201910

Contracted Service Provider Notice

New Legislation and Contract
(CSPN - 201910)

Provisions Taking Effect on 1 October 2019

Specific Claiming Provisions

Providers are reminded however that there are three key changes that will take effect on 1 October 2019 and the transition period does not apply. From 1 October

• Providers must only deliver and claim for services when the service is available on the client’s current voucher i.e. between the start and end date of the client’s current voucher.
• Minor Maintenance is no longer available to clients whose voucher has expired and are no longer eligible for a return voucher.
• Audiological Case Management (items 610/810) can only be claimed where an audiologist has received a referral from an audiometrist for a non-routine client and the audiologist provides advice back to the referring audiometrist.

All requirements of the Schedule of Service Items must also be met. Please note any invalid claims related to the above matters will be automatically recovered after 1 October 2019.

Schedule of Services Items and Fees

The new instrument requires the creation of a Schedule of Service Items and Fees, which must consist of program standards and schedules. This document will be referred to as the Services Schedule. During 2019-20 the department will be liaising with consumer and industry representatives to review and consolidate the program standards and schedules. Further information about the Services Schedule will be released in the coming months.

For the remainder of 2019-20, the five existing components form an interim Services Schedule. The five components are the three existing program standards (Hearing Rehabilitation Outcomes, MHLT Guidelines, and Eligibility Criteria for Refitting), the Schedule of Service Items, and Schedule of Fees. There have been minor edits to these existing documents including required changes resulting from the instrument and contract. Please note the benefit amounts listed in the Schedule of Fees for 2019-20 remain unchanged.

Further information and links to these documents are available on the program website.

Medical Certification

The new instrument removes the requirement to obtain medical certification prior to the issuing of a new client voucher. Providers are still required to ensure new clients provide authorisation for eligibility checking and give consent for the collection, storage and disclosure of their information. All clients must continue to be referred where medically appropriate.

Providers will note changes occurring with the website and portal up to and around 1 October 2019. From 1 October 2019, new program client vouchers can be issued without the medical certification.

Other Key Updates

Claim Form

From 1 October 2019, providers are no longer required to obtain the client’s signature on the claim form. A new program claim form/tax invoice will be released. Providers will have until 31 March 2020 to implement changes.

You may still use the existing claim forms but do not need to have the client sign the claim form, unless the form is being used to obtain the clients acknowledgement to enter into the Maintenance Agreement. A new Maintenance Agreement form will also be made available.

Further information regarding these and other changes will be included in the Provider Transition Guide. For further information please visit the Provider Transition Webpage.

Download this CSPN 2019-10 New Legislation and Contract