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Continence Aids Payment Scheme 2020

Authoritative Version
Schemes as made
This instrument repeals and replaces the Continence Aids Payment Scheme 2010 which is due to sunset on 1 October 2020.
Administered by: Health
Registered 18 Jun 2020

Commonwealth Coat of Arms of Australia

Continence Aids Payment Scheme 2020

 

I, Richard Colbeck, Minister for Aged Care and Senior Australians, make the following Instrument under section 12 of the National Health Act 1953.

Dated   17 June 2020                          

Richard Colbeck

Minister for Aged Care and Senior Australians


Contents

Part 1Preliminary                                                                                                     1

1  Name of Scheme...................................................................................................................... 1

2  Commencement........................................................................................................................ 1

3  Repeal.........................................................................................................................................         1

4  Interpretation............................................................................................................................ 1

Part 2—Participation in the Scheme                                                                           4

5  Eligibility criteria...................................................................................................................... 4

6  Application to participate in the Scheme................................................................................... 5

7  Notification to Chief Executive Medicare................................................................................. 6

8  Requirement to notify change of circumstances........................................................................ 6

9  Decision that a person has ceased to be eligible........................................................................ 6

10 When participation ceases to have effect.................................................................................. 6

Part 3—Payments                                                                                                         7

11  Amount of CAPS payment.................................................................................................... 7

12  Payment procedure................................................................................................................. 7

13  Payment by instalments.......................................................................................................... 7

14  Payment to approved person.................................................................................................. 8

15  Notification of details of payments......................................................................................... 9

Part 4—Representatives and organisations                                                              10

16  Interpretation........................................................................................................................ 10

17  Ceasing representation of a person....................................................................................... 10

18  Authorised representative..................................................................................................... 10

19  Correspondence recipient..................................................................................................... 11

20  Authorised payment recipient............................................................................................... 11

21  Responsible person for a participating person...................................................................... 11

22  Organisations authorised to receive CAPS payments........................................................... 12

Part 5—Miscellaneous                                                                                                14

23  Debts.................................................................................................................................... 14

24  Investigations....................................................................................................................... 14

25  Review of decisions............................................................................................................. 14

Schedule                                                                                            15

Part 1—Eligible neurological condition                                                                    15

Part 2—Eligible other condition                                                                                25


Part 1Preliminary

  

1  Name of Instrument

                   This Instrument is the Continence Aids Payment Scheme 2020.

2  Commencement

This Instrument commences on 1 July 2020.

3  Repeal of previous instrument and maintenance of Scheme

(1)   The Continence Aids Payment Scheme 2010 is repealed.

(2)   This Instrument maintains in existence the Continence Aids Payment Scheme formulated by the Continence Aids Payment Scheme 2010.

4  Interpretation

             (1)  In this Instrument:

Act means the National Health Act 1953.

Amendment Act means the National Health Amendment (Continence Aids Payment Scheme) Act 2010.

approved form, when used in a provision of this Instrument, means a form approved, whether before or after the commencement of this Instrument, by the Secretary or Chief Executive Medicare in writing for the purposes of that provision.

authorised payment recipient, for a participating person, means the person referred to subsection 20(3).

authorised representative means a person referred to in subsection 18(3).

CAPS payment, for a participating person, means:

                     (a)  for a financial year—the amount specified in subsection 11(1); or

                     (b)  for part of a financial year—the amount calculated in accordance with, subsection 11(2).

continence aid means a product intended to assist in the management of incontinence and, for the avoidance of doubt, includes continence‑related products.

correspondence recipient means a person referred to in section 19.

eligibility criteria has the meaning given by section 5.

eligible neurological condition means a condition listed in Part 1 of the Schedule.

eligible other condition means a condition listed in Part 2 of the Schedule.

family member, in relation to a participating person, means:

                     (a)  the partner or a parent of the participating person; or

                     (b)  a sister, brother or child of the participating person; or

                     (c)  any other person who, in the opinion of the Chief Executive Medicare, should be treated for the purposes of this definition as one of the relevant person’s relations described in paragraph (a) or (b).

health professional:

                     (a)  means:

                              (i)  a person engaged in a health care related vocation or profession who must be registered or licensed (however described) under a Commonwealth, State or Territory law in order to practise that vocation or profession; or

                             (ii)  a person who is an eligible Aboriginal health worker under the Health Insurance (Allied Health Services) Determination 2009 made under the Health Insurance Act 1973; but

                     (b)  does not include a person who is a family member of the relevant participating person.

Note:          Section 10 of the Acts Interpretation Act 1901 deals with references to legislation that has been amended or replaced.

legal representative means a person with legal authority under a law of a State or Territory to act for another person such as a guardian or attorney under a power of attorney.

organisation means an entity, including a body politic, with an Australian Business Number which provides, will provide or will facilitate the provision of continence aids to a participating person, but does not include a person:

                     (a)  with legal authority under a law of a State or Territory to act for the applicant or participating person; or

                     (b)  a person referred to in paragraphs 18(2)(a) to (c) or 20(1)(a) to(c).

participating person means:

                     (a)  a person approved under section 6 to participate in the Scheme; or

                     (b)  a person taken to participate, and to be eligible to participate, in the Scheme under item 3 of the Amendment Act,

unless the person’s participation has ceased to have effect under this Instrument.

Note:          Item 3 of the Amendment Act and section 10 of this Instrument deal with when a person’s participation ceases to have effect.

permanent and severe incontinence means frequent and uncontrollable moderate to large loss of urine or faeces which impacts on a person’s quality of life and which is unlikely to improve with medical, surgical or clinical treatment regimes.

Secretary includes a person authorised by the Secretary to act on his or her behalf in approving forms for, or related to, this Instrument.

Scheme means the Continence Aids Payment Scheme formulated by the Continence Aids Payment Scheme 2010 and maintained in existence by this Instrument.

             (2)  Nothing in this Instrument is intended to affect the operation of any law of a State or Territory that deals with legal representatives.

             (3)  References to a legal representative in particular provisions and not in others is not intended to limit a legal representative’s powers to act for the represented person.

Part 2Participation in the Scheme

  

5  Eligibility criteria

             (1)  The eligibility criteria for a person to participate in the Scheme are that the person:

                     (a)  suffers from permanent and severe incontinence:

                              (i)  caused by an eligible neurological condition; or

                             (ii)  Caused by an eligible other condition; and the person has or is eligible to have a pensioner concession card issued under Division 1 of Part 2A.1 of the Social Security Act 1991 or is the dependant of a holder of a pensioner concession card, as defined in section 6A of the Social Security Act 1991; or

                            (iii)  caused by an eligible other condition and the person has a Department of Veterans’ Affairs Pensioner Concession Card or entitlement, whether as a primary cardholder or a dependant of a cardholder; and

                     (b)  is an Australian citizen or permanent resident within the meaning of those terms in the Australian Citizenship Act 2007; and

                     (c)  is not ineligible because of subsection (2).

             (2)  A person in any of the following categories is not eligible to participate in the Scheme:

                     (a)  (for the avoidance of doubt) people who suffer from transient, rather than permanent and severe, incontinence;

                     (b)  children under 5 years of age;

                     (c)  care recipients, under the Aged Care Act 1997:

                              (i)  whose classification level includes any of the following:

                                        (A)  high ADL domain category;

                                        (B)  high CHC domain category;

                                        (C)  high behaviour category;

                                        (D)  a medium domain category in at least 2 domains; or

                             (ii)  who are receiving a home care package and the care recipient’s care plan includes continence aids;

Note:          The following expressions are defined in the Classification Principles 2014

·            ADL domain

·            CHC domain

·            behaviour domain

·            domain

·            domain category

                     (d)  NDIS participants where an NDIS plan is in effect for the NDIS participant and the NDIS plan includes a consumables budget (that includes continence aids) as evidence that reasonable and necessary support will be funded under the National Disability Insurance Scheme;

                     (e)  people eligible to receive assistance for continence aids under the Rehabilitation Appliances Program (or replacement program if the name of that program is changed) through the Department of Veterans’ Affairs;

                      (f)  Australian citizens or permanent residents who have resided outside Australia for a continuous period of three years (including any periods of leave from the country in which that person resides);

                     (g)  a person serving a prison sentence.

             (3)  For a person who:

                     (a)  is eligible to participate in the Scheme under subparagraph (1)(a)(iii); and

                     (b)  meets the other eligibility criteria for participation in the Scheme; and

                     (c)  applied to participate in the Scheme between 1 July 2010 and the commencement of the Continence Aids Payment Scheme Variation 2011 (No.2);

the CAPS payment is the amount calculated in accordance with section 11 with effect from the date of application.

             (4)  Subsection (3) applies, even if the person’s application was rejected, provided that the person would have been eligible to participate in the Scheme if subparagraph (1)(a)(iii) had been in effect at that time.

             (5)  For the purposes of this section:

NDIS participant means a participant within the meaning of the National Disability Insurance Scheme Act 2013.

NDIS plan means a plan, for an NDIS participant, within the meaning of the National Disability Insurance Scheme Act 2013.

6  Application to participate in the Scheme

             (1)  A person may apply to the Chief Executive Medicare to participate in the Scheme.

             (2)  The Chief Executive Medicare must approve a person to participate in the Scheme if:

                     (a)  the applicant meets the eligibility criteria; and

                     (b)  the application is made on the approved form; and

                     (c)  the application:

                              (i)  includes a statement prepared and signed by a health professional certifying that the applicant has been diagnosed by a doctor with an eligible neurological condition or eligible other condition, as the case may be, which has caused permanent and severe incontinence; and

Note:       Health professional is defined in subsection 4(1).

                             (ii)  includes any other document or information required by the approved form.

Note:          Section 14 of the Act provides that if an application is refused the Chief Executive Medicare must give the applicant a signed notice that includes the reasons for the decision and advising that the person may apply to the Chief Executive Medicare for a review of the decision. The application for review of the decision is dealt with in section 25 of this Instrument.

7  Notification to Chief Executive Medicare

             (1)  A participating person, legal representative or authorised representative must notify the Chief Executive Medicare promptly on becoming aware that the participating person does not meet the eligibility criteria.

Example:    A participating person must notify the Chief Executive Medicare if the person
begins receiving a high level of residential care in a residential care facility: see subparagraph 5(2)(c)(i).

             (2)  A legal representative or authorised representative must notify the Chief Executive Medicare promptly on becoming aware that the participating person has died.

8  Requirement to notify change of circumstances

                   A participating person, or their legal representative or authorised representative, must notify the Chief Executive Medicare promptly if:

(a)    an event or change of circumstances happens that affects, or might affect, the participating person’s eligibility to participate in the Scheme; or

(b)   the participating person, or their legal representative or authorised representative, becomes aware that such an event or change of circumstances is likely to happen.

9  Decision that a person has ceased to be eligible

                   If notification has not been given under subsection 7(1) or section 8, but the Chief Executive Medicare is satisfied that a participating person does not meet the eligibility criteria, the Chief Executive Medicare must decide, by determination in writing, that the person is not eligible to participate in the Scheme and the date on which the person ceased to be eligible.

Note :         Section 15 of the Act provides that if the Chief Executive Medicare decides that a participating person is not eligible to participate in the scheme, he or she must give the person a signed notice that includes the reasons for the decision and advising that the person may apply to the Chief Executive Medicare for a review of the decision.  The application for review of the decision is dealt with in section 25 of this Instrument.

10 When participation ceases to have effect

                   A person’s participation in the Scheme ceases to have effect:

                     (a)  if notification is given under paragraph 7(1)—from the date the person ceased to meet the eligibility criteria; or

                     (b)  if the Chief Executive Medicare decides that the person is not eligible to participate—from the date specified in the determination under section 9.

Note:          Where a person entitled to a CAPS payment has died, payment will be made to the estate:  see paragraph 12(1)(c).

Part 3Payments

11  Amount of CAPS payment

             (1)  The amount of the CAPS payment for a financial year is $623.80.

             (2)  However, if a person is approved under section 6 as a participating person after the beginning of a financial year, the CAPS payment for the person for that financial year is calculated on a pro rata basis, being the period starting on the date the application under section 6 was received and ending on 30 June (inclusive) of the financial year.

Example:    A person applies on 1 August 2020. The person’s CAPS payment is calculated for the period 1 August to 30 June 2021 (inclusive).

             (3)  A participating person may not receive:

                     (a)  more than the amount of the CAPS payment for a financial year in any one financial year;

                     (b)  more than one payment for the same period in a financial year.

12  Payment procedure

             (1)  The Chief Executive Medicare must pay a CAPS payment, or an instalment of a CAPS payment, to which a participating person has become entitled under the Scheme to:

                     (a)  the person; or

                     (b)  if there is an authorised payment recipient for the person—the authorised payment recipient; or

                     (c)  if the person has died, the person’s estate.

             (2)  The CAPS payment must be made:

                     (a)  in one transaction unless the person has elected, in the approved
form, to receive the payment in two instalments (except where subsection 13(4) applies); and

                     (b)  by way of electronic funds transfer to the bank account notified, in the approved form, to the Chief Executive Medicare.

13  Payment by instalments

             (1)  A person may elect to receive the CAPS payment in two instalments, worked out in accordance with this section, in a financial year.

             (2)  If the person is a participating person on 1 July in the financial year:

                     (a)  the first instalment is half of the CAPS payment specified in subsection 11(1), to be paid no later than 30 July in the financial year; and

                     (b)  the second instalment is the remaining half of the CAPS payment, to be paid on or after 1 January but no later than 31 January in the financial year.

             (3)  If an application under section 6 is received after 1 July but before 1 January in the financial year and is approved, the CAPS payment for the financial year is the amount calculated in accordance with subsection 11(2) with:

                     (a)  the first instalment a pro rata amount calculated for the period starting on the day the application was received and ending on 31 December (inclusive) in that financial year, to be paid within 30 days of approval of the application; and

                     (b)  the second instalment is the remaining amount of the CAPS payment, to be paid on or after 1 January but no later than 31 January in the financial year.

             (4)  If an application under section 6 is received after 31 December in the financial year and is approved, the CAPS payment for that financial year is the amount calculated in accordance with 11(2), to be paid within 30 days of approval of the application.

             (5)  However, despite anything in this Instrument, a second instalment must not be paid if the person’s participation has ceased to have effect before January in the financial year.

14  Payment to approved person

             (1)  This section applies to a person who is a participating person because of an approval under section 6 of this Instrument (approved person).

             (2)  The approved person is entitled to:

                     (a)  the CAPS payment specified in subsection 11(1) or 11(2), whichever applies in the circumstances, in the financial year in which the application is approved; and

                     (b)  the CAPS payment specified in subsection 11(1) in each subsequent financial year as long as the person’s participation has not ceased on a date before 1 July of that financial year.

             (3)  The Chief Executive Medicare must make a CAPS payment for the approved person:

                     (a)  if the person is a participating person on 1 July in the financial year:

                              (i)  by 30 July in the financial year; or

                             (ii)  if the payment is by instalments, in the manner specified in subsection 13(2); or

                     (b)  if an application under section 6 is received after 1 July but before 31 December in the financial year and is approved:

                              (i)  within 30 days of approving the application; or

                             (ii)  if the payment is by instalments, in the manner specified in subsection 13(3);or

                     (c)  if an application under section 6 is received after 31 December in the financial year and is approved—within 30 days of approving the application.

15  Notification of details of payments

             (1)  The Chief Executive Medicare, as soon as practicable after making a CAPS payment, must give a written statement containing details about the payment to:

                     (a)  the participating person or his or her correspondence recipient; and

                     (b)  if the payment was made to an organisation—the organisation.

Part 4Representatives and organisations

16  Interpretation

             (1)  In this part:

assisted person means:

                     (a)  a person applying to participate in the Scheme; or

                     (b)  a participating person,

who is unable to act on his or her own behalf because of a physical or mental impairment.

17  Ceasing representation of a person

                   In this Part:

                     (a)  if a person is recognised as representing another person because of a particular status under the social security law or veterans’ entitlements law, and the person ceases to hold that status, the person’s representation of the other person under the Scheme is also taken to cease;

                     (b)  if a person may authorise, in accordance with this Part, another to do something, the person may also revoke the authorisation by notice in writing to the Chief Executive Medicare;

                     (c)  if a person is authorised, in accordance with this Part, to do something and wishes to end the arrangement, the person may cease the arrangement by notice in writing to the Chief Executive Medicare.

18  Authorised representative

             (1)  This section applies to an assisted person who does not have a legal representative.

             (2)  The assisted person may be represented for the purposes of the Scheme, other than to receive payments, by one of the following, subject to subsection (3):

                     (a)  the assisted person’s correspondence nominee appointed under section 123C of the Social Security (Administration) Act 1999; or

                     (b)  the assisted person’s Department of Veterans’ Affairs (DVA) trustee, as recognised by DVA for the purposes of veterans’ entitlements (see the Veterans’ Entitlements Act 1986); or

                     (c)  if the person does not have a representative mentioned in paragraph (a) or (b)—a responsible person approved as an authorised representative under section 21.

             (3)  A person mentioned in subsection (2) who signs the application form for an assisted person, or nominates him or herself, in the approved form, after the application has been made, as the person authorised to represent the assisted person is taken to be the assisted person’s authorised representative.

             (4)  An authorised representative must act in the interests of the assisted person at all times.

19  Correspondence recipient

                   An applicant, participating person or an assisted person’s legal representative or authorised representative may authorise, in the approved form, another person (correspondence recipient) to receive correspondence under the Scheme for the applicant or participating person.

20  Authorised payment recipient

             (1)  One of the following people may receive payments as agent for a participating person if the conditions mentioned in subsection (2) are satisfied:

                     (a)  the person recognised as the participating person’s payment nominee for the purposes of the social security law; or

                     (b)  the person recognised as the participating person’s trustee or agent for the purposes of veterans’ entitlements; or

                     (c)  a responsible person approved as an authorised payment recipient under section 21; or

                     (d)  an organisation authorised in accordance with subsection 22(2).

             (2)  The conditions are:

                     (a)  the person who is to receive the payments as agent for the participating person has been notified to the Chief Executive Medicare, in the approved form, that that person is to receive the payments; and

                     (b)  if the applicant or participating person has a legal representative—the Chief Executive Medicare has not been notified by the legal representative that the CAPS payments are to be made to another person in accordance with this Instrument.

             (3)  The person who is to receive the payments as agent for the participating person is the authorised payment recipient of the participating person.

21  Responsible person for a participating person

             (1)  The Secretary may approve an individual to represent an assisted person or a minor:

                     (a)  as an authorised representative to act for the person; or

                     (b)  as an authorised payment recipient to receive payments as agent of the person; or

                     (c)  as both (a) and (b).

             (2)  However, the Secretary must not approve an individual unless the Secretary is satisfied that:

                     (a)  if the assisted person has a legal representative, or representation by a person referred to in paragraph 18(2)(a) or (b) or 20(1)(a) or (b)—the representative does not oppose the approval; and

                     (b)  the individual provides care or assistance to the person; and

                     (c)  the arrangement for the receipt of CAPS payments is for the benefit of the person; and

                     (d)  the individual seeking approval will use the funds only for the purpose for which they are provided.

             (3)  The Secretary may revoke an approval if satisfied that it is appropriate to do so in the circumstances, having regard to the matters mentioned in this section.

22  Organisations authorised to receive CAPS payments

             (1)  In paragraphs 4(c), (d), (e) and (f) and subsections (5) and (6), a reference to a “participating person” includes a former participating person and, where the context permits, an authorised representative or correspondence nominee.

             (2)  An applicant, participating person, or assisted person’s legal representative, authorised representative or authorised payment recipient, other than an organisation, may authorise, in the approved form, an organisation to receive CAPS payments, or instalments of CAPS payments, as the authorised payment recipient for a person entitled to the payment.

             (3)  If the organisation agrees to receive the CAPS payments as agent, the organisation must provide details to the Chief Executive Medicare for the payments in the approved form.

             (4)  The organisation must comply with the following obligations:

                     (a)  assist the participating person to obtain continence aids that are appropriate to his or her needs;

                     (b)  assist the participating person to use the CAPS payment as a contribution towards to the cost of purchasing continence aids;

                     (c)  inform the participating person of any unused CAPS payment amount 30 days before the end of the financial year to which the payment relates;

                     (d)  refund to the estate of a participating person who has died any unused portion of a CAPS payment;

                     (e)  refund to the participating person any unused portion of a CAPS payment if notified, in writing, that:

                              (i)  the person has ceased to  meet the eligibility criteria; or

                             (ii)  the person wishes to terminate the payment arrangement with the organisation;

                      (f)  refund to the participating person any unused portion of a CAPS payment if the participating person was not entitled to the payment at the time it was made;

                     (g)  inform the Chief Executive Medicare promptly on becoming aware that the participating person does not meet the eligibility criteria.

             (5)  An organisation which receives a CAPS payment as agent for a participating person must:

                     (a)  keep records that:

                              (i)  are in a collated and accessible form; and

                             (ii)  contain details of the amounts received and the dates the amounts were received; and

                            (iii)  contain details of how the amounts were used; and

                     (b)  in relation to each of those records, retain the record for the period ending 3 years after 30 June of the year in which the record was made.

             (6)  An organisation must provide details on the use of a CAPS payment if requested to do so by the participating person or his or her authorised representative.

             (7)  The Secretary may direct, in writing, the Chief Executive Medicare to decline to make a CAPS payment to an organisation if the Secretary is satisfied that:

                     (a)  the arrangement for the payment is not operating to the benefit of the participating person; or

                     (b)  the organisation has not complied with an obligation imposed by this Instrument in respect of any participating person.

             (8)  If a direction is given under subsection (7):

                     (a)  the Chief Executive Medicare must comply with the direction; and

                     (b)  the Secretary must inform the participating person and the organisation in writing that the organisation is no longer able to act as an authorised payment recipient.

Part 5Miscellaneous

23  Debts

                   If a participating person or former participating person has received, either directly or through an agent, a CAPS payment to which the person was not entitled, the amount paid is a debt due to the Commonwealth, recoverable by the Chief Executive Medicare.

24  Investigations

                   The Chief Executive Medicare may conduct investigations, as he or she thinks appropriate, in order to ensure that an applicant or a participating person meets the eligibility criteria.

25  Review of decisions

             (1)  For sections 14 and 15 of the Act, a person aggrieved by a decision under section 6 or 9 of this Instrument may apply, in the way set out in subsection (2), to the Chief Executive Medicare for review of the decision.

             (2)  The application for review must:

                     (a)  be made by written notice given to the Chief Executive Medicare within 28 days after the day on which the person received notice of the decision; and

                     (b)  set out the reasons for making the request.

Note:          Sections 14 and 15 of the Act provide for the reconsideration of decisions by the Chief Executive Medicare and review of such decisions by the Administrative Appeals Tribunal.


Schedule

Part 1Eligible neurological condition

 

Category 1

CONGENITAL MORPHOLOGICAL DISORDERS

 

Agenesis of Corpus Callosum

 

Anorectal Malformation

 

Apert Syndrome

 

Arnold-Chiari Syndrome

 

Arthrogryposis

 

Bladder Exstrophy

 

Caudal agenesis

 

Caudal Regression Syndrome

 

Cerebral Neuronal Migration Disorders

 

Charge Syndrome

 

Cloacal Exstrophy

 

Congenital Epispadias

 

Congenital Hydrocephalus

 

Dandy-Walker malformation

 

Developmental Cord Disorder

 

Hirschsprung’s Disease

 

Holoprosencephaly

 

Imperforate Anus

 

Incomplete Corpus Callosum/Aicardi Syndrome

 

Lissencephaly

 

Megalencephaly

 

Microcephaly

 

Neural tube defect

 

Polymicrogyria

 

Pontocerebellar Hypoplasia

 

Posterior Urethral Valve Syndrome

 

Prune Belly Syndrome

 

Sacral Agenesis

 

Schizencephaly

 

Spinal Agenesis

 

Spinal Dysraphism

 

Spinal Hemangioma

 

Syringobulbia

 

Syringomyelia

 

Tethered spinal cord

 

Vater Syndrome/Vacterl Syndrome

 

Velocardiofacial Syndrome

 

 

Category 2

CEREBRAL PALSY

 

Dystonic Cerebral Palsy

 

Hereditary Spastic Paralysis

 

Spastic Quadriplegia

 

Mixed cerebral palsy

 

 

Category 3

SYNDROMES ASSOCIATED WITH INTELLECTUAL IMPAIRMENT

 

2-Hydroxyglutaric Aciduria

 

Alpers Disease

 

Angelman Syndrome

 

Alpha Thalassaemia X-linked intellectual disability Syndrome

 

Bardet Biedl Syndrome

 

Beare-Stevenson Syndrome

 

Cyclin Dependent Kinase-Like 5 Gene Mutation

 

Chime Syndrome

 

Chromosome 1 Deletion

 

Chromosome 5q deletion (Cri Du Chat Syndrome)

 

Chromosome 13q Deletion Syndrome

 

Chromosome 15q Duplication Syndrome

 

Chromosome 18q Deletion Syndrome

 

Chromosome 1p36 Deletion Syndrome/Mono 1p36

 

Chromosome 22 Ring

 

Chromosome 2q Deletion Syndrome

 

Chromosome 6 Ring Syndrome

 

Chromosome 8  Inversion or Duplication

 

Chromosome 9p Deletion Syndrome

 

Chromosome 9q Deletion Syndrome

 

Chromosome 11q (Jacobsen Syndrome)

 

Chromosome Xp Duplication

 

Cockayne Syndrome

 

Coffin-Lowry Syndrome

 

Cognitive Impairment

 

Cohen Syndrome

 

Congenital disorders of glycosylation

 

Congenital Neurological Infections

 

Cornelia de Lange Syndrome

 

Costello Syndrome

 

Cowden Disease

 

Developmental Delay

 

Developmental Delay associated with Autism, Autism Spectrum Disorder and Aspergers Syndrome

 

Dravet Syndrome

 

Fragile X Syndrome

 

Fumarase Deficiency

 

GLUT1-Deficiency Syndrome

 

Glutaric Aciduria Type 1

 

Goldenhar’s Syndrome

 

Hunter Syndrome

 

Hurler-Scheie Syndrome

 

Hypomyelination disorders

 

Joubert Syndrome

 

Kabuki Syndrome

 

Langer-Gideon Syndrome

 

Lawrence Moon Biedel Syndrome

 

Lennox-Gastaut Syndrome

 

Lesch-Nyhan Syndrome

 

Lowe Syndrome

 

Mannosidosis

 

Maple Syrup Urine Disease

 

Meningitis

 

Menkes Syndrome

 

Mitochondrial Dieases

 

Molybdenum Cofactor Deficiency

 

Mowat-Wilson Syndrome

 

Mucolipidosis IV

 

Myotonic Dystrophy (Type 1)

 

Neonatal Hypoxic ischaemic encephalopathy

 

Neonatal Onset Multisystem Inflammatory Disease

 

Neuronal ceroid lipofuscinosis

 

Normal Pressure Hydrocephalus

 

OHDO Syndrome

 

Opitz Trigonocephaly Syndrome

 

Ohtahara Syndrome

 

Ouvrier Syndrome

 

Pallister-Killian Mosaic Syndrome

 

Peroxisome Biogenesis Disorder

 

Phelan McDermid Syndrome/22q 13 Deletion Syndrome

 

Phenylketonuria

 

Prader-Willi Syndrome

 

Pyruvate Dehydrogenase Deficiency/Leigh’s Disease

 

Rasmussen’s Disease

 

Rett Syndrome

 

Rubinstein-Taybi Syndrome

 

Sensory Integration Disorder/Dysfunction

 

Smith-Lemli-Opitz Syndrome

 

Smith-Magenis Syndrome

 

Sotos Syndrome

 

Sturge-Weber Syndrome

 

Subcortical Band Heterotopia

 

Translocation of Chromosome 2

 

Translocation Trisomy 5/18

 

Trichothiodystrophy

 

Triploidy

 

Trisomy 10

 

Trisomy 13 (Patau syndrome)

 

Trisomy 18 (Edward Syndrome)

 

Trisomy 20p

 

Trisomy 21 (Down Syndrome)

 

Trisomy 47

 

Trisomy 4p

 

Trisomy 9

 

Tuberous Sclerosis

 

Turner Syndrome

 

Urea Cycle Defect

 

Valproate Embryopathy

 

West Syndrome

 

Williams Syndrome

 

Wolf-Hirschhorn Syndrome

 

X-Linked Adrenoleukodystrophy

 

Young-Simpson Syndrome

 

 

Category 4

PARAPLEGIA and QUADRIPLEGIA

 

Paraparesis

 

Spinal Cord Compression

 

Spinal Cord Infarction

 

Spinal Cord Damage

 

Tetraplegia

 

Transverse Myelitis

 

 

Category 5

ACQUIRED NEUROLOGICAL CONDITIONS

 

Acquired Brain Injury

 

Acute disseminated encephalomyelitis

 

Adhesive Arachnoiditis

 

Alcoholic Encephalopathy

 

Alzheimer’s Disease

 

Amyloidosis

 

Arachnoiditis

 

Ascending Polyneuropathy

 

Astrocytoma

 

Autonomic Neuropathy

 

Basal Ganglia Infarction

 

Benign Meningioma

 

Brown-Sequard Syndrome

 

Cauda Equina compression syndrome

 

Cerebral Abscess

 

Cerebral Aneurysm

 

Cerebral Anoxia

 

Cerebral Toxoplasmosis

 

Cerebral Tumour

 

Cerebrovascular Disease

 

Chronic Hypoxia

 

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

 

Cortical-Basal Ganglionic Degeneration

 

Dementia (any cause)

 

Developmental/Motor Dyspraxia

 

Diabetic Autonomic Neuropathy

 

Diabetic Neuropathic Bladder

 

Dorsal Pontine Band Syndrome

 

Encephalitis

 

Ependymoma

 

Epilepsy

 

Focal Cerebral Degeneration

 

Glioblastoma Multiforme

 

Glioblastoma of Spine

 

Hepatic Encephalopathy

 

Hydrocephalus (communicating or non-communicating)

 

Hypoxic Brain Injury

 

Inoperable Neurogenic Incontinence

 

Intracerebral Haemorrhage (Subarachnoid Haemorrhage, Subdural Haematoma)

 

Korsakoff’s Syndrome

 

Lambert-Eaton Myasthenic syndrome

 

Lewi Body Disease

 

Macroencephaly

 

Malignant Meningioma

 

Meningoencephalitis

 

Metastatic Carcinoma with Neurological Syndrome

 

Multiple Systems Atrophy

 

Myopathy

 

Nemaline Myopathy

 

Oligodendroglioma

 

Pachymeningitis

 

Periventricular Leukomalacia

 

Picks Disease

 

Pilocytic Astrocytoma

 

Poliomyelitis

 

Polymyoneuropathy

 

Posterior Leuco Encephalopathy

 

Primary Dystonia (case by case)

 

Primary or secondary CNS B-cell neoplasm

 

Progressive supranuclear palsy

 

Progressive Systemic Sclerosis

 

Sacral Neuroplexy

 

Sacral Plexopathy

 

Schizophrenia (Catatonic)

 

Schwannoma

 

Spinal Canal Disease

 

Spinal Chordoma

 

Spinal Ependymoma

 

Spinal Tumour

 

Stroke/Cerebrovascular Accident (CVA)

 

 

Category 6

DEGENERATIVE NEUROLOGICAL DISEASES

 

Alexander Disease

 

Amyotrophic Lateral Sclerosis

 

Ataxia Telangiectasia

 

Canavan disease

 

Cauda Equina Syndrome

 

Cervical Myelopathy

 

Creutzfeldt-Jakob Disease (CJD)

 

Cytochrome C Oxidase Deficiency

 

Dejerine-Sottas Disease

 

Demyelinating Neuropathy

 

Demyelination of White Matter

 

Fahr’s Disease

 

Friedreich’s Ataxia

 

Guillain Barre Syndrome

 

Huntington Chorea

 

Huntington Disease

 

Hypoxic Ischaemic Encephalopathy

 

Idiopathic Axonal Neuropathy

 

Krabbe disease

 

Kugelberg-Welander Syndrome

 

Machado Joseph Disease

 

Metachromatic Leukodystrophy

 

Mitochondrial Myopathy with Encephalopathy

 

Morquio Syndrome

 

Motor Neurone Disease

 

Multiple Sclerosis

 

Muscular Dystrophy

 

Myotonic dystrophy

 

Myoneural Disorders

 

Neuroaxonal Dystrophy

 

Neurofibromatosis NF

 

Neurogenic Bowel

 

Neuromyelitis optica

 

Niemann-Pick Disease Type C

 

Pallister-Hall Syndrome

 

Parkinson Disease

 

Parkinsonism

 

PEHO Syndrome (Progressive encephalopathy with oedema, hypsarrhythmia and optic atrophy)

 

Pelizaeus Merzbacher Disease

 

Primary Lateral Sclerosis

 

Progressive Supranuclear Palsy/Steele Richardson Syndrome

 

Sanfilippo Syndrome

 

Sarcoidosis of the Brain

 

Shy-Drager Syndrome

 

Spinal Cord Syndrome

 

Spinal Muscular Atrophy Type 1

 

Spinal Muscular Atrophy Type 2

 

Spinocerebellar Degeneration

 

Stiff-Mans Syndrome

 

Striato-Nigral Degeneration

 

Subacute sclerosing pan-encephalitis

 

Thiamine deficiency

 

Vascular Myelopathy

 

Vertebral Canal Stenosis

 

Vertebral Degeneration

 

Wallerian Degeneration of White Matter

 

Wilson’s Disease

 

 

Category 7

BLADDER OR BOWEL INNERVATION DISORDERS

 

Atonic Bladder/Hypotonic Bladder

 

Bladder Innervation Urgency

 

Cystocele (not suitable for surgery)

 

Dysfunctional Voiding

 

Dystonic Bladder

 

Ectopia Vesica

 

Linear Sebaceous Nevus Genetic

 

Myasthenia Gravis

 

Neurogenic Bladder

 

Neuronal Intestinal Dysplasia

 

Neuropathic Bladder

 

Post Bladder Surgery

 

Prostatectomy with nerve removal or damage

 

Pudendal Nerve Palsy

 

Radical Prostatectomy

 

Schmidli Autonomic Neuropathy

 

Slow Transit Constipation

 

Smooth Muscle MyopathySphincter Deficiency (anal or bladder)

 

Spinal Stenosis

Part 2Eligible other condition

 

Category 8

OTHER

 

Anal Carcinoma

 

Anal Fistula

 

Anterior rectal Prolapse

 

Atonic Bladder

 

Bilateral Nephrostomy Tubes

 

Bladder Cancer

 

Bladder Muscle Dysfunction

 

Bladder Neck Dysfunction

 

Bladder Neck Fibrosis

 

Bladder Prolapse

 

Bowel Cancer

 

Bowel Prolapse

 

Cervical Cancer

 

Chronic Urinary Retention

 

Crohn’s disease

 

Detrusor Instability

 

Detrusor Overactivity

 

Endometriosis

 

Enterocutaneous Fistula

 

Faecal Incontinence Post-Colectomy

 

Hypertonic Bladder

 

Irradiated Rectum/Radiation Proctitis/urethritis/Cystitis

 

Ovarian or fallopian tube Carcinoma

 

Post Ileorectal Anastomosis

 

Post Ileal J Pouch Anastomosis

 

Prostate Cancer

 

Benign Prostatatic hypertrophy

 

Rectal Prolapse

 

Rectal Ulcer Syndrome

 

Recto-vaginal fistula

 

Ulcerative Colitis or Proctitis

 

Transurethral Resection of the Prostate sequelae

 

Urethral Stenosis

 

Urinary Tract Fistula

 

Uterine Cancer

 

Uterine Prolapse

 

Vaginal Prolapse

 

Vesico-Vaginal Fistula

 

 

Vulval carcinoma