following main features:
·assessment – a general practitioner (GP) will assess a person with complex care needs due to chronic disease to see if the person would benefit from the clinical care services under the program and ascertain if the person meets the program’s eligibility criteria;
·consent – a person needs to consent to participation in the program and the GP needs to record that consent. As treatment is being provided it is the GP’s responsibility to ensure a potential participant in the program understands the nature of the program and that the person’s personal details that are relevant to the person’s treatment under the program may be provided to bodies and individuals such as the Department, the Department of Human Services and health care providers, who have a need for the information in connection with the person’s treatment under the program;
·care plan – the GP will prepare a comprehensive care plan (GPMP) for a person the GP admits to the program;
·consultation – the person will be consulted in the preparation of the care plan and its review;
·implementation and co-ordination – the GP’s practice nurse (or a community nurse via a DVA-contracted community nursing provider, or an aboriginal health worker, if more appropriate) will implement the care plan and, in particular, co-ordinate services under the plan.
“Coordinated Veterans' Care Program treatment” means:
(a) GP Care Leadership treatment; or
(b) Practice Nurse Care Co‑ordination treatment; or
(c) Community Nurse Care Co‑ordination treatment; or
(d) Aboriginal Health Worker Care Co‑ordination treatment.
"co payment", in relation to the MRCA Home Care Program, means an amount of money an approved provider or a sub‑contractor is permitted to charge an entitled person, pursuant to an arrangement between the approved provider and the Commission, in respect of a Home Care service (category A).
“country area” means that part of the State outside the metropolitan area of the capital city of that State, determined by the Repatriation Commission to be a country area under paragraph 80(2)(b) of the Veterans' Entitlements Act 1986.
“daily care fee” means:
(a) in relation to an entitled person in a hospital — an amount determined under the Health Insurance Act 1973 to be the resident contribution applicable under that Act to a nursing‑home‑type patient of that hospital; or
(b) in relation to an entitled person (including a former prisoner of war or a person awarded the Victoria Cross for Australia) who is receiving, or received, residential care — the maximum daily amount of resident fees worked out under section 52C‑3 of the Aged Care Act 1997.
“Day Procedure Centre” means premises that would be Contracted Day Procedure Centre premises if the operator of the premises was contracted to the Commission, the Repatriation Commission or the Department.
“DVA document” means a document prepared in the Department and available on the Internet at:
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.
“dental prosthetist” means a person, however described, authorised under a law of a State or a Territory, to carry out the work of dental prosthetics without a written work order from a dentist or other person who may lawfully give a written work order for that purpose.
“dental specialist” means a qualified dental practitioner who:
(a) is registered with a Dental Board of the State or Territory in which he or she practises; and
(b) has obtained an appropriate higher qualification; and
(c) has been recognised as a specialist in the particular field by:
(i) a Dental Board of the State or Territory in which he or she practises, where the Dental Board of the State or Territory has available a mechanism for such recognition; or
(ii) another appropriate body mutually agreed in advance with the Australian Dental Association Incorporated.
“dentist”means a person registered or licensed as a dentist under a law of a State or Territory that provides for the registration or licensing of dentists but does not include a person so registered or licensed:
(a) whose registration, or licence to practise, as a dentist in any State or Territory 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 register or practise as a dentist in that State or Territory.
“enrolled nurse” means a person who is registered under a law of a State or Territory or of the Commonwealth to practise as an enrolled nurse.
“Department” means the Commonwealth as represented by the Department of Veterans’ Affairs.
“Department of Health” means the Commonwealth Department of State, however named, that from time to time is responsible for the administration of the National Health Act 1953.
“Department of Human Services” means the Department administered by the Minister administering the Human Services (Medicare) Act 1973.
“Department of Prime Minister and Cabinet” means the Commonwealth Department of State responsible for Commonwealth Aboriginal and Torres Strait Islander policy, programmes and service delivery.
“Department of Social Services” means the Commonwealth Department of State, however named, that from time to time is responsible for the administration of the Aged Care Act 1997.
"dependent eligible young person" has the same meaning as "dependent child" in the Social Security Act 1991.
“diabetes educator” means a person who:
(a) is credentialled as a diabetes educator by the Australian Diabetes Educators Association (ADEA); and
(b) is a member of, or eligible for membership of, the ADEA.
“diabetes educator services” means a program of education about diabetes with an emphasis on self‑care, provided by a diabetes educator to a person with diabetes.
"Domestic Assistance" means the service under the MRCA Home Care Program consisting of:
(a)assistance with domestic chores, including assistance with cleaning, dishwashing, clothes washing and ironing, shopping and bill paying; and
(b)help with meal preparation where this is not the primary focus of the occasion of the service; and
(c) in remote areas, activities such as collecting firewood.
“elective surgery” means any non‑urgent surgical procedure performed for diagnostic or therapeutic purposes.
"eligible young person" has the meaning it has in section 5 of the Act.
“emergency” means a situation where a person requires immediate treatment in circumstances where there is serious threat to the person’s life or health.
"emergency short term home relief" means care provided to an entitled person in his or her home on the following conditions:
(a) the person or the person's carer is unable to provide care due to sudden and unforeseen circumstances; and
(b) the period for which the care is provided does not exceed 72 hours (episode) per emergency except that, if the entitled person requires further care within 24 hours after the end of the previous episode in an emergency, and obtains prior approval, a further episode of care (up to 72 hours) may be provided in that emergency; and
(c) the cumulative period of the care provided to the entitled person did not exceed 216 hours in a Financial year.
Note: emergency short term home relief is not relevant to the calculation of the daily care fee for residential care or residential care (respite).
“entitled member" means a member or former member as defined in section 5 of the Actwho is or was entitled to treatment under Part 3 of Chapter 6 of the Act and means a person with a SRCA disability.
“entitled person” means a person who is entitled to treatment under Part 3 of Chapter 6 of the Act.
Note: this includes a person with a SRCA disability.
“wholly dependent partner” or “wholly dependent partnerer” means a wholly dependent partner as defined in section 5 of the Act.
"episode of care" means services provided to a patient by a health provider that:
(a) have been detailed in a patient care plan;
(b) are characterised by continuity of treatment or provision of service;
and an episode of care arises:
(c) every time a service provider sees a new patient; or
(d) where a service provider has not seen a patient for some time and therefore no continuity of service can be provided, and the original patient care plan is no longer applicable or appropriate.
“exceptional case process” means the process whereby the Commission may accept financial liability for community nursing services provided to an entitled person who, due to dependency or complex needs, requires community nursing services which, in the opinion of the Commission, fall significantly outside those referred to in any arrangement between the Commission and a DVA‑contracted community nursing provider.
Note: paragraph 3.5.1 (after paragraph (f)) enables the Commission, in exceptional circumstances to, among other things, accept financial liability for fees higher than those set out in an arrangement.
“excluded service” means:
(a) a HACC Review Agreement (National Partnership) service; or
(b) a Commonwealth Home Support Programme service;
that is the same type of service that may be provided under the MRCA Home Care Program as a Home Care service (category A) or Home Care service (category C).
Note : the intention is that a Home Care service (category A), Home Care service (category B) and Home Care service (category C) are mutually exclusive.
"exempt amount” means an amount of money not payable by an entitled person in respect of any Home Care service (category A) or Home Care service (category C) provided to the entitled person by an approved provider, because the entitled person is an exempt entitled person.
"exempt entitled person" means, in relation to the provision of any Home Care service (category A) or Home Care service (category C) to an entitled person, an entitled person who:
(a) has a dependent eligible young person; or
Note: under the Acts Interpretation Act 1901 the singular includes the plural meaning a person can have more than one dependent eligible young person.
(b) is a person who, in the opinion of the Commission, is experiencing severe financial hardship or who could experience severe financial hardship if the person was to make a payment in respect of the service; or
(c) is in receipt of an income support payment at the maximum rate and does not earn, derive or receive ordinary income exceeding $40 per fortnight.
Note: the Commission may allow exemption from payment for a period or until the occurrence of an event.
“Fee Schedule” means a DVA document approved by the Repatriation Commission, the Commission, or a member of the Repatriation Commission or of the Commission, or by the Secretary to the Department, with the words “Fees” and ‘Schedule”, in relation to a category of health care provider, in the title to the document, that sets out the terms on which, and the conditions subject to which, the Commission will accept financial responsibility for treatment provided to an entitled person by the health care provider the subject of the document.
Note: the DVA documents called Fee Schedules set out amounts the Department will pay for health care services and can designate whether a service required the prior approval of the Commission before it could be provided.
“flexible care” has the meaning it has in section 49‑3 of the Aged Care Act 1997.
“general practitioner” has the same meaning as “general practitioner” has in the Health Insurance Act 1973.
“Gold Card” means the identification card (also known as the Veteran Card) provided by the Department to a person who is entitled under the Act to treatment, subject to these Principles, for all injuries or diseases.
“GP Care Leadership treatment” means treatment provided by a general practitioner to an entitled person, under the Coordinated Veterans' Care Program, comprised of the following:
(a) preparing and managing the GPMP for the person under the Program;
(b) overseeing a practice nurse in the implementation of the GPMP — where a practice nurse and not a community nurse or aboriginal health worker or the general practitioner co-ordinates treatment under the GPMP (Practice Nurse Care Co-ordination treatment);
(c) referring the person to a DVA-contracted community nursing provider for Community Nurse Care Co-ordination treatment or to an aboriginal health worker for Aboriginal Health Worker Care Co-ordination treatment, if appropriate;
(d) performing such other functions under the program that the general practitioner has under the Notes for Coordinated Veterans' Care Program Providers.
“GP Home Care service (category C) Referral” means treatment comprised of a general practitioner preparing a written document that refers an entitled person, who the general practitioner has admitted to and is treating under the Coordinated Veterans' Care Program, to a VHC assessment agency for assessment for a Home Care service (category C) under the Veterans’ Home Care Program and which:
(a) is in the form, if any, approved by the Commission; and
(b) is sent to the MHC assessment agency, including as a facsimile message.
“GPMP” means the care plan prepared by a general practitioner, in accordance with the Notes for Coordinated Veterans' Care Program Providers, for an entitled person participating in the Coordinated Veterans' Care Program.
Note: “GPMP” is used in the Department of Veterans’ Affairs Fee Schedules for Medical Services (see: paragraph 3.5.1).
“HACC Review Agreement (National Partnership) service” means a service of home or community care that could be, or could have been, provided to a person under an agreement between the Commonwealth and a State or the Northern Territory — being an agreement made under the Home and Community Care Act 1985 but deemed to be a National Partnership Agreement in the context of the Intergovernmental Agreement on Federal Financial Relations of 2008, made under the Federal Financial Relations Act 2009.
“health care provider” means a person who provides treatment to an entitled person in accordance with these Principles.
“high level of residential care (respite)”, in relation to a person, means that under the Classification Principles 2014 the classification level for the person as a care recipient being provided with residential care as respite care is “high level residential respite care”.
Note: see section 7 and section 11(2) of the Classification Principles 2014 and paragraph 7(6)(b) of the Quality of Care Principles 2014.
“home” includes:
(a) the premises, or part of the premises, where the person normally resides; or
(b) a share house where the person normally resides;
but does not include:
(c) a hospital; or
(d)the premises where the person is receiving residential care.
Note: ‘residential care’ is also defined in paragraph 1.4.1.”.
“Home and Community Care Program service” means a service provided to a person under the auspices of the Home and Community Care Act 1985 when that Act was in force.
Note: in 2015 there was a proposal to repeal the Home and Community Care Act 1985 by the Omnibus Repeal Day (Spring 2014) Act 2014.
"Home and Garden Maintenance" means the service, under the MRCA Home Care Program, of maintaining the home, garden or yard of an entitled person, and includes:
(a)assistance with minor maintenance and minor repair of the home (e.g changing light bulbs, minor carpentry, minor painting, replacing tap washers, but not the supply of replacement items), garden or yard to keep the home, garden or yard safe and habitable;
(b) lawn mowing;
but does not mean:
(c) tree felling or tree removing or other major tasks related to a garden or yard;
(d) provision of materials.
Note: recipients of MRCA Home Care services will be expected to supply materials used in home maintenance, eg replacement light bulbs and tap washers. Service providers will be required to provide any equipment needed, eg garden tools.
“home care” has the meaning given by section 45‑3 of the Aged Care Act 1997.
"Home Care service (category A) " means the provision of Domestic Assistance, Personal Care, Home and Garden Maintenance or Respite Care to an entitled person pursuant to the MRCA Home Care Program.
“Home Care service (category B)” means:
(a) for an entitled person in Victoria or Western Australia at a time when the Commonwealth Home Support Programme service in Victoria or Western Australia, as the case may be, does not include a service that would satisfy the description of a HACC Review Agreement (National Partnership) service — the provision of treatment to the person pursuant to the MRCA Home Care Program that would satisfy the description of:
(i) a HACC Review Agreement (National Partnership) service ; or
(ii) a Commonwealth Home Support Programme service other than such a service that would satisfy the description of a HACC Review Agreement (National Partnership) service; or
(ii) both services in (i) and (ii);
but does not mean the provision of treatment pursuant to the MRCA Home Care Program that would satisfy the description of an excluded service; or
(b) for an entitled person in a State or Territory at a time when the Commonwealth Home Support Programme service in the State or Territory in which the person is in includes a service that would satisfy the description of a HACC Review Agreement (National Partnership) service — the provision of treatment to the person pursuant to the MRCA Home Care Program that would satisfy the description of a Commonwealth Home Support Programme service but does not mean the provision of treatment pursuant to the MRCA Home Care Program that would satisfy the description of an excluded service.
Note 1: as at 1 July 2015 some services under the Commonwealth Home Support Programme (CHSP) (generally speaking CHSP services are a Home Care service (category B)) were not provided in Victoria or Western Australia. The services in question are known as “HACC services”. HACC services are home or community care services that were originally provided under agreements under the Home and Community Care Act 1985 (the HACC Act) except in Victoria and Western Australia where similar services were provided under Bilateral Agreements with the Commonwealth Government. At or about 2008/2009 HACC services in States/Territories (except Victoria/Western Australia) were provided under agreements known as “National Partnership Agreements”. The National Partnership Agreements were made under the auspices of the Intergovernmental Agreement on Federal Financial Relations of 2008 and the Federal Financial Relations Act 2009. In short, the original agreements under the HACC Act were deemed to be National Partnership Agreements and the HACC Act was rendered obsolete. On 1 July 2015, in all States/Territories except Victoria/Western Australia, HACC services ceased being provided under National Partnership Agreements and were provided under CHSP. However as at 1 July 2015 HACC‑type services in Victoria/Western Australia continued to be provided under the Bilateral Agreements between those States and the Commonwealth.
Note 2: the intention of paragraph (a) of this definition is to enable the Department of Veterans’ Affairs (DVA) to pay for HACC services for an entitled person in Victoria and Western Australia in addition to paying for services for the person under the Commonwealth Home Support Programme service until the Commonwealth Home Support Programme applies fully in those States and includes the HACC services. The intention in paragraph (b) of this definition is that where the Commonwealth Home Support Programme operates fully in Australia i.e. includes HACC services, DVA will only pay, under this definition, for services under the Commonwealth Home Support Programme. There is to be no potential for double‑dipping.
“Home Care service (category C)” means the provision by an approved provider of a service to an entitled person under the MRCA Home Care Program that is:
(a) pursuant to a GP Home Care service (category C) Referral and allocated to the provider by a MHC assessment agency; and
(b) aimed at reducing the person’s social isolation by improving their social networks; and
(c) provided to an entitled person by an approved provider.
"income support payment" has the same meaning it has in the Social Security Act 1991, save that it includes an income support supplement under the VEA;
Note: As at 1 January 2001 income support payments were:(a) a social security benefit; (b) a job search allowance; (c) a social security pension; (d) a youth training allowance; (e) a service pension.
“in‑home respite” means care provided to a person in his or her own home for a maximum of 196 hours in a Financial year to provide rest or relief from the role of caring:
(a) to the person; or
(b) to the person’s carer;
Note: in‑home respite is not relevant to the calculation of the daily care fee for residential care or residential care (respite).
“inpatient” means a person formally admitted for treatment by a hospital.
“institution”, in Part 11, includes:
(a) a retirement village;
(b) a cluster of self‑care units.
“MBS” and “Medicare Benefits Schedule” mean, in the context of amounts payable for treatment under the Principles, a Fee Schedule, and in any other context means:
(a) Schedule 1 to the Health Insurance Act 1973 as substituted by regulations made under subsection 4(2) of that Act; and
(b) Schedule 1A to the Health Insurance Act 1973 as substituted by regulations made under subsection 4(2) of that Act; and
(c) the table of diagnostic imaging services prescribed under subsection 4AA(1) of that Act as in force from time to time.
Note: an example of where “Medicare Benefits Schedule” is used in a non‑payment context is paragraph 4.2.1.
“medical practitioner” has the same meaning as “medical practitioner” has in the Health Insurance Act 1973.
“medical specialist” means a medical practitioner who is recognised as a consultant physician or as a specialist, in the appropriate specialty, for the purposes of the Health Insurance Act 1973.
“medicare benefit” has the meaning it has in the Health Insurance Act 1973.
“medicare program” has the meaning it has in the Human Services (Medicare) Act 1973.
"member" has the meaning it has in the Act save that it includes former member and a person with a SRCA disability.
"Memorandum of Understanding of 1995" means the Memorandum of Understanding between the Commonwealth of Australia as represented by the Department of Veterans' Affairs, the Repatriation Commission and the Australian Medical Association Ltd, relating to the provision of medical services by Local Medical Officers to entitled persons, dated 10 December 1995.
“MHC assessment agency” means a person to whom the Commission has delegated its power to:
(a) assess whether a person needs:
(i) a Home Care service (category A); or
(ii) a Home Care service (category B); or
(iii) a Home Care service (category C;
under the MRCA Home Care Program; and
(b) allocate a service in (a) to an approved provider.
“minor procedure” means a surgical procedure that:
(a) does not involve hospitalisation or theatre fees; and
(b) is of a type that is undertaken routinely in doctors’ and specialists’ rooms; and
(c) does not require general anaesthesia; and
(d) is not undertaken in a private day facility centre.
“MPPPs” means the MRCA Private Patient Principles determined by the Commission under paragraph 286(1(b) of the Act.
“MRCA Access Payment” means the amount set out in the DVA document entitled “Department of Veterans’ Affairs Fee Schedules for Medical Services” referred to in Schedule 1 and called the “MRCA Access Payment” — being an additional amount payable by the Department to a general practitioner for a medical service provided by the general practitioner to an entitled person in accordance with these Principles and the Notes for General Practitioners.
Note: a MRCA Access Payment is an amount additional to any amount otherwise payable by the Department to a general practitioner for a medical service provided by the general practitioner to an entitled person in accordance with these Principles and the Notes for General Practitioners .
"MRCA Home Care Program" means:
(a) the treatment program under which the Commission ensures the provision of care and assistance services to entitled persons who are frail, or who have disabilities, with the aim of maintaining the independence of those people, allowing them to remain in their own home for as long as possible, and reducing avoidable illness and injury, and is comprised of section 7 of the Veterans’ Affairs (Extended Eligibility for Treatment) Instrument 2015, paragraphs 7.3A to 7.3A.22 (inclusive) of the Principles, and other relevant paragraphs in the Principles, and the arrangements under section 285 of the Actin support thereof.
(b)the treatment program under which the Commission ensures the provision of social support services to entitled persons referred to the program under a GP Home Care service (category C) Referral.
"MRCA Pharmaceutical Benefits Scheme" means the scheme determined by the Commission under paragraph 286(1)(c) of the Act.
"MRCA Private Patient Principles" means the principles in the determination made by the Commission under paragraph 286(1)(b) of the Act.
“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:
means a person who:
(a) specialises in the assessment, diagnosis and treatment of psychological disorders associated with conditions affecting the brain such as difficulties with memory, learning, attention, language, reading, problem‑solving, decision‑making or other aspects of behaviour and thinking abilities; and
(b) in the opinion of an employee of, or consultant to, the Department or the Department of Human Services, has appropriate qualifications in clinical neuropsychology and practises as a neuropsychologist.
“Notes for Allied Health Providers” means the document approved by the Secretary to the Department entitled “Notes for Allied Health Providers”, and referred to in Schedule 1, that sets out the terms on which, and the conditions subject to which, an allied health provider is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.
“Notes for Coordinated Veterans' Care Program Providers” means the document approved by the Commission, the Repatriation Commission, or a member of the Commission or Repatriation Commission, or by the Secretary to the Department, entitled “Notes for Coordinated Veterans' Care Program”, and referred to in Schedule 1, that sets out the terms on which:
(a) a general practitioner;
(b) a practice nurse;
(c) a community nurse (via a DVA‑contracted community nursing provider); and
(d) an aboriginal health worker;
is to provide treatment to an entitled person under the Coordinated Veterans' Care Program in order for the Commission to accept financial responsibility for that treatment.
“Notes for General Practitioners” means the document that:
(a) is approved by the Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for General Practitioners”; and
(b) is referred to in Schedule 1; and
(c) sets out the terms on which, and the conditions subject to which, a general practitioner is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment, except those parts of the document that deal with the formation of a contractual relationship between a general practitioner and the Commission or the Department.
“Notes for Providers” means a DVA document approved by the Secretary to the Department, or by the Repatriation Commission or the Commission, or a member of either Commission, with the word ‘Notes’ in its title, and referred to 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.
“optical dispenser”, in the case of an individual, means a person who:
(a) interprets optical prescriptions and fits and services optical appliances such as spectacle frames and lenses; and
(b) holds a qualification that, in the opinion of the Commission, is appropriate for the skills needed to practise optical dispensing; and
(c) is a member of a body established to supervise the occupation of optical dispenser; and
(d) holds a provider number as an optometrist, ophthalmologist, orthoptist or optical dispenser.
“optical dispenser”, in the case of a company, means a company that:
(a) holds an ABN (Australian Business Number);
(b) carries on a business of optical dispensing;
(c) employs or engages for the optical dispensing aspects of the business — an individual who is an optical dispenser.
“optical dispensing” means interpreting optical prescriptions and fitting and servicing optical appliances such as spectacle frames and lenses.
“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.
“occupational therapist” means an occupational therapist who has been given a provider number in respect of being an occupational therapist.
“occupational therapist (mental health)” means an occupational therapist:
(a) who has been given a provider number in respect of being an occupational therapist; and
(b) who, in the opinion of an employee of, or consultant to, the Department or the Department of Human Services, has appropriate qualifications in occupational therapy in the area of mental health and who practises as an occupational therapist in the area of mental health.
“Optical Coherence Tomography” means the treatment comprised of a non‑contact, non‑invasive high resolution imaging technique that provides cross‑sectional tomographic images of the ocular microstructure through the thickness of the retina.
"ordinary income" has the same meaning it has under the definition of "ordinary income" in the "Social Security Act 1991" including where terms in that meaning are further defined save that "ordinary income" does not include a payment of Income support supplement.
Note: Income support supplement is described in Part IIIA of the VEA.
“outpatient service” means a health service or procedure provided by a hospital but not involving admission to the hospital.
“outreach program counselling” means the treatment of that name established by paragraph 7.7A.1 of the Principles — comprised of mental health counselling under the Veterans and Veterans Families Counselling Service provided by an outreach program counsellor to an entitled person eligible for the treatment under the Principles.
“outreach program counsellor” means:
(a) a psychologist who:
(i) is registered as a psychologist with the Psychology Board of Australia; and
(ii) has been given a provider number and is eligible to provide psychological services under the Australian Government’s Better Access initiative; and
(iii) in the opinion of the Commission, has an adequate appreciation of veteran and military culture; or
(b) a social worker (mental health) who:
(i) is accredited as a Mental Health Social Worker with the Australian Association of Social Workers; and
(ii) has been given a provider number and is eligible to provide social work services under the Australian Government’s Better Access initiative; and
(iii) in the opinion of the Commission, has an adequate appreciation of veteran and military culture;
being a person who does not have a written contract (described as a Deed of Standing Offer) with the Commission or the Department in respect of the provision of a counselling service to an entitled person under the auspices of the Veterans and Veterans Families Counselling Service.
"patient care plan" means a document that is completed by a health provider who provides a service to a patient and that contains details of:
(a) the patient's medical history;
(b) the injury or disease in respect of which the service is to be provided;
(c) the proposed management of the injury or disease; and
(d) an estimation of the duration and frequency of the service to be provided.
“period of care” in relation to the care provided by:
(a) a general practitioner; or
(b) a practice nurse; or
(c) an aboriginal health worker; or
(d) a community nurse (via a DVA‑contracted community nursing provider);
to an entitled person under the Coordinated Veterans' Care Program (Program), means the period set out in the Notes for Coordinated Veterans' Care Program Providers in relation to the general practitioner, practice nurse, community nurse or aboriginal health worker, provided that any subsequent period of care by the same general practitioner is approved by the general practitioner for the person.
"Personal Care" means the service under the MRCA Home Care Program consisting of assistance with daily self care tasks, such as eating, bathing, toileting, dressing, grooming, getting in and out of bed, and moving about the house.
“PBS” means the Pharmaceutical Benefits Scheme authorised under the National Health Act 1953.
“physiotherapy” includes hydrotherapy.
“practitioner” has the same meaning as in section 124B of the Health Insurance Act 1973 in force from time to time.
“practice nurse” means a registered nurse or enrolled nurse employed or engaged by a general practitioner as a nurse in the practice of the general practitioner.
“Practice Nurse Care Co‑ordination treatment” means
treatment provided by a practice nurse to an entitled person, under the Coordinated Veterans' Care Program, comprised of:
(a) implementing the GPMP for the person under the Program — in particular co‑ordinating treatment services under the GPMP;
(b) liaising, in relation to the GPMP, with the general practitioner supervising the practice nurse in relation to the implementation of the GPMP;
(c) performing such other functions under the program that the practice nurse has under the Notes for Coordinated Veterans' Care Program Providers.
“Principles” means the MRCA Treatment Principles.
“prior approval” means that approval for the assumption by the Commission of the whole, or partial, financial responsibility for certain treatment must be given by the Commission before that treatment is commenced or undertaken.
“prisoner of war” means an entitled member who was captured by the enemy (including a terrorist) while rendering defence service.
“private health insurer” has the meaning it has in the Private Health Insurance Act 2007.
“private hospital” means premises that have been declared specifically as private hospitals for the purposes of the Health Insurance Act 1973.
"proscribed amount" means, in relation to the MRCA Home Care Program:
(a)subject to paragraph (b), an amount of money that if paid by an entitled person would mean the entitled person has paid in respect of a Home Care service (category A) comprised of Domestic Assistance provided to that entitled person by any approved provider or by any sub‑contractor during a week or part thereof, an amount exceeding $5;
Note: for the purpose of ascertaining if an amount of money is a proscribed amount where the amount demanded, received or assigned is in respect of a service (s) provided during two or more weeks, without the service (s) being related to the particular week in which the service(s) was delivered, the amount shall be apportioned pro rata to those weeks.
(aa) subject to paragraph (b), an amount of money that if paid by an entitled person would mean the entitled person has paid in respect of a Home Care service (category A) comprised of Home and Garden Maintenance, provided to that entitled person by any approved provider or by any sub‑contractor during the relevant period referred to in paragraph 7.3A.3 (2) of the Principles, an amount exceeding $75;
Note (1): the "relevant period" is a period of 12 months.
Note (2): under paragraph 7.3A.8(a) of the Principles, an entitled person cannot be charged more than $5 per hour of service.
(c) subject to paragraph (b), an amount of money that if paid by an entitled person would mean the entitled person has paid, in respect of a Home Care service (category A) comprised of Personal Care provided to that entitled person by any approved provider or by any sub‑contractor during a week or part thereof, an amount exceeding $10;
Note: for the purpose of ascertaining if an amount of money is a proscribed amount where the amount demanded, received or assigned is in respect of a service (s) provided during two or more weeks, without the service (s) being related to the particular week in which the service(s) was delivered, the amount shall be apportioned pro rata to those weeks.
(d) an amount of money in respect of Respite Care provided, or to be provided, by an approved provider or by a subcontractor, to an entitled person;
Note: the intention is that any amount charged for Respite Care is a proscribed amount regardless of whether it would or would not exceed $5 per hour of service.
(g) an exempt amount;
Note: the intention is that an exempt amount remains a proscribed amount and therefore not chargeable notwithstanding it would or would not exceed $5 per hour of service.
“provider number” means the number:
(a) allocated by:
(i) the Chief Executive Medicare or by his or her delegate or by a person authorised by the Chief Executive Medicare — to a practitioner; or
(ii) the Chief Executive Officer of Medicare Australia under the Medicare Australia Act 1973 — to a practitioner; and
(b) which identifies the practitioner and the places where the practitioner practises his or her profession.
Note: see regulation 2 of the Health Insurance Regulations 1975.
"provision of a Home Care service (category A) to an entitled person by an approved provider" includes the situation where an approved provider engages a sub‑contractor to provide a Home Care service (category A) to an entitled person.
"provision of a Home Care service (category B) to an entitled person by the Commission" includes the situation where the Commission engages a sub‑contractor to provide a Home Care service (category B) to an entitled person.
“provision of a Home Care service (category C) to an entitled person by an approved provider” includes the situation where an approved provider engages a sub‑contractor to provide a Home Care service (category C) to an entitled person.
"psychologist” means a psychologist who has been given a provider number in respect of being a psychologist.
“public hospital” has the same meaning as “recognized hospital” as defined in the Health Insurance Act 1973.
Note: Section 3 of the Health Insurance Act 1973 defines “recognized hospital” in terms of hospitals recognized for the purposes of the Medicare agreement, or hospitals declared by the Minister who administers the Health Insurance Act 1973 to be recognized hospitals.
“Quality of Care Principles 2014” means the legislative instrument of that name made under section 96‑1 of the Aged Care Act 1997.
“RAP National Schedule of Equipment” means the document of that name approved by the Repatriation Commission or the Commission or by a member of the Repatriation Commission or the Commission or by the Secretary to the Department, and referred to in Schedule 1, that lists the surgical aids and appliances for self‑help and rehabilitation available to an entitled person under the Department’s Rehabilitation Appliances Program.
“registered nurse” means a person who is registered under a law of a State or Territory or of the Commonwealth to practise as a registered nurse.
"Rehabilitation Appliances Program (RAP) National Guidelines"
means the document of that name approved by the Repatriation Commission or the Commission or by a member of the Repatriation Commission or the Commission or by the Secretary to the Department, and referred to in Schedule 1, that assists Commission delegates when determining approval for surgical aids and appliances for self‑help and rehabilitation (items) available under the Department’s Rehabilitation Appliances Program and which informs prescribers and suppliers of the processes necessary for an item to be provided to an entitled person.
"Repatriation Commission" means the body corporate continued in existence by section 179 of the Veterans' Entitlements Act 1986;
"residential care" means personal care or nursing care, or both personal care and nursing care, that is provided to a person in a residential care facility in which the person is also provided with:
(a) meals and cleaning services; and
(b)appropriate staffing, furnishings, furniture and equipment for the
provision of that care and accommodation;
but does not include any of the following:
(c) care provided to a person in the person’s private home; or
(d) care provided in a hospital or psychiatric facility; or
(e) care provided in a residential facility that primarily provides care to people who are not frail and aged.
“residential care (consisting of at least one high or two medium domain categories)” means the care or service provided to a person in residential care who is a person described in paragraph 7(6)(a) of the Quality of Care Principles 2014.
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.
“residential care facility” means a facility in which residential care is provided to a person.
"residential care (respite)" means residential care provided as respite and includes residential care (28 day respite).
"residential care (28 day respite)" means residential care provided as respite for up to 28 days in a Financial year pursuant to the MRCA Home Care Program.
"residential care subsidy" means an amount worked out under Chapter 3 of the Aged Care Act 1997 (including any amount of veterans’ supplement) that is payable by the Commonwealth in respect of an entitled person’s residential care according to the classification level determined under Part 2.4 of that Act.
“respite” means a rest, break or relief for a person’s carer or a person caring for himself or herself, from the role of caring.
"Respite Care" means the service under the MRCA Home Care Program consisting of in‑home respite, residential care (28 day respite) or emergency short term home relief.
“respite care in an institution” means care provided as respite to a person in an institution.
“retirement village” has the same meaning it has in the Veterans’ Entitlements Act 1986 and as applied by the Treatment Principles.
Note: retirement village is defined in section 5M of the Veterans’ Entitlements Act1986 (VEA) and is also applied by the Treatment Principles. The intention is that the Commission is to have the same power as the Repatriation Commission to determine premises have the same function as a retirement village for the purposes of Part 11 of the Principles.
“revoked MRCA Treatment Principles” means the MRCA Treatment Principles (Instrument 2004 No. M21).
"Rural Enhancement Scheme" means the scheme jointly established by the Commission (under section 285 of the Act) and the Repatriation Commission, in consultation with the Australian Medical Association Ltd, and which has the following features:
(a) general practitioners who provide medical services (services) to entitled persons under the Rural Enhancement Scheme (Scheme) receive higher payments (as set out in the Principles) from the Department for those services than they would receive if the services were not provided under the Scheme;
(b) the Scheme only applies to general practitioners who provide medical services to entitled persons at certain rural public hospitals (identified rural hospitals);
(c) an identified rural hospital is a hospital at which a medical practitioner may provide a medical service (service) to the public and receive from the state or territory government that, respectively, administers the state or territory in which the hospital is located, an extra amount (extra amount) for that service.
(d) the extra amount is an amount representing the difference between the amount the State or Territory actually pays the medical practitioner for the service and the fee for the service listed in the Medicare Benefits Schedule.
Note: as at 1 January 2005 the Rural Enhancement Scheme only operated in NSW, Vic, SA and WA.
"service injury" has the meaning it has in section 5 of the Act.
"service disease" has the meaning it has in section 5 of the Act.
“short‑term restorative care” has the meaning it has in section 106A of the Subsidy Principles 2014.
“social worker (general)” means a social worker who in the opinion of an employee of, or consultant to, the Department, has appropriate qualifications in social work and practises as a social worker.
“social worker (mental health)” means a social worker:
(a) who has been given a provider number in respect of being a social worker; and
(b) who, in the opinion of an employee of, or consultant to, the Department or the Department of Human Services, has appropriate qualifications in social work in the area of mental health and who practises as a social worker in the area of mental health.
“speech pathologist”, for the purposes of the Principles, is a person who:
(a) has been trained to assess and treat people who have complex communication needs; and
(b) has a provider number (i.e. “registered” with the Department of Human Services); and
(c) is not a disqualified health care provider in the terms mentioned in paragraph 7.1B of the Principles.
Note: under paragraph 7.1B a disqualified health care provider is a person whose services would not, under section 19B of the Health Insurance Act 1973, attract a medicare benefit.
“SRCA” means the Safety, Rehabilitation and Compensation Act 1988.
“SRCA disability” means an injury (within the meaning of the Safety, Rehabilitation and Compensation Act 1988):
(a) for which the Military Rehabilitation and Compensation Commission has accepted liability to pay compensation under that Act; and
(b) for which the person with the injury is eligible to be provided with treatment under Part 3 of Chapter 6 of the Act.
Note 1: In the Safety, Rehabilitation and Compensation Act 1988 the definition of injury includes a disease (see section 5A of that Act).
Note 2: Section 280A of the Actprovides eligibility for treatment of a person with an injury under the Safety, Rehabilitation and Compensation Act 1988.
“sub‑contractor” means, in relation to the MRCA Home Care Program, a State, Territory or Local Government, or incorporated organisation, or person, engaged by an approved provider or the Commission to provide a Home Care service (category A) or a Home Care service (category B) or a Home Care service (category C) to an entitled person.
“subsequent period of care”, in relation to the provision of care by a general practitioner to an entitled person, means a period of care that may be provided by the general practitioner after the expiry of a period of care that has already been provided by the general practitioner to the entitled person.
Note: a subsequent period of care must be approved by the general practitioner (see: 6A.3). A period of care by a general practitioner that is not a “subsequent period of care” would be the first period of care provided to a person under the Coordinated Veterans' Care Program (Program) and the first period of care provided to a person under the Program by a new general practitioner for the person i.e. where the person has changed general practitioners.
“transition care” has the meaning it has in section 106 of the Subsidy Principles 2014.
“Tier 1 Hospital” means a hospital in the category described as Tier 1 in 2.1 of the MPPPs.
“Treatment Principles” means the legislative instrument entitled ‘Treatment Principles’ made by the Repatriation Commission under section 90 of the VEA.
"VEA" means the Veterans' Entitlements Act 1986.
“Veterans and Veterans Families Counselling Service” or “VVCS” means the service funded by the Department of Veterans’ Affairs that provides free, confidential and Australia‑wide mental health counselling and group programs to Australian veterans, peacekeepers, their families, eligible current serving Australian Defence Force members and F‑111 workers and their families.
“VVCS criterion” means a criterion in the DVA document “Factsheet VCS01 ‑ Veterans and Veterans Families Counselling Service (VVCS)”, referred to in Schedule 1, under the heading “Am I eligible for VVCS?” being a criterion that relates to a person who is eligible for treatment under the Act.
“VVCS OPC Provider Notes” means the document approved by the Commission, the Repatriation Commission, a member of the Commission or Repatriation Commission or by the Secretary to the Department, entitled “Veterans and Veterans Families Counselling Services Outreach Program Counsellors Provider Notes”, and referred to in Schedule 1, that sets out the terms on which an outreach program counsellor is to provide outreach program counselling to an eligible entitled person.
“service injury” and “service disease” are defined in section 5 of the Act; and in relation to a person with a SRCA disability mean the person’s injury (within the meaning of the Safety, Rehabilitation and Compensation Act 1988) that was caused by, or arose out of, the person’s employment in the Defence Force that is covered by the Safety, Rehabilitation and Compensation Act 1988.
Note: in the Safety, Rehabilitation and Compensation Act 1988 the definition of injury includes a disease (see section 5A of that Act).
“Vertical Platform Lift” means a lift installed adjacent to vertical walls, which travels up and down, with the platform finishing flat against the floor, and the user embarking/disembarking onto an even surface.
“veterans’ supplement”, in relation to an entitled person, means the supplement of that name that applies under the Aged Care Act 1997 to the person as a care recipient under that Act.
Note (1): see s.44‑5 of the Aged Care Act 1997.
Note (2): the Subsidy Principles under the Aged Care Act 1997 may specify, in respect of a veterans’ supplement, the circumstances in which the supplement will apply to a care recipient in respect of a payment period.
"week" means the period from Sunday to Saturday, inclusive.
"White Card" means the identification card (also known as the Veteran Card) provided by the Department to a person who is eligible under the Act for treatment, subject to these Principles, for a service injury or a service disease and also means a written authorisation issued on behalf of the Commission under subparagraph 2.1.1(a)(iii) and provided to a person who is entitled under the Act for treatment.
Note: a White Card is issued to a person with a SRCA disability.
The following terms are defined in the Act:
·Defence Force (s.5(1))
·member (s.5(1))
1.4.2 In the MRCA Treatment Principles, if a Note follows a principle, paragraph or subparagraph, the Note is taken to be part of that principle, paragraph or subparagraph, as the case may be.
PART 2 — ENTITLEMENT TO TREATMENT
2.1 Treatment for entitled persons in Australia
2.1.1 Subject to these Principles, the Commission may provide or arrange for treatment in Australia of:
(a) entitled persons who have been issued with:
(i) a Gold Card; or
(ii) a White Card; or
(iii) a written authorisation issued on behalf of the Commission; and
2.2 Treatment for entitled persons residing or travelling overseas
2.2.1 Subject to these Principles, the Commission will accept financial responsibility for the treatment overseas of service injuries or service diseases only for:
(a) a member or former member who is resident overseas; or
(b) a member or former member who is travelling overseas.
2.2.2 Except where the Commission decides otherwise, the Commission will not accept financial responsibility under paragraph 2.2.1 for costs incurred in the treatment of a service injury or a service disease while a member or former member is temporarily absent from Australia unless, prior to departure, an office of the Department has been notified of the member's or former member’s intention to travel.
2.2.3 Except in an emergency, for treatment other than residential care or residential care (respite), financial responsibility under paragraph 2.2.1 will be limited to:
(a) the cost of treatment provided in accordance with the mode and duration that would have been provided or arranged, under these Principles, in Australia; or
(b) the cost of treatment provided by a health authority or facility nominated by the Commission.
Treatment that is residential care/residential care (respite)
2.2.4 For treatment that is residential care or residential care (respite), financial responsibility under paragraph 2.2.1 will be limited to:
(a) in the case of residential care provided for a period to a member or former member, whether provided in an emergency or not — the lesser of:
(i) the amount charged the member or former member; or
(ii) an amount equal to the amount of residential care subsidy payable for a person given a high level of residential care for the same period in Australia plus any daily care fee the Commission would have accepted for the member or former member in Australia;
(b) in the case of residential care (respite) provided for a period to a member or former member, whether provided in an emergency or not — the lesser of:
(i) the amount charged the member or former member; or
(ii) an amount equal to the amount of residential care subsidy payable for a person given a high level of residential care (respite) for the same period in Australia (not exceeding 63 days in a Financial year) plus any daily care fee the Commission would have accepted for the member or former member in Australia.
Note (1): Subject to the Principles, the Commission will not accept financial responsibility for medical or allied‑health treatment applied to an injury or disease of a member or former member that is not a service injury or a service disease.
Note (2): By virtue of Part 10 of the Principles the Commission, in the first instance, rather than the Commonwealth, accepts financial responsibility for the provision of residential care and residential care (respite) under the Aged Care Act 1997 to entitled persons.
Note (3): the daily care fee is the amount worked out under s.52C‑3 of the Aged Care Act 1997
(d) in the case of residential care (respite), the cost of that care (as worked out under paragraph (c)) for only a maximum of 63 days in any Financial year.
Note (1): the intention is that the Commission will not accept any further financial responsibility for residential care (respite) provided to the member/former member in a financial year where in that year the person had already been provided residential care (respite) for 63 days.
Note (2): for the purpose of calculating the number of days spent by a member in residential care (respite) in a Financial year, any day spent in residential care (respite) in Australia in that year is also to be taken into account.
2.2.5 Notwithstanding paragraphs 2.2.2 or 2.2.3, the Commission will not be responsible for treatment costs incurred by any person who travels overseas from Australia where a significant reason for that travel is to obtain treatment or rehabilitation appliances.
No Overseas MRCA Home Care
2.2.8 The Commission will not accept financial liability for the provision overseas of treatment under the MRCA Home Care Program.
2.3 Treatment of associated non‑service injury or disease injuries or diseases
2.3.1 Subject to these Principles, the Commission will provide, arrange, or accept financial responsibility for treatment of an injury or disease that is not a service injury or a service disease to the extent that it is a necessary part of treatment for a service injury or service disease.
2.6 Referrals by the Veterans and Veterans Families Counselling Service
2.6.1 The Veterans and Veterans Families Counselling Service may refer its clients who are members to other counselling services.
2.6.2 The Commission will accept financial responsibility for counselling referred under paragraph 2.6.1 only where that referral is in accordance with guidelines prepared by the Commission.
Note: The guidelines are prepared by the Commission after, and subject to, consideration of advice from the National Advisory Committee on the Veterans and Veterans Families Counselling Service.
2.7A—TRCP treatment (Training, Research, Communication‑improvement, Policy Development for ADF‑Members’ etc Health Issues)
Note: This provision is for information only. TRCP treatment is provided to members and former members and certain dependants under the Treatment Principles under the Veterans’ Entitlements Act 1986 pursuant to a determination under s.88A(1)(d) of that Act.
2.7B Australian Centre for Posttraumatic Mental Health Treatment
2.7B.1 The Commission may accept financial liability for ACPMH treatment provided for the benefit of an entitled member who is entitled to such treatment under the Act.
Note (1): under subsection 13(1) of the Acttreatment can be action taken with a view to maintaining a person in physical or mental health.
Note (2): the intention is that the Commission may accept liability for ACPMH treatment even though such treatment is not necessarily provided by the Australian Centre for Posttraumatic Mental Health but under its auspices.
Note (3): prior approval for ACPMH treatment is not required.
2.8 Loss of eligibility for treatment
2.8.1The Commission will not accept financial responsibility for treatment provided to a person if that person is not, in the Commission's opinion, entitled to the treatment.
2.8.2Where a person was entitled to treatment but is considered by the Commission to no longer be entitled to treatment or the person has received treatment for which, in the Commission's opinion, he or she was not entitled, the Commission or an employee of the Department must make a reasonable effort to notify the person that they are not entitled to treatment .
PART 3 — COMMISSION APPROVAL FOR TREATMENT
3.1 Approval for treatment
3.1.1 The Commission’s prior approval may be required for treatment.
3.2 Circumstances in which prior approval is required
3.2.1 Treatment requiring prior approval includes:
(b)provision of services that are not made available under the Medicare Benefits Schedule except where otherwise stated.
Note: see paragraph 4.2.3.
(d)outpatient treatment at a private hospital where the requirement for prior approval for such treatment is specified in a contract;
(e) treatment at a hospital according to the requirements contained in section 4 of the MPPPs;
Note: where the patient is a holder of a White Card and eligibility for the treatment required is uncertain, the Commission will not accept financial responsibility for the cost of care unless the Department has verified eligibility.
(f) admission to a hospital or the provision of hospital treatment not otherwise specified;
Note: see paragraph 9.1.9.
(h) convalescent care in an institution — except where the institution is a private hospital or public hospital;
Note: for convalescent care in an institution that is a hospital see paragraph 9.5.2
(ha) respite care in an institution — except where the institution is a private hospital or public hospital;
Note: for respite care in an institution where the institution is a hospital see paragraph 10.4A.
(j) in‑home respite care;
(ja) emergency short term home relief (ESTHR) to be provided within 24 hours after a previous service of ESTHR;
Note: the intention is that 3 days (the max ESTHR per emergency) should be sufficient time for alternative respite care to be arranged and prior approval is required before a further immediately subsequent service of ESTHR may be provided.
(b) for a person in an institution, any alteration to the structure of part of the institution necessary to install or attach the appliance satisfies the requirements in (a) and (b) of 11.3.7; and
Note: (a) and (b) deal with compliance with relevant laws and approval by owner of property to installation/attachment together with an undertaking by the owner not to seek compensation if the appliance is removed.
(c) the rehabilitation appliance is not a consumable
rehabilitation appliance.
Note (1): “institution” includes a retirement village, premises the Commission considers have similar functions to a retirement village, and a cluster of self‑care units.
Note (2): 11.3.6A is relevant in relation to the maintenance or repair of the appliance. Generally, only an approved appliance may be maintained or repaired at Commission expense.
11.3.7 Subject to other conditions specified in this Part, the Commission may approve the installation or the attachment of a rehabilitation appliance to property when:
(a) the installation or the attachment conforms to Commonwealth, State or Territory laws relating to alterations to property; and
(b) the property owner has given approval and an undertaking not to seek compensation for restoration of the property when the appliance is no longer required by the entitled person to whom the aid was supplied.
11.3.8 Subject to this Part, the Commission may provide or accept financial responsibility for the installation of a telephone deaf aid and/or touch phone and the rental of the aid for the first year, in the workplace of an entitled member who has a medically assessed need for these items because of a service injury or service disease.
11.4 Visual aids
11.4.1 The Commission may accept financial liability for visual aids dispensed by an optical dispenser (who may be an optometrist) to an entitled person on the prescription of an ophthalmologist or an optometrist (with a current provider number) where the visual aids have been provided in accordance with:
(a) the Principles; and
(b) Notes for Allied Health Providers (Section 1 General Information and Section 2(h)(as section 2(h) affects optometrists and optical dispensers)); and
(c) the DVA document entitled “Pricing Schedule for Visual Aids”, referred to in Schedule 1.
11.4.2 Visual aids may be prescribed from the DVA document entitled “Pricing Schedule for Visual Aids”, referred to in Schedule 1.
11.4.3 The Commission’s prior approval is required for the prescription of items not listed in the DVA document entitled “Pricing Schedule for Visual Aids”, referred to in Schedule 1, except in the circumstances referred to in paragraph 11.4.6.
11.4.4 Subject to paragraph 11.4.5, in any two year period, the Commission shall not provide an entitled person with:
(a) more than one pair of distance spectacles and one pair of readers; or
(b) more than one pair of bifocals, trifocals or progressive power lenses.
11.4.5 The Commission will provide an entitled person with renewed lenses before the expiration of two years if:
(a) in the opinion of the treating practitioner, there has been a change in;
(i) the person’s refraction; or
(ii) the condition of the person’s eyes,
that necessitates new lenses; or
(b) there has been accidental loss or breakage.
11.4.6 If an entitled person chooses spectacle frames or lenses that differ from those listed in the DVA document entitled “Pricing Schedule for Visual Aids”, referred to in Schedule 1, or that have not been medically prescribed, the Commission will accept financial responsibility only to the financial limits set out in the schedule.
11.5 Hearing aids
11.5.1 The Commission will approve the supply of a spectacle hearing aid when it is the only type of hearing aid appropriate and the person is entitled to the treatment:
(a) of all injuries or diseases; or
(b) of deafness that is a service injury or service disease; or
(c) of a visual defect that is a service injury or service disease and the need for a spectacle hearing aid arises from the person’s inability to accommodate spectacles and a separate hearing aid.
11.5.2 Where a person who has a hearing defect that is a service injury or service disease is provided with a spectacle hearing aid under paragraph 11.5.1:
(a) new lenses will be provided; or
(b) the existing spectacle lenses will be fitted as part of the aid.
11.5.3 The Commission will not be responsible, under paragraph 11.5.2, for the further supply or the fitting of lenses if the person is not entitled to the supply of spectacles.
11.5.4 Subject to prior approval, the Commission may accept financial responsibility for the supply of a hearing aid from an audiology provider if the hearing aid is unable to be supplied to the entitled person under the Hearing Services Administration Act 1997 or the Hearing Services Act 1991.
11.5.5 The Commission may accept financial responsibility for service charges in respect of a hearing aid that has been supplied under paragraph 11.5.4.
11.5.6 The Commission may accept financial responsibility for service charges in respect of a hearing aid following the supply of that hearing aid under paragraph 11.5.4 or 11.5.5.
11.6 Other rehabilitation appliances
11.6.1 Subject to this Part, the Commission may arrange for a wig to be supplied to an entitled person who:
(a) became bald as a result of a service injury or service disease or as a result of the treatment of a service injury or service disease; or
(b) requires a wig as part of medical treatment for disfigurement.
11.6.2 The Commission will not accept financial responsibility for the cleaning and setting of a wig.
11.6.4 Where the Commission approves the provision of stoma appliances and consumables, the provision will be through:
(a) a stoma association; or
(b) the Pharmaceutical Benefits Scheme; or
(c) the MRCA Pharmaceutical Benefits Scheme.
11.6.5 The Commission will accept financial responsibility for the cost of membership of a stoma association and for the cost of postage of stoma supplies.
11.7 Repair and replacement
11.7.1 The Commission may approve the provision of more than one of the same rehabilitation appliance if the entitled person depends completely on the appliance, and:
(a) it is necessary to maintain the appliance in a hygienic condition because of domestic or occupational circumstances; or
(b) the entitled person lives in an isolated country area and would be handicapped by loss or breakage; or
(c) there are other circumstances where the Commission considers it reasonable to do so.
11.7.2 Subject to paragraphs 11.7.6 and 11.7.7, the Commission will not be financially responsible for the alteration to, or the repair of, a treatment aid without prior approval.
11.7.3 The Commission will not be financially responsible for, or reimburse, the cost of an alteration to, or a repair of, a rehabilitation appliance for which it has not accepted financial responsibility, unless there are circumstances where the Commission considers it reasonable to accept financial responsibility.
11.7.4 The Commission will not be financially responsible for repair or replacement of a rehabilitation appliance for a non service injury or disease injury or disease while an entitled person is travelling overseas.
11.7.5 Prior approval will be given for the repair or replacement of an appliance where repair or renewal is necessary because:
(a) the appliance was damaged by normal wear and tear;
(b) the appliance inadvertently was damaged or lost; or
(c) the health‑care practitioner treating the entitled person considers that a replacement is required because the person’s condition has changed.
11.7.6 The Commission will not give approval for the repair or replacement of an appliance if repair or renewal is necessary as the result of:
(a) a wilful act of the entitled person using or wearing the appliance; or
(b) a negligent act of the entitled person using or wearing the appliance and the person has damaged or lost a similar appliance in the past as a result of negligence or wilfulness.
11.7.7 Prior approval is not required for repairs to spectacles.
11.8 Treatment aids from hospitals
11.8.1 The Commission may provide, or accept financial responsibility for, treatment aids as part of inpatient treatment where the aids expedite discharge from hospital.
11.8.2 The conditions for the supply of treatment aids are the same as those normally applied by the hospitals for patients not covered by these Principles.
11.8.3 The Commission will not provide, or accept financial responsibility for, a treatment aid as part of inpatient or outpatient treatment where the treatment solely comprises the provision of the treatment aid.
PART 12 — OTHER TREATMENT MATTERS
12.1 Ambulance transport
12.1.1 With the exception of arrangements for medical emergency under paragraph 12.1.4 and special arrangements under paragraph 12.1.5, prior approval must be obtained in all cases before ambulance transport is used by an entitled person.
12.1.2 Approval for ambulance transport normally will be given where the entitled person:
(a) is a stretcher case; or
(b) requires treatment during transport; or
(c) is grossly disfigured; or
(d) is incontinent to a degree that precludes the use of other forms of transport.
12.1.3 Other than in exceptional circumstances, air ambulance will be approved only to transport an entitled person with acute medical and surgical complaints for admission to, or discharge from, a hospital.
12.1.4 The Commission will accept financial responsibility for the use of ambulance transport in a medical emergency for an entitled person if an office of the Department is notified on the first working day after the ambulance transport is used or as soon thereafter as is reasonably practicable.
12.1.5 Prior approval for ambulance transport for entitled persons is not required where the transport is provided under arrangements between the ambulance service provider and the Commission.
12.2 Treatment under Medicare Program
12.2.1 Entitled persons may choose to have their treatment arranged through the Department or under a medicare program.
12.2.2 Subject to these Principles, entitled persons who are treated under a medicare program may also receive services that are not covered by the MBS at the Commission’s expense.
12.2.3 When part or all of the cost of a treatment item has been paid as a medicare benefit, the Commission will not pay for the same professional or ancillary service regardless of the person’s entitlement under the Act.
12.4 Prejudicial or unsafe acts or omissions by patients
12.4.1 The Commission may refuse to be financially responsible for, or provide treatment to, or any further treatment to, an entitled person who, by an act or omission, deliberately prejudices his or her own, or a fellow patient’s, treatment or the safety of persons providing treatment.
12.6 Recovery of moneys
12.6.1 Where a payment has been made to any person or body, purportedly as payment for treatment, the Commission may recover (up to the extent that the payment exceeds the amount, if any, that should have been paid to that person or body) any moneys, the payment of which was induced or affected at all by:
(a) any misrepresentation; or
(b) any mistake of fact; or
(c) any mistake of law; or
(d) any other cause.
12.6.2 Further to paragraph 12.6.1, the Commission may recover moneys for any excess amounts that should not have been paid to that person or body:
(a) in a single demand; or
(b) by instalments; or
(c) subject to section 317 of the Act, by offsetting moneys for any excess amounts against any later claims for payment by that person or body; or
Note: Section 317 provides, in effect, that where amounts have been overpaid, the Commission may, if the person agrees, offset money owed against later payments.
(d) by a combination of any of these methods of recovery.
12.6.3 Nothing in this principle is to be taken to restrict any other right or action for recovery of moneys.
Transitional Provisions
(1) MRCA Treatment Principles (2013 No. MRCC 53)
(a) any arrangement entered into, or taken to have been entered into, by the Commission or the Department (on behalf of the Commission) with a health provider, under the revoked MRCA Treatment Principles, being an arrangement that is in force immediately before the commencement of these Principles ¾ is taken to have been entered into under these Principles.
(b) any action taken (e.g. issue of a notice, grant of approval, giving of a receipt), and any document produced in the course of that action, by the Commission, the Department (on behalf of the Commission), a health provider or an entitled person, under the revoked MRCA Treatment Principles, being action or a document that is in effect or in force immediately before the commencement of these Principles ¾ is deemed, respectively, to have been taken or produced under these Principles.
(c) a Scheme (eg Local Medical Officer Scheme, Local Dental Officer Scheme) prepared by the Repatriation Commission under the Treatment Principles under section 90 of the Veterans' Entitlements Act 1986, that is in force immediately before the commencement of these Principles and is referred to in these Principles, is taken to have been made by the Commission under these Principles.
(d) a person who was receiving care under a Community Aged Care Package or Extended Aged Care at Home Package under the revoked MRCA Treatment Principles immediately before the commencement of these Principles, is, on the commencement of these Principles, entitled to a continuation of that care as if it is home care under these Principles.
(e) a requirement in a provision under the Principles for a person to hold a qualification (current qualification), being a different qualification required by the provision in the revoked MRCA Treatment Principles (former qualification) in the state the revoked MRCA Treatment Principles existed immediately before the commencement of these Principles under 1.1.4, is satisfied where a person holds a former qualification.
Note: under the revoked MRCA Treatment Principles an aboriginal health worker needed to have undertaken an “aboriginal health care course” at an institution recognised by the Department of Health and Ageing but under these Principles the institution must be recognised by the Department of Prime Minister and Cabinet. The qualification of an aboriginal health worker obtained at an institution recognised by the former Department of Health and Ageing is recognised under these Principles as if the institution had been recognised by the Department of Prime Minister and Cabinet.
SCHEDULE 1 DATES FOR INCORPORATED DOCUMENTS
The following documents are incorporated‑by‑reference into the MRCA Treatment Principles
in the form in which they exist from time to time:
1. Notes for General Practitioners (paragraph 1.4.1)
Department of Veterans’ Affairs Fee Schedules for Medical Services (paragraph 3.5.1)
Notes for Allied Health Providers (paragraphs 3.5.1 and 7.1A.1)
Optometrist Fees for Consultation (paragraph 3.5.1)
Orthoptists Schedule of Fees (paragraph 3.5.1)
6. Pricing Schedule for visual aids (paragraph 3.5.1)
Fee Schedule of Dental Services for Dentists and Dental Specialists (paragraph 3.5.1)
Fee Schedule of Dental Services for Dental Prosthetists (paragraph 3.5.1)
Chiropractors Schedule of Fees (paragraph 3.5.1)
Diabetes Educators Schedule of Fees (paragraph 3.5.1)
Dietitians Schedule of Fees (paragraph 3.5.1)
Exercise Physiologists Schedule of Fees (paragraph 3.5.1)
Occupational Therapists Schedule of Fees (paragraph 3.5.1)
Osteopaths Schedule of Fees (paragraph 3.5.1)
Physiotherapists Schedule of Fees (paragraph 3.5.1)
Psychologists Schedule of Fees (paragraph 3.5.1)
Podiatrists Schedule of Fees (paragraph 3.5.1)
Social Workers Schedule of Fees (paragraph 3.5.1)
Clinical Psychologists Schedule of Fees (paragraph 3.5.1)
Speech Pathologists Schedule of Fees (paragraph 3.5.1)
DVA Community Nursing Schedule of Fees (paragraph 6A.4.2(b))
Notes for Coordinated Veterans' Care Program Providers (Part 6A)
Rehabilitation Appliances Program (RAP) National Guidelines (paragraph 11.2A.1)
RAP National Schedule of Equipment (paragraph 11.2A.1)
Veterans and Veterans Families Counselling Services Outreach Program Counsellors Provider Notes (paragraph 1.4.1 and 7.1A.1)
Veterans and Veterans Families Counselling Service (VVCS) Outreach Program Counsellor Schedule of Fees (paragraph 3.5.1)
Factsheet VCS01 ‑ Veterans and Veterans Families Counselling Service (VVCS) (paragraph 1.4.1, definition of “VVCS criterion”)
Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (Better Access) initiative (paragraph 1.4.1, definition of “Australian Government’s Better Access initiative”):
Orthotists Schedule of Fees (paragraph 3.5.1)
1—About the endnotes
The endnotes provide information about this compilation and the compiled law.
The following endnotes are included in every compilation:
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history
Abbreviation key—Endnote 2
The abbreviation key sets out abbreviations that may be used in the endnotes.
Legislation history and amendment history—Endnotes 3 and 4
Amending laws are annotated in the legislation history and amendment history.
The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.
The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.
Editorial changes
The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.
If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.
Misdescribed amendments
A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.
If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.
Endnote 2—Abbreviation key
ad = added or inserted o = order(s) am = amended Ord = Ordinance amdt = amendment orig = original c = clause(s) par = paragraph(s)/subparagraph(s) C[x] = Compilation No. x /sub‑subparagraph(s) Ch = Chapter(s) pres = present def = definition(s) prev = previous Dict = Dictionary (prev…) = previously disallowed = disallowed by Parliament Pt = Part(s) Div = Division(s) r = regulation(s)/rule(s) ed = editorial change reloc = relocated exp = expires/expired or ceases/ceased to have renum = renumbered effect rep = repealed F = Federal Register of Legislation rs = repealed and substituted gaz = gazette s = section(s)/subsection(s) LA = Legislation Act 2003 Sch = Schedule(s) LIA = Legislative Instruments Act 2003 Sdiv = Subdivision(s) (md) = misdescribed amendment can be given SLI = Select Legislative Instrument effect SR = Statutory Rules (md not incorp) = misdescribed amendment Sub‑Ch = Sub‑Chapter(s) cannot be given effect SubPt = Subpart(s) mod = modified/modification underlining = whole or part not No. = Number(s) commenced or to be commenced Endnote 3—Legislation history
Name
Registration
Commencement
Application, saving and transitional provisions
MRCA Treatment Principles
2013 No. MRCC53
29 November 2013 (F2013L02016)
30 November 2013 (except references to “SRCA disability” in para.1.4.1)
10 December 2013 (for references to “SRCA disability” in para.1.4.1)Para. 1.2
MRCA Treatment Principles (Rehabilitation Appliance Program) Amendment Instrument 2014
2014 No. MRCC2
2 May 2014 (F2014L00494)
3 May 2014
Para. [3]
MRCA Treatment Principles (Residential Care Classification) Amendment Instrument 2014
2014 No. MRCC 25
30 June 2014 (F2014L00879)
1 July 2014
Veterans’ Affairs (Treatment Principles – Private Accommodation in Hospital Surcharge) Amendment Instrument 2014
2014 No. R78/MRCC78
14 October 2014 (F2014L01348)
15 October 2014
Para. [3]
Veterans’ Affairs (Treatment Principles – Provision of Falls Prevention Items) Amendment Instrument 2014
2014 No. R107/MRCC107
19 January 2015 (F2015L00055)
6 February 2015
Para. [3]
Veterans’ Affairs (Treatment Principles – TRCP Treatment and Updating of RAP Schedules) Amendment Instrument 2015
2015 No. R29/MRCC29
21 May 2015 (F2015L00713)
22 May 2015
Veterans’ Affairs (Treatment Principles – Updating Home and Community Care (HACC) References and other References) Amendment Instrument 2015
2015 No. R46/MRCC46
17 September 2015 (F2015L01446)
1 July 2015
Veterans’ Affairs (Treatment Principles – Removal of Prior Approval Requirement and Time Limits for Convalescent and Respite Care in Hospital) Amendment Instrument 2015
2015 No. R32/MRCC32
27 August 2015 (F2015L01342)
28 August 2015
Veterans’ Affairs (Treatment Principles – Updating of Rehabilitation Appliance Schedule/VVCS Outreach Program Counsellors Fees Schedule) Amendment Instrument 2015
2015 No. R73/MRCC73
7 December 2015 (F2015L01941)
8 December 2015
Veterans’ Affairs (Treatment Principles – Lodgment of Claims by Providers) Amendment Instrument 2016
2016 No. R3/MRCC3
8 March 2016 (F2016L00256)
31 March 2016
Section 4
Veterans’ Affairs (Treatment Principles – Updating of RAP National Schedule of Equipment) Amendment Instrument 2016
2016 No. R31/MRCC31
12 May 2016 (F2016L00781)
1 June 2016
Veterans’ Affairs (Treatment Principles – Community Nursing) Amendment Instrument 2016
2016 No. R30/MRCC30
17 May 2016 (F2016L00805)
1 July 2016
Veterans’ Affairs Treatment Principles (Short‑term Restorative Care) Amendment Instrument 2016
2016 No. R46/MRCC46
6 December 2016 (F2016L01869)
1 January 2017
Veterans’ Affairs (Treatment Principles – Updating of RAP National Schedule of Equipment) Amendment Instrument 2017
2017 No. R1/MRCC1
20 March 2017 (F2017L00260)
1 April 2017
Veterans’ Affairs (Treatment Principles – Updating of Fee Schedules for Medical Services and Other Matters) Amendment Instrument 2017
2017 No. R21/MRCC21
1 July 2017 (F2017L00711)
1 July 2017
Veterans’ Affairs (Treatment Principles – Incorporated Documents) Amendment Instrument 2018
2017 No. R12/MRCC12
13 Mar 2018 (F2018L00242)
Sch 2: 1 Apr 2018 (s 2)
Veterans’ Affairs (Treatment Principles – Orthotists) Amendment Instrument 2018
2018 No. R88/MRCC88
21 Jan 2019 (F2019L00049)
Sch 2: 1 Feb 2019 (s 2)
Veterans’ Affairs (Treatment Principles – Electric Mobility Aids and Other Measures) Amendment Instrument 2019
2019 No. R13/MRCC13
16 May 2019 (F2019L00678)
Sch 2: 25 Apr 2019 (s 2)
Veterans’ Affairs (Treatment Principles – Local Medical Officer) Amendment Instrument 2019
2019 No. R41/M42
10 Sep 2019 (F2019L01171)
Sch 2: 1 Oct 2019 (s 2)
Endnote 4—Amendment history
Provision affected
How affected
1.1.4
rep LA s 48D
1.1.5
rep LA s 48D
1.4.1
am. 2014 No. MRCC 2; am. 2014 No. MRCC 25; am. 2014 No. R78/MRCC78; am. 2015 No. R29/MRCC29; am. 2015 No. R46/MRCC46; am. 2015 No. R32/MRCC32; am 2016 No. R30/MRCC30; am 2016 No. R46/MRCC46; am 2017 No. R21/MRCC21; am 2018 No. R88/MRCC88; am 2019 No. R13/MRCC13; am 2019 No. R41/M42; ed C19
2.2.2
am 2018 No. R88/MRCC88
2.2.4
am.2015 No. R46/MRCC46; 2015 No. R32/MRCC32
2.7A (heading)
rs. 2015 No. R29/MRCC29
2.7A.1
rep. 2015 No. R29/MRCC29
3.2.1
am 2015 No. R32/MRCC32; am 2018 No. R88/MRCC88
3.3.2
am 2015 No. R32/MRCC32; am 2016 No. R30/MRCC30; am 2019 No. R41/M42
3.5.1
am 2017 No.R21/MRCC21; am 2018 No. R88/MRCC88; am 2019 No. R41/M42; ed C19
3.5.2(c)(iii)
am. 2016 No.R3/MRCC3
3.5.2A
am.2016 No.R3/MRCC3
3.5.3
am. 2014 No.R78/MRCC78
3.5.3A
ad. 2014 No.R78/MRCC78
4.1 (heading)
am 2019 No. R41/M42
4.1.3
rs 2019 No. R41/M42
4.1.4
am 2019 No. R41/M42
4.2.2
am 2019 No. R41/M42
4.2.5
am 2019 No. R41/M42
4.3.1
am 2019 No. R41/M42
4.3.2
am 2019 No. R41/M42
4.3.4
am 2019 No. R41/M42
4.3A.1
am 2019 No. R41/M42
4.4.1
am 2019 No. R41/M42
4.5.1
am 2019 No. R41/M42
4.7.3
am 2019 No. R41/M42
4.8.1
am 2019 No. R41/M42
5.2.1
am 2018 No. R88/MRCC88
5.2.2
am 2018 No. R88/MRCC88
5.3.2
am 2018 No. R88/MRCC88
5.3.3
am 2018 No. R88/MRCC88
5.4.1
am 2018 No. R88/MRCC88
6A.1 (heading)
am 2019 No. R41/M42; ed C19
6A.2.1
am 2019 No. R41/M42
6A.2.2
rs 2019 No. R41/M42
6A.3 (heading)
am 2019 No. R41/M42
6A.3.1
am 2019 No. R41/M42
6A.3.2
am 2019 No. R41/M42
6A.3.3
am 2019 No. R41/M42
6A.3.4
am 2019 No. R41/M42
6A.3.5
am 2019 No. R41/M42
6A.3.6
am 2019 No. R41/M42
6A.4.1
am 2019 No. R41/M42
6A.4.2
am. 2016 No. R30/MRCC30; am 2018 No. R88/MRCC88; am 2019 No. R41/M42
6A.4.3
am 2019 No. R41/M42
6A.4.4
am 2019 No. R41/M42
6A.4.5
am 2019 No. R41/M42
6A.4A.1
am 2019 No. R41/M42; ed C19
6A.5.1
am 2019 No. R41/M42
6A.6 (heading)
am 2019 No. R41/M42
6A.6.1
am 2019 No. R41/M42
6A.6.2
am 2019 No. R41/M42
6A.7.1
am 2019 No. R41/M42
6A.8 (heading)
am 2019 No. R41/M42
6A.8.1
am 2019 No. R41/M42; ed C19
6A.8.2
am 2019 No. R41/M42
6A.9.1
am 2019 No. R41/M42
6A.9.2
am 2019 No. R41/M42
6A.9.3
am 2019 No. R41/M42
6A.9.4
am 2019 No. R41/M42
6A.9.5
am 2019 No. R41/M42; ed C19
6A.9.6
am 2019 No. R41/M42
6A.9.7
am 2019 No. R41/M42
6A.9.8
am 2019 No. R41/M42
6A.9.9
am 2019 No. R41/M42
PART 6B
rep 2019 No. R41/M42
6B.1 (heading)
rep 2019 No. R41/M42
6B.1.1
rep 2019 No. R41/M42
6B.1.2
rep 2019 No. R41/M42
6B.2 (heading)
rep 2019 No. R41/M42
6B.2.1
rep 2019 No. R41/M42
6B.2.2
rep 2019 No. R41/M42
6B.2.3
rep 2019 No. R41/M42
6B.2.4
rep 2019 No. R41/M42
6B.2.5
rep 2019 No. R41/M42
6B.2.6
rep 2019 No. R41/M42
6B.3 (heading)
rep 2019 No. R41/M42
6B.3.1
rep 2019 No. R41/M42
6B.4 (heading)
rep 2019 No. R41/M42
6B.4.1
rep 2019 No. R41/M42
6B.4.2
rep 2019 No. R41/M42
6B.4.3
rep 2019 No. R41/M42
6B.4.4
rep 2019 No. R41/M42
6B.4.5
rep 2019 No. R41/M42
6B.5 (heading)
rep 2019 No. R41/M42
6B.5.1
rep 2019 No. R41/M42
6B.5.2
rep 2019 No. R41/M42
6B.6 (heading)
rep 2019 No. R41/M42
6B.6.1
rep 2019 No. R41/M42
7.1.2
am 2018 No. R88/MRCC88
7.1.3
rs. 2014 No. MRCC 25
7.1A.1
am 2018 No. R88/MRCC88
7.3.3
am. 2016 No. R30/MRCC30; am 2019 No. R41/M42; ed C19
7.3.4
am. 2016 No. R30/MRCC30
7.3.6
am. 2016 No. R30/MRCC30
7.3.6A
am. 2016 No. R30/MRCC30
7.3A.1
am 2019 No. R41/M42
7.3A.6B
am 2019 No. R41/M42
7.3A.11
am.2015 No. R46/MRCC46
7.4.2
am 2018 No. R88/MRCC88
7.4.3
am 2018 No. R88/MRCC88
7.5.1
am 2019 No. R41/M42
7.5.2
am 2019 No. R41/M42
7.5.3
am. 2014 No. MRCC 25
7.6.1
am 2019 No. R41/M42
7.6.2
rs. 2014 No. MRCC 2; am. 2014 No. MRCC 25
7.6A.1
am 2019 No. R41/M42
7.6A.2
am. 2014 No. MRCC 25
7.7.1
am 2019 No. R41/M42
9.3.2
am.2015 No. R46/MRCC46
9.5.1
rs. 2015 No. R32/MRCC32
9.5.2
add. 2015 No. R32/MRCC32
10.1.5
am.2015 No. R46/MRCC46
10.2 (Heading)
rs.2015 No. R46/MRCC46
10.2.1
am. 2014 No. MRCC 25; am.2015 No. R46/MRCC46; am. 2015 No. R32/MRCC32
10.3.2
am.2015 No. R46/MRCC46; am. 2015 No. R32/MRCC32
10.3.2 (Table)
rs.2015 No. R46/MRCC46; am. 2015 No. R32/MRCC32
10.3.4
am.2015 No. R46/MRCC46
10.3.4(a)
am. 2015 No. R32/MRCC32
10.3.5
am.2015 No. R46/MRCC46
10.3.6
am.2015 No. R46/MRCC46;am. 2015 No. R32/MRCC32
10.3.7
am.2015 No. R46/MRCC46;am. 2015 No. R32/MRCC32
10.3.8
am.2015 No. R46/MRCC46
10.3.9
am.2015 No. R46/MRCC46
Part C (Heading and Notes)
rs. 2015 No. R32/MRCC32
10.4
rs. 2015 No. R32/MRCC32; am 2016 No. R46/MRCC46
10.4A
add. 2015 No. R32/MRCC32
10.8.1
am.2015 No. R46/MRCC46
10.8.2
am.2015 No. R46/MRCC46
Part F
ad 2016 No. R46/MRCC46
10.10
ad 2016 No. R46/MRCC46
10.11
ad 2016 No. R46/MRCC46
11.1.4
am. 2014 No. MRCC 2
11.2A.1
am 2018 No. R88/MRCC88
11.3.1
am. 2014 No. MRCC 2
11.3.1(a)
rep 2019 No. R13/MRCC13
11.3.1(b)
rs. 2014 No. MRCC 2; rs 2019 No. R13/MRCC13
11.3.1(c)
rs. 2014 No. MRCC 2
11.3.2
rs. 2014 No. MRCC 2
11.3.3
rs. 2014 No. MRCC 2
11.3.4
rep. 2014 No. MRCC 2
11.3.4.1
ad 2019 No. R13/MRCC13
11.3.4.2
ad 2019 No. R13/MRCC13
11.3.5.1
ad 2019 No. R13/MRCC13
11.3.5.2
ad 2019 No. R13/MRCC13
11.3.5.3
ad 2019 No. R13/MRCC13
11.3.5.4
ad 2019 No. R13/MRCC13
11.4.1
am 2018 No. R88/MRCC88
11.4.2
am 2018 No. R88/MRCC88
11.4.3
am 2018 No. R88/MRCC88
11.4.6
am 2018 No. R88/MRCC88
11.6.3
rep. 2014 No. MRCC 2
11.9
rep. 2014 No. R107/MRCC107
11.9.1
rep. 2014 No. R107/MRCC107
11.9.1A
rep. 2014 No. R107/MRCC107
11.9.1B
rep. 2014 No. R107/MRCC107
11.9.2
rep. 2014 No. R107/MRCC107
11.9.3
rep. 2014 No. R107/MRCC107
11.9.4
rep. 2014 No. R107/MRCC107
11.9.5
rep. 2014 No. R107/MRCC107
11.9.7
rep. 2014 No. R107/MRCC107
11.9.8
rep. 2014 No. R107/MRCC107
Schedule 1
rs. 2014 No. MRCC 2; rs. 2014 No. MRCC 25; rs. 2014 No. R107/MRCC107; rs. 2015 No. R29/MRCC29; rs.2015 No. R46/MRCC46; rs 2015 No. R73/MRCC73; rs 2016 No. R31/MRCC31; rs 2016 No. R30/MRCC30; rs 2017 No. R1/MRCC1; rs 2017 No. R21/MRCC21; rs 2018 No. R12/MRCC12; am 2018 No. R88/MRCC88; am 2019 No. R41/M42
Endnote 5—Editorial changes
In preparing this compilation for registration, the following kinds of editorial change(s) were made under the Legislation Act 2003.
Paragraph 1.4.1 (Interpretation) definition of “Notes for General Practitioners”
Kind of editorial change
Change to punctuation
Details of editorial change
Schedule 2 item 15 of the Veterans’ Affairs (Treatment Principles – Local Medical Officer) Amendment Instrument 2019 omits the definition of “Notes for Local Medical Officers” and substitutes the definition for “Notes for General Practitioners”.
In the newly substituted definition there are no double quotation marks around the term “Notes for General Practitioners”.
This compilation was editorially changed to insert the double quotation marks around the term “Notes for General Practitioners” in paragraph 1.4.1 (Interpretation) to correct the punctuation.
Paragraph 1.4.1 (Interpretation) definition of “period of care” (paragraph (a))
Kind of editorial change
Give effect to the misdescribed amendment as intended
Details of editorial change
Schedule 2 paragraph 18(a) of the Veterans’ Affairs (Treatment Principles – Local Medical Officer) Amendment Instrument 2019 provides as follows:
18 Paragraph 1.4.1 (Interpretation) definition of “period of care”
(a) omit the paragraph, substitute:
“(a) a general practitioner; or”; and
The instruction does not specify which paragraph is to be omitted.
This compilation was editorially changed to omit and substitute paragraph (a) of the definition “period of care” in paragraph 1.4.1 (Interpretation) to give effect to the misdescribed amendment as intended.
Paragraph 1.4.1 (Interpretation) definition of “subsequent period of care”
Kind of editorial change
Change to typeface
Details of editorial change
Schedule 2 item 22 of the Veterans’ Affairs (Treatment Principles – Local Medical Officer) Amendment Instrument 2019 instructs to omit and substitute the definition of “subsequent period of care” (including the Note)”.
In the newly substituted definition, “practitioner” (first occurring) is missing italics from the letter “r” (last occurring).
This compilation was editorially changed to italicise the letter “r” (last occurring) in “practitioner” (first occurring) in the definition of “subsequent period of care” in paragraph 1.4.1 (Interpretation).
Paragraph 3.5.1(1)(h)
Kind of editorial change
Change to punctuation
Details of editorial change
Schedule 2 item 25 of the Veterans’ Affairs (Treatment Principles – Local Medical Officer) Amendment Instrument 2019 omits and substitutes paragraph 3.5.1(1)(h). The newly substituted paragraph ends with a full stop after the semicolon.
This compilation was editorially changed to omit the full stop at the end of paragraph 3.5.1(1)(h) to correct the punctuation.
Paragraphs 6A.1 and 6A.9.5
Kind of editorial change
Give effect to the misdescribed amendments as intended and change to typeface
Details of editorial change
Schedule 2 paragraph 34(g) of the Veterans’ Affairs (Treatment Principles – Local Medical Officer) Amendment Instrument 2019 instructs to omit “The LMO” and substitute “The general practitioner” in Part 6A.
The words “The LMO” appear twice in paragraph 6A.1 and once in paragraph 6A.9.5 of Part 6A.
This compilation was editorially changed to omit the words “The LMO” and substitute “The general practitioner” in paragraphs 6A.1 and 6A.9.5 to give effect to the misdescribed amendments as intended.
In paragraph 6A.9.5 the words “general practitioner” are missing italics and are now inconsistent with the rest of those words in that paragraph.
This compilation was editorially changed to insert italics on the words “general practitioner” in paragraph 6A.9.5.
Subparagraph 6A.4A.1(a)(iii)
Kind of editorial change
Give effect to the misdescribed amendment as intended
Details of editorial change
Schedule 2 item 40 of the Veterans’ Affairs (Treatment Principles – Local Medical Officer) Amendment Instrument 2019 instructs to omit “LMOs” and substitute “general practitioners”.
The word “LMOs” does not appear in subparagraph 6A.4A.1(a)(iii). However, the word “LMOs” does appear.
This compilation was editorially changed to omit the word “LMOs” and substitute “general practitioners” in subparagraph 6A.4A.1(a)(iii) to give effect to the misdescribed amendment as intended.
Paragraph 6A.8.1
Kind of editorial change
Give effect to the misdescribed amendment as intended
Details of editorial change
Schedule 2 paragraph 34(d) of the Veterans’ Affairs (Treatment Principles – Local Medical Officer) Amendment Instrument 2019 instructs to omit “an LMO” (wherever occurring) and substitute “a general practitioner” in Part 6A.
The words “An LMO” appear in paragraph 6A.8.1.
This compilation was editorially changed to omit the words “An LMO” and substitute “A general practitioner” in paragraph 6A.8.1 to give effect to the misdescribed amendment as intended.
Paragraph 7.3.3(a)
Kind of editorial change
Give effect to the misdescribed amendment as intended
Details of editorial change
Schedule 2 item 47 of the Veterans’ Affairs (Treatment Principles – Local Medical Officer) Amendment Instrument 2019 instructs to omit “a Local Medical Officer or other GP” and substitute “a general practitioner” in paragraph 7.3.3(a).
The words “a Local Medical Officer or other GP” do not appear in paragraph 7.3.3(a). However, the words “a Local Medical Officer or other GP” do appear.
This compilation was editorially changed to omit the words “a Local Medical Officer or other GP” and substitute “a general practitioner” in paragraph 7.3.3(a) to give effect to the misdescribed amendment as intended.
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