ACFI updates and new user guide

The Department of Health has published further information relating to ACFI to clarify Question 12.4 relating to a Federal Court decision made in August 2016.

As per the ACFI User Guide 2017 which is to be used for reassessments and new clients from 1 January 2017:

  • The evidence requirements for Complex Pain Management ACFI 12.4a claims include a directive given by a registered nurse or medical practitioner or allied health professional, as well as an evidence based pain assessment.
  • The evidence requirements for Complex Pain Management ACFI 12.4b claims include a directive given by a medical practitioner or allied health professional, as well as an evidence based pain assessment.
  • Under question 12.4a and 12.4b, it is permissible for the treatment to be undertaken by a different health professional than the one who gave the directive, noting that for question 12.4a the different health professional is limited, to an allied health professional or registered nurse, and for question 12.4b, an allied health professional only. Health professionals undertaking these treatments must be operating within their scope of practice and comply with the registration and/or accreditation requirements outlined on pages 38 to 39 of the ACFI User Guide 2017.

This clarification relates to a decision made by the Full Federal Court on 23 August 2016 for the case, Secretary, Department of Health v DLW Health Services Pty Ltd which related to ACFI Question 12.


To align with the Federal Court judgement the requirements outlined for ACFI Question 12 in relation to Directives, and the definition of a Health Professional, have been revised, as reflected in the updated ACFI User Guide published on 9 December 2016. The changes regarding directives make it clear that a ‘directive must indicate that the treatment is to be undertaken by the relevant qualified health professional such as an allied health professional or registered nurse (see pages 38 and 40 to 42 of the ACFI User Guide 2017)’.

The Federal Court’s decision supported the department’s review approach. This will continue to be applied to ensure ACFI Answer Appraisal Packs involving 12.4a and 12.4b claims must include:

  • a directive issued by a medical practitioner or allied health professional that indicates the care is to be provided by a registered nurse or allied health professional
  • a record of treatment – that is, evidence that the treatment was provided in accordance with the directive by one of these health professionals.

The Department has advised that further updates to the Classification Principles are planned to be released in early 2017.

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