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Consumer Directed Care (CDC) – Mechanics of Consumer Transfers From Feb 2017

18 Dec 2016

 

  1. Consumer to find a new provider – via My Aged Care (MAC) website & contact centre (can use the My Aged Care Service Finder)

  2. Consumer & new provider – reactivate/accept referral code through My Aged Care or do it themselves through MAC client portal. New provider has to accept them.

  3. Consumer & existing provider – consumer notifies intention to cease services and agrees on cessation date with existing provider. Consumer should have already notified their existing provider and complied with the notice period if included in their Home Care Agreement.

  4. Consumer & new provider – Negotiate and enter into new Home Care Agreement

  5. New provider – Notify DHS of entry date within 28 days – through Aged Care Entry Record

  6. Existing provider – Notify DHS of cessation date within 31 days – through claims process

The existing & new providers can’t claim the subsidy for the same day so must ensure no overlapping claim which is why there has to be a mutually agreed cessation date.  E.g.  Consumer ceases with existing provider on 1 Dec and starts with new provider on 2 Dec ensuring no overlap

Once unspent funds have been calculated, the existing provider has 56 days to provide the following information to the consumer:

  • Cessation date

  • Unspent home care amount

  • Exit amount, if deducted

  • Amount of Unspent funds being transferred, broken down by Commonwealth and Consumer portions

  • Amount of unpaid home care fees deducted from the consumer’s portion

  • Information on how the provider will arrange payment of the unspent home care amount, depending on the circumstances.

The existing provider then gets another 14 days to transfer the funds to the new provider and issue them with a copy of the written notice.

 

The new provider has to include the unspent amount in the consumer’s next monthly statement to confirm that the funds have been received.

 

If the consumer passes away, the only difference is that the consumer’s portion will be paid within 14 days from receipt of Probate or Letter of Administration.

 

The existing provider gets 70 days to inform the Commonwealth of the refund amount through the claims process which will be included in the new column of the claim form.  The Commonwealth then deducts it from future subsidy payments.  If the amount is zero, it still has to be reported on the form.

 

Please note that it doesn’t mean the new provider has to wait up to 70 days to sign up the consumer and start services, it just means the new provider won’t receive the consumer’s unspent funds for up to that number of days.  The consumer can be “transferred” to the new provider after they have finished their notice period with the current provider.

 

Sanctions will be placed on providers if don’t pay back unspent funds to Commonwealth.

Providers have to retain records of these amounts and calculations.

 

To discuss your Consumer Directed Care processes, or to arrange a demonstration of Care Collaborator – specialist cloud based software developed to complete the on-boarding process at the initial consumer visit – please contact Debra Ward at Care Collaborator via the web page:  www.carecollaborator.com.au, email debra@carecollaborator.com.au or mobile 0438 020 728.

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