Document ID: chunk:federal_register_of_legislation:F2024C00744:reg:18:p26
Version: federal_register_of_legislation:F2024C00744
Segment Type: reg
Provision Reference: reg 18 (pt 26/47)
Character Range: 241458–244367

out requirements for agreements (client agreement) between an approved provider and a recipient of flexible care or flexible care that is transition care:

              (i) the client agreement satisfies any requirements in respect of it in the Provider/Secretary Agreement; and

              (ii) the provision of care complies with the client agreement.

          (d) whether the care essentially duplicates treatment the POW or VC recipient is receiving under other provisions of the Principles (double‑dipping).

         10.12 Billing

    10.12.1 An approved provider should bill the Department of Human Services for the co‑payment for transition care, rather than the POW or VC recipient (client) but if the client is billed, the Commission may, subject to 10.11.1 and 10.11.2, accept financial responsibility for the amount.

Part F – SHORT‑TERM RESTORATIVE CARE CO‑PAYMENT

Definition:

"co‑payment", in this Part, means an amount a person must pay for short‑term restorative care but does not include an amount payable to the approved provider of the short‑term restorative care as subsidy under the Aged Care Act 1997.

10.13  Financial Responsibility for Co‑Payment

10.13.1 The Commission may accept financial responsibility for the co‑payment a former prisoner of war (POW), or an entitled veteran awarded the Victoria Cross (VC recipient), paid, or is to pay, to an approved provider for short‑term restorative care (care) provided to the person:

          (a) on condition that the care is provided on a day in respect of which flexible care subsidy is payable for the care under the Subsidy Principles 2014, in force from time to time; and

         Note (1): The maximum number of days for which flexible care subsidy is payable for an episode of short‑term restorative care by an approved provider for a care recipient is 56 days. See section 111A of the Subsidy Principles 2014.
          (b) to the extent the co‑payment does not exceed the amount the approved provider is permitted to charge the POW or VC recipient under section 56‑3 of the Aged Care Act 1997.

         Note (2): The maximum co‑payment amount an approved provider is permitted to charge is set out in section 23AB of the User Rights Principles 2014 made for paragraph 56‑3(a) of the Aged Care Act 1997.

10.13.2 In deciding whether to accept financial responsibility for the co‑payment for short‑term restorative care (care) provided to a POW or VC recipient the Commission should take into account:

         (a) whether the care was provided in accordance with the "agreed care plan" (within the meaning of section 111A of the Subsidy Principles 2014) in place between the approved provider and the POW or VC recipient;

         (b) whether the care was otherwise provided in accordance with the relevant provisions of the Aged Care Act 1997 and relevant instruments under that Act; and

     Note (1): Part 3.3