Providers advised to check practices are compliant with DVA Notes

Each year DVA targets specific health care provider activity to ensure payments made to providers, suppliers and clients are legitimate and made in accordance with DVA’s legislation.

21 September 2018

A woman reviews her work on a notebook computerThe priority of DVA health arrangements is to ensure the provision of best-practice care for the veteran community. DVA supports providers to offer all clinically necessary treatment and achieve the best health outcomes possible for DVA clients, in adherence with the DVA Provider Notes and Fees Schedules.

While the majority of providers adhere to DVA regulations, our investigations in 2017 highlighted there had been high levels of non-compliance by a small number of providers. The department continues to target areas of concern including over-claiming, as detailed in the table below.

What behaviour is DVA targeting?

  • Service provision at levels significantly higher than their peers;
  • Non-compliant advertising;
  • Claiming patterns that are inconsistent with industry norms; and
  • Non-compliance with DVA policy e.g. Notes and Fee Schedule.

Please refer to the Notes for Allied Health Providers and Fee Schedules

Providers who have demonstrated non-compliant behaviour may receive a letter from DVA highlighting the issues found. DVA will recommend an appropriate course of action to rectify the anomalies. The action you are required to take will depend on what is specified in each individual letter.

Compliance tips for providers

Below are some tips for providers on matters which have been identified as areas for attention.

Tip 1: Familiarise yourself with the Notes and Fee Schedule

When you agree to provide services to DVA clients you are bound by the conditions set out in the Notes. These Notes are a legally binding document setting out the conditions under which health care providers may provide treatment to entitled persons under DVA’s health care arrangement.

There is a Fee Schedule for each dental and allied health discipline. These documents were recently updated in July 2018. The Fee Schedule will identify treatment restrictions, also whether prior financial authorisation is required for treatment.

Tip 2: Keep clear and updated clinical notes

All health care providers must create and maintain adequate and appropriate records relating to all administrative and clinical aspects of the provision of treatment to an entitled person. Health care providers should comply with any reasonable request from DVA to supply information in relation to any entitled person. For more detail, please refer to page 12 of the Notes.

Tip 3: Appropriate Advertising

The only words providers can use to indicate the availability of allied health services to the veteran community are ‘DVA Health Cards (Gold and White) are accepted as payment upon GP referral’, noting these services should not be advertised as free to DVA clients. Failure to amend advertising material may result in DVA taking further action. For more detail about DVA guidelines and policies related to advertising, please refer to page 13 of the Notes.

Tip 4: Provide a suitable number of treatment sessions

Where appropriate, providers should work with clients towards self-management. Treatment must be delivered in accordance with available scientific literature. Treatment of chronic conditions should have a focus on promoting independence from treatment by facilitating the DVA client’s self-management of the condition.

Tip 5: Claim correctly — kilometre allowance

A health care provider may perform treatment in an entitled person’s place of residence. There must be a genuine need to travel to see the entitled person. If there is no evidence of a genuine need to travel, the kilometre allowance will not be paid. For detail on what is genuine please refer to page 8 of the Notes. Allied health practitioners who are registered as mobile providers, that is you have no fixed practice location, are unable to claim allowance for any travel undertaken to see a DVA client.