Explanatory Statement
Issued by the Authority of the Minister for Health and Ageing
Health Insurance Act 1973
Health Insurance (Allied Health Services) Amendment Determination 2011(No 1)
Subsection 3C(1) of the Health Insurance Act 1973 (the Act) provides that the Minister may, by writing, determine that a health service not listed in the general medical services table (the Table) shall, in specified circumstance and for specified statutory provisions, be treated as if it were so listed. This Table is set out in the Health Insurance (General Medical Services Table) Regulations, remade annually.
Subsection 3C(8) of the Act specifies the health services about which a determination under subsection 3C(1) of the Act may be made. These include certain specified services and any other prescribed service that relates to health. Regulation 3A of the Health Insurance Regulations 1975 prescribes classes of allied health services as “health services” for the purposes of section 3C of the Act.
The purpose of the amendment is to introduce mandatory continuing professional development requirements for providers of focused psychological strategies.
This Determination amends the Health Insurance (Allied Health Services) Determination 2010.
Continuing Professional Development (CPD) requirements
Currently, focussed psychological strategies (FPS) services performed by allied health professionals who are registered with Medicare Australia for FPS attract Medicare benefits. These allied health professionals include eligible psychologists, occupational therapists and social workers.
Under this measure, allied health professionals registered with Medicare Australia to provide FPS services are required to undertake 10 hours of CPD annually. An allied health professional who does not meet this requirement may be removed from the Medicare Australia register, meaning he or she would cease to be eligible to provide FPS services attracting Medicare benefits.
Mandatory CPD standards for allied health professionals providing FPS services promotes good clinical practice and is an important step to ensure that Commonwealth-funded mental health services are of a suitably high quality.
Restricting the payment of Medicare rebates to FPS services rendered by providers who have completed CPD, provides a quality assurance mechanism that all FPS are delivered by highly qualified allied health professionals, who have maintained their clinical skills and knowledge base. The initiative is part of the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule 2009–10 Budget measure.
CPD activities must be relevant to delivering FPS services. Acceptable CPD activities (where the content is related to FPS) can include formal postgraduate education, workshops, seminars, lectures, journal reading, writing papers, receipt of supervision and peer consultation and online training programs.
There is flexibility in the CPD activities that can be undertaken to meet individual professional needs and an allied health practitioner’s practice/client base and client needs. For example, activities can also include assessment and treatment of specific disorders and client types such as youth, or different modalities and delivery such as working with groups.
Allied health professionals providing FPS will be required to retain written records of completion of FPS related CPD activities for two years from the end of the CPD year (i.e. 30 June) to which the records relate. Where the Minister is satisfied that a provider has not met his or her FPS related CPD requirements, the Minister may decide to remove that person from the register of eligible providers of Medicare FPS services.
A reconsideration mechanism allows for allied health professionals to either request of the Minister a further 28 days to complete their CPD requirements, or apply to the Minister for internal review of the decision that the allied health professional has not completed their FPS CPD requirements.
Allied health professionals who are removed from the approved provider register by Medicare Australia can be placed back on the list once they meet their CPD requirements for the previous CPD cycle. Allied health professionals who are reinstated to the register are also required to meet the 10 hour requirement for the current CPD year in full by 30 June of that CPD year.
Details of this Determination are set out in the Attachment.
Consultation
Continuing Professional Development (CPD) requirements
Consultation on CPD for FPS services was provided via a working group, which was established in 2009 and included the following peak bodies:
- The Australian Psychological Society;
- The Australian Association of Social Workers; and
- Occupational Therapy Australia.
The working group provided technical expertise on the content of CPD for each profession.
Consultations were also held with the Psychology Board of Australia which provided advice on managing compliance with CPD requirements.
This Determination is a legislative instrument for the purposes of the Legislative Instruments Act 2003.
This Determination commences on the day after registration.
Attachment
Details of the health insurance (allied health services) AMENDMENT determination 2011 (NO 1)
Part 1 Preliminary
Section 1 Name of Determination
Section 1 provides that the name of the Determination is the Health Insurance (Allied Health Services) Amendment Determination 2011 (No 1).
Section 2 Commencement
Section 2 provides that the Determination commences on the day after registration.
Section 3 Schedule 1 – amendment of Health Insurance (Allied Health Services) Determination 2010
This section sets out that Schedule 1 contains the amendments to the Health Insurance (Allied Health Services) Determination 2010.
Schedule 1 – Amendments
[1] Subsection 4(1) definition of allied health professional
A note has been added to the end of the definition. The note explains that section 10 of the Determination applies to allied health professionals providing focussed psychological strategies services.
[2] Subsection 4(1) definition of CPD year
A new definition of ‘CPD year’ has been added. The definition provides that a CPD year is the period of time in which focussed psychological strategies continuing professional development requirements must be completed, being 1 July to 30 June each year. However, the first CPD year will be from the date of the commencement of the Determination to 30 June 2011.
[3] Subsection 4(1) definition of focussed psychological strategies continuing professional development
A new definition for ‘focussed psychological strategies continuing professional development’ has been added. The definition provides that focussed psychological strategies continuing professional development means the completion of 10 units each CPD year. Each unit consists of one hour of continuing professional development that relates to the delivery of focussed psychological strategies in any of psycho-education, cognitive-behavioural therapy, cognitive interventions, relaxation strategies, skills training, interpersonal therapy, narrative therapy (for Aboriginal or Torres Strait Islander people) or clinical skills.
[4] Section 10 Focussed Psychological Strategies health services
Subsection 10(1) provides that a person must complete focussed psychological strategies continuing professional development each CPD year.
Subsection 10(2) provides that a person is required to keep written records of their participation in focussed psychological strategies continuing professional development for a period of two years from the end of the CPD year to which the focussed psychological strategies continuing professional development relates.
Subsection 10(3) provides that for the first CPD year, allied health professionals are able to count any focussed psychological strategies continuing professional development accrued from 1 July 2009 to 30 June 2011 towards their requirements for that relevant CPD year.
Subsection 10(4) provides that, other than when seeking reregistration, when a person seeks to become an allied health professional during a CPD a year that person will be registered until the end of the CPD year and will have until the end of the CPD year to meet the focussed psychological strategies continuing professional development on a pro-rata basis, with units being calculated from the first day of the month immediately succeeding the date of registration.
Under subsection 10(5)(a) the Minister may decide to remove an allied health professional’s name from the register kept by the Medicare Australia CEO if the Minister is satisfied that the allied health professional does not comply with the focussed psychological strategies continuing professional development . Under subsection 10(5)(b) the Minister may then notify the Medicare Australia CEO to remove the name of the allied health professional from the register.
Under subsection 10(6) before the Minister provides notice to the Medicare Australia CEO under subsection 10(5)(b) the Minister must notify the allied health professional in writing of the decision, the reasons for the decision and the allied health professional’s reconsideration rights under section 11.
Subsection 10(7) sets out certain requirements that must be met before a person, whose name was removed from the register of allied health professionals in relation to the provision of focussed psychological strategies services, may be reinstated to the register. These requirements are that:
- he or she provides evidence of completing the necessary number of units that would have been required for him or her to meet the 10 units in the year that he or she failed to comply; and
- he or she completes focussed psychological strategies continuing professional development for the CPD year in which he or she was reregistered. For the year of reregistration, the CPD year is taken to have commenced on the date the person is reregistered.
Subsection 10(8) provides for the Minister to grant an exemption from focussed psychological strategies continuing professional development if special circumstances exist. This may include circumstances where it has not been practical for an allied health professional to complete the focussed psychological strategies continuing professional development due to ill health, maternity/paternity leave or other special circumstances.
Subsection 10(9) provides that upon receiving notification under subsection 10(5)(b) the Medicare Australia CEO shall not remove the name of the allied health professional from the register until notified that where :
a) the allied health professional has sought a review of the decision to remove, the decision has been affirmed; or
b) the allied health professional has sought time to complete the number of units required to satisfy the Minister that the allied health professional complies with subsection 10(1), the Minister has given notice under subsection 11(9)(c) where the Minister was not satisfied that the units were completed; or
c) neither a) or b) applies, the time for apply for reconsideration referred to in subsection 11(2) has expired.
Section 11 Reconsideration of Decision
This section provides that an allied health professional who has been notified of a decision by the Minister to remove his or her name from the register of allied health professionals may either:
- apply to the Minister for either a reconsideration of that decision by the Minister (subsection 11(1)); or
- request a further 28 days in which to complete the number of units required to satisfy the Minister that the allied health professional has complied with subsection 10(1) (subsections 11(6) and 11(8)).
Under subsection 11(3) the allied health professional must set out reasons for the application and may include new material for the Minister to consider.
Under subsection 11(4) the Minister must within 28 days from the receipt of an application for a reconsideration decision, make that decision and under subsection 11(5) must notify the applicant in writing of the outcome and reasons for the reconsideration decision.
Under subsection 11(7) where an allied health professional has made a request under subsection 11(6) that request takes the place of his or her rights under subsection 11(1).
Under subsection 11(9), where a person who has requested further time to complete his or her CPD requirements fails to complete those requirements to the Minister’s satisfaction in the allotted time, the Minister must proceed as if the allied health professional applied under subsection 11(1); make a decision that will be regarded as having been made under subsection 11(4); and give notice in writing of that decision to the allied health professional, as if the notice was given under subsection 11(5).).
Under subsection 11(10) the Minister must provide a written copy of a decision made under section 11 to the Medicare Australia CEO.
[5] Schedule 1, item 7
Schedule 1 sets out the qualification requirements for the various types of allied health professionals.
A note has been added to item 7 to indicate that allied health professionals in relation to the provision of a focussed psychological strategies health service are subject to the requirements of section 10 of the Determination.