Australian Government - Department of Health - Office of Hearing Services
Hearing Services Program

Provider Transition Guide

The Department of Health (the department) is responsible for managing and administering the Australian Government Hearing Services Program (the program). This Transition Guide details the background, legislative and contractual changes and transition arrangements for providers to assist them to transition to the new legislative and contractual arrangements for the program. The guide provides an overview of key changes. Providers must ensure they familiarise themselves with the new legislation and contract.

Legislative & Contractual Changes - Background

Changes to be implemented from 1 October 2019

Other Legislative and Contractual changes

Transition period

Links and Resources

Legislative & Contractual Changes - Background  

Program Legislation   

The program is governed by the Hearing Services Administration Act 1997 and a range of subordinate legislation and the contract. In 2018 and 2019, the department completed a Thematic Review of the subordinate legislation supporting the program. The review considered whether the legislation was fit for purpose. As a result of the review, including consultation with a broad range of stakeholders, the five existing instruments were repealed and replaced with a single instrument. The new instrument, Hearing Services Program (Voucher) Instrument 2019, is effective 1 October 2019.

Service Provider Contract  

As a result of the legislative changes, the department consulted on a revised version of the Service Provider Contract and a new contract has been developed and executed by the department and all existing service providers. The new contract is effective 1 October 2019.

The new legislation and contract have significantly reduced duplication and simplified the program requirements. An overview of the legislative and contractual changes is outlined in Figure 1 below.

Figure 1 Overview of Legislative and Contractual Changes

While the legislation and new contract take effect on 1 October 2019 and certain program changes must be in place as of 1 October 2019, a transition period has been allowed for other changes which must be implemented by 1 April 2020.

Changes that must be implemented from 1 October 2019  

  • Removal of the medical certificate component of an application.
  • All services must be provided within the start and end dates of a voucher.
  • Minor Maintenance services can no longer be provided after 1/10/2019.
  • Audiological case management can only be claimed where an audiometrist seeks advice from an audiologist to help complete an assessment service for a non-routine client.
  • Clients must sign a maintenance agreement form. Providers may continue to have the claim for payment form signed until 1 April 2020.
  • Updated accreditation process.

Changes that must be implemented by 1 April 2020  

  • Subcontracting for clinical services is no longer accepted.
  • Devices must be purchased directly from an appointed supplier.
  • Device quotes are now a requirement for all device fittings (fully and partially subsidised devices, replacements and spare aids).
  • Updated device supply arrangements disclosure.
  • Clients are no longer required to sign the claim for payment form.
  • Implementation of private service delivery policies.
  • Increased insurance levels.

In understanding the program legislative and contractual changes, providers should familiarise themselves with the definitions included in the Act, instrument, and contract.

Changes to be implemented from 1 October 2019  

Medical certificate 

From 1 October, when a new client applies for the program, they will no longer be required to have a medical practitioner sign a medical certificate or indicate if there are contraindications to a hearing device fitting.

Providers are still required to ask clients to sign (written or electronic signatures are acceptable) a consent and authorisation form as per the Privacy Act 1988. This form must detail how providers collect, store and share the client’s personal information. When a provider applies for the program on behalf of a client, the Hearing Services Online (HSO) portal requires them to certify the client understands how the department will collect, store and disclose their information.

If a client applies online, the service provider will still need to complete the draft application in the portal. Please see the quick reference guide on how to finalise a draft application.

In addition, providers are still required to have medical referral policies which hearing practitioners must adhere to.

Voucher Services (Instrument s14, Contract Cl 7.1(f) & 12.4)  

Providers must ensure clients have a current voucher prior to delivering any service.

Providers must only deliver and claim for services when the service is available on the client’s current voucher i.e. between the start and end dates of the client’s current voucher. Any claims where the date of service is outside the client’s current voucher period will be recovered.

For fitting services, if the fitting date and follow-up date are split over two vouchers, providers need to ensure a return voucher has been issued prior to the follow up appointment. If a client’s voucher has expired and they have lost eligibility for program before they can attend a follow up appointment, providers must claim a non-follow up item. Fitting services must be claimed against the voucher which was current at the date of fitting.

Minor Maintenance Services and Claims 

Minor Maintenance is no longer available to clients who have an expired voucher and no longer meet the eligibility criteria for the program. Providers will have one year to submit any outstanding minor maintenance claims with a date of service prior to 1 October 2019. Minor maintenance claims with a date of service from 1 October 2019 will be recovered.

Audiological Case Management  

Providers must only claim for audiological case management services (items 610/810) where an audiologist has received a referral from an audiometrist, the client meets one of the criteria for Non-routine Clients, and the audiologist provides advice back to the referring audiometrist.

When submitting the claim items 610/810, providers must use the QP number of the audiologist who provided advice to the referring audiometrist. That audiologist must be linked to the provider in the portal.

Maintenance Agreement 

When a client chooses to enter into an annual maintenance agreement, providers must obtain a client signature.

A new Maintenance Agreement form is available on the program website. Providers can continue to get clients to sign the claim for payment form for maintenance items up to 1 April 2020. From 1 April 2020, providers will need to ask clients to sign the maintenance agreement form annually, provided the client chooses to enter into an agreement.

Accreditation  

Instrument of Accreditation(Act s15, Instrument s16-23, Contract – Definitions)  

New providers will no longer be provided with an Instrument of Accreditation. Providers will be deemed to be accredited and able to supply and claim for services to program clients once they have been provided with a fully executed contract. The new instrument recognises the accreditation of existing providers.

Conditioning of Accreditation(Act s16, Instrument s19, Contract (Definitions, Cl 7.1(e) ii, 8.1(d), 16.1(a), Item E - Schedule A)  

The Act, instrument and contract allow for the conditioning of accreditation at the commencement of accreditation or at any time the provider holds a contract with the department.

Accreditation Transfers (Instrument s22, Contract Cl 32)  

Providers may be able to transfer their accreditation and contract to a new entity with some minor changes to corporate entity status, for example where a sole trader is becoming a company. Previously providers had to terminate their accreditation and contract and apply for accreditation as the new entity. Providers are reminded that they must notify the department prior to any planned corporate change.

Termination of Accreditation (Act s20, Instrument s21)  

If the contract between the department and provider ceases, the provider’s accreditation will automatically cease. Providers who do not hold accreditation and a current contract with the department must not deliver or claim for services to program clients.

Other Legislative and Contractual changes  

Contract Term (Contract Cl 2 & 35, Schedule A - Item A)  

New contracts will no longer need to be developed and executed every three years. The contract currently expires on 30 June 2022. Contracts can now be extended, by written notice, for period of up to three years in perpetuity. Variation clauses continue to exist and will only be required where an amendment to the body of the contract is required.

Service Provider Warranties and Acknowledgements (Contract Cl 5 & 6)  

Existing warranties and acknowledgements have been reviewed and updated. Providers must

  • be able to deliver all available services under the program in accordance with appropriate program and professional standards.
  • cease communication with clients if the client has requested to be removed from marketing and contact lists.
  • ensure policies and procedures are put in place in relation to delivering services as specified in Item C of Schedule A.

Providers are advised that additional laws have been explicitly added, including the Australia Consumer and Competition Act, and providers must ensure they comply with any Commonwealth, State and/or Territory power of attorney/guardianship requirements.

Portal Information Management (Contract Cl 6.1(h) & 15.4)  

Providers must ensure information in the portal is kept up to date. This includes

  • site details
  • practitioner details and links
  • provider contact details

Ambient noise and equipment calibration (Contract Cl 10)  

Clause 10 of the contract specifies the requirements regarding site management. Specific requirements regarding ambient noise and equipment calibration have been added. At visiting sites or home visits, providers must document on the client record how ambient noise was managed when completing an assessment.

A new clause specifies that if a provider moves a site to a new address they must obtain a new site ID for that site.

Schedule A (Contract Cl 35.7, Schedule A) 

Provider and contract specific information is now located in a new contract section referred to as Schedule A, which is found at the end of the contract terms. Schedule A can be updated by the department at any time via a notice to providers. Schedule A outlines information regarding the term of the contract, standards, policies and procedures, insurance, conditions of accreditation and details of the Commonwealth Contact Point.

Qualified Practitioners (Instrument s38 & s39, Contract Cl8)  

Clarifications have been made regarding the management of personnel, including qualified practitioners. Providers must keep the details of their practitioners up to date in the portal. QP numbers must only be assigned to qualified practitioners (please refer to the definition of a qualified practitioner in the Instrument). Claims must be submitted with the QP number of the practitioner who delivered or supervised the delivery of the service.

Providers are also required to ensure that maintenance and rehabilitation related services are undertaken by people with the appropriate qualifications and skills.

Providers are responsible for the actions of their personnel and must ensure their personnel, including practitioners, comply with the legislative and contractual requirements of the program.

Transition period 

There will be a transition period of six months to allow providers to update their policies and procedures to comply with the new legislation and contract by 1 April 2020.

Subcontracting (Contract Cl 21) 

From 1 April 2020, providers will no longer be able to subcontract the delivery of clinical hearing services unless covered by one of the exceptions. Providers may still subcontract for

  • non-clinical services, for example accounting, cloud storage etc.
  • locum support at a site operated by the provider 
  • specific services where subcontracting is allowed by the Services Schedule. For example, rehabilitation plus or audiological case management.

Any subcontracting agreements must ensure compliance with program requirements. For example locum practitioners must still have a QP number and must deliver services in accordance with program requirements. Subcontracting of cloud storage must ensure Privacy Act compliance and compliance of program requirements regarding storage of client information.

Any practitioners who are operating their own site under a subcontracting arrangement and who wish to continue to deliver program services must obtain their own accreditation with the program before 1 April 2020. Further information about Becoming a Contracted Service Provider is available on the program website.

Device Supply 

Approved Devices and Appointed Suppliers (Instrument s 44 & 45, Contract Cl 9.1 - 9.4)  

From 1 April 2020, all devices purchased, fitted and claimed for through the program must be purchased directly from an Appointed Supplier.

Any device supplied to program clients and claimed for through the program must be on a Schedule of Approved Devices (Fully Subsidised or Partially Subsidised Device Schedules), unless approved by the Minister or their delegate.

Devices must be purchased directly from an Appointed Supplier who has a current Deed of Standing Offer with the department for the supply of devices through the program. Appointed Suppliers have committed to a range of provisions and conditions, including warranties, repairs, and maintenance. When a device is purchased from an Appointed Supplier, a contract is formed between the provider and Appointed Supplier.

Existing third party suppliers can apply to Become an Appointed Supplier under the program.

Device Quotes (Instrument s46(2))  

From 1 April 2020, providers must provide program clients with a device quote when fitting

  • a fully subsidised device,
  • a partially subsidised device, or
  • a replacement device.

The quote must be signed by the client prior to the fitting. A provider factsheet and quotation template is available on the website. The use of this template is optional, however it outlines the information required on a quote in order to be compliant with the legislation.

Please note, from 1 October 2019 providers must continue to get quotes signed for partially subsidised devices.

Device Supply Arrangements Disclosure (Instrument s28, Contract Cl 9.5)   

From 1 April 2020, providers must ensure their existing disclosure statements are compliant with the new legislation and contract.

Under the new legislation and contract, the disclosure is now referred to as the Device Supply Arrangements Disclosure. Section 28 of the instrument and clause 9.5 of the new service provider contract outline the requirements including two changes 

  1. The existing disclosure must include information regarding whether the provider or its staff receive any financial benefit including rewards, incentives or gifts related to device supply. Financial benefit now specifically references commissions.
  2. The disclosure is also now required to include information if the provider is also an appointed supplier of devices.

Please note, providers are not required to disclose specific details of their arrangements. The disclosure is only required to include whether arrangements exist, the type of arrangement (for example reward programs, financial support, limited range of suppliers) and with whom the arrangements exist.

When services including devices are being provided, the provider must disclose in writing whether

  1. the provider, including any of its personnel, receive direct or indirect benefits related to the purchase and supply of any devices to program clients, including price discounts, commissions, gifts and rewards etc
  2. the supplies being provided are manufactured or supplied by a related party, or where there has been significant financial support provided or received and/or
  3. the provider is also an appointed supplier and supplies its own devices.

As currently required, disclosure statements must be in writing. It is up to each provider to decide how their supplier relationships are disclosed to program clients. For example, this could include an information brochure for individual program clients, inclusion on device quotes or a poster displayed in a prominent place such as the waiting room at each site.

During the transition period, the department will liaise with consumer and industry groups to develop further guidance, including development of example statements.

Payments to Providers and Claiming  

Claiming (Contract Cl 11, 12, 13, 17 & 27.3) 

From 1 April 2020, claims must be submitted within 12 months of the date of service. Any claims submitted from 1 April 2020, where the difference between the date of service and submission date is more than 12 months will be recovered.

Claim Form (Contract Cl 11,12,13,17)  

From 1 October 2019, providers are no longer required to obtain the client’s signature on the claim form. A new program claim form/tax invoice will be released. Providers will have until 1 April 2020 to implement changes to their claim forms.

An authorised person employed by providers will still be required to substantiate any claim and demonstrate that the related service/s were compliant with the program requirements. Providers can nominate any of their employees to sign the claim form. We do not require providers to keep a record of who is authorised to sign the claim form.

Claim forms are part of the client records and copies must still be held on the client record, either digitally or in paper form. Copies of claim forms must be placed on the client record if the record is returned to the department or to a new provider if a client relocates.

Please note, original claim forms must be retained for at least seven (7) years.

Business closures/transfers and claiming (Contract Cl 27.3)  

If a provider determines it will cease to operate as a provider in the program, there will now be additional limitations on providing services in the 20 business days prior to the end date of the provider’s contract. These include assessment, fitting, and maintenance services to program clients.

Service Management Systems 

Private Services (Instrument s49, Contract Cl 11 & 17)  

By 1 April 2020, providers must have in place systems and processes that support compliance with the program requirements for delivering private services. When delivering private services to program clients, providers must retain supporting documentation such as receipts and invoices. This information does not need to be kept on the client record and does not need to be transferred with the client record if they relocate. However the original provider must retain the information related to the private service for seven years and it must be accessible by the department.

For continuity of care, information on the type of private service provided and outcomes must be documented on the client record and this information must be supplied with the client record if the client relocates.

Insurance Requirements (Contract Cl 23, Schedule A - Item D) 

From 1 April 2020, providers need to ensure their insurance levels are set at a minimum of $20m Public Liability, $10m Professional Indemnity and relevant state/territory workers compensation. Insurance certification must be on a per claim basis. Previously providers were required to hold separate insurance for each staff, the new requirements specify that they must ensure all staff are covered by the entities Professional Indemnity insurance.

Links and Resources  

Legislation and Contracts 

Program Specific Legislation and Contracts  

Hearing Services Administration Act 1997

Hearing Services Program (Voucher) Instrument 2019

Service Provider Contract

Other Relevant Legislation 

Privacy Act 1988

Notifiable Data Breach Information

National Archives Act 1983

Program Resources and Support 

Provider Transition Webpage

Schedule of Service Items and Fees (Services Schedule) 

Hearing Rehabilitation Outcomes

MHLT Guidelines

Eligibility Criteria for Refitting

Schedule of Service Items

Schedule of Fees

Other  

Provider Factsheets

Forms and Publications

Contracted Service Provider Notices

Provider transition guide (PDF 477 KB)

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