LMO Notes – Amendments
Date of effect 1 July 2003
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Amended terms and conditions
Terms and conditions of the DVA Local Medical Officer Agreement
Remuneration
Indexation
Billing
Amended schedule of fees
On 2 May 2003 the Department of Veterans' Affairs (DVA) wrote to Local Medical Officers (LMOs) with an offer of a 3 year agreement, in accordance with certain terms and conditions, as a DVA LMO providing medical services to veterans and their eligible dependants from 1 July 2003. Central to this offer is increased remuneration by way of a payment in addition to 100% of the Medicare Benefits Schedule fee, paid quarterly in arrears.
The amended terms and conditions, which are to be read in conjunction with Appendix C
of the Notes for LMO fees, and changes to the Appendix F are listed below. Where there is a conflict, these terms and conditions shall take precedent.
Amended terms and conditions
The following are terms and conditions for the agreement between the Department of Veterans' Affairs and "DVA Registered" Local Medical Officers (participating LMOs) providing medical services to persons eligible for care and treatment under the Veterans' Entitlements Act 1986.
The Repatriation Commission recognises the contribution of veterans and their dependants to the Nation in times of conflict and has approved the LMO arrangements. The obligations of the Commission under this agreement will be met and administered by the Commonwealth Department of Veterans' Affairs (DVA). Participating LMOs are required to register individually in accordance with these terms and conditions 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 which are prepared under Section 90 and 90A respectively of the Veterans' Entitlements Act 1986. LMOs will provide quality care with the best possible health outcomes for eligible persons in accordance with the prescribed Commission arrangements in this agreement and the Notes for LMOs.
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Terms and conditions of the DVA Local Medical Officer Agreement
- The Notes for LMOs as amended from time to time in conjunction with these terms and conditions of this agreement 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 or use other remedies available to it. 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.
- 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 agreement.
- 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.
- Prior to any significant changes to the Notes for LMOs, DVA and the Commission agree to consult with organisations representing LMOs on those changes.
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Remuneration
- Fees for all consultations and procedures provided by participating LMOs under the Repatriation Comprehensive Care program is subject to Clause 10 below:
(i) An amount equivalent to the 100% of the Schedule fee paid on a fee for service basis for each item of service on the Medicare Benefits Schedule; and
(ii) A retrospective payment paid quarterly (within a maximum of 28 days of the close of the April, June, September and December quarters) based on $3 for each item of service provided during the quarter.
- A medical practitioner (except a specialist and/or a consultant) who is not registered for the purposes of the Repatriation Comprehensive Care program but treats eligible persons will be remunerated as follows:
(i) 85% of the Commonwealth Medicare Benefits Schedule (MBS) fee plus 60 cents for attendance and Enhanced Primary Care items; and
(ii) 100% of the MBS fee for procedures.
Indexation
- Indexation of MBS items within this agreement will be in accordance with the MBS rate and will be rounded to the nearest 5 cents.
- Except for first year, indexation of the veterans access payment will be made from 1 January of each year based on the 'All groups' index in the June quarter Consumer Price Index and will be rounded to the nearest 5 cents. Indexation to be applied 1 January 2004 will be based the net movement in the 'All groups' index from 1 January 2003 until 30 June 2003.
Billing
- Participating LMOs will only bill DVA (Health Insurance Commission) in full payment of accounts with no charge or co-payment to individual veterans or dependants.
- 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 a maximum of 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.
Amended schedule of fees
LMOs who agree to continue as a LMO from 1 July 2003 will receive a retrospective payment paid quarterly (within 28 days of the close of the March, June, September and December quarters) based on $3 for each item of service provided to eligible veterans and their dependants during the quarter.
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