Document ID: chunk:federal_register_of_legislation:F2024C00800:front:0:p31
Version: federal_register_of_legislation:F2024C00800
Segment Type: other
Provision Reference: 
Character Range: 81592–84669

or will not be given and what conditions, if any, will apply, the following will be taken into account:

(a) any specific requirements contained in these Principles or the Act;

(c) the extent of funds that are available;

(d) reasonable control over expenditure;

(e) the clinical need for the proposed treatment; and

(f) the suitability and quality of the proposed treatment.

3.3 Circumstances in which prior approval is not required
3.3.2 Treatment not requiring prior approval includes:

(a) treatment by a general practitioner except where otherwise indicated in Part 4;

         (b) medical specialist consultations in country and Territory areas, except where otherwise indicated in principle 4.7;

        Note: Prior approval is not required for medical specialist consultations in States or Territories where the MPPPs apply — see paragraph 1.2.2.
         (c) dental treatment specified as not requiring prior approval in Part 5 or in a DVA document incorporated into the Principles;

         (d) dental prosthetic treatment specified as not requiring prior approval in Part 5 or in a DVA document incorporated into the Principles;

         (da) diabetes educator services, except where otherwise indicated in Principle 7.6A;
(e) the prescription and supply of pharmaceutical items as set out in Part 6;

         (f) subject to paragraph 7.3.5, the provision of community nursing services by a community nurse in accordance with paragraph 7.3.3 after the services have been provided;

         (fa) treatment under the MRCA Home Care Program except a service of emergency short term home relief (ESTHR) within 24 hours of a previous service of ESTHR;

  Note: see principle 7.3A.

(g) optometrical treatment provided by an optometrist to an entitled person in accordance with these Principles and the dispensing of optical products by an optometrist (or an optical dispenser) provided that, if an optical product is dispensed, any requirement for prior approval in relation to that product imposed by 3.2.1(s) is satisfied.

              Note: see principle 7.4.

         (h) physiotherapy treatment, except where otherwise indicated in principle 7.5.

         (j) podiatry treatment, except where otherwise indicated in principle 7.6;
         (k)  treatment at a hospital under the conditions set out in paragraph 9.1.8;
         (ka) convalescent care at a private hospital or public hospital;
         (kb) respite care in an institution — where the institution is a private hospital or public hospital.

         (m) ambulance transport in an emergency or where that is the arrangement between ambulance service providers and the Commission;
              Note: see paragraph 12.1.5.

(n) referral to the Australian Hearing Service; and

(o) chiropractic or osteopathic treatment.

3.4 Other retrospective approval
3.4.1 On application, the Commission may approve, and pay the cost of, any treatment that was undertaken in the period between:

(a) the effective date of eligibility under the Act; and

(b) the date on which the person is notified of