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Instrument No. R41/M42 of 2019 Principles as made
This instrument varies the MRCA Treatment Principles (No. MRCC 53/2013) and the Treatment Principles (No. R52/2013) to remove all references to ‘Local Medical Officer’ (LMO) and replace it with the commonly referred title of ‘General Practitioner’ (GP). It also removes Part 6B of the Treatment Principles and related definitions which are redundant.
Administered by: Veterans' Affairs
Registered 10 Sep 2019
Tabling HistoryDate
Tabled HR11-Sep-2019
Tabled Senate12-Sep-2019
To be repealed 28 Nov 2019
Repealed by Division 1 of Part 3 of Chapter 3 of the Legislation Act 2003

 

Australian Government

Veterans’ Entitlements Act 1986

Military Rehabilitation and Compensation Act 2004

 

 

Veterans’ Affairs (Treatment PrinciplesLocal Medical Officer) Amendment Instrument 2019

Instrument 2019 No.R41/M42 

 

 

 

 

I, Mark Cormack, Deputy Secretary, Policy & Programs, delegate of the Minister for Veterans and Defence Personnel, approve:

 

(a)    under section 90 of the Veterans’ Entitlements Act 1986 (VEA) — the variations by the Repatriation Commission of the Treatment Principles in the following instrument; and

 

(b) under section 286 of the Military Rehabilitation and Compensation Act 2004 (MRCA) — the variations by the Military Rehabilitation and Compensation Commission of the MRCA Treatment Principles in the following instrument.

 

Dated this       8              day of           September                                 2019

 

Mark Cormack

MARK CORMACK

 

 

 

 

 

 

The Repatriation Commission makes, under section 90 of the Veterans’ Entitlements Act 1986, the variations to the Treatment Principles in the following instrument.

 

Dated this    5th                  day of     September                              2019

 

 

The Seal of the                                                               )

Repatriation Commission                                              )  SEAL

was affixed hereto in the                                                )

presence of:                                                                    )

 

 

Elizabeth Cosson

 

Donald Spinks

ELIZABETH COSSON

 

DONALD SPINKS

AM CSC

 

AM

PRESIDENT

 

COMMISSIONER

 

The Military Rehabilitation and Compensation Commission makes, under section 286 of the Military Rehabilitation and Compensation Act 2004, the variations to the MRCA Treatment Principles in the following instrument.

 

Dated this     5th            day of     September                      2019

 

 

The Seal of the                                                                    )

Military Rehabilitation and Compensation Commission    )  SEAL

was affixed hereto in the                                                     )

presence of:                                                                         )

 

 

 

 

Elizabeth Cosson

 

Donald Spinks

ELIZABETH COSSON

 

DONALD SPINKS

AM CSC

 

AM

CHAIR

 

MEMBER

 

 

 

Tracy Smart

 

Susan Weston

AIR VICE-MARSHALL TRACY SMART AO

 

SUSAN WESTON

PSM

AM

MEMBER

 

ACTING MEMBER

 

 

 

 

 

1 Name

This instrument is the Veterans’ Affairs (Treatment PrinciplesLocal Medical Officer) Amendment Instrument 2019.

2 Commencement

This instrument commences on 1 October 2019.

3 Authority

This instrument is made under:

(a)    section 90 of the Veterans’ Entitlements Act 1986 in respect of the variations to the Treatment Principles in Schedule 1; and

(b)   section 286 of the Military Rehabilitation and Compensation Act 2004 in respect of the variations to the MRCA Treatment Principles in Schedule 2.

4 Schedules

Each instrument that is specified in a Schedule to this instrument is varied as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.


Schedule 1-Variations to the Treatment Principles (Instrument 2013 No. R52) (F2019C00431)

1  Paragraph 1.4.1 (Interpretation) definitions of “Aboriginal Health Worker Care Co-ordination treatment” (paragraph (b)), “Community Nurse Care Co-ordination treatment” (paragraph (b)) and “Practice Nurse Care Co-ordination treatment” (paragraph (b))

          Omit LMO”, substitute general practitioner”.

2  Paragraph 1.4.1 (Interpretation) definition of “admission date”

          Omit the definition, substitute:

“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.

3  Paragraph 1.4.1 (Interpretation) definition of “admitting LMO”

          Omit the definition, substitute:

“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.

4  Paragraph 1.4.1 (Interpretation) definition of “Coordinated Veterans’ Care Program”

Omit the definition, substitute:

“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.

5  Paragraph 1.4.1 (Interpretation) definitions of “Coordinated Veterans’ Care Program treatment” (paragraph (a)) and “Veterans’ Home Care Program” (paragraph (b))

Omit “LMO”, substitute GP”.

Paragraph 1.4 1 (Interpretation)

Omit the following definitions:

(a)                “Authorised Representative”;

(b)           “community patient”;

(c)        “community services”,

(d)        “consumable rehabilitation appliance”,

(e)        “data repository”;

(f)        “data repository controller”;

(g)        “DVA Telemonitoring Practice Incentive”;

(h)        “enrolment day”;

(i)         “inhome telemonitoring equipment”;

(j)         “InHome Telemonitoring for Veterans Initiative”;

(k)        “internet carriage service”;

(l)         “ISP Provider”;

(m)       “Level A attendance”;

(n)        “limited VHC – type service”;

(o)        “National Broadband Network”;

(p)        “NBN”;

(q)        “NBN wave site”;

(r)         “nominated residence”.

7  Paragraph 1.4.1 (Interpretation) definition of “GPMP”

Omit “an LMO”, substitute “a general practitioner”.

8  Paragraph 1.4.1 (Interpretation) definition of “general practitioner”

Omit the definition, substitute:

“general practitioner” has the same meaning as “general practitioner” has in the Health Insurance Act 1973.

9  Paragraph 1.4.1 (Interpretation) definition of “Home Care service (category C)” (paragraph (a))

Omit “an LMO Home Care service (category C) Referral, substitute “a GP Home Care service (category C) Referral”.

10  Paragraph 1.4.1 (Interpretation) definition of “LMO” (including the Note)

Omit the definition and the Note.

11  Paragraph 1.4.1 (Interpretation) definition of “LMO Care Leadership treatment”

Omit the definition, substitute:

“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.

12  Paragraph 1.4.1 (Interpretation) definition of “LMO Home Care service (category C) Referral”

Omit the definition, substitute:

“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 VHC assessment agency, including as a facsimile message.

13  Paragraph 1.4.1 (Interpretation) definition of “Notes for Coordinated Veterans' Care Program Providers” (paragraph (a))

Omit the paragraph, substitute:

(a)        a general practitioner;

14  Paragraph 1.4.1 (Interpretation) definition of “Notes for Local Medical Officers” (including the Note)

Omit the definition and the Note, substitute:

“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.

15  Paragraph 1.4.1 (Interpretation) definition of “other GP” (including the Notes)

Omit the definition and the Notes.

16  Paragraph 1.4.1 (Interpretation) definition of “participating LMO” (including the Note)

Omit the definition and the Note.

17  Paragraph 1.4.1 (Interpretation) definition of “period of care” (paragraph (a))

(a)        omit the paragraph, substitute:

                        “(a)      a general practitioner; or”; and

 

(b)                omit “LMO” (wherever occurring), substitute “general practitioner”.

18  Paragraph 1.4.1 (Interpretation) definition of “period of care” (Notes 1 and 2)

Omit the Notes.

19  Paragraph 1.4.1 (Interpretation) definition of “practice nurse”

Omit the definition, substitute:

“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.

20  Paragraph 1.4.1 (Interpretation) definition of “Rural Enhancement Scheme” (paragraphs (a) and (b))

Omit LMOs”, substitute general practitioners”.

21  Paragraph 1.4.1 (Interpretation) definition of “subsequent period of care” (including the Note)

Omit the definition and the Note, substitute:

“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.

22  Paragraph 1.4.1 (Interpretation)

Omit the following definitions:

(a)      “telemonitoring care plan”;

(b)     “telemonitoring equipment”;

(c)   “telemonitoring initiative data”;

(d)  “telemonitoring initiative participant”;

(e)   “telemonitoring treatment”;

(f)   “TRCP treatment”;

(g)   “TRCP provider”.

23  Paragraph 1.4.1 (Interpretation) definition of “Veterans’ Access Payment” (including the Note)

Omit the definition and Note, substitute:

“Veterans' 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 “Veterans’ 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 Veterans’ 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.

24  Paragraph 3.3.2(a)

Omit “LMO or other GP”, substitute “a general practitioner”.

25  Paragraph 3.5.1(1)(h)

Omit the paragraph, substitute:

(h)       a general practitioner ¾ the amount worked out under the DVA document entitled “Department of Veterans’ Affairs Fee Schedules for Medical Services” referred to 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 General Practitioners;

General Practitioners Fee Schedule;

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

Kilometre Allowance;

Medication Review Fees;

Pathology Fee Schedule;

Ready Reckoner for General Practitioners;

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 General Practitioners ;.

26  Paragraph 3.5.1(1)(i)

Omit “LMOs” (twice occurring), substitute “GPs”.

27  Paragraph 3.5.1(1)(o)

Omit the paragraph.

28  PART 4

Omit “LMO or other GP” (wherever occurring), substitute general practitioner”.

29  Paragraph 4.1 (heading)

Omit the heading, substitute:

General Practitioners

30  Paragraph 4.1.3

Omit the paragraph, substitute:

4.1.3 The aim of the medical services program is to ensure that as far as practicable entitled persons have access to free, safe and cost-effective treatment.

 To achieve this objective the Commission or the Department deals with medical practitioners on two levels.

At the first level the Commission or the Department deals with medical practitioners called general practitioners.  Services provided by these medical practitioners must be in accordance with these Principles and the Notes for General Practitioners if the Department is to pay for the services.

It should be noted that while it is the Commission that accepts financial liability for treatment it is the Department (Commonwealth) that actually pays for the treatment.

The second level of interaction between the Commission or the Department and medical practitioners is where the medical practitioner is a specialist. 

Unlike general practitioners, medical specialists (as at 1 April 2006) are not prepared to submit to the same level of regulation as general practitioners regarding services to entitled persons (at DVA expense) but if they are prepared to treat an entitled person at the rate set out in the Principles and charge DVA and not the entitled person, then the relationship between DVA and the specialist is covered by the Principles.

31  Paragraph 4.1.4

Omit “an LMO, an other GP”, substitute “a general practitioner”.

32  Paragraphs 4.3A.1 and 4.7.3

Omit “LMO, other GP” (wherever occurring), substitute general practitioner”.

33  Paragraph 4.8.1(a)

Omit “LMO or other GP’s”, substitute general practitioner’s”.

34  PART 6A

(a)           Omit “the LMO” (wherever occurring), substitute “the general practitioner”;

(b)           Omit “the LMO (wherever occurring), substitute “the general practitioner”;

(c)           Omit LMO Care Leadership treatment (wherever occurring), substitute GP Care Leadership treatment”;

(d)          Omit “an LMO (wherever occurring), substitute “a general practitioner”;

(e)           Omit “an LMO” (wherever occurring), substitute “a general practitioner”;

 

(f)            Omit “LMO Home Care service (category C) Referral” (wherever occurring), substitute “GP Home Care service (category C) Referral”;

 

(g)           Omit “The LMO”, substitute “The general practitioner”.

35    Paragraph 6A.1

(a)        Omit “LMO Care Leadership treatment”, substitute “GP Care Leadership treatment”;

(b)        Omit “LMO referral for social support service assessment”, substitute “GP referral for social support service assessment”;

(c)        Omit “Local Medical Officer (LMO)”, substitute general practitioner”;

(d)       Omit “LMO’s practice nurse” (twice occurring), substitute general practitioner’s practice nurse”.

36  Paragraphs 6A.2.1 (heading), 6A.3 (heading), 6A.6 (heading) and 6A.8 (heading)

Omit “LMO” (wherever occurring), substitute GP”.

37  Paragraph 6A.2.2

Omit the paragraph, substitute:

6A.2.2 A general practitioner may, under the Coordinated Veterans' Care Program, provide:

(a) GP Care Leadership treatment; or

(b) a GP Home Care service (category C) Referral; or

(c) both (a) and (b);

for an entitled person.

38  Paragraph 6A.3.1 (Note 1)

Omit Note 1, substitute:

Note 1: the first period of care by a general practitioner commences on the date the general practitioner decides to admit the entitled person to the Program (admission date).  Any following period of care by the same general practitioner is a subsequent period of care.  The first period of care by a general practitioner may also occur where the general practitioner is a different general practitioner for the person.  Any following period of care by the same general practitioner is a subsequent period of care.

39  Subparagraph 6A.4A.1(a)(i)

Omit LMO”, substitute “general practitioner”.

40  Subparagraph 6A.4A.1(a)(iii) and Paragraph 6A.4A.1(b)

Omit LMOs”, substitute general practitioners”.

41  Paragraph 6A.5.1(4) (including the Note)

Omit the paragraph, substitute:

(4)        the person has consented to participation in the program and the admitting general practitioner has recorded the consent (which may be an electronic record); and

 

                             Note: under the Notes for Coordinated Veterans' Care Program Providers the general practitioner is to store the consent.

42  Paragraph 6A.8.2

(a)    Omit “The LMO”, substitute “The general practitioner”;

(b)   Omit “an LMO Home Care service (category C) Referral, substitute “a GP Home Care service (category C) Referral”.

43  Paragraph 6A.9.1

Omit “An LMO” substitute “A general practitioner”.

44  Paragraphs 6A.9.2 and 6A.9.4

Omit “The LMO”, substitute “The general practitioner”.

45  Paragraph 6A.9.8

Omit “LMO Home Care service (category C) Referral”, substitute “GP Home Care service (category C) Referral”.

46  PART 6B

Omit the Part.

47  Paragraph 7.3.3(a)

Omit “an LMO or other GP”, substitute “a general practitioner”.

48  Subparagraph 7.3A.1(1)(a)(iii) and Paragraph 7.3A.6B(2)

Omit “a LMO Home Care service (category C) Referral”, substitute “a GP Home Care service (category C) Referral”.

49  Paragraphs 7.3A.6B and 7.5.1

Omit “an LMO”, substitute “a general practitioner”.

50  Paragraph 7.5.2

Omit “LMO or other GP’s”, substitute general practitioner’s”.

51  Paragraphs 7.6.1 and 7.7.1

Omit “LMO or other GP”, substitute general practitioner”.

52  Paragraph 7.6A.1(a)

Omit “LMO, other GP”, substitute “general practitioner”.

53  SCHEDULE 1

Omit:

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

https://www.dva.gov.au/providers/doctors#lmonotes

Substitute:

“1.       Notes for General Practitioners (paragraph 1.4.1)

https://www.dva.gov.au/providers/notes-providers.


Schedule 2-Variations to the MRCA Treatment Principles (Instrument 2013 No. MRCC53) (F2019COO427)

1  Paragraph 1.4.1 (Interpretation) definitions of “Aboriginal Health Worker Care Co-ordination treatment” (paragraph (b)), “Community Nurse Care Co-ordination treatment” (paragraph (b)) and “Practice Nurse Care Co-ordination treatment” (paragraph (b))

          Omit LMO”, substitute general practitioner”.

2  Paragraph 1.4.1 (Interpretation) definition of “admission date”

          Omit the definition, substitute:

“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.

3  Paragraph 1.4.1 (Interpretation) definition of “admitting LMO”

          Omit the definition, substitute:

“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.

4  Paragraph 1.4.1 (Interpretation) definition of “Coordinated Veterans’ Care Program”

Omit the definition, substitute:

“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.

5  Paragraph 1.4.1 (Interpretation) definitions of “Coordinated Veterans’ Care Program treatment” (paragraph (a)) and “MRCA Home Care Program” (paragraph (b))

Omit “LMO”, substitute GP”.

Paragraph 1.4 1 (Interpretation)

Omit the following definitions:

(a)                “Authorised Representative”;

(b)        “community services”,

(c)        “consumable rehabilitation appliance”,

(d)       “data repository”;

(e)        “data repository controller”;

(f)        “DVA Telemonitoring Practice Incentive”;

(g)        “enrolment day”;

(h)        “inhome telemonitoring equipment”;

(i)         “InHome Telemonitoring for Veterans Initiative”;

(j)         “internet carriage service”;

(k)        “ISP Provider”;

(l)         “limited MHC – type service”;

(m)       “National Broadband Network”;

(n)        “NBN”;

(o)        “NBN wave site”;

(p)        “nominated residence”.

7  Paragraph 1.4.1 (Interpretation) definition of “GPMP”

Omit “an LMO”, substitute “a general practitioner”.

8  Paragraph 1.4.1 (Interpretation)

Insert the following definition in its correct alphabetical position:

“general practitioner” has the same meaning as “general practitioner” has in the Health Insurance Act 1973.

9  Paragraph 1.4.1 (Interpretation) definition of “Home Care service (category C)” (paragraph (a))

Omit “an LMO Home Care service (category C) Referral, substitute “a GP Home Care service (category C) Referral”.

10  Paragraph 1.4.1 (Interpretation) definition of “Local Medical Officer” or “LMO” (including the Note)

Omit the definition and the Note.

11  Paragraph 1.4.1 (Interpretation) definition of “LMO Care Leadership treatment”

Omit the definition, substitute:

“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.

12  Paragraph 1.4.1 (Interpretation) definition of “LMO Home Care service (category C) Referral”

Omit the definition, substitute:

“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.

13 Paragraph 1.4.1 (Interpretation) Definition of “MRCA Access Payment” (including the Note)

Omit the definition and Note, substitute:

“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 .

14  Paragraph 1.4.1 (Interpretation) definition of “Notes for Coordinated Veterans' Care Program Providers” (paragraph (a))

Omit the paragraph, substitute:

(a)        a general practitioner;

15  Paragraph 1.4.1 (Interpretation) definition of “Notes for Local Medical Officers” (including the Note)

Omit the definition and the Note, substitute:

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.

16  Paragraph 1.4.1 (Interpretation) definition of “other GP” (including the Notes)

Omit the definition and the Notes.

17  Paragraph 1.4.1 (Interpretation) definition of “participating LMO” (including the Note)

Omit the definition and the Note.

18  Paragraph 1.4.1 (Interpretation) definition of “period of care”

(a)        omit the paragraph, substitute:

                        “(a)      a general practitioner; or”; and

 

(b)                omit “LMO” (wherever occurring), substitute “general practitioner”.

19  Paragraph 1.4.1 (Interpretation) definition of “period of care” (Notes 1 and 2)

Omit the Notes.

20  Paragraph 1.4.1 (Interpretation) definition of “practice nurse”

Omit the definition, substitute:

“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.

21  Paragraph 1.4.1 (Interpretation) definition of “Rural Enhancement Scheme” (paragraphs (a) and (b))

Omit LMOs”, substitute general practitioners”.

22  Paragraph 1.4.1 (Interpretation) definition of “subsequent period of care” (including the Note)

Omit the definition and the Note, substitute:

“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.

23  Paragraph 1.4.1 (Interpretation)

Omit the following definitions:

(a)      “telemonitoring care plan”;

(b)     “telemonitoring equipment”;

(c)   “telemonitoring initiative data”;

(d)  “telemonitoring initiative participant”;

(e)   “telemonitoring treatment”;

(f)   “TRCP treatment”.

24  Paragraph 3.3.2(a)

Omit “Local Medical Officer or other GPs”, substitute “a general practitioner”.

25  Paragraph 3.5.1(1)(h)

Omit the paragraph, substitute:

(h)       a general practitioner ¾ the amount worked out under the DVA document entitled “Department of Veterans’ Affairs Fee Schedules for Medical Services” referred to 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 General Practitioners;

General Practitioners Fee Schedule;

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

Kilometre Allowance;

Medication Review Fees;

Pathology Fee Schedule;

Ready Reckoner for General Practitioners;

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 General Practitioners;.

26  Paragraph 3.5.1(1)(i)

Omit “LMOs” (twice occurring), substitute “GPs”.

27  Paragraph 3.5.1(1)(o)

Omit the paragraph.

28  PART 4

Omit “Local Medical Officer or other GP” (wherever occurring), substitute general practitioner”.

29  Paragraph 4.1 (heading)

Omit the heading, substitute:

General Practitioners

30  Paragraph 4.1.3

Omit the paragraph, substitute:

4.1.3 The aim of the medical services program is to ensure that as far as practicable entitled persons have access to free, safe and cost-effective treatment.

 To achieve this objective the Commission or the Department deals with medical practitioners on two levels.

At the first level the Commission or the Department deals with medical practitioners called general practitioners.  Services provided by these medical practitioners must be in accordance with these Principles and the Notes for General Practitioners if the Department is to pay for the services.

It should be noted that while it is the Commission that accepts financial liability for treatment it is the Department (Commonwealth) that actually pays for the treatment.

The second level of interaction between the Commission or the Department and medical practitioners is where the medical practitioner is a specialist. 

Unlike general practitioners, medical specialists (as at 1 April 2006) are not prepared to submit to the same level of regulation as general practitioners regarding services to entitled persons (at DVA expense) but if they are prepared to treat an entitled person at the rate set out in the Principles and charge DVA and not the entitled person, then the relationship between DVA and the specialist is covered by the Principles.

31  Paragraph 4.1.4

Omit “an LMO, an other GP”, substitute “a general practitioner”.

32  Paragraphs 4.3A.1 and 4.7.3

Omit “LMO, other GP” (wherever occurring), substitute general practitioner”.

33  Paragraph 4.8.1(a)

Omit “Local Medical Officer or other GP’s”, substitute general practitioner’s”.

34  PART 6A

(a)      Omit “the LMO” (wherever occurring), substitute “the general practitioner”;

(b)     Omit “the LMO (wherever occurring), substitute “the general practitioner”;

(c)      Omit LMO Care Leadership treatment (wherever occurring), substitute GP Care Leadership treatment”;

(d)     Omit “an LMO (wherever occurring), substitute “a general practitioner”;

(e)      Omit “an LMO” (wherever occurring), substitute “a general practitioner”;

(f)      Omit “LMO Home Care service (category C) Referral” (wherever occurring), substitute “GP Home Care service (category C) Referral”;

(g)     Omit “The LMO”, substitute “The general practitioner”.

35    Paragraph 6A.1

(a)      Omit “LMO Care Leadership treatment”, substitute “GP Care Leadership treatment”;

(b)     Omit “LMO referral for social support service assessment”, substitute “GP referral for social support service assessment”;

(c)      Omit “Local Medical Officer (LMO)”, substitute general practitioner”;

(d)     Omit “LMO’s practice nurse” (twice occurring), substitute general practitioner’s practice nurse”.

36  Paragraphs 6A.2.1 (heading), 6A.3 (heading), 6A.6 (heading) and 6A.8 (heading)

Omit “LMO” (wherever occurring), substitute GP”.

37  Paragraph 6A.2.2

Omit the paragraph, substitute:

6A.2.2 A general practitioner may, under the Coordinated Veterans' Care Program, provide:

(a) GP Care Leadership treatment; or

(b) a GP Home Care service (category C) Referral; or

(c) both (a) and (b);

for an entitled person.

38  Paragraph 6A.3.1 (Note 1)

Omit Note 1, substitute:

Note 1: the first period of care by a general practitioner commences on the date the general practitioner decides to admit the entitled person to the Program (admission date).  Any following period of care by the same general practitioner is a subsequent period of care.  The first period of care by a general practitioner may also occur where the general practitioner is a different general practitioner for the person.  Any following period of care by the same general practitioner is a subsequent period of care.

39  Subparagraph 6A.4A.1(a)(i)

Omit LMO”, substitute “general practitioner”.

40  Subparagraph 6A.4A.1(a)(iii) and Paragraph 6A.4A.1(b)

Omit LMOs”, substitute general practitioners”.

41  Paragraph 6A.5.1(4) (including the Note)

Omit the paragraph, substitute:

(4)        the person has consented to participation in the program and the admitting general practitioner has recorded the consent (which may be an electronic record); and

 

                             Note: under the Notes for Coordinated Veterans' Care Program Providers the general practitioner is to store the consent.

42  Paragraph 6A.8.2

(a)      Omit “The LMO”, substitute “The general practitioner”;

(b)      Omit “an LMO Home Care service (category C) Referral, substitute “a GP Home Care service (category C) Referral”.

43  Paragraph 6A.9.1

Omit “An LMO” substitute “A general practitioner”.

44  Paragraphs 6A.9.2 and 6A.9.4

Omit “The LMO”, substitute “The general practitioner”.

45  Paragraph 6A.9.8

Omit “LMO Home Care service (category C) Referral”, substitute “GP Home Care service (category C) Referral”.

46  PART 6B

Omit the Part.

47  Paragraph 7.3.3(a)

Omit “a Local Medical Officer or other GP”, substitute “a general practitioner”.

48  Subparagraph 7.3A.1(1)(a)(iii) and Paragraph 7.3A.6B(2)

Omit “a LMO Home Care service (category C) Referral”, substitute “a GP Home Care service (category C) Referral”.

49  Paragraphs 7.3A.6B and 7.5.1

Omit “an LMO”, substitute “a general practitioner”.

50  Paragraph 7.5.2

Omit “Local Medical Officer or other GP’s”, substitute general practitioner’s”.

51  Paragraphs 7.6.1 and 7.7.1

Omit “Local Medical Officer or other GP”, substitute general practitioner”.

52  Paragraph 7.6A.1(a)

Omit “LMO, other GP”, substitute “general practitioner”.

53  SCHEDULE 1

Omit:

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

https://www.dva.gov.au/providers/doctors#lmonotes

Substitute:

“1.       Notes for General Practitioners (paragraph 1.4.1)

https://www.dva.gov.au/providers/notes-providers.