EXPLANATORY STATEMENT
MRCA Private Patient Principles 2004 (Removal of Arrangements for Local Medical Officers) Instrument 2007.
EMPOWERING PROVISION
Subsection 286(1)(b) of the Military Rehabilitation and Compensation Act 2004 (the Act).
PURPOSE
The attached instrument amends the MRCA Private Patient Principles 2004 (MPPPs).
The MPPPs is a legislative instrument made under paragraph 286(1)(b) of the Act and sets out the circumstances in which the Military Rehabilitation and Compensation Commission may accept financial liability for treatment provided to members, former members, and their dependants, (entitled persons) as private patients.
A person is a private patient if, for the purposes of the Health Insurance Act 1973, he or she is a private patient of a hospital or if the person is treated by a medical specialist at a place other than a hospital.
The attached instrument removes a criterion from the definition of “Local Medical Officer” namely that the Local Medical Officer is a medical practitioner who provides treatment to an entitled person under arrangements with the Military Rehabilitation and Compensation Commission.
Prior to the attached Instrument, unless a Local Medical Officer had an arrangement with the Military Rehabilitation and Compensation Commission in relation to treating entitled persons, then under the MPPPs the Military Rehabilitation and Compensation Commission could not accept financial liability for the Local Medical Officer’s services (arrangement-requirement).
Arrangements between Local Medical Officers and the Military Rehabilitation and Compensation Commission addressed matters such as fees for treatment, manner of claiming fees and a registration system aimed at securing better services for entitled persons and facilitating accountability.
The arrangements the Military Rehabilitation and Compensation Commission has with Local Medical Officers are the same arrangements the Repatriation Commisson has with those Local Medical Officers under the Treatment Principles made under the Veterans’ Entitlements Act 1986.
Issuing contracts to new providers and the renewal of contracts for existing providers is a huge task for DVA and likewise imposes a significant burden on busy health care providers. Accordingly DVA reviewed the situation.
It was found that the use of arrangements by the Military Rehabilitation and Compensation Commission was not necessary for Local Medical Officers or indeed the majority of health care providers and that the matters addressed in arrangements could be dealt with in the MRCA Treatment Principles made under paragraph 286(1)(a) of the Military Rehabilitation and Compensation Act 2004, either directly or indirectly via incorporated documents.
Accordingly the Repatriation Commission, acting on advice from DVA, decided to remove the arrangement-requirement from the MRCA Treatment Principles and the MPPPs and regulate relationships with Local Medical Officers and other health care providers in a more prescriptive way ie in the MRCA Treatment Principles.
Under the MPPPs, Local Medical Officers will now no longer need an arrangement with the Military Rehabilitation and Compensation Commission but must provide medical services to entitled persons in accordance with the MRCA Treatment Principles in order for the Military Rehabilitation and Compensation Commission to accept financial liability for the Local Medical Officer’s services.
The role of a Local Medical Officer under the MPPPs is that he or she may refer an entitled person to a medical specialist without needing to obtain the prior approval of the Military Rehabilitation and Compensation Commission.
The amendments made by the attached instrument will not operate in situations where a Local Medical Officer still has a current arrangement/contract with the Military Rehabilitation and Compensation Commission as previously required by the MPPPs.
Where a current arrangement/contract is on foot, the MPPPs will apply to the situation in the state they were in immediately before they were amended by the attached instrument.
It is only when that current arrangement/contract expires (or is terminated) and the Local Medical Officer refers an entitled person to a medical specialist and claims payment from DVA that the attached amendments would apply.
The reason for allowing any current arrangements/contracts with Local Medical Officers to run their course, rather than terminating them, is because terminating several thousands of arrangements/contracts would impose significant demands on both Local Medical Officers and DVA.
RETROSPECTIVE
No.
CONSULTATION
Yes, consultation occurred with representatives of Local Medical Officers in a number of DVA/provider consultative forums at various times.
DOCUMENTS INCORPORATED-BY-REFERENCE
Yes. The “Notes for Local Medical Officers” (a non-legislative document) as in force on 1 May 2007 is incorporated into the MPPPs by the attached instrument.
At the time the attached instrument was made, the “Notes for Local Medical Officers” was available on the Internet (Department of Veterans’ Affairs web page – under Health – Doctors):
http://www.dva.gov.au/
At the time the attached instrument was made, the “Notes for Local Medical Officers” was also available at:
Department of Veterans’ Affairs (ACT Office), Lovett Tower, 13 Keltie St Woden ACT 2606 / PO Box 21 Woden ACT 2606. Tel.no.(02) 6289 6243.
FURTHER EXPLANATION
Attachment A.
Attachment A
Clauses Explanation
1. sets out the name of the instrument.
2. provides that the instrument commences when it is registered on the Federal Register of Legislative Instruments.
3. contains definitions.
4. ensures that the amendments made by the instrument do not apply to the situation where a Local Medical Officer has a current contract or arrangement with the Military Rehabilitation and Compensation Commission (Commission), being a contract or arrangement entered into before the commencement of the attached instrument. The amendments will only regulate the relationship between the Commission and a Local Medical Officer who refers an entitled person to a medical specialist and seeks payment from DVA, where there is no pre-existing contract or other arrangement between the parties governing that relationship.
5. inserts a revised definition of “Local Medical Officer” and inserts a new definition of “medical practitioner”. The definition of Local Medical Officer no longer contains an arrangement-requirement.
A Local Medical Officer is a medical practitioner who:
- is registered under the Notes for Local Medical Officers;
- treats entitled persons in accordance with the terms and conditions in the Treatment Principles and Notes for Local Medical Officers; and
- has a current provider number from Medicare Australia.
A medical practitioner is a person currently registered or licensed as a medical practitioner under a State or Territory providing for the registration or licensing of medical practitioners.
6. inserts a definition of “Medicare Australia”.
7. inserts a definition of “Notes for Local Medical Officers”.
The Notes for Local Medical Officers is a document approved by the Repatriation Commission, the Military Rehabilitation and Compensation Commission or the Department of Veterans’ Affairs, as in force on 1 May 2007 that sets out the detailed terms and conditions that a Local Medical officer must comply with when providing medical treatment to an entitled person if the Military Rehabilitation and Compensation Commission is to accept financial liability for that treatment. Other, more general, terms and conditions are set out in the MRCA Treatment Principles.