Providers have reacted strongly to the Department of Health’s announcement that it will charge for ACFI reviews and empower review officers to demand any document or record kept on the premises.
The fee of $375 (ex GST) for reconsideration per question will be charged from 1 March 2017 and requires providers to fill in a six-page form, which the peak bodies agree is completely unreasonable.
“LASA strongly lobbied the Department against the introduction and application fee of $375 (GST exclusive) for reconsideration of an ACFI question,” LASA CEO Sean Rooney said.
“Providers usually only discover that they are required to include more information once they receive the Department’s written review report. Exit interviews do not give providers information regarding potential downgrades.”
“Members have indicated that this will create inequities for providers because most requests for reconsideration involve additional supporting information that was not included at the validation stage because the provider was unaware the Department required it,” he said.
ACSA CEO Pat Sparrow said she has raised the issue with the Department as there is no justification for the fee or lack of transparency.
“There is concern that there is no clear rationale or explanation for the application fee of $375 per question as opposed to a fee per application.”
“We believe this should be made available transparently to assist industry’s understanding of the new process and charges,” she said.
It is understood the Department will not refund the fee if new information is provided that should have been provided at validation.
Provider have 28 days from the date of the review decision to lodge a request for reconsideration and must pay the fee before a decision will be made.
The Department has said it will refund the fee if you do not provide any new information other than what was considered as part of the review and the decision made at review is varied or set aside.
The Department said it will no longer routinely seek additional information to verify ACFI subsidy claims after the ACFI review visit is completed.
- The ACFI User Guide requires a care recipient’s pack to be made available on request when a review is undertaken by the department.
- Approved providers are required to keep records so that claims for payments of subsidy to be properly verified and proper assessments to be made of whether the approved provider has complied or is complying with its responsibilities.
- Approved providers are able to submit additional information for 48 hours (i.e. two working days) following the completion of an ACFI review visit.
In addition to these changes, review officers have the power to inspect any document or record kept at the premises and to take extracts from, or make copies of, any document or record at the premises.
If an approved provider does not provide documents requested by a review officer, the officers may refer the matter to the ACFI compliance team to consider whether compliance action should be taken.
LASA said it will be taking members’ concerns about the inequities of the changes to the Department through NACA, and with the Minister.
Mr Rooney said he will continue to advocate for a full cost of care study be undertaken as part of the review of the Aged Care Funding Instrument.