Document ID: chunk:federal_register_of_legislation:F2024C00800:reg:18:p10
Version: federal_register_of_legislation:F2024C00800
Segment Type: reg
Provision Reference: reg 18 (pt 10/42)
Character Range: 177954–180930

the primary beneficiary ie the entitled member.

7.3B Sustainability payments—MRCA Home Care Program
7.3B.1 This subpart deals with a quarterly payment made to an approved provider for the MRCA Home Care Program (a sustainability payment):

         (a) for the costs incurred by the provider in delivering care coordination and management necessary for the provision of a service under the program; and

         (b) that is to be paid between 1 July 2024 and 30 June 2026.

7.3B.2 The Commission will, on its own initiative, pay a sustainability payment to an approved provider, for a quarter between 1 April 2024 and 31 March 2026 (the claim processed period), if:

         (a) the provider delivers a service under the program to an entitled person in accordance with this Part; and

         (b) the service is delivered under an agreement with the Commission that is in force at the time the eligibility for the payment is determined; and

         (c) a claim for payment for the service is approved during the quarter.

7.3B.3 A sustainability payment for a quarter within the claim processed period that is payable to an approved provider under paragraph 7.3B.2 is worked out using the following steps:

         (a) work out the number of entitled people who received from the provider a service under the program for which a claim for payment was approved in each calendar month during the quarter;

            (i) from the provider in each calendar month during the quarter; and

            (ii) for which the Commission has accepted financial responsibility;

         (b) multiply the number worked out under paragraph (a) by the amount determined, in writing, by the Commission for this paragraph.

7.3B.4 To remove any doubt, for the purposes of paragraph 7.3B.3(a), an entitled person is counted once for a calendar month even if more than one claim for payment was approved in the calendar month for services that the person received from the provider.

7.4 Optometrical services
7.4.1 The Commission may accept financial responsibility for optometrical services provided by an optometrist (with a current provider number) to an entitled person in accordance with these Principles and the Notes for Allied Health Providers (Section 1 General Information and Section 2(h)(as section 2(h) affects optometrists)).

7.4.2 The Commission may accept financial responsibility for optometrical products provided by an optical dispenser (who may be an optometrist) to an entitled person if those products have been provided in accordance with:

         (a) the Principles; and

         (b) the Notes for Allied Health Providers (Section 1 General Information and Section 2(h)(as section 2(h) affects optometrists and optical dispensers)); and

         (c)              the DVA document entitled "Pricing Schedule for Visual Aids", referred to in Schedule 1.

7.4.3 Optometrical products are those referred to in the DVA document entitled "Pricing Schedule for