1.4 Interpretation
1.4.1 In these Principles, unless a contrary intention appears:
“ABN (Australian Business Number)” has the meaning given by the A New Tax System (Australian Business Number) Act 1999.
“Aboriginal and/or Torres Strait Islander Primary Health Care worker”
means a person who is qualified as an Aboriginal and/or Torres Strait primary health care worker after undertaking a course in Aboriginal and/ or Torres Strait Islander Health, provided by an institution recognised by the Aboriginal and Torres Strait Health Islander Practice Board of Australia as suitable for providing a course of that nature, and who obtained a Certificate Level III (or higher) under the course.
“Aboriginal and/or Torres Strait Islander Health Worker Care Co‑ordination treatment” means treatment provided by an Aboriginal and/or Torres Strait Islander Primary Health Care worker to an entitled person under the Coordinated Veterans' Care Program, comprised of:
(a) implementing the Comprehensive Care Plan for the person under the Program — in particular co‑ordinating treatment services under the Comprehensive Care Plan;
(b) liaising, in relation to the Comprehensive Care Plan, with the general practitioner who manages the Comprehensive Care Plan for the person;
(c) performing such other functions under the program that the Aboriginal and/or Torres Strait Islander Primary Health Care worker has under the Fees for Coordinated Veterans' Care Program Providers.
“ACPMH treatment” means action taken with a view to maintaining an entitled member in mental health and includes:
(a) training members of the Defence Force or staff made available under section 382 of the Act, or both, in the mental health care disciplines that could benefit the mental health of an entitled member; and
(b) conducting research into mental injuries or diseases suffered by members of the Defence Force or into the mental state generally of such members with the resulting knowledge being applied to the benefit of the health of an entitled member; and
(c) improving communication on mental injury or disease health care matters between:
(i) members of the Defence Force who are staff‑managers; and
(ii) staff made available under section 382 of the Act; and
(iii) an entitled member; and
(d) conducting mental injury or disease health care policy research with the outcomes of that research being applied to the benefit of the health of an entitled member.
Note (1): under section 13 of the Act treatment can be action taken with a view to maintaining a person in physical or mental health.
Note (2): the term “member” is defined in these Principles so as to include “former member“ and the term “Defence Force” is defined in s.5 of the Act.
“Act” means the Military Rehabilitation and Compensation Act 2004.
“admission date” means the date on which a general practitioner records in writing (including in electronic form) that the general practitioner has decided an entitled person may participate in the Coordinated Veterans' Care Program.
“admitting general practitioner”, in relation to an entitled person in the Coordinated Veterans' Care Program, means the general practitioner who decided an entitled person may participate in the Coordinated Veterans' Care Program.
“Aged Care Rules” means the rules, as in force from time to time, made under section 602 of the Aged Care Act 2024.
“AHPRA” means the Australian Health Practitioner Regulation Agency established under section 23 of the Health Practitioner Regulation National Law as in force in a State or Territory.
“allied health provider” means a category of provider mentioned in the Table in 7.1A.1.
“approved provider” means a State, Territory or Local Government, or incorporated organisation, or person, that has entered into an arrangement with the Commission for the provision of:
(a) a Home Care service (category A); or
(b) a Home Care service (category B); or
(c) a Home Care service (category C); or
(d) a limited MHC‑type service;
to an entitled person, whether by the approved provider or a sub‑contractor engaged by it.
“assistive communication device” means an object that enhances the ability of a person with complex communication needs to communicate and includes items such as:
communication books or boards
speech generating devices
modified personal computers
computerised devices, which may include a keyboard and screen display and which may incorporate synthetic speech, memory functions, and word prediction facilities
devices commonly known as computer tablets and smart `phones.
“Australian Centre for Posttraumatic Mental Health” and “ACPMH” mean the Australian Centre for Posttraumatic Mental Health Incorporated.
“authorised nurse practitioner” has the meaning it has in subsection 84(1) of the National Health Act 1953.
“acute care certificate” means a certificate given by a medical practitioner in similar form to the acute care certificate provided for in section 3B of the Health Insurance Act 1973 to the extent that the provisions of that section are applicable.
“carer” means a person who provides ongoing care, attention and support for a severely incapacitated or frail person to enable that person to continue to reside in his or her home, and is not limited to a person who is receiving a carer service pension.
“Chief Executive Medicare” has the meaning it has in the Human Services (Medicare) Act 1973.
“clinical psychologist” means a psychologist:
(a) who has been given a provider number in respect of being a psychologist; and
(b) who, in the opinion of an employee of, or consultant to, the Department or the Human Services Department, has appropriate qualifications in clinical psychology and practises as a clinical psychologist.
“Commission” means the Military Rehabilitation and Compensation Commission.
"Commission‑funded treatment" means treatment for which the Commission may accept financial responsibility.
Note: although the Commission may accept financial responsibility for treatment, actual payment for that treatment is made by the Commonwealth. See paragraph 423(c) of the Act.
“Commonwealth Home Support Programme service” means a service provided to a person under the programme administered by the Department of Health called the “Commonwealth Home Support Programme” and includes any service provided under that programme as the name of the programme may change from time to time.
“community nurse” means a registered nurse or enrolled nurse who works in a community nursing setting and who is employed or engaged by a community nursing provider.
“Community Nurse Care Co‑ordination treatment” means
treatment provided by a community nurse to an entitled person under the Coordinated Veterans' Care Program, comprised of:
(a) implementing the Comprehensive Care Plan for the person under the Program — in particular co‑ordinating treatment services under the Comprehensive Care Plan; and
(b) liaising, in relation to the Comprehensive Care Plan, with the general practitioner who manages the Comprehensive Care Plan for the person.
“community nursing provider” means a community nursing provider who has entered into an agreement with the Commission to provide community nursing services to entitled persons.
"community nursing services" means the community nursing services provided to an entitled person, in respect of which the Commission will accept financial responsibility for under Part 7 of the Principles.
“Comprehensive Care Plan” means the care plan prepared by a general practitioner, in accordance with the Notes for Coordinated Veterans' Care Program Providers, for an entitled person participating in the Coordinated Veterans' Care Program.
Note: Fees for the preparation of a “Comprehensive Care Plan” are set out in the Schedule 8, Co‑ordinated Veterans’ Care (CVC) Program of the Department of Veterans’ Affairs Fee Schedules for Medical Services (see: paragraph 3.5.1).
“Contracted Day Procedure Centre” means premises:
(a) at which any patient is admitted and discharged on the same day for medical, surgical or other treatment; and
(b) operated by a person contracted to the Commission, the Repatriation Commission or the Department in respect of treatment provided at the premises to entitled persons;
but does not include any of the following premises:
(c) premises conducted by or on behalf of the State;
(d) a public hospital or health service under the control of a public health organisation;
(e) a private hospital;
(f) a nursing home;
(g) a residential rehabilitation establishment.
“contracted private hospital” means a private hospital with which the Commission has entered into arrangements for the care and welfare of entitled persons.
“convalescent care” means a period of medically prescribed convalescence for an entitled person who is recovering from an acute illness or an operation.
“Coordinated Veterans’ Care Program” means the treatment program of that name set out in Part 6A of these Principles and in the Notes for Coordinated Veterans' Care Program Providers that aims to reduce the need for hospitalisation among Gold Card holders and eligible White Card holders of the veteran and defence force community and improve their social well‑being. In particular the program has the following main features:
assessment – a general practitioner (GP) will assess a person with complex care needs due to chronic disease to see if the person would benefit from the clinical care services under the program and ascertain if the person meets the program’s eligibility criteria;
consent – a person needs to consent to participation in the program and the GP needs to record that consent. As treatment is being provided it is the GP’s responsibility to ensure a potential participant in the program understands the nature of the program and that the person’s personal details that are relevant to the person’s treatment under the program may be provided to bodies and individuals such as the Department, the Human Services Department and health care providers, who have a need for the information in connection with the person’s treatment under the program;
care plan – the GP will prepare a Comprehensive Care Plan for a person the GP admits to the program;
consultation – the person will be consulted in the preparation of the care plan and its review;
implementation and co‑ordination – the GP’s practice nurse (or a community nurse via a DVA‑contracted community nursing provider, or an Aboriginal and/or Torres Strait Islander Primary Health Care worker, if more appropriate) will implement the care plan and, in particular, co‑ordinate services under the plan.
“Coordinated Veterans' Care Program treatment” means:
(a) GP Care Leadership treatment; or
(b) Practice Nurse Care Co‑ordination treatment; or
(c) Community Nurse Care Co‑ordination treatment; or
(d) Aboriginal and/or Torres Strait Islander Health Worker Care Co‑ordination treatment.
"co payment", in relation to the MRCA Home Care Program, means an amount of money an approved provider or a sub‑contractor is permitted to charge an entitled person, pursuant to an arrangement between the approved provider and the Commission, in respect of a Home Care service (category A).
“country area” means that part of the State outside the metropolitan area of the capital city of that State, determined by the Repatriation Commission to be a country area under paragraph 80(2)(b) of the Veterans' Entitlements Act 1986.
“daily care fee” means:
(a) in relation to an entitled person in a hospital — an amount determined under the Health Insurance Act 1973 to be the resident contribution applicable under that Act to a nursing‑home‑type patient of that hospital; or
(b) in relation to an entitled person (including a former prisoner of war or a person awarded the Victoria Cross for Australia) who is receiving, or received, residential care—the maximum daily amount of the resident contribution for the person worked out under section 277 of the Aged Care Act 2024; or
(c) in relation to an entitled person (including a former prisoner of war or a person awarded the Victoria Cross for Australia) who is in a class referred to in section 275A of the Aged Care Act 2024 and is receiving, or received, residential care—the maximum daily amount of the transitional resident contribution worked out under section 285A-10 of the Aged Care Rules; or
(d) in relation to an entitled person (including a former prisoner of war or a person awarded the Victoria Cross for Australia) who is receiving, or received, residential care (respite)—the amount of resident respite fee for the person worked out under subsection 283(2) of the Aged Care Act 2024.
“Day Procedure Centre” means premises that would be Contracted Day Procedure Centre premises if the operator of the premises was contracted to the Commission, the Repatriation Commission or the Department.
“DVA document” means a document prepared in the Department and available on the Internet at:
http://www.dva.gov.au/Pages/home.aspx
“dental hygienist” means a person who has a general registration in the dental hygienists division under the National Law in the dental profession.
“dental therapist” means a person who has a general registration in the dental therapists division under the National Law in the dental profession.
“dental prosthetist” means a person, however described, authorised under a law of a State or a Territory, to carry out the work of dental prosthetics without a written work order from a dentist or other person who may lawfully give a written work order for that purpose.
“dental specialist” means a qualified dental practitioner who:
(a) is registered with a Dental Board of the State or Territory in which he or she practises; and
(b) has obtained an appropriate higher qualification; and
(c) has been recognised as a specialist in the particular field by:
(i) a Dental Board of the State or Territory in which he or she practises, where the Dental Board of the State or Territory has available a mechanism for such recognition; or
(ii) another appropriate body mutually agreed in advance with the Australian Dental Association Incorporated.
“dentist” means a person registered or licensed as a dentist under a law of a State or Territory that provides for the registration or licensing of dentists but does not include a person so registered or licensed:
(a) whose registration, or licence to practise, as a dentist in any State or Territory has been suspended, or cancelled, following an inquiry relating to his or her conduct; and
(b) who has not, after that suspension or cancellation, again been authorised to register or practise as a dentist in that State or Territory.
“enrolled nurse” means a person who is registered under a law of a State or Territory or of the Commonwealth to practise as an enrolled nurse.
“Department” means the Commonwealth as represented by the Department of Veterans’ Affairs.
“Department of Health” means the Commonwealth Department of State, however named, that from time to time is responsible for the administration of the National Health Act 1953.
"dependent eligible young person" has the same meaning as "dependent child" in the Social Security Act 1991.
“diabetes educator” means a person who:
(a) is credentialled as a diabetes educator by the Australian Diabetes Educators Association (ADEA); and
(b) is a member of, or eligible for membership of, the ADEA.
“diabetes educator services” means a program of education about diabetes with an emphasis on self‑care, provided by a diabetes educator to a person with diabetes.
"Domestic Assistance" means the service under the MRCA Home Care Program consisting of:
(a) assistance with domestic chores, including assistance with cleaning, dishwashing, clothes washing and ironing, shopping and bill paying; and
(b) help with meal preparation where this is not the primary focus of the occasion of the service; and
(c) in remote areas, activities such as collecting firewood.
“DRCA” means the Safety, Rehabilitation and Compensation (Defence‑related Claims) Act 1988.
“DRCA disability” means an injury (within the meaning of the Safety, Rehabilitation and Compensation (Defence‑related Claims) Act 1988):
(a) for which the Military Rehabilitation and Compensation Commission has accepted liability to pay compensation under that Act; and
(b) for which the person with the injury is eligible to be provided with treatment under Part 3 of Chapter 6 of the Act.
Note 1: In the Safety, Rehabilitation and Compensation (Defence‑related Claims) Act 1988 the definition of injury includes a disease (see section 5A of that Act).
Note 2: Section 85(2A) of the Act provides eligibility for treatment of a person with an injury under the Safety, Rehabilitation and Compensation (Defence‑related Claims) Act 1988.
“elective surgery” means any non‑urgent surgical procedure performed for diagnostic or therapeutic purposes.
"eligible young person" has the meaning it has in section 5 of the Act.
“emergency” means a situation where a person requires immediate treatment in circumstances where there is serious threat to the person’s life or health.
"emergency short term home relief" means care provided to an entitled person in his or her home on the following conditions:
(a) the person or the person's carer is unable to provide care due to sudden and unforeseen circumstances; and
(b) the period for which the care is provided does not exceed 72 hours (episode) per emergency except that, if the entitled person requires further care within 24 hours after the end of the previous episode in an emergency, and obtains prior approval, a further episode of care (up to 72 hours) may be provided in that emergency; and
(c) the cumulative period of the care provided to the entitled person did not exceed 216 hours in a Financial year.
Note: emergency short term home relief is not relevant to the calculation of the daily care fee for residential care or residential care (respite).
“entitled member" means a member or former member as defined in section 5 of the Act who is or was entitled to treatment under Part 3 of Chapter 6 of the Act and means a person with a DRCA disability.
“entitled person” means a person who is entitled to treatment under Part 3 of Chapter 6 of the Act.
Note: this includes a person with a DRCA disability.
“wholly dependent partner” or “wholly dependent partner” means a wholly dependent partner as defined in section 5 of the Act.
"episode of care" means services provided to a patient by a health provider that:
(a) have been detailed in a patient care plan;
(b) are characterised by continuity of treatment or provision of service;
and an episode of care arises:
(c) every time a service provider sees a new patient; or
(d) where a service provider has not seen a patient for some time and therefore no continuity of service can be provided, and the original patient care plan is no longer applicable or appropriate.
“exceptional case process” means the process whereby the Commission may accept financial liability for community nursing services provided to an entitled person who, due to dependency or complex needs, requires community nursing services which, in the opinion of the Commission, fall significantly outside those referred to in any arrangement between the Commission and a DVA‑contracted community nursing provider.
Note: paragraph 3.5.1 (after paragraph (f)) enables the Commission, in exceptional circumstances to, among other things, accept financial liability for fees higher than those set out in an arrangement.
“excluded service” means:
(a) a HACC Review Agreement (National Partnership) service; or
(b) a Commonwealth Home Support Programme service;
that is the same type of service that may be provided under the MRCA Home Care Program as a Home Care service (category A) or Home Care service (category C).
Note: the intention is that a Home Care service (category A), Home Care service (category B) and Home Care service (category C) are mutually exclusive.
"exempt amount” means an amount of money not payable by an entitled person in respect of any Home Care service (category A) or Home Care service (category C) provided to the entitled person by an approved provider, because the entitled person is an exempt entitled person.
"exempt entitled person" means, in relation to the provision of any Home Care service (category A) or Home Care service (category C) to an entitled person, an entitled person who:
(a) has a dependent eligible young person; or
Note: under the Acts Interpretation Act 1901 the singular includes the plural meaning a person can have more than one dependent eligible young person.
(b) is a person who, in the opinion of the Commission, is experiencing severe financial hardship or who could experience severe financial hardship if the person was to make a payment in respect of the service; or
(c) is in receipt of an income support payment at the maximum rate and does not earn, derive or receive ordinary income exceeding $40 per fortnight.
Note: the Commission may allow exemption from payment for a period or until the occurrence of an event.
“Fee Schedule” means a DVA document approved by the Repatriation Commission, the Commission, or a member of the Repatriation Commission or of the Commission, or by the Secretary to the Department, with the words “Fees” and ‘Schedule”, in relation to a category of health care provider, in the title to the document, that sets out the terms on which, and the conditions subject to which, the Commission will accept financial responsibility for treatment provided to an entitled person by the health care provider the subject of the document.
Note: the DVA documents called Fee Schedules set out amounts the Department will pay for health care services and can designate whether a service required the prior approval of the Commission before it could be provided.
“general practitioner” has the same meaning as “general practitioner” has in the Health Insurance Act 1973.
“Gold Card” means the identification card (also known as the Veteran Card) provided by the Department to a person who is entitled under the Act to treatment, subject to these Principles, for all injuries or diseases.
“GP Care Leadership treatment” means treatment provided by a general practitioner to an entitled person, under the Coordinated Veterans' Care Program, comprised of the following:
(a) preparing and managing the Comprehensive Care Plan for the person under the Program;
(b) overseeing a practice nurse in the implementation of the Comprehensive Care Plan — where a practice nurse and not a community nurse or Aboriginal and/or Torres Strait Islander Primary Health Care worker or the general practitioner co‑ordinates treatment under the Comprehensive Care Plan (Practice Nurse Care Co‑ordination treatment);
(c) referring the person to a DVA‑contracted community nursing provider for Community Nurse Care Co‑ordination treatment or to an Aboriginal and/or Torres Strait Islander Primary Health Care worker for Aboriginal and/or Torres Strait Islander Health Worker Care Co‑ordination treatment, if appropriate;
(d) performing such other functions under the program that the general practitioner has under the Notes for Coordinated Veterans' Care Program Providers.
“GP Home Care service (category C) Referral” means treatment comprised of a general practitioner preparing a written document that refers an entitled person, who the general practitioner has admitted to and is treating under the Coordinated Veterans' Care Program, to a VHC assessment agency for assessment for a Home Care service (category C) under the Veterans’ Home Care Program and which:
(a) is in the form, if any, approved by the Commission; and
(b) is sent to the MHC assessment agency, including as a facsimile message.
“HACC Review Agreement (National Partnership) service” means a service of home or community care that could be, or could have been, provided to a person under an agreement between the Commonwealth and a State or the Northern Territory — being an agreement made under the Home and Community Care Act 1985 but deemed to be a National Partnership Agreement in the context of the Intergovernmental Agreement on Federal Financial Relations of 2008, made under the Federal Financial Relations Act 2009.
“health care provider” means a person who provides treatment to an entitled person in accordance with these Principles.
“home” includes:
(a) the premises, or part of the premises, where the person normally resides; or
(b) a share house where the person normally resides;
but does not include:
(c) a hospital; or
(d) the premises where the person is receiving residential care.
Note: ‘residential care’ is also defined in paragraph 1.4.1.”.
“Home and Community Care Program service” means a service provided to a person under the auspices of the Home and Community Care Act 1985 when that Act was in force.
Note: in 2015 there was a proposal to repeal the Home and Community Care Act 1985 by the Omnibus Repeal Day (Spring 2014) Act 2014.
"Home and Garden Maintenance" means the service, under the MRCA Home Care Program, of maintaining the home, garden or yard of an entitled person, and includes:
(a) assistance with minor maintenance and minor repair of the home (e.g changing light bulbs, minor carpentry, minor painting, replacing tap washers, but not the supply of replacement items), garden or yard to keep the home, garden or yard safe and habitable;
(b) lawn mowing;
but does not mean:
(c) tree felling or tree removing or other major tasks related to a garden or yard;
(d) provision of materials.
Note: recipients of MRCA Home Care services will be expected to supply materials used in home maintenance, eg replacement light bulbs and tap washers. Service providers will be required to provide any equipment needed, eg garden tools.
“home care” means a funded aged care service (within the meaning of the Aged Care Act 2024) that is in the service group referred to in paragraph 8(3)(a) of that Act.
"Home Care service (category A) " means the provision of Domestic Assistance, Personal Care, Home and Garden Maintenance or Respite Care to an entitled person pursuant to the MRCA Home Care Program.
“Home Care service (category B)” means:
(a) for an entitled person in Victoria or Western Australia at a time when the Commonwealth Home Support Programme service in Victoria or Western Australia, as the case may be, does not include a service that would satisfy the description of a HACC Review Agreement (National Partnership) service — the provision of treatment to the person pursuant to the MRCA Home Care Program that would satisfy the description of:
(i) a HACC Review Agreement (National Partnership) service ; or
(ii) a Commonwealth Home Support Programme service other than such a service that would satisfy the description of a HACC Review Agreement (National Partnership) service; or
(ii) both services in (i) and (ii);
but does not mean the provision of treatment pursuant to the MRCA Home Care Program that would satisfy the description of an excluded service; or
(b) for an entitled person in a State or Territory at a time when the Commonwealth Home Support Programme service in the State or Territory in which the person is in includes a service that would satisfy the description of a HACC Review Agreement (National Partnership) service — the provision of treatment to the person pursuant to the MRCA Home Care Program that would satisfy the description of a Commonwealth Home Support Programme service but does not mean the provision of treatment pursuant to the MRCA Home Care Program that would satisfy the description of an excluded service.
Note 1: as at 1 July 2015 some services under the Commonwealth Home Support Programme (CHSP) (generally speaking CHSP services are a Home Care service (category B)) were not provided in Victoria or Western Australia. The services in question are known as “HACC services”. HACC services are home or community care services that were originally provided under agreements under the Home and Community Care Act 1985 (the HACC Act) except in Victoria and Western Australia where similar services were provided under Bilateral Agreements with the Commonwealth Government. At or about 2008/2009 HACC services in States/Territories (except Victoria/Western Australia) were provided under agreements known as “National Partnership Agreements”. The National Partnership Agreements were made under the auspices of the Intergovernmental Agreement on Federal Financial Relations of 2008 and the Federal Financial Relations Act 2009. In short, the original agreements under the HACC Act were deemed to be National Partnership Agreements and the HACC Act was rendered obsolete. On 1 July 2015, in all States/Territories except Victoria/Western Australia, HACC services ceased being provided under National Partnership Agreements and were provided under CHSP. However as at 1 July 2015 HACC‑type services in Victoria/Western Australia continued to be provided under the Bilateral Agreements between those States and the Commonwealth.
Note 2: the intention of paragraph (a) of this definition is to enable the Department of Veterans’ Affairs (DVA) to pay for HACC services for an entitled person in Victoria and Western Australia in addition to paying for services for the person under the Commonwealth Home Support Programme service until the Commonwealth Home Support Programme applies fully in those States and includes the HACC services. The intention in paragraph (b) of this definition is that where the Commonwealth Home Support Programme operates fully in Australia i.e. includes HACC services, DVA will only pay, under this definition, for services under the Commonwealth Home Support Programme. There is to be no potential for double‑dipping.
“Home Care service (category C)” means the provision by an approved provider of a service to an entitled person under the MRCA Home Care Program that is:
(a) pursuant to a GP Home Care service (category C) Referral and allocated to the provider by a MHC assessment agency; and
(b) aimed at reducing the person’s social isolation by improving their social networks; and
(c) provided to an entitled person by an approved provider.
“Human Services Department” means a Department, or Executive Agency, administered by the Minister administering the Human Services (Centrelink) Act 1997.
"income support payment" has the same meaning it has in the Social Security Act 1991, save that it includes an income support supplement under the VEA;
Note: As at 1 January 2001 income support payments were:(a) a social security benefit; (b) a job search allowance; (c) a social security pension; (d) a youth training allowance; (e) a service pension.
“in‑home respite” means care provided to a person in his or her own home for a maximum of 196 hours in a Financial year to provide rest or relief from the role of caring:
(a) to the person; or
(b) to the person’s carer;
Note: in‑home respite is not relevant to the calculation of the daily care fee for residential care or residential care (respite).
“inpatient” means a person formally admitted for treatment by a hospital.
“institution”, in Part 11, includes:
(a) a retirement village;
(b) a cluster of self‑care units.
“MBS” and “Medicare Benefits Schedule” mean, in the context of amounts payable for treatment under the Principles, a Fee Schedule, and in any other context means:
(a) Schedule 1 to the Health Insurance Act 1973 as substituted by regulations made under subsection 4(2) of that Act; and
(b) Schedule 1A to the Health Insurance Act 1973 as substituted by regulations made under subsection 4(2) of that Act; and
(c) the table of diagnostic imaging services prescribed under subsection 4AA(1) of that Act as in force from time to time.
Note: an example of where “Medicare Benefits Schedule” is used in a non‑payment context is paragraph 4.2.1.
“medical practitioner” has the same meaning as “medical practitioner” has in the Health Insurance Act 1973.
“medical specialist” means a medical practitioner who is recognised as a consultant physician or as a specialist, in the appropriate specialty, for the purposes of the Health Insurance Act 1973.
“medicare benefit” has the meaning it has in the Health Insurance Act 1973.
“medicare program” has the meaning it has in the Human Services (Medicare) Act 1973.
"member" has the meaning it has in the Act save that it includes former member and a person with a DRCA disability.
"Memorandum of Understanding of 1995" means the Memorandum of Understanding between the Commonwealth of Australia as represented by the Department of Veterans' Affairs, the Repatriation Commission and the Australian Medical Association Ltd, relating to the provision of medical services by Local Medical Officers to entitled persons, dated 10 December 1995.
“MHC assessment agency” means a person to whom the Commission has delegated its power to:
(a) assess whether a person needs:
(i) a Home Care service (category A); or
(ii) a Home Care service (category B); or
(iii) a Home Care service (category C;
under the MRCA Home Care Program; and
(b) allocate a service in (a) to an approved provider.
“minor procedure” means a surgical procedure that:
(a) does not involve hospitalisation or theatre fees; and
(b) is of a type that is undertaken routinely in doctors’ and specialists’ rooms; and
(c) does not require general anaesthesia; and
(d) is not undertaken in a private day facility centre.
“MPPPs” means the MRCA Private Patient Principles determined by the Commission under paragraph 286(1(b) of the Act.
“MRCA Access Payment” means the amount set out in the DVA document entitled “Department of Veterans’ Affairs Fee Schedules for Medical Services” referred to in Schedule 1 and called the “MRCA Access Payment” — being an additional amount payable by the Department to a general practitioner for a medical service provided by the general practitioner to an entitled person in accordance with these Principles and the Notes for General Practitioners.
Note: a MRCA Access Payment is an amount additional to any amount otherwise payable by the Department to a general practitioner for a medical service provided by the general practitioner to an entitled person in accordance with these Principles and the Notes for General Practitioners.
"MRCA Home Care Program" means:
(a) the treatment program under which the Commission ensures the provision of care and assistance services to entitled persons who are frail, or who have disabilities, with the aim of maintaining the independence of those people, allowing them to remain in their own home for as long as possible, and reducing avoidable illness and injury, and is comprised of section 7 of the Veterans’ Affairs (Extended Eligibility for Treatment) Instrument 2015, paragraphs 7.3A to 7.3A.22 (inclusive) of the Principles, and other relevant paragraphs in the Principles, and the arrangements under section 285 of the Act in support thereof.
(b) the treatment program under which the Commission ensures the provision of social support services to entitled persons referred to the program under a GP Home Care service (category C) Referral.
"MRCA Pharmaceutical Benefits Scheme" means the scheme determined by the Commission under paragraph 286(1)(c) of the Act.
"MRCA Private Patient Principles" means the principles in the determination made by the Commission under paragraph 286(1)(b) of the Act.
“National Law” has the same meaning as in section 3 of the Health Insurance Act 1973.
“neuropsychologist” means a person who:
(a) specialises in the assessment, diagnosis and treatment of psychological disorders associated with conditions affecting the brain such as difficulties with memory, learning, attention, language, reading, problem‑solving, decision‑making or other aspects of behaviour and thinking abilities; and
(b) in the opinion of an employee of, or consultant to, the Department or the Human Services Department, has appropriate qualifications in clinical neuropsychology and practises as a neuropsychologist.
“Notes for Allied Health Providers” means the document approved by the Secretary to the Department entitled “Notes for Allied Health Providers”, and referred to in Schedule 1, that sets out the terms on which, and the conditions subject to which, an allied health provider is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.
“Notes for Coordinated Veterans' Care Program Providers” means the document approved by the Commission, the Repatriation Commission, or a member of the Commission or Repatriation Commission, or by the Secretary to the Department, entitled “Notes for Coordinated Veterans' Care Program”, and referred to in Schedule 1, that sets out the terms on which:
(a) a general practitioner;
(b) a practice nurse;
(c) a community nurse (via a DVA‑contracted community nursing provider); and
(d) an Aboriginal and/or Torres Strait Islander Primary Health Care worker;
is to provide treatment to an entitled person under the Coordinated Veterans' Care Program in order for the Commission to accept financial responsibility for that treatment.
“Notes for General Practitioners” means the document that:
(a) is approved by the Commission or a member thereof, or by the Secretary to the Department, entitled “Notes for General Practitioners”; and
(b) is referred to in Schedule 1; and
(c) sets out the terms on which, and the conditions subject to which, a general practitioner is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment, except those parts of the document that deal with the formation of a contractual relationship between a general practitioner and the Commission or the Department.
“Notes for Providers” means a DVA document approved by the Secretary to the Department, or by the Repatriation Commission or the Commission, or a member of either Commission, with the word ‘Notes’ in its title, and referred to in Schedule 1, that sets out the terms on which, and the conditions subject to which, a health care provider is to provide treatment to an entitled person in order for the Commission to accept financial responsibility for that treatment.
“optical dispenser”, in the case of an individual, means a person who:
(a) interprets optical prescriptions and fits and services optical appliances such as spectacle frames and lenses; and
(b) holds a qualification that, in the opinion of the Commission, is appropriate for the skills needed to practise optical dispensing; and
(c) is a member of a body established to supervise the occupation of optical dispenser; and
(d) holds a provider number as an optometrist, ophthalmologist, orthoptist or optical dispenser.
“optical dispenser”, in the case of a company, means a company that:
(a) holds an ABN (Australian Business Number);
(b) carries on a business of optical dispensing;
(c) employs or engages for the optical dispensing aspects of the business — an individual who is an optical dispenser.
“optical dispensing” means interpreting optical prescriptions and fitting and servicing optical appliances such as spectacle frames and lenses.
“oral health therapist” means a person who has general registration in the oral health therapists division under the National Law in the dental profession.
“occupational therapist” means an occupational therapist who has been given a provider number in respect of being an occupational therapist.
“occupational therapist (mental health)” means an occupational therapist:
(a) who has been given a provider number in respect of being an occupational therapist; and
(b) who, in the opinion of an employee of, or consultant to, the Department or the Human Services Department, has appropriate qualifications in occupational therapy in the area of mental health and who practises as an occupational therapist in the area of mental health.
“Optical Coherence Tomography” means the treatment comprised of a non‑contact, non‑invasive high resolution imaging technique that provides cross‑sectional tomographic images of the ocular microstructure through the thickness of the retina.
"ordinary income" has the same meaning it has under the definition of "ordinary income" in the "Social Security Act 1991" including where terms in that meaning are further defined save that "ordinary income" does not include a payment of Income support supplement.
Note: Income support supplement is described in Part IIIA of the VEA.
“outpatient service” means a health service or procedure provided by a hospital but not involving admission to the hospital.
“outreach program counselling” means the treatment of that name established by paragraph 7.7A.1 of the Principles — comprised of mental health counselling under the Veterans and Veterans Families Counselling Service provided by an outreach program counsellor to an entitled person eligible for the treatment under the Principles.
“outreach program counsellor” means:
(a) a person who is registered with AHPRA to practise as a psychologist;
(b) a person who is registered with AHPRA to practise as an occupational therapist;
(c) a person who is registered with AHPRA to practise as a registered nurse;
(d) a person who is eligible for membership with the Australian Association of Social Workers (ABN 93 008 576 010);
(e) a person who is registered:
(i) as a registered clinical counsellor with the Psychotherapy and Counselling Federation of Australia (ABN 91 794 316 901); or
(ii) at registration category Level 3 or Level 4 with the Australian Counselling Association Limited (ABN 12 242 711 378):
being a person approved by the Department or the Commission to provide outreach program counselling under Part 7.7A.
"patient care plan" means a document that is completed by a health provider who provides a service to a patient and that contains details of:
(a) the patient's medical history;
(b) the injury or disease in respect of which the service is to be provided;
(c) the proposed management of the injury or disease; and
(d) an estimation of the duration and frequency of the service to be provided.
“period of care” in relation to the care provided by:
(a) a general practitioner; or
(b) a practice nurse; or
(c) an Aboriginal and/or Torres Strait Islander Primary Health Care worker; or
(d) a community nurse (via a DVA‑contracted community nursing provider);
to an entitled person under the Coordinated Veterans' Care Program (Program), means the period set out in the Notes for Coordinated Veterans' Care Program Providers in relation to the general practitioner, practice nurse, community nurse or Aboriginal and/or Torres Strait Islander Primary Health Care worker, provided that any subsequent period of care by the same general practitioner is approved by the general practitioner for the person.
"Personal Care" means the service under the MRCA Home Care Program consisting of assistance with daily self care tasks, such as eating, bathing, toileting, dressing, grooming, getting in and out of bed, and moving about the house.
“PBS” means the Pharmaceutical Benefits Scheme authorised under the National Health Act 1953.
“physiotherapy” includes hydrotherapy.
“practitioner” has the same meaning as in section 124B of the Health Insurance Act 1973 in force from time to time.
“practice nurse” means a registered nurse or enrolled nurse employed or engaged by a general practitioner as a nurse in the practice of the general practitioner.
“Practice Nurse Care Co‑ordination treatment” means
treatment provided by a practice nurse to an entitled person, under the Coordinated Veterans' Care Program, comprised of:
(a) implementing the Comprehensive Care Plan for the person under the Program — in particular co‑ordinating treatment services under the Comprehensive Care Plan;
(b) liaising, in relation to the Comprehensive Care Plan, with the general practitioner supervising the practice nurse in relation to the implementation of the Comprehensive Care Plan;
(c) performing such other functions under the program that the practice nurse has under the Notes for Coordinated Veterans' Care Program Providers.
“Principles” means the MRCA Treatment Principles.
“prior approval” means that approval for the assumption by the Commission of the whole, or partial, financial responsibility for certain treatment must be given by the Commission before that treatment is commenced or undertaken.
“prisoner of war” means an entitled member who was captured by the enemy (including a terrorist) while rendering defence service.
“private health insurer” has the meaning it has in the Private Health Insurance Act 2007.
“private hospital” means premises that have been declared specifically as private hospitals for the purposes of the Health Insurance Act 1973.
"proscribed amount" means, in relation to the MRCA Home Care Program:
(a) subject to paragraph (b), an amount of money that if paid by an entitled person would mean the entitled person has paid in respect of a Home Care service (category A) comprised of Domestic Assistance provided to that entitled person by any approved provider or by any sub‑contractor during a week or part thereof, an amount exceeding $5;
Note: for the purpose of ascertaining if an amount of money is a proscribed amount where the amount demanded, received or assigned is in respect of a service (s) provided during two or more weeks, without the service (s) being related to the particular week in which the service(s) was delivered, the amount shall be apportioned pro rata to those weeks.
(aa) subject to paragraph (b), an amount of money that if paid by an entitled person would mean the entitled person has paid in respect of a Home Care service (category A) comprised of Home and Garden Maintenance, provided to that entitled person by any approved provider or by any sub‑contractor during the relevant period referred to in paragraph 7.3A.3 (2) of the Principles, an amount exceeding $75;
Note (1): the "relevant period" is a period of 12 months.
Note (2): under paragraph 7.3A.8(a) of the Principles, an entitled person cannot be charged more than $5 per hour of service.
(c) subject to paragraph (b), an amount of money that if paid by an entitled person would mean the entitled person has paid, in respect of a Home Care service (category A) comprised of Personal Care provided to that entitled person by any approved provider or by any sub‑contractor during a week or part thereof, an amount exceeding $10;
Note: for the purpose of ascertaining if an amount of money is a proscribed amount where the amount demanded, received or assigned is in respect of a service (s) provided during two or more weeks, without the service (s) being related to the particular week in which the service(s) was delivered, the amount shall be apportioned pro rata to those weeks.
(d) an amount of money in respect of Respite Care provided, or to be provided, by an approved provider or by a subcontractor, to an entitled person;
Note: the intention is that any amount charged for Respite Care is a proscribed amount regardless of whether it would or would not exceed $5 per hour of service.
(g) an exempt amount;
Note: the intention is that an exempt amount remains a proscribed amount and therefore not chargeable notwithstanding it would or would not exceed $5 per hour of service.
“provider number” means the number:
(a) allocated by:
(i) the Chief Executive Medicare or by his or her delegate or by a person authorised by the Chief Executive Medicare — to a practitioner; or
(ii) the Chief Executive Officer of Medicare Australia under the Medicare Australia Act 1973 — to a practitioner; and
(b) which identifies the practitioner and the places where the practitioner practises his or her profession.
Note: see regulation 2 of the Health Insurance Regulations 1975.
"provision of a Home Care service (category A) to an entitled person by an approved provider" includes the situation where an approved provider engages a sub‑contractor to provide a Home Care service (category A) to an entitled person.
"provision of a Home Care service (category B) to an entitled person by the Commission" includes the situation where the Commission engages a sub‑contractor to provide a Home Care service (category B) to an entitled person.
“provision of a Home Care service (category C) to an entitled person by an approved provider” includes the situation where an approved provider engages a sub‑contractor to provide a Home Care service (category C) to an entitled person.
"psychologist” means a psychologist who has been given a provider number in respect of being a psychologist.
“public hospital” has the same meaning as “recognized hospital” as defined in the Health Insurance Act 1973.
Note: Section 3 of the Health Insurance Act 1973 defines “recognized hospital” in terms of hospitals recognized for the purposes of the Medicare agreement, or hospitals declared by the Minister who administers the Health Insurance Act 1973 to be recognized hospitals.
“RAP National Schedule of Equipment” means the document of that name approved by the Repatriation Commission or the Commission or by a member of the Repatriation Commission or the Commission or by the Secretary to the Department, and referred to in Schedule 1, that lists the surgical aids and appliances for self‑help and rehabilitation available to an entitled person under the Department’s Rehabilitation Appliances Program.
“registered nurse” means a person who is registered under a law of a State or Territory or of the Commonwealth to practise as a registered nurse.
“registered provider” has the meaning given in subsection 11(2) of the Aged Care Act 2024.
"Rehabilitation Appliances Program (RAP) National Guidelines"
means the document of that name approved by the Repatriation Commission or the Commission or by a member of the Repatriation Commission or the Commission or by the Secretary to the Department, and referred to in Schedule 1, that assists Commission delegates when determining approval for surgical aids and appliances for self‑help and rehabilitation (items) available under the Department’s Rehabilitation Appliances Program and which informs prescribers and suppliers of the processes necessary for an item to be provided to an entitled person.
"Repatriation Commission" means the body corporate continued in existence by section 179 of the Veterans' Entitlements Act 1986;
"residential care" means personal care or nursing care, or both personal care and nursing care, that is provided to a person in a facility in which the person is also provided with:
(a) meals and cleaning services; and
(b) appropriate staffing, furnishings, furniture and equipment for the
provision of that care and accommodation;
but does not include any of the following:
(c) care provided to a person in the person’s private home; or
(d) care provided in a hospital or psychiatric facility; or
(e) care provided in a residential facility that primarily provides care to people who are not frail and aged.
“residential care facility” means a facility in which residential care is provided to a person.
"residential care (respite)" means residential care provided as respite and includes residential care (28 day respite).
"residential care (28 day respite)" means residential care provided as respite for up to 28 days in a Financial year pursuant to the MRCA Home Care Program.
“residential care subsidy” means a subsidy worked out under Division 4 or Division 4A of Part 2 of Chapter 4 of the Aged Care Act 2024.
“respite” means a rest, break or relief for a person’s carer or a person caring for himself or herself, from the role of caring.
"Respite Care" means the service under the MRCA Home Care Program consisting of in‑home respite, residential care (28 day respite) or emergency short term home relief.
“respite care in an institution” means care provided as respite to a person in an institution.
“retirement village” has the same meaning it has in the Veterans’ Entitlements Act 1986 and as applied by the Treatment Principles.
Note: retirement village is defined in section 5M of the Veterans’ Entitlements Act1986 (VEA) and is also applied by the Treatment Principles. The intention is that the Commission is to have the same power as the Repatriation Commission to determine premises have the same function as a retirement village for the purposes of Part 11 of the Principles.
“revoked MRCA Treatment Principles” means the MRCA Treatment Principles (Instrument 2004 No. M21).
"Rural Enhancement Scheme" means the scheme jointly established by the Commission (under section 285 of the Act) and the Repatriation Commission, in consultation with the Australian Medical Association Ltd, and which has the following features:
(a) general practitioners who provide medical services (services) to entitled persons under the Rural Enhancement Scheme (Scheme) receive higher payments (as set out in the Principles) from the Department for those services than they would receive if the services were not provided under the Scheme;
(b) the Scheme only applies to general practitioners who provide medical services to entitled persons at certain rural public hospitals (identified rural hospitals);
(c) an identified rural hospital is a hospital at which a medical practitioner may provide a medical service (service) to the public and receive from the state or territory government that, respectively, administers the state or territory in which the hospital is located, an extra amount (extra amount) for that service.
(d) the extra amount is an amount representing the difference between the amount the State or Territory actually pays the medical practitioner for the service and the fee for the service listed in the Medicare Benefits Schedule.
Note: as at 1 January 2005 the Rural Enhancement Scheme only operated in NSW, Vic, SA and WA.
“service injury” and “service disease” are defined in section 5 of the Act; and in relation to a person with a DRCA disability mean the person’s injury (within the meaning of the Safety, Rehabilitation and Compensation (Defence‑related Claims) Act 1988) that was caused by, or arose out of, the person’s employment in the Defence Force that is covered by the Safety, Rehabilitation and Compensation (Defence‑related Claims) Act 1988.
Note: in the Safety, Rehabilitation and Compensation Act 1988 the definition of injury includes a disease (see section 5A of that Act).
"service injury" has the meaning it has in section 5 of the Act.
"service disease" has the meaning it has in section 5 of the Act.
“social worker (general)” means a social worker who in the opinion of an employee of, or consultant to, the Department, has appropriate qualifications in social work and practises as a social worker.
“social worker (mental health)” means a social worker:
(a) who has been given a provider number in respect of being a social worker; and
(b) who, in the opinion of an employee of, or consultant to, the Department or the Human Services Department, has appropriate qualifications in social work in the area of mental health and who practises as a social worker in the area of mental health.
“specialist aged care program” has the meaning given by section 7 of the Aged Care Act 2024.
“speech pathologist”, for the purposes of the Principles, is a person who:
(a) has been trained to assess and treat people who have complex communication needs; and
(b) has a provider number (i.e. “registered” with the Human Services Department); and
(c) is not a disqualified health care provider in the terms mentioned in paragraph 7.1B of the Principles.
Note: under paragraph 7.1B a disqualified health care provider is a person whose services would not, under section 19B of the Health Insurance Act 1973, attract a medicare benefit.
“sub‑contractor” means, in relation to the MRCA Home Care Program, a State, Territory or Local Government, or incorporated organisation, or person, engaged by an approved provider or the Commission to provide a Home Care service (category A) or a Home Care service (category B) or a Home Care service (category C) to an entitled person.
“subsequent period of care”, in relation to the provision of care by a general practitioner to an entitled person, means a period of care that may be provided by the general practitioner after the expiry of a period of care that has already been provided by the general practitioner to the entitled person.
Note: a subsequent period of care must be approved by the general practitioner (see: 6A.3). A period of care by a general practitioner that is not a “subsequent period of care” would be the first period of care provided to a person under the Coordinated Veterans' Care Program (Program) and the first period of care provided to a person under the Program by a new general practitioner for the person i.e. where the person has changed general practitioners.
“System Governor” has the meaning given in section 7 of the Aged Care Act 2024.
“transition care” means a Transition Care Program as defined in section 7 of the Aged Care Act 2024.
“Tier 1 Hospital” means a hospital in the category described as Tier 1 in 2.1 of the MPPPs.
“Treatment Principles” means the legislative instrument entitled ‘Treatment Principles’ made by the Repatriation Commission under section 90 of the VEA.
"VEA" means the Veterans' Entitlements Act 1986.
“Veterans and Veterans Families Counselling Service” or “VVCS” means the service funded by the Department known as Open Arms – Veterans & Families Counselling.
“VVCS OPC Provider Notes” means the document approved by the Commission, the Repatriation Commission, a member of the Commission or Repatriation Commission or by the Secretary to the Department, entitled “Veterans and Veterans Families Counselling Services Outreach Program Counsellors Provider Notes”, and referred to in Schedule 1, that sets out the terms on which an outreach program counsellor is to provide outreach program counselling to an eligible entitled person.
“Vertical Platform Lift” means a lift installed adjacent to vertical walls, which travels up and down, with the platform finishing flat against the floor, and the user embarking/disembarking onto an even surface.
“veterans’ supplement”, in relation to an entitled person, means a primary person‑centred supplement or a secondary person-centred supplement that applies under the Aged Care Act 2024 to the person as a care needs recipient under that Act because the person is a veteran.
Note (1): See sections 196 and 231 of the Aged Care Act 2024.
Note (2): The Aged Care Rules may specify, in respect of a veterans’ supplement, the circumstances in which the supplement will apply.
"week" means the period from Sunday to Saturday, inclusive.
"White Card" means the identification card (also known as the Veteran Card) provided by the Department to a person who is eligible under the Act for treatment, subject to these Principles, for a service injury or a service disease and also means a written authorisation issued on behalf of the Commission under subparagraph 2.1.1(a)(iii) and provided to a person who is entitled under the Act for treatment.
Note: a White Card is issued to a person with a DRCA disability.
The following terms are defined in the Act:
Defence Force (s.5(1))
member (s.5(1))
1.4.2 In the MRCA Treatment Principles, if a Note follows a principle, paragraph or subparagraph, the Note is taken to be part of that principle, paragraph or subparagraph, as the case may be.