Medicare, Centrelink and NDIS
Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (ME/CFS) services have been developed for use within the current funding restraints of Australian Medicare Chronic Disease Management and Australian Primary Care services. They enable patients to access management care planning and referrals under Medicare Chronic Disease Management arrangements.
Australian Medicare funded Care Plans are provided through local General Practice centres, they facilitate referrals to allied health and community education programs. Care Plans enable the central monitoring and coordination of all treatments and service interventions.
Patients are encouraged to take an active role in decision-making. Services available for patients vary according to Government Policy and between States (Hospitals and Primary Care Centres are usually State-funded). Additional services are accessed using patients’ various private health covers. Case Managers are encouraged to record all services and interventions in care plans so they can be centrally monitored and included in regular reviews and outcome management.
Current policy states management programs for Centrelink and National Disability Insurance Scheme (NDIS) assessments require patients to have documentation that they are ‘fully stabilised’ and ‘fully managed’.
To assist with this requirement South Australian primary care providers have developed the ME/CFS Annual Cycle of Care Program. This program and documentation assists Primary Care Providers to enable patients to provide the required documentation of their proactive management.
ME/CFS Management uses Medicare Care Planning and incorporates the “Cycle of Care Checklist” to review health conditions for management and general health. It is important to complete a regular cycle of care to identify any health concerns early and discuss the best treatment options with patients.
The ME/CFS Cycle of Care Checklist features core topics from generic chronic disease lifestyle management programs adapted specifically for use with ME/CFS patients. It provides a management template for Case Managers and patients to demonstrate they are proactively managing and coordinating ME/CFS multi system care over the 12-month Care Plan.
Please refer to the following links for more information