Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Act 2021 (2 of 2021)
Schedule 1 Amendments
Part 1 Payment on invoice for services provided
Aged Care Act 1997
7 At the end of Part 3.2
Add:
Subdivision C - Shortfall amount
48-13 Shortfall amount
(1) The shortfall amount for the care recipient in respect of the *payment period is worked out as follows:
Shortfall amount calculator
Step 1. Work out, in accordance with the Subsidy Principles, the price for the home care provided during the *payment period to the care recipient by the approved provider.
Step 1A. If, in accordance with the User Rights Principles, the approved provider elects to return the *Commonwealth portion of the care recipient's *unspent home care amount to the Commonwealth, reduce the price by the amount of the Commonwealth portion available at the end of the previous *payment period, up to 100% of the price.
Step 2. Subtract the care recipient contribution amount (if any) specified in, or worked out in accordance with, the Subsidy Principles.
The result is the shortfall amount for the care recipient in respect of the *payment period. However, if the result does not exceed zero, the shortfall amount is zero.
(2) The Subsidy Principles must specify the way to work out the price for home care provided during a *payment period to a care recipient by an approved provider for the purposes of step 1 of the shortfall amount calculator.
(3) Without limiting subsection (2), the Subsidy Principles may require the price to include or exclude amounts in relation to particular matters.
(4) The Subsidy Principles may specify the care recipient contribution amount, or the way to work out the care recipient contribution amount, for a care recipient in respect of a *payment period for the purposes of step 2 of the shortfall amount calculator.
Subdivision D - Home care accounts
48-14 Home care account
(1) There is a home care account for each person who is, at any time on or after the *implementation day, a *prioritised home care recipient.
(2) A person starts to have a *home care account on:
(a) if the person is, on the *implementation day, a *prioritised home care recipient - the implementation day; or
(b) otherwise - the day the Secretary first makes, after the implementation day, a determination under section 23B-1 that the person is a prioritised home care recipient.
48-15 Home care credits
The following table sets out when a credit arises in a care recipient's *home care account and the amount of the credit. The credit is called a home care credit .
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Credits in the home care account |
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Item |
If ... |
a credit of ... |
arises ... |
|
1 |
the amount worked out at step 1 (Commonwealth contribution amount) of the home care subsidy calculator in subsection 48-1(2) for the care recipient in respect of a *payment period exceeds the amount worked out at step 2 (shortfall amount) of that calculator for the care recipient in respect of the payment period |
the amount of the excess |
at the later of: (a) the end of the subsequent payment period; and (b) the time the approved provider gives to the Secretary, under section 47-4, a claim in respect of the payment period |
|
2 |
the circumstances specified in the Subsidy Principles happen |
an amount specified in, or worked out in accordance with, the Subsidy Principles |
at the time specified in the Subsidy Principles |
48-16 Home care debits
The following table sets out when a debit arises in a care recipient's *home care account and the amount of the debit. The debit is called a home care debit .
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Debits in the home care account |
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Item |
If ... |
a debit of ... |
arises ... |
|
1 |
the amount worked out at step 2 (shortfall amount) of the home care subsidy calculator in subsection 48-1(2) for the care recipient in respect of a *payment period exceeds the amount worked out at step 1 (Commonwealth contribution amount) of that calculator for the care recipient in respect of the payment period |
the amount (if any) that is the difference between: (a) the amount identified in step 5 of that calculator for the care recipient in respect of the payment period; and (b) the amount worked out at step 1 (Commonwealth contribution amount) of that calculator for the care recipient in respect of the payment period |
at the time the approved provider gives to the Secretary, under section 47-4, a claim in respect of the payment period |
|
2 |
the circumstances specified in the Subsidy Principles happen |
an amount specified in, or worked out in accordance with, the Subsidy Principles |
at the time specified in the Subsidy Principles |
48-17 Home care account balance
The home care account balance in a care recipient's *home care account at a particular time equals:
(a) the sum of the *home care credits in that account at that time; less
(b) the sum of the *home care debits in that account at that time.
48-18 When home care account ceases
A care recipient's *home care account ceases when the care recipient dies.