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MEMORANDUM OF UNDERSTANDING BETWEEN THE COMMONWEALTH OF AUSTRALIA AS REPRESENTED BY THE DEPARTMENT OF VETERANS’ AFFAIRS, THE REPATRIATION COMMISSION AND THE AUSTRALIAM MEDICAL ASSOCIATION LTD
Preamble The Repatriation Commission (the Commission) and the Australian Medical Association Ltd (the AMA) acknowledge the following Memorandum of Understanding (MoU) for "DVA Registered" Local Medical Officers (participating LMOs) providing medical services to persons eligible for treatment under the Veterans’ Entitlements Act 1986. The parties acknowledge that this MoU represents a unique and limited plan for the care and treatment of eligible persons in recognition of their contribution to the Nation in times of conflict. This MoU provides for a participating LMO to be central to the care of eligible persons with a responsibility to integrate that care within the Commission’s treatment guidelines. For this purpose the Commission has approved the LMO Scheme including its Repatriation Comprehensive Care elements which are outlined in this MoU and the ‘Notes for LMOs’. The obligations of the Commission under this MoU will be met and administered by the Commonwealth Department of Veterans’ Affairs (DVA). Participating LMOs are required to register individually for the LMO Scheme in accordance with this MoU and the ‘Notes for LMOs’. The Commission will meet the cost of care by participating LMOs on a fee-for-service basis in accordance with its Treatment Principles and Repatriation Private Patient Principles and will provide training and education, and undertake research. LMOs provide quality care with the best health outcomes for eligible persons in accordance with the prescribed Commission arrangements in this MoU and the ‘Notes for LMOs’. The Commission has determined these arrangements after consultation with the AMA, and the following reflects the principles to which both parties are committed in providing appropriate care and treatment. Principles
1. An LMO Registration Committee has been established and consists of 1 nominee from the AMA, 1 medical nominee from DVA and a chair, being the DVA Branch Head, Health Services. The Registration Committee assesses all applicants for the scheme and monitors and assesses participating LMOs observance of this MoU as a basis of continuing registration under the LMO scheme. The Committee may delegate its power to accept applicants to nominated officers in State Offices of DVA. 2. An LMO Appeals Board has been established and consists of an independent chair, who is a senior member of the legal profession, a nominee of the AMA and a nominee of DVA. Applicants have the right of appeal to the Board in relation to any decision by the LMO Registration Committee concerning their entry into the LMO scheme. Participating LMOs have a right of appeal to the Board concerning any adverse decision concerning their continuing participation in the scheme. 3. The terms of this MoU and the provisions in the ‘Notes for LMOs’ must be substantially complied with by participating LMOs in order to access the fees under these arrangements. Substantial non-compliance may lead to a warning from DVA following a recommendation from the Committee. Such a warning will be acted upon only after the elapse of a three month period from the warning and only where during that three month period the substantial non-compliance has continued. 4. DVA and the AMA will consult on the contents of the ‘Notes for LMOs’ issued by DVA from time to time. 5. Referrals will be made as clinically necessary to other health-care providers in accordance with the guidelines specified in the ‘Notes for LMOs’ and in this MoU.
6. DVA encourages quality use of medicines through a range of medication management initiatives including the prescriber feedback program. LMOs will participate in the program to improve the health outcomes of veterans. 7. DVA and the AMA will jointly develop proposals to encourage general practitioners to undertake minor surgery in their rooms, with the objective of having agreed arrangements and incentives in place by mid 2000. 8. DVA will provide funding for the development of educational packages for general practitioners on practical issues associated with the treatment of veterans. These educational packages will be developed in consultation with the AMA and be structured so as to attract recognition under formal continuing medical education programs for general practitioners. 9. DVA and the AMA will during the life of the MoU, review the arrangements applying to the LMO Scheme with a view to simplifying the administrative requirements for general practitioners participating in the scheme and identifying appropriate remuneration for those requirements.
10. Fees for all consultations and procedures provided by participating LMOs under the Repatriation Comprehensive Care elements of the LMO Scheme will be made at the equivalent of 100 per cent of the CMBS fee, subject to Clause 11 below. 11. The Commission will, through DVA/state government hospital funding agreements, implement payments to general practitioners treating veterans in rural public hospitals at rates equivalent to those which apply to the treatment of public patients under state government public hospital arrangements at those hospitals, where such state hospital payments exceed 100 per cent of the CMBS fee. DVA will consult with the AMA on implementation of these arrangements. 12. The Commission will introduce a medication review fee of $80 for in-surgery reviews and $105 for reviews conducted in a patient’s home or in an institution. DVA and the AMA will jointly develop criteria for the medication review of veterans. 13. The current arrangements for Health Care Plans will be retained and entitled veterans, war widows(ers) or dependents may receive a Health Care Plan if they meet criteria currently outlined in DVA care plan forms, irrespective of age. Payment for such Health Care Plans will be made at the equivalent of 100 per cent of the CMBS fee for Multi Disciplinary Care Plans. Payment for Health Assessments and Case Conferences will be made at 100% of the CMBS. 14. Remuneration consistent with other similar bodies within the DVA portfolio shall apply to members of the LMO Appeal Board and the LMO Registration Committee. 15. A medical practitioner (except a specialist and/or a consultant) who is not registered for the purposes of the Repatriation Comprehensive Care elements of the LMO Scheme but treats eligible persons will be remunerated as follows:
will be in accordance with the June to June movements in the Health and Personal Care component of the CPI to be effective from 1 November. 17. If the component results in a negative or neutral amount there will be no change. All calculations will be rounded to the nearest 5 cents. 18. Indexation of other non-CMBS items within this MoU will be in accordance with the CMBS.
19. Participating LMOs will directly bill DVA in full payment of accounts with no billing to individual veterans. 20. Provided the accounts are submitted to an address nominated by DVA and on prescribed stationery in accordance with the ‘Notes for LMOs’, DVA undertakes to pay all completed and accurate accounts within 28 days of receipt by DVA. In the absence of payment despatched by DVA within 28 days of receipt, DVA will be liable for a penalty of 1.5% of the account for each 28 days the account is overdue. 21. DVA and the AMA will jointly develop initiatives to encourage electronic billing for DVA services and access by electronic means to DVA forms. 22. DVA will, in line with the practices of the Health Insurance Commission, remove the requirement to submit paper copies of accounts when electronic billing has been utilised.
23. DVA and the AMA will jointly review the arrangements for the Repatriation Comprehensive Care elements of the LMO Scheme and the content of the MoU:
24. Three months before the expiration of this MoU, DVA and the AMA agree to consult on the contents of a further MoU.
25. This MoU will take effect from 13 December 1999 and will continue for three years.
SIGNED for and on behalf of the COMMONWEALTH OF AUSTRALIA by ………………………………………… in the presence of ………………………………………… THE SEAL OF THE REPATRIATION COMMISSION duly affixed: DATE: 13 December 1999
SIGNED for and on behalf of the AUSTRALIAN MEDICAL ASSOCIATION LTD by …………………………………………. in the presence of …………………………………………. DATE: 10 December 1999 |