Document ID: chunk:federal_register_of_legislation:F2024C00744:front:0:p39
Version: federal_register_of_legislation:F2024C00744
Segment Type: other
Provision Reference: 
Character Range: 103031–105972

for a war‑caused injury or disease without prior approval only if approval is sought as soon as possible after the event.

Note: this Principle does not to apply to residential care or residential care (respite) provided overseas or in Australia.  In such cases the extent of Commission liability is determined under paragraphs 2.2.3 (c) and (d),
and Part 10, of the Principles.

3.4.4 The Commission's financial liability under paragraphs 3.4.1 and 3.4.3 is limited to the difference between:

(a) the reasonable cost of treatment; and

         (b) the amount that an eligible person has claimed or is entitled to claim from the Department of Human Services as a medicare benefit, a health insurance fund or another third party.

3.4.5 The Commission's financial liability under paragraph 3.4.2 is limited to the difference between:

(a) the cost of treatment for which it is financially responsible under paragraph 3.5.1; and

         (b) the amount that an eligible person has claimed or is entitled to claim from the Department of Human Services as a medicare benefit, a health insurance fund or another third party.

3.4.6 The Commission will not pay or reimburse the Medicare levy or the Medicare levy surcharge or pay or reimburse health insurance fund premiums.

    Note: see the Medicare Levy Act 1986 for the Medicare levy and Medicare levy surcharge.

3.4.7 The Commission will accept financial responsibility under paragraphs 3.4.1, 3.4.2, and 3.4.3 if an application is supported by accounts, receipts, declarations or other evidence of the condition treated.

3.5 Financial responsibility
3.5.1 The extent of the financial liability accepted by the Commission for the provision of treatment to an entitled person by a health care provider is as follows:

    (1) for fees charged by:

              (a) a chiropractor  the amount worked out under the DVA document entitled "Chiropractors Schedule of Fees", referred to in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Allied Health Providers (Section 1 General Information and Section 2(b)(Chiropractors));

              (b) a dentist (Local Dental Officer), including for dental services provided by a dental hygienist, dental therapist or oral health therapist on behalf of the dentist  the amount worked out under the DVA document entitled "Fee Schedule of Dental Services for Dentists and Dental Specialists", referred to in Schedule 1, on condition that the treatment was provided in accordance with the Principles and the Notes for Allied Health Providers (Section 1 General Information and Section 2(c)(as section 2(c) affects dentists));

              (c) a dental prosthetist  the amount worked out under the DVA document entitled "Fee Schedule of Dental Services for Dental Prosthetists", referred to in Schedule 1, on condition that the treatment was provided in accordance with the Principles