PART 7 — TREATMENT FROM ALLIED HEALTH PROVIDERS FOR CONDITIONS ASSOCIATED WITH MALIGNANT NEOPLASIA

7.1 Prior approval and financial responsibility for health services

7.1.1 Except where provided in:

(1) the Principles;

(2) the Notes for Allied Health Providers; or

(3) a Fee Schedule;

the Commission’s prior approval for a treatment under this Part is not required.

7.1.1A In relation to any occasion of service to an entitled person under this Part, a health provider shall bill only the Department and that bill shall be for full settlement of the account for the service provided to the entitled person.

7.1.2 Subject to these Principles and in addition to services provided under paragraph 5.1.3, the Commission may provide, arrange, or accept financial responsibility for, the following services in respect of treatment of a condition associated with malignant neoplasia:

(a) audiology

(aa) diabetes educator services;

(b) dietetics;

(c) chiropractic services;

(d) community nursing;

(dd) exercise physiology;

(e) occupational therapy;

(f) optometry;

(g) orthoptics;

(h) osteopathic services;

(j) physiotherapy;

Note: Physiotherapy includes hydrotherapy (see paragraph 1.4.1)

(k) podiatry;

(l) psychology;

(m) social work;

(n) speech pathology.

7.1.3 The Commission will not accept financial responsibility for services listed in paragraph 7.1.2 for an entitled person receiving a high level of residential care where the provision of those services is covered by a State or Commonwealth subsidy.

7.1.4 Treatment in an entitled person’s home may be approved where the entitled person is medically unable to attend the relevant facilities.

7.1A Notes for Providers

7.1A.1 In order for the Commission to accept financial responsibility for treatment provided to an entitled person by a health care provider in an item (denoted by a number) in Column A below, the treatment must have been provided in accordance with the section of the Notes for Allied Health Providers for that item in Column B below, as that section relates to the health care provider:

Column A Column B