Federal Register of Legislation - Australian Government

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M8/2010 Principles as made
This instrument amends the MRCA Treatment Principles to give treatment providers 5 years instead of 6 months to lodge claims and remove the need for dental treatment for defence force members and their dependants to have the Military Rehabilitation and Compensation Commission's prior approval (except where specified). The instrument also authorises payments of fees for treatment providers and updates references in the MRCA Treatment Principles to incorporated documents.
Administered by: Veterans' Affairs
General Comments: Saving: Despite the omission of the Schedule 3 by paragraph 26, the documents in that Schedule entitled “RAP National Schedule of Equipment” and “Rehabilitation Appliances Program (RAP) National Guidelines” in force on 1 September 2008 remain incorporated in the MRCA Treatment Principles until 1 September 2010.
Registered 19 Oct 2010
Tabling HistoryDate
Tabled HR24-Oct-2010
Tabled Senate24-Oct-2010
Date of repeal 19 Mar 2014
Repealed by Veterans' Affairs (Spent and Redundant Instruments) Repeal Regulation 2014

 

Australian Government

Military Rehabilitation and Compensation Act 2004

 

MRCA Treatment Principles (Claims/Dental/Fees) Instrument 2010

 

Instrument No.M8/2010

 

 

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

Dated this         First     day of               October           2010

Warren Snowdon

……………………………………………………

WARREN SNOWDON

 

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

Dated this         23rd     day of               September        2010

 

The Seal of the                                                 )                   Seal

Military Rehabilitation                                       )

and Compensation Commission                      )

was affixed hereto in the                                    )

presence of:                                                      )

Ian Campbell                                       Major General Mark Kelly AO

………………………………………………………………………………………....

IAN CAMPBELL                           Major General Mark Kelly AO

CHAIR                                                                          MEMBER

 

 

 

 

 

 

[1]     Name of Instrument

This instrument is the MRCA Treatment Principles (Claims/Dental/Fees) Instrument 2010

 

[2]     Commencement

 

        (a)      Subject to (b), (c) and (d) this instrument commences on the day after the day on which it is registered on the Federal Register of Legislative Instruments.

 

(b)     Paragraph 26 (which inserts the Schedule 1 in the MRCA Treatment Principles) is taken to have commenced, in respect of the items in Part 1 of the Schedule 1 that relate to fees, on 1 November 2009.  Paragraph 26 commences in respect of the remaining items in Part 1 of Schedule 1 on the day after the day on which this instrument is registered on the Federal Register of Legislative Instruments.

 

(c)     The variation made by paragraph 26 (which inserts the Schedule 1 in the MRCA Treatment Principles) is, immediately after commencement of this instrument, revoked, or taken to have been revoked, on 1 May 2010.

 

(d)     The variation made by paragraph 26A (which inserts the Schedule 1 in the MRCA Treatment Principles) is taken to have commenced after the revocation of the variation made by paragraph 26 and:

 

                 (i)      in respect of the items in Part 1 of the Schedule 1 that relate to fees, on 1 May 2010.  In respect of the remaining items in Part 1 of Schedule 1, on the day after the day on which this instrument is registered on the Federal Register of Legislative Instruments;

 

(ii)      in respect of the items in Part 2 of the Schedule 1, on

1 November 2010.

 

 

[3]     Application

 

(1) (a)     Where, before the commencement of this instrument, a health care provider treated an entitled person and, on the commencement of the instrument, had not lodged a claim for payment for the treatment, the situation is governed by the MRCA Treatment Principles as varied by this instrument.

 

            Note: this means that the provider has 5 years from the date of service in which to lodge a claim with the possibility of that period being extended.

 

(b)     Where, before the commencement of this instrument, a health care provider treated an entitled person and, on the commencement of the instrument:

 

          (i)      had lodged a claim for payment for the treatment    within 6 months after the treatment but the claim had        not been determined;

         

(ii)      had lodged a claim for payment for the treatment more     than 6 months after the treatment and the claim had       not been determined;

 

          the situation is governed by the MRCA Treatment Principles as varied by this instrument.

 

Note:      for case (i), this means that the claim is within the claim period of  5 years from the date of service.

for case (ii), if the claim is within the claim period of  5 years from the date of service, it will be assessed routinely. If the period is greater than 5 years from the date of service it will be assessed under late-lodgement guidelines.

 

(c)     Where, before the commencement of this instrument, a health care provider treated an entitled person and, on the commencement of the instrument, had applied to the Military Rehabilitation and Compensation Commission for an extension of time in which to lodge a claim for payment for the treatment and the application had not been determined:

 

          (i)      if the application had been made within 5 years after         the treatment had been provided, the Military      Rehabilitation and Compensation Commission is to           accept the claim in respect of which the application is       made;

         

                    Note:      applications tend to have claims attached.

 

          (ii)      if the application had been made more than 5 years after the treatment had been provided the application is governed by the MRCA Treatment Principles as           varied by this instrument;

           

                        Note: this means the application will be assessed under late-lodgement   guidelines.

                              

(2)     Where, under [2](b) and [2](d), a document setting out a fee is incorporated into the MRCA Treatment Principles on

1 November 2009 and 1 May 2010 respectively, then for the periods 1 November 2009 to 1 May 2010 and 1 May 2010 to the commencement date in [2](a) (day after registration), only that part of the document that sets an increased fee applies, and on the commencement date in [2](a), the remainder of the document applies

 

[4]     Saving

 

Despite the omission of the Schedule 3 by paragraph 26, the documents in that Schedule entitled “RAP National Schedule of Equipment” and “Rehabilitation Appliances Program (RAP) National Guidelines” in force on 1 September 2008 remain incorporated in the MRCA Treatment Principles until 1 September 2010.

 

[5]     A term in [2], [3] or [4] that is defined in the Military Rehabilitation and Compensation Act 2004 (Act) or in the MRCA Treatment Principles (Principles) under paragraph 286 (1)(a) of the Act, has the same meaning it has in the Act or the Principles, as the case may be.

 

Schedule

 

1.       Paragraph 1.4.1 (definitions) and wherever else occurring

 

          omit:

 

          in force on the date in Schedule 3

 

          substitute:

 

in force on the date in Schedule 1

 

2.       Paragraph 1.4.1 (definition of “in force on the date in Schedule 3”)

 

          omit (wherever occurring):

 

          Schedule 3

 

          substitute:

 

Schedule 1

 

3.       Paragraph 1.4.1 (definitions)

 

omit definition of dental schedules

 

          omit definition of Fee Schedule

 

          omit definition of Notes for Local Medical Officers

 

omit definition of Notes for Providers of Optometric Services /Dispensers of Optical Appliances

 

          omit definition of Pricing Schedule for Visual Aids

 

          insert:

 

“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.

 

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:

 

http://www.dva.gov.au/Pages/home.aspx

 

Notes for Chiropractors” means the document approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Chiropractors”, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which, a chiropractor is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

 

Notes for Diabetes Educators” means the document approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Diabetes Educators”, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which, a diabetes educator is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

 

Notes for Dietitians” means the document approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Dietitians”, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which, a dietitian is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

 

Notes for Exercise Physiologists” means the document approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Exercise Physiologists”, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which, an exercise physiologist is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

 

Notes for Local Dental Officers” means the document approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Local Dental Officers”, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which, a dentist or dental specialist is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

 

          “Notes for Local Medical Officers” means the document:

 

(i)      approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Local Medical Officers”; and

 

(ii)      in force on the date in Schedule 1; and

 

(iii)     that sets out the terms on which, and the conditions subject to which, a LMO 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 LMO and the Commission or the Department.

 

                Note: the intention is that the treatment provided by a Local Medical Officer (LMO) to an entitled person may be regarded as having been provided in accordance with the Principles and the “Notes for Local Medical Officers” despite the LMO not entering into any arrangement with the Commission or the Department as required by the Notes (without the parts mentioned above omitted).  See: paragraph 5.3 of the Notes for Local Medical Officers.

 

Notes for Occupational Therapists” means the document approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Occupational Therapists”, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which, an occupational therapist is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

 

Notes for Osteopaths” means the document approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Osteopaths”, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which, an osteopath is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

 

Notes for Physiotherapists” means the document approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Physiotherapists”, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which, a physiotherapist is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

 

“Notes for Psychologists” means the document approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Psychologists”, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which, a psychologist is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

 

Notes for Podiatrists” means the document approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Podiatrists”, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which, a podiatrist is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

 

Notes for Providers of Optometric Services / Dispensers of Optical Appliances” means the document approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Providers of Optometric Services / Dispensers of Optical Appliances”, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which an optometrist, and an optical dispenser, are to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

 

Notes for Speech Pathologists” means the document approved by the Commission or a member thereof, the Repatriation Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for Speech Pathologists”, and in force on the date in Schedule 1, that sets out the terms on which, and the conditions subject to which, a speech pathologist is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.

 

“Tier 1 Hospital” means a hospital in the category described as Tier 1 in 2.1 of the MPPPs.

 

4.       Paragraph 1.4.1 (definition of MRCA Access Payment)

 

          omit:

 

          the Fee Schedule for LMO treatment services

 

          substitute:

 

the DVA document entitled “Department of Veterans’ Affairs Fee Schedules for Medical Services”, in force on the date in Schedule 1,

 

5.       Paragraph 3.5.1

 

          omit the paragraph, substitute:

 

3.5.1  The extent of the financial liability accepted by the Commission for the provision of treatment to an entitled person by a health care provider is as follows:

 

(1) for fees charged by:

 

(a)      a chiropractor ¾ the amount worked out under the DVA document entitled “Chiropractors Schedule of Fees”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Chiropractors;

 

(b)     a dentist (Local Dental Officer) ¾ the amount worked out under the DVA document entitled “Fee Schedule of Dental Services for Dentists and Dental Specialists”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Local Dental Officers;

 

(c)     a dental prosthetist ¾ the amount worked out under the DVA document entitled “Fee Schedule of Dental Services for Dental Prosthetists”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles;

 

(d)     a dental specialist ¾ the amount worked out under the DVA document entitled “Fee Schedule of Dental Services for Dentists and Dental Specialists”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Local Dental Officers;

 

(e)      a diabetes educator ¾ the amount worked out under the DVA document entitled “Diabetes Educators Schedule of Fees”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Diabetes Educators;

 

(f)      a dietitian ¾ the amount worked out under the DVA document entitled “Dietitians Schedule of Fees”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Dietitians;

 

(g)     an exercise physiologist ¾ the amount worked out under the DVA document entitled “Exercise Physiologists Schedule of Fees”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Exercise Physiologists;

 

(h)     a LMO ¾ the amount worked out under the DVA document entitled “Department of Veterans’ Affairs Fee Schedules for Medical Services”, in force on the date in Schedule 1, pursuant to the following parts of that document:

 

Chronic Pain Honorarium Fees;

Clinical Note Fees;

Compensation Consultation Fees;

Diagnostic Imaging Fee Schedule

Dose Administration Aid (DAA) Service Fees for GPs and LMOs;

Guide to the Assessment of Rates of Veterans' Pensions (GARP) Fee;

Kilometre Allowance;

Local Medical Officers (LMOs) Fee Schedule;

Medication Review Fees;

Pathology Fee Schedule;

Ready Reckoner for LMOs

Relative Value Guide Fee Schedule;

Repatriation Medical Fee Schedule;

         

          on condition that the treatment was provided in accordance with the Principles and the Notes for Local Medical Officers;

 

(i)      a medical specialist ¾ the amount worked out under

          the DVA document entitled “Department of Veterans’ Affairs Fee Schedules for Medical Services”, in force on the date in Schedule 1, pursuant to the following parts of that document:

 

Chronic Pain Honorarium Fees;

Clinical Note Fees;

Compensation Consultation Fees;

Diagnostic Imaging Fee Schedule

Dose Administration Aid (DAA) Service Fees for GPs and LMOs;

Guide to the Assessment of Rates of Veterans' Pensions (GARP) Fee;

Kilometre Allowance;

Medication Review Fees;

Pathology Fee Schedule;

Ready Reckoner for LMOs

Relative Value Guide Fee Schedule;

Repatriation Medical Fee Schedule;

 

          on condition that the treatment was provided in accordance with the Principles;

 

(j)      an occupational therapist ¾ the amount worked out under the DVA document entitled “Occupational Therapists Schedule of Fees”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Occupational Therapists;

 

(k)     an optical dispenser of visual aids ¾ the amount worked out under the DVA document entitled “Pricing Schedule for Visual Aids”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Providers of Optometric Services/Dispensers of Optical Appliances;

 

(l)      an optometrist ¾ the amount worked out under the DVA document entitled “Optometrist Fees for Consultation”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Providers of Optometric Services/Dispensers of Optical Appliances;

 

(m)    an orthoptist ¾ the amount worked out under the DVA document entitled “DVA Schedule of Fees Orthoptists”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles;

 

(n)     an osteopath ¾ the amount worked out under the DVA document entitled “Osteopaths Schedule of Fees”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Osteopaths;

 

(o)     an other GP ¾ the amount worked out under the Notes for Local Medical Officers in respect of an other GP;

 

(p)     a physiotherapist ¾ the amount worked out under the DVA document entitled “Physiotherapists Schedule of Fees”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Physiotherapists;

 

(q)     a podiatrist ¾ the amount worked out under the DVA document entitled “Podiatrists Schedule of Fees”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Podiatrists;

 

(r)      a psychologist ¾ the amount worked out under the DVA document entitled “Psychologists Schedule of Fees”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Psychologists;

 

(s)      a social worker ¾ the amount worked out under the DVA document entitled “Social Workers Schedule of Fees”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles;

 

(t)      a social worker (clinical counsellor) ¾ the amount worked out under the DVA document entitled “Clinical Counsellors Schedule of Fees”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles;

 

(u)     a speech pathologist ¾ the amount worked out under the DVA document entitled “Speech Pathologists Schedule of Fees”, in force on the date in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Speech Pathologists;

 

except where the Commission, having regard to the matters specified in paragraph 3.2.2, is satisfied that there are exceptional circumstances justifying payment of a higher fee.

 

6.       Paragraphs 3.5.1A.1, 3.5.1A.2 and 3.5.1A.3

 

          omit the paragraphs.

 

7.       Paragraph 3.5.2(b)

 

          omit:

 

          health provider

 

          substitute:

 

          health care provider

 

8.       Paragraph 3.5.2(c)(iii)

 

          omit:

         

6 months

 

          substitute:

 

          5 years

 

8A.    Paragraph 3.5.2A

 

omit:

         

6 months

 

          substitute:

 

          5 years

 

9.       Paragraph 4.3.1

 

          at the end, insert as a note:

 

Note: Principle 3.5.1 also deals with financial liability for medical practitioner fees.

 

10.     Paragraph 4.8.1 (j)

 

          omit.

 

11.     Paragraph 5.1.1

 

          omit:

 

approved by the Commission or the Department and entitled Notes for Local Dental Officers and in force on the date in Schedule 3 for this document

 

substitute:

 

entitled Notes for Local Dental Officers

 

12.     Paragraph 5.1.2

 

          omit, substitute:

 

          5.1.2           The Commission will accept financial responsibility for dental treatment provided to an entitled person in a Tier 1 Hospital or Contracted Day Procedure Centre without the need for prior approval.

 

          5.1.2A         Except in an emergency, the Commission’s prior approval is required before dental treatment is provided to an entitled person in a hospital other than a Tier 1 Hospital or on premises other than a Contracted Day Procedure Centre unless the

“Fee Schedule of Dental Services for Dentists and Dental Specialists” or the “Fee Schedule of Dental Services for Dental Prosthetists” provides that prior approval is not required for the treatment.

 

          at the end of the paragraph, insert:

 

Note: the Notes for Local Dental Officers, the “Fee Schedule of Dental Services for Dentists and Dental Specialists” and the “Fee Schedule of Dental Services for Dental Prosthetists”, as incorporated-by-reference into the Principles, could be relevant to dental treatment provided to an entitled person in a hospital.

 

13.     Paragraphs 5.2.1 - 5.2.4 (inclusive)

 

          omit, substitute:

 

          5.2.1  The DVA document entitled “Fee Schedule of Dental Services for Dentists and Dental Specialists”, in force on the date in Schedule 1, and comprised of Dental Schedules A, B and C,

          lists the dental services provided by dentists, or dental specialists, for which the Commission will accept financial responsibility, when provided to an entitled person, and sets out the limits of that financial responsibility.

 

          5.2.2  The DVA document entitled “Fee Schedule of Dental Services for Dental Prosthetists”, in force on the date in Schedule 1, lists the dental services provided by dental prosthetists for which the Commission will accept financial responsibility, when provided to an entitled person, and sets out the limits of that financial responsibility.

 

          5.2.3  Dental Schedule C in 5.2.1 imposes a monetary limit (annual monetary limit) in respect of dental services provided to an entitled person under that Schedule in a Calendar year.

 

          5.2.4  Subject to 5.1.2 and 5.1.2A (treatment in Tier 1 Hospital/Contracted Day Procedure Centre), where a Schedule in 5.2.1 or 5.2.2 specifies a need for prior approval in respect of a service, the Commission is not to accept financial liability for the service unless it has granted prior approval or retrospective approval for the service.

 

14.     Paragraph 5.2.5

 

          omit:

 

          paragraph 5.2.2

 

          substitute:

 

          Dental Schedule C in 5.2.1

 

15.     Paragraphs 5.3.2 and 5.3.4

 

                   omit the paragraphs, substitute:

 

5.3.2  A person who holds a Gold Card will be provided with the following dental services:

 

(a)      for treatment of an injury or disease that is not a service injury or a service disease:

 

(i)      the dental services listed in Schedules A, B and C of the DVA document entitled “Fee Schedule of Dental Services for Dentists and Dental Specialists”, in force on the date in Schedule 1 — on condition the services are provided in accordance with those Schedules;

 

                   Note: Schedule C imposes an annual monetary limit.

 

(ii)      the dental services listed in the DVA document entitled “Fee Schedule of Dental Services for Dental Prosthetists”, in force on the date in Schedule 1on condition the services are provided in accordance with that Schedule.

 

(b)     for treatment of a service injury or service disease:

 

(i)      the dental services listed in Schedules A, B and C of the DVA document entitled “Fee Schedule of Dental Services for Dentists and Dental Specialists”, in force on the date in Schedule 1 — on condition the services are provided in accordance with those Schedules (but without the annual monetary limit in the Schedule C);

 

(ii)      the dental services listed in the DVA document entitled “Fee Schedule of Dental Services for Dental Prosthetists”, in force on the date in Schedule 1on condition the services are provided in accordance with that Schedule.

 

5.3.3  A person who holds a White Card is entitled to dental treatment of a service injury or service disease and will be provided with:

 

(a)      the dental services listed in the DVA document entitled “Fee Schedule of Dental Services for Dentists and Dental Specialists”, in force on the date in Schedule 1on condition the services are provided in accordance with that Schedule; and

 

Note: Schedule C of the Fee Schedule imposes an annual monetary limit

 

(b)     the dental services listed in the DVA document entitled “Fee Schedule of Dental Services for Dental Prosthetists”, in force on the date in Schedule 1on condition the services are provided in accordance with that Schedule.

 

16.     Paragraph 5.4.1

 

          omit, substitute:

 

          5.4.1  Prior Approval is not necessary for emergency dental treatment provided to an entitled person where the treatment is provided in accordance with:

 

(a)      the Principles;

(b)     the “Fee Schedule of Dental Services for Dentists and Dental Specialists”, in force on the date in Schedule 1;

(c)     the “Fee Schedule of Dental Services for Dental Prosthetists”, in force on the date in Schedule 1; and

(d)     the Notes for Local Dental Officers;

 

as those documents relate to the treatment, but the Commission’s retrospective approval for the treatment must be sought as soon as possible after the treatment is provided and approval must be granted if the Commission is to accept financial liability for the emergency dental treatment.

 

Note: Schedule C of the “Fee Schedule of Dental Services for Dentists and Dental Specialists” imposes an annual monetary limit

 

 

17.     Paragraph 5.6.1

 

          omit, substitute:

 

5.6.1  Financial responsibility for a general anaesthetic provided as part of dental treatment will be accepted only if:

 

(a)      the anaesthetic is administered by a specialist anaesthetist or approved medical practitioner in a hospital, Day Procedure Centre or dental surgery where adequate resuscitation equipment is provided; and

 

(b)     unless the anaesthetic is administered in a Tier 1 Hospital or Contracted Day Procedure Centreprior approval has been obtained.

 

18.     Paragraphs 7.1A.1 and 7.1A.2

 

          omit the paragraphs.

 

19.     Paragraph 7.1A.3

 

          omit the paragraph, substitute:

 

7.1A.1         In order for the Commission to accept financial liability for treatment provided to an entitled person by a health care provider in Column A below, the treatment must have been provided in accordance with the terms and conditions in the corresponding document described in Column B below:

 

Column A                                                   Column B

 

Chiropractor

Notes for Chiropractors

diabetes educator

Notes for Diabetes Educators

Dietitian

Notes for Dietitians

exercise physiologist

Notes for Exercise Physiologists

occupational therapist

Notes for Occupational Therapists

optical dispenser

optometrist

 

Notes for Providers of Optometric Services /Dispensers of Optical Appliances

Osteopath

Notes for Osteopaths

Physiotherapist

Notes for Physiotherapists

Podiatrist

Notes for Podiatrists

Psychologist

Notes for Psychologists

speech pathologist

Notes for Speech Pathologists

 

20.     Paragraph 7.4.3 (excluding the Note)

 

          omit:

 

          Pricing Schedule for Visual Aids

 

          substitute:

 

          DVA document entitled “Pricing Schedule for Visual Aids”, in force on the date in Schedule 1

 

21.     Paragraph 11.2A.1

 

          omit:

 

          documents

 

          insert:

 

          DVA documents

 

          omit (wherever occurring):

 

          in force on the date in Schedule 3 for this document

 

          substitute:

 

          in force on the date in Schedule 1

 

22.     Paragraph 11.4.2

 

                   omit:

 

          Pricing Schedule for Visual Aids

 

          substitute:

 

          DVA document entitled “Pricing Schedule for Visual Aids”, in force on the date in Schedule 1

 

23.     Paragraph 11.4.3

 

omit:

 

          Pricing Schedule for Visual Aids

 

          substitute:

 

DVA document entitled “Pricing Schedule for Visual Aids”, in force on the date in Schedule 1,

 

24.     Paragraph 11.4.6

 

omit:

 

          Pricing Schedule for Visual Aids,

 

          substitute:

 

DVA document entitled “Pricing Schedule for Visual Aids”, in force on the date in Schedule 1,

 

25.     Schedule 1 (Heading)

 

                   omit the words:

 

          Schedule 1

 

26.     Schedules 2 and 3

 

                   omit, substitute:

 

SCHEDULE 1 DATES FOR INCORPORATED DOCUMENTS

 

PART 1

 

The date for :

 

1.       Notes for Local Medical Officers (paragraph 1.4.1);

 

2.       Department of Veterans’ Affairs Fee Schedules for Medical Services (paragraph 3.5.1);

 

3.       Notes for Providers of Optometric Services/Dispensers of Optical Appliances (paragraphs 1.4.1 and 7.1A.1);

 

4.       Optometrist Fees for Consultation (paragraph 3.5.1);

 

5.       DVA Schedule of Fees Orthoptists (paragraph 3.5.1);

 

6.       Pricing Schedule for visual aids (paragraph 3.5.1);

 

7.       …

 

          8.       Notes for Local Dental Officers (paragraphs 1.4.1 and 5.1.1);

 

9.       Fee Schedule of Dental Services for Dentists and Dental Specialists (paragraph 3.5.1);

 

10.     Fee Schedule of Dental Services for Dental Prosthetists (paragraph 3.5.1);

 

11.     Notes for Chiropractors (paragraphs 1.4.1 and 7.1A.1);

 

          12.     Chiropractors Schedule of Fees (paragraph 3.5.1);

 

13.     Notes for Diabetes Educators (paragraphs 1.4.1 and 7.1A.1);

 

14.     Diabetes Educators Schedule of Fees (paragraph 3.5.1);

 

15.     Notes for Dietitians (paragraphs 1.4.1 and 7.1A.1);

 

16.     Dietitians Schedule of Fees (paragraph 3.5.1);

 

17.     Notes for Exercise Physiologists (paragraphs 1.4.1 and 7.1A.1);

 

18.     Exercise Physiologists Schedule of Fees (paragraph 3.5.1);

 

19.     Notes for Occupational Therapists (paragraphs 1.4.1 and 7.1A.1);

 

20.     Occupational Therapists Schedule of Fees (paragraph 3.5.1);

 

21.     Notes for Osteopaths (paragraphs 1.4.1 and 7.1A.1);

 

22.     Osteopaths Schedule of Fees (paragraph 3.5.1);

 

23.     Notes for Physiotherapists (paragraphs 1.4.1 and 7.1A.1);

 

24.     Physiotherapists Schedule of Fees (paragraph 3.5.1);

 

25.     Notes for Psychologists (paragraphs 1.4.1 and 7.1A.1);

 

26.     Psychologists Schedule of Fees (paragraph 3.5.1);

 

27.     Notes for Podiatrists (paragraphs 1.4.1 and 7.1A.1);

 

28.     Podiatrists Schedule of Fees (paragraph 3.5.1);

 

29.     Social Workers Schedule of Fees (paragraph 3.5.1);

 

30.     Clinical Counsellors Schedule of Fees (paragraph 3.5.1);

 

31.     Notes for Speech Pathologists (paragraphs 1.4.1 and 7.1A.1);

 

32.     Speech Pathologists Schedule of Fees (paragraph 3.5.1);

 

is 1 November 2009.

 

26A.  Schedule 1 Dates for Incorporated Documents

 

          omit, substitute:

 

SCHEDULE 1 DATES FOR INCORPORATED DOCUMENTS

 

PART 1

 

The date for :

 

1.       Notes for Local Medical Officers (paragraph 1.4.1);

 

2.       Department of Veterans’ Affairs Fee Schedules for Medical Services (paragraph 3.5.1);

 

3.       Notes for Providers of Optometric Services/Dispensers of Optical Appliances (paragraphs 1.4.1 and 7.1A.1);

 

4.       Optometrist Fees for Consultation (paragraph 3.5.1);

 

5.       DVA Schedule of Fees Orthoptists (paragraph 3.5.1);

 

6.       Pricing Schedule for visual aids (paragraph 3.5.1);

 

7.       The fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (commonly known as DSM-IV) (paragraph 2.4.2A);

 

          8.       Notes for Local Dental Officers (paragraphs 1.4.1 and 5.1.1);

 

9.       Fee Schedule of Dental Services for Dentists and Dental Specialists (paragraph 3.5.1);

 

10.     Fee Schedule of Dental Services for Dental Prosthetists (paragraph 3.5.1);

 

11.     Notes for Chiropractors (paragraphs 1.4.1 and 7.1A.1);

 

          12.     Chiropractors Schedule of Fees (paragraph 3.5.1);

 

13.     Notes for Diabetes Educators (paragraphs 1.4.1 and 7.1A.1);

 

14.     Diabetes Educators Schedule of Fees (paragraph 3.5.1);

 

15.     Notes for Dietitians (paragraphs 1.4.1 and 7.1A.1);

 

16.     Dietitians Schedule of Fees (paragraph 3.5.1);

 

17.     Notes for Exercise Physiologists (paragraphs 1.4.1 and 7.1A.1);

 

18.     Exercise Physiologists Schedule of Fees (paragraph 3.5.1);

 

19.     Notes for Occupational Therapists (paragraphs 1.4.1 and 7.1A.1);

 

20.     Occupational Therapists Schedule of Fees (paragraph 3.5.1);

 

21.     Notes for Osteopaths (paragraphs 1.4.1 and 7.1A.1);

 

22.     Osteopaths Schedule of Fees (paragraph 3.5.1);

 

23.     Notes for Physiotherapists (paragraphs 1.4.1 and 7.1A.1);

 

24.     Physiotherapists Schedule of Fees (paragraph 3.5.1);

 

25.     Notes for Psychologists (paragraphs 1.4.1 and 7.1A.1);

 

26.     Psychologists Schedule of Fees (paragraph 3.5.1);

 

27.     Notes for Podiatrists (paragraphs 1.4.1 and 7.1A.1);

 

28.     Podiatrists Schedule of Fees (paragraph 3.5.1);

 

29.     Social Workers Schedule of Fees (paragraph 3.5.1);

 

30.     Clinical Counsellors Schedule of Fees (paragraph 3.5.1);

 

31.     Notes for Speech Pathologists (paragraphs 1.4.1 and 7.1A.1);

 

32.     Speech Pathologists Schedule of Fees (paragraph 3.5.1).

 

 

is 1 May 2010.

 

PART 2

 

The date for :

 

1.       RAP National Schedule of Equipment (paragraph 11.2A.1);

 

2.       Rehabilitation Appliances Program (RAP) National Guidelines (paragraph 11.2A.1);

 

is 1 November 2010.

 

27.     Renumbering

 

The numbering of provisions in Part 5 and in any other part of the MRCA Treatment Principles affected by this instrument is to be sequential and cross-references in provisions are to correspond.