Federal Register of Legislation - Australian Government

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M4/2008 Principles as made
This Principle amends MRCA Treatment Principles (Instrument No. M21 of 2004) to provide that the Military Rehabilitation and Compensation Commission is not to accept financial liability for treatment provided to members or former members of the Defence Force, or their dependants (entitled persons), by a health care provider who is not permitted to participate in Medicare arrangements. This variation also introduces a new strategic mental health treatment for entitled persons and streamlines the process for updating incorporated documents in the MRCA Treatment Principles.
Administered by: Veterans' Affairs
General Comments: This instrument revokes MRCA Treatment Principles (Providers/ACPMH Treatment/Incorporated Documents) Instrument 2007 (No. M6 of 2007). As the instrument was signed by the Minister and never registered it needed to be formally revoked.
Registered 22 Feb 2008
Tabling HistoryDate
Tabled HR11-Mar-2008
Tabled Senate11-Mar-2008
Date of repeal 19 Mar 2014
Repealed by Veterans' Affairs (Spent and Redundant Instruments) Repeal Regulation 2014

 

EXPLANATORY STATEMENT

 

MRCA Treatment Principles (Providers/ACPMH Treatment/Incorporated Documents) Instrument 2008

 

EMPOWERING PROVISION

 

Paragraph 286(1)(a) of the Military Rehabilitation and Compensation Act 2004 (the Act).

 

PURPOSE

 

The attached instrument (M4/2008) amends the MRCA Treatment Principles. 

 

The MRCA Treatment Principles is a legislative instrument made under paragraph 286(1)(a) 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 (or former members) of the Defence Force or their dependants (entitled persons).

 

The purpose of the attached instrument is to:

 

·        enable the Department of Veterans’ Affairs (DVA) to decline to pay for treatment provided to an entitled person if the practitioner providing the treatment is disqualified under the Health Insurance Act 1973 from being paid a medicare benefit (“Disqualification Amendment”);

 

·        introduce a new treatment for entitled members (including former members) of the Defence Force – ACPMH treatment, being treatment provided under the auspices of the Australian Centre for Posttraumatic Mental Health Incorporated;

 

·        update certain documents incorporated-by-reference into the MRCA Treatment Principles (“Incorporated Documents Amendment”).

 

Disqualification Amendment

 

The aim here is to maintain the financial integrity of the Repatriation Comprehensive Care Scheme (as adopted for the purposes of the Military Rehabilitation and Compensation Act 2004) by ensuring that DVA does not pay for treatment services provided by practitioners who have been found by Medicare Australia to have acted in an unprofessional manner e.g. overserviced.

 

ACPMH Treatment

 

This is a new “strategic treatment” provided by the Australian Centre for Posttraumatic Mental Health Incorporated to entitled members of the Defence Force (including entitled former members) and involves, among other things, 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 (or entitled former member).

 

This new treatment does not fall within commonly held views of “treatment” but under the Military Rehabilitation and Compensation Act 2004 treatment is a very broad concept and includes “… action taken, with a view to … maintaining a person in, physical or mental health…” (s.13).  It is this component of the treatment-concept that forms the basis for ACPMH treatment.

 

Incorporated Documents Amendment

 

The MRCA Treatment Principles refer to a number of documents that are not set out in the Principles (external documents).  An example of such a document is the Pricing Schedule for Visual Aids in force on

1 May 2007.

 

It is legally permissible to make external documents part of a legislative instrument but the Legislative Instruments Act 2003 specifies that unless the external document is also legislative then it can only be incorporated into the legislative instrument as it, the external document, exists at the time the legislative instrument takes effect and not as the external document might exist at a future date when it has changed (s.14).  In other words, a non-legislative external document is “frozen” in the form it is in when the legislative instrument that incorporates it, takes effect.

 

Accordingly, if an external document has been changed then it is necessary to amend the legislative instrument that refers to the document so that the reference to the document is made a reference to the updated document.

 

The attached instrument amends the MRCA Treatment Principles so that references to certain external documents are references to those documents in their updated (changed) form.

 

 

 

RETROSPECTIVE

 

No.

 

CONSULTATION

 

In relation to the “Disqualification Amendment”, Medicare Australia was consulted.  Practitioners were not consulted because the Rule-Maker considered that consultation was not appropriate because the relevant practitioners were already subject to the same type of provision in the Health Insurance Act 1973 in relation to treating Commonwealth-funded patients and essentially all the attached instrument does is enlarge that group of Commonwealth-funded patients.

 

In relation to the “ACPMH Amendment”, the Australian Centre for Posttraumatic Mental Health Incorporated was consulted by the Department of Veterans’ Affairs (DVA) in relation to ACPMH treatment. DVA clients were not consulted because the relevant treatment is beneficial and, further, is of an indirect nature (strategic mental health measure) and in these circumstances the Rule-Maker decided that consultation was not appropriate.

 

In relation to the “Incorporated Documents Amendment”, the Rule-Maker considered that consultation was not appropriate because the amendment was of a machinery nature and did not substantially alter existing arrangements.

 

Documents Incorporated-by-Reference

 

Yes.

 

The following non-legislative documents in force on 1 November 2007 are incorporated into the MRCA Treatment Principles by the attached instrument:

 

·        Dental Schedules;

·        Fee Schedules for treatment provided by health care providers;

·        Notes for Local Medical Officers;

·        Notes for Providers of Optometric Services /Dispensers of Optical Appliances;

·        Pricing Schedule for Visual Aids;

·        Notes for Providers (general);

·        Notes for Local Dental Officers;

·        Notes for Chiropractors;

·        Notes for Diabetes Educators;

·        Notes for Dietitians;

·        Notes for Exercise Physiologists;

·        Notes for Occupational Therapists;

·        Notes for Osteopaths;

·        Notes for Podiatrists;

·        Notes for Physiotherapists;

·        Notes for Speech Pathologists;

·        RAP National Schedule of Equipment;

·        Rehabilitation Appliances Program (RAP) National Guidelines.

 

At the time the attached instrument was made, all the documents were available on the Internet (Department of Veterans’ Affairs web page – under Health – Doctors/Health Care Professionals):

 

http://www.dva.gov.au/

 

and at the time the attached instrument was made all the documents were available, or could be made 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.

 

Any State or Territory Office of the Department of Veterans’ Affairs:

Tel.no: 133 254

 

FURTHER EXPLANATION

 

Attachment A.

 


Attachment A

 

Clauses                                   Explanation

 

1.       sets out the name of the instrument.

 

2.       revokes instrument No.M6/2007 (approved by the Minister for Veterans’ Affairs on 24 January 2008) because the Minister’s name was misspelt.

 

3.       provides that the instrument commences when it is registered on the Federal Register of Legislative Instruments.

 

4.       contains definitions.

 

5.       ensures that any action taken, or decision made, under Notes for Providers, before the commencement of the attached instrument, that on the commencement of the instrument had not been completed or implemented, as the case requires, may be completed or implemented under the relevant Notes for Providers as those Notes are incorporated into the MRCA Treatment Principles by the attached instrument.

 

Schedule A – Disqualification of Providers

 

1.       inserts a more accurate definition of “medicare benefit”.

 

2.       inserts a new definition of “practitioner”.  This complements the amendments at items 3, 4, 5 and 6.

 

3.       revises the definition of “provider number” in order to incorporate the more comprehensive definition of “practitioner” in the Health Insurance Act 1973 so that a practitioner under that Act (who may also be a provider under the MRCA Treatment Principles) is not only a medical practitioner, dentist or optometrist (as was formerly the case) but is also an allied health care provider. 

 

This means that allied health care providers, and not just medical practitioners, dentists and optometrists, need a provider number if DVA is to pay them for treating entitled persons under the MRCA Treatment Principles.

 

4.       prohibits the Military Rehabilitation and Compensation Commission from accepting financial responsibility for a medical-service provided to an entitled person by a medical practitioner if, had the medical practioner provided the service as a practitioner under the Health Insurance Act 1973, a medicare benefit would not have been payable in respect of the service because the practitioner had been disqualified under that Act.

 

         It should be noted that the Military Rehabilitation and Compensation Commission may accept financial liability for a treatment-service and DVA may meet the Commission’s liability by paying for the service.

 

5.       prohibits the Military Rehabilitation and Compensation Commission from accepting financial responsibility for a dental-service provided to an entitled person by a dental practitioner if, had the dental practioner provided the service as a practitioner under the Health Insurance Act 1973, a medicare benefit would not have been payable in respect of the service because the practitioner had been disqualified under that Act.

 

6.       prohibits the Military Rehabilitation and Compensation Commission from accepting financial responsibility for a service provided to an entitled person by a health care provider (i.e. a provider covered by Part 7 of the MRCA Treatment Principles) if, had the health care provider provided the service as a practitioner under the Health Insurance Act 1973, a medicare benefit would not have been payable in respect of the service because the practitioner had been disqualified under that Act.

 

Schedule B – ACPMH Treatment

 

1/2.    insert definitions.

 

3.       enables the Military Rehabilitation and Compensation Commission to accept financial liability for ACPMH treatment. 

 

Schedule C – Incorporated Documents

 

1.       incorporates the dental schedules in force on 1 November 2007 into the MRCA Treatment Principles.

 

2.       incorporates Fee Schedules in force on 1 November 2007 into the MRCA Treatment Principles.

 

3.       incorporates Notes for Local Medical Officers in force on 1 November 2007 into the MRCA Treatment Principles.

 

4.       incorporates Notes for Providers of Optometric Services/Dispensers of Optical Appliances in force on 1

November 2007 into the MRCA Treatment Principles.

 

5.       incorporates the Pricing Schedule for Visual Aids in force on 1 November 2007 into the MRCA Treatment Principles.

 

6.       amends the general provisions that incorporate Notes for Providers into the MRCA Treatment Principles by providing that Notes for Providers in force on 1 November 2007 are incorporated into the Principles.

 

7.       incorporates the Notes for Local Dental Officers in force on 1 November 2007 into the MRCA Treatment Principles.

 

8.                amends the specific provisions that incorporate Notes for Providers into the MRCA Treatment Principles by providing that Notes for Providers in force on 1 November 2007 are incorporated into the MRCA Treatment Principles.

 

9.       provides that in order for the Military Rehabilitation and Compensation Commission to be able to accept financial liability for exercise physiology treatment provided by an exercise physiologist to an entitled person, the treatment must have been provided in accordance with the Notes for Exercise Physiologists (in force on 1 November 2007).

 

10.     incorporates the RAP National Schedule of Equipment and the Rehabilitation Appliances Program (RAP) National Guidelines, in force on 1 November 2007, into the MRCA Treatment Principles.

 

11.     specifies the date on which external documents incorporated into the MRCA Treatment Principles are to be regarded as being in force for the purposes of the MRCA Treatment Principles – 1 November 2007.