Continence Aids Payment Scheme 2010

Subscribe to a Global-Regulation Premium Membership Today!

Key Benefits:

Subscribe Now for only USD$20 per month, or Get a Day Pass for only USD$4.99.
 
 
Continence Aids Payment Scheme 2010
I, JUSTINE ELLIOT, Minister for Ageing, formulate this Scheme under section 12 of the National Health Act 1953.
Dated  __28 June____ 2010
 
 
Justine Elliot
____________________________________
Minister for Ageing
 
 
 
 
 
 
 
Contents
 
 
Part 1                   Preliminary                                                                                           3
1.           Name of Scheme                                                                                     3
2.           Commencement                                                                                      3
3.           Interpretation                                                                                           3
Part 2                   Participation in the Scheme                                                                 5
4.           Eligibility criteria                                                                                      5
5.           Application to participate in the Scheme                                                    5
6.           Notification to Medicare Australia CEO                                                      6
7.           Decision that a person has ceased to be eligible                                        6
8.           When participation ceases to have effect                                                   7
Part 3                   Payments                                                                                              8
9.           Amount of CAPS payment                                                                       8
10.          Payment procedure                                                                                 8
11.          Payment by instalments                                                                          8
12.          Payment to transferred person                                                                  9
13.          Payment to approved person                                                                   10
14.          Notification of details of payments                                                           10
Part 4                   Representatives and organisations                                                     11
15.          Interpretation                                                                                         11
16.          Ceasing representation of a person                                                          11
17.          Authorised representative                                                                       11
18.          Correspondence recipient                                                                       12
19.          Authorised payment recipient                                                                  12
20.          Responsible person for a participating person                                           12
21.          Organisations authorised to receive CAPS payments                                13
Part 5                   Miscellaneous                                                                                     15
22.          Debts                                                                                                   15
23.          Investigations                                                                                        15
24.          Review of decisions                                                                                15
Schedule                                                                                                                         16
 
Part 1        Preliminary
1.                      Name of Scheme
This Scheme is the Continence Aids Payment Scheme 2010.
2.                      Commencement
This Scheme commences on 1 July 2010.
3.                      Interpretation
(1)        In this Scheme:
Act means the National Health Act 1953.
Amendment Act means the National Health Amendment (Continence Aids Payment Scheme) Act 2010.
approved form, when used in a provision of this Scheme, means a form approved, whether before or after the commencement of this Scheme, by the Secretary or Medicare Australia CEO in writing for the purposes of that provision.
authorised payment recipient, for a participating person, means the person referred to subsection 19(3).
authorised representative means a person referred to in subsection 17(3).
CAPS payment, for a participating person, means:
(a)                    for a financial year—the amount specified in subsection 9(1); or
(b)                   for part of a financial year—the amount calculated in accordance with, subsection 9(2).
continence aid means a product intended to assist in the management of incontinence and, for the avoidance of doubt, includes continence-related products.
correspondence recipient means a person referred to in section 18.
eligibility criteria has the meaning given by section 4.
eligible neurological condition means a condition listed in Part 1 of the Schedule.
eligible other condition means a condition listed in Part 2 of the Schedule.
health professional means:
(a)                    a person engaged in a health care related vocation or profession who must be registered or licensed (however described) under a Commonwealth, State or Territory law in order to practise that vocation or profession; or
(b)                   a person who is an eligible Aboriginal health worker under the Health Insurance (Allied Health Services) Determination 2009 made under the Health Insurance Act 1973.
Note:  Section 10 of the Acts Interpretation Act 1901 deals with references to legislation that has been amended or replaced.
legal representative means a person with legal authority under a law of a State or Territory to act for another person such as a guardian or attorney under a power of attorney.
organisation means an entity, including a body politic, with an Australian Business Number which provides, will provide or will facilitate the provision of continence aids to a participating person, but does not include a person:
(a)                    with legal authority under a law of a State or Territory to act for the applicant or participating person; or
(b)                   a person referred to in paragraphs 17(2)(a) to (c) or 19(1)(a) to (c).
participating person means:
(a)                    a person approved under section 5 to participate in this Scheme; or
(b)                   a person taken to participate, and to be eligible to participate, in this Scheme under item 3 of the Amendment Act,
unless the person’s participation has ceased to have effect under this Scheme.
Note:  Item 3 of the Amendment Act and section 8 of this Scheme deal with when a person’s participation ceases to have effect.
permanent and severe incontinence means frequent and uncontrollable moderate to large loss of urine or faeces which impacts on a person's quality of life and which is unlikely to improve with medical, surgical or clinical treatment regimes.
Secretary includes a person authorised by the Secretary to act on his or her behalf in approving forms for, or related to, this Scheme.
(2)        Nothing in this Scheme is intended to affect the operation of any law of a State or Territory that deals with legal representatives.
(3)        References to a legal representative in particular provisions and not in others is not intended to limit a legal representative’s powers to act for the represented person.
Part 2        Participation in the Scheme
4.                      Eligibility criteria
(1)        The eligibility criteria for a person to participate in this Scheme is that the person:
(a)                    suffers from permanent and severe incontinence:
(i)                      caused by an eligible neurological condition; or
(ii)                     caused by an eligible other condition and the person has a Centrelink Pensioner Concession card or entitlement, whether as primary cardholder or a dependant of a cardholder; and
(b)                   is an Australian citizen or permanent resident within the meaning of those terms in the Australian Citizenship Act 2007; and
(c)                    is not ineligible because of subsection (2).
Note:   Item 3 of the Amendment Act provides that a person who was receiving assistance under the Continence Aids Assistance Scheme immediately before 1 July 2010 is taken to participate in this Scheme from 1 July 2010 subject to complying with that section and, after 30 June 2011, meeting the eligibility criteria in this section.
(2)        A person in any of the following categories is not eligible to participate in this Scheme:
(a)                    (for the avoidance of doubt) people who suffer from transient, rather than permanent and severe, incontinence;
(b)                   children under 5 years of age;
(c)                    care recipients, under the Aged Care Act 1997:
(i)                      where the approved provider is providing the care recipient with a high level of residential care and receiving a subsidy in respect of the care recipient for that level of care; or
(ii)                     who are receiving an Extended Aged Care at Home (EACH) or Extended Aged Care at Home Dementia (EACHD) package and the care recipient’s care plan includes continence products;
(d)                   people eligible to receive assistance for continence aids under the Rehabilitation Appliances Program (or replacement program if the name of that program is changed) through the Department of Veterans' Affairs;
(e)                    Australian citizens or permanent residents who have resided outside Australia for a continuous period of three years (including any periods of leave from the country in which that person resides);
(f)                     a person serving a prison sentence.
5.                      Application to participate in the Scheme
(1)        A person may apply to the Medicare Australia CEO to participate in this Scheme.
(2)        The Medicare Australia CEO must approve a person to participate in this Scheme if:
(a)                    the applicant meets the eligibility criteria; and
(b)                   the application is made on the approved form; and
(c)                    the application:
(i)                      includes a statement prepared and signed by a health professional certifying that the applicant has been diagnosed by a doctor with an eligible neurological condition or eligible other condition, as the case may be, which has caused permanent and severe incontinence; and
Note:  Health professional is defined in subsection 3(1).
(ii)                     includes any other document or information required by the approved form.
Note:  Section 14 of the Amendment Act provides that if an application is refused the Medicare Australia CEO must give the applicant a signed notice that includes the reasons for the decision and advising that the person may apply to the Medicare Australia CEO for a review of the decision.  The application for review of the decision is dealt with in section 24 of this Scheme.
(3)        If a person has provided a completed application, in the approved form, to the Medicare Australia CEO before this Scheme commences, the application is taken to have been made under this section on the day this Scheme commences.
6.                      Notification to Medicare Australia CEO
(1)        A participating person, legal representative or authorised representative must notify the Medicare Australia CEO promptly on becoming aware that the participating person does not meet the eligibility criteria.
Example:   A participating person must notify the Medicare Australia CEO if the person begins receiving a high level of residential care in a residential care facility:  see subparagraph 4(2)(c)(i).
(2)        A legal representative or authorised representative must notify the Medicare Australia CEO promptly on becoming aware that the participating person has died.
7.                      Decision that a person has ceased to be eligible
If notification has not been given under subsection 6(1), but the Medicare Australia CEO is satisfied that a participating person does not meet the eligibility criteria, the CEO must decide, by determination in writing, that the person is not eligible to participate in this Scheme and the date on which the person ceased to be eligible.
Note 1:  Item 3 of the Amendment Act provides that, until 1 July 2011, the Medicare Australia CEO cannot make a decision about ineligibility in respect of a person to whom that item applies.
Note 2:   Section 15 of the Amendment Act provides that if the Medicare Australia CEO decides that a participating person is not eligible to participate in the scheme, he or she must give the person a signed notice that includes the reasons for the decision and advising that the person may apply to the Medicare Australia CEO for a review of the decision.  The application for review of the decision is dealt with in section 24 of this Scheme.
8.                      When participation ceases to have effect
A person’s participation in this Scheme ceases to have effect:
(a)                    if notification is given under paragraph 6(1)─from the date the person ceased to meet the eligibility criteria; or
(b)                   if the Medicare Australia CEO decides that the person is not eligible to participate─from the date specified in the determination under section 7.
Note:   Where a person entitled to a CAPS payment has died, payment will be made to the estate:  see paragraph 10(1)(c).
Part 3        Payments
9.                      Amount of CAPS payment
(1)        The amount of the CAPS payment for a financial year is $497.79.
(2)        However, if a person is approved under section 5 as a participating person after the beginning of a financial year, the CAPS payment for the person for that financial year is calculated on a pro rata basis, being the period starting on the date the application under section 5 was received and ending on 30 June (inclusive) of the financial year.
Example:  A person applies on 1 August 2010.  The person’s CAPS payment is calculated for the period 1 August to 30 June 2011 (inclusive).
(3)        A participating person may not receive:
(a)                    more than the amount of the CAPS payment for a financial year in any one financial year;
(b)                   more than one payment for the same period in a financial year.
10.                  Payment procedure
(1)        The Medicare Australia CEO must pay a CAPS payment, or an instalment of a CAPS payment, to which a participating person has become entitled under this Scheme to:
(a)                    the person; or
(b)                   if there is an authorised payment recipient for the person─the authorised payment recipient; or
(c)                    if the person has died, the person’s estate.
(2)        The CAPS payment must be made:
(a)                    in one transaction unless the person has elected, in the approved form, to receive the payment in two instalments (except where subsection 11(4) applies); and
(b)                   by way of electronic funds transfer to the bank account notified, in the approved form, to the Medicare Australia CEO.
11.                  Payment by instalments
(1)        A person may elect to receive the CAPS payment in two instalments, worked out in accordance with this section, in a financial year.
(2)        If the person is a participating person on 1 July in the financial year:
(a)                    the first instalment is half of the CAPS payment specified in subsection 9(1), to be paid no later than 30 July in the financial year; and
(b)                   the second instalment is the remaining half of the CAPS payment, to be paid on or after 1 January but no later than 31 January in the financial year.
(3)        If an application under section 5 is received after 1 July but before 1 January in the financial year and is approved, the CAPS payment for the financial year is the amount calculated in accordance with subsection 9(2) with:
(a)                    the first instalment a pro rata amount calculated for the period starting on the day the application was received and ending on 31 December (inclusive) in that financial year, to be paid within 30 days of approval of the application; and
(b)                   the second instalment is the remaining amount of the CAPS payment, to be paid on or after 1 January but no later than 31 January in the financial year.
(4)        If an application under section 5 is received after 31 December in the financial year and is approved, the CAPS payment for that financial year is the amount calculated in accordance with 9(2), to be paid within 30 days of approval of the application.
(5)        However, despite anything in this Scheme, a second instalment must not be paid if the person’s participation has ceased to have effect before January in the financial year.
12.                  Payment to transferred person
(1)        This section applies to a person who is a participating person because of item 3 of the Amendment Act (transferred person).
(2)        The transferred person is entitled to the CAPS payment specified in subsection 9(1):
(a)                    for the 2010-11 financial year;
(b)                   and each subsequent financial year as long as the person’s participation has not ceased on a date before 1 July of that financial year.
(3)        For the financial year beginning on 1 July 2010, the Medicare Australia CEO must:
(a)                    make the CAPS payment for the person no later than 30 days after receiving the completed transfer form (transfer form) mentioned in item 3 of the Amendment Act; or
(b)                   if the person elects to receive the CAPS payment in two instalments, pay half the CAPS payment no later than 30 days after receiving the transfer form and half after 1 January 2011 but no later than 31 January 2011.
(4)        For a financial year after 30 June 2011, the CAPS payment for the person must be paid no later than 31 July in that financial year or, if the person has elected to receive the CAPS payment in two instalments, in the manner specified in paragraph 11(2).
(5)        If the person gives the transfer form to the Medicare Australia CEO before 1 July 2010, the form is taken to have been provided on 1 July 2010.
13.                  Payment to approved person
(1)        This section applies to a person who is a participating person because of an approval under section 5 of this Scheme (approved person).
(2)        The approved person is entitled to:
(a)                    the CAPS payment specified in subsection 9(1)or 9(2), whichever applies in the circumstances, in the financial year in which the application is approved; and
(b)                   the CAPS payment specified in subsection 9(1) in each subsequent financial year as long as the person’s participation has not ceased on a date before 1 July of that financial year.
(3)        The Medicare Australia CEO must make a CAPS payment for the approved person:
(a)                    if the person is a participating person on 1 July in the financial year:
(i)                      by 30 July in the financial year; or
(ii)                     if the payment is by instalments, in the manner specified in subsection 11(2); or
(b)                   if an application under section 5 is received after 1 July but before 31 December in the financial year and is approved:
(i)                      within 30 days of approving the application; or
(ii)                     if the payment is by instalments, in the manner specified in subsection 11(3);or
(c)                    if an application under section 5 is received after 31 December in the financial year and is approved—within 30 days of approving the application.
14.                  Notification of details of payments
(1)        The Medicare Australia CEO, as soon as practicable after making a CAPS payment, must give a written statement containing details about the payment to:
(a)                    the participating person or his or her correspondence recipient; and
(b)                   if the payment was made to an organisation─the organisation.
Part 4        Representatives and organisations
15.                  Interpretation
(1)        In this part:
assisted person means:
(a)                    a person applying to participate in this Scheme; or
(b)                   a participating person,
who is unable to act on his or her own behalf because of a physical or mental impairment.
16.                  Ceasing representation of a person
In this Part:
(a)                    if a person is recognised as representing another person because of a particular status under the social security law or veterans’ entitlements law, and the person ceases to hold that status, the person’s representation of the other person under this Scheme is also taken to cease;
(b)                   if a person may authorise, in accordance with this Part, another to do something, the person may also revoke the authorisation by notice in writing to the Medicare Australia CEO;
(c)                    if a person is authorised, in accordance with this Part, to do something and wishes to end the arrangement, the person may cease the arrangement by notice in writing to the Medicare Australia CEO.
17.                  Authorised representative
(1)       This section applies to an assisted person who does not have a legal representative.
(2)       The assisted person may be represented for the purposes of this Scheme, other than to receive payments, by one of the following, subject to subsection (3):
(a)                    the assisted person’s Centrelink correspondence nominee, as recognised by Centrelink for the purposes of the social security law (see Part 3A of the Social Security (Administration) Act 1999); or
(b)                   the assisted person’s Department of Veterans’ Affairs (DVA) trustee, as recognised by DVA for the purposes of veterans' entitlements (see the Veterans’ Entitlements Act 1986); or
(c)                    if the person does not have a representative mentioned in paragraph (a) or (b)—a responsible person approved as an authorised representative under section 20.
(3)        A person mentioned in subsection (2) who signs the application form for an assisted person, or nominates him or herself, in the approved form, after the application has been made, as the person authorised to represent the assisted person is taken to be the assisted person’s authorised representative.
(4)        An authorised representative must act in the interests of the assisted person at all times.
18.                  Correspondence recipient
An applicant, participating person or an assisted person’s legal representative or authorised representative may authorise, in the approved form, another person (correspondence recipient) to receive correspondence under this Scheme for the applicant or participating person.
19.                  Authorised payment recipient
(1)        One of the following people may receive payments as agent for a participating person if the conditions mentioned in subsection (2) are satisfied:
(a)                    the person recognised as the participating person's payment nominee for the purposes of the social security law; or
(b)                   the person recognised as the participating person's trustee or agent for the purposes of veterans' entitlements; or
(c)                    a responsible person approved as an authorised payment recipient under section 20; or
(d)                   an organisation authorised in accordance with subsection 21(2).
(2)        The conditions are:
(a)                    the person who is to receive the payments as agent for the participating person has been notified to the Medicare Australia CEO, in the approved form, that that person is to receive the payments; and
(b)                   if the applicant or participating person has a legal representative—the Medicare Australia CEO has not been notified by the legal representative that the CAPS payments are to be made to another person in accordance with this Scheme.
(3)        The person who is to receive the payments as agent for the participating person is the authorised payment recipient of the participating person.
20.                  Responsible person for a participating person
(1)        The Secretary may approve an individual to represent an assisted person or a minor:
(a)                    as an authorised representative to act for the person; or
(b)                   as an authorised payment recipient to receive payments as agent of the person; or
(a)                    as both (a) and (b).
(2)        However, the Secretary must not approve an individual unless the Secretary is satisfied that:
(b)                   if the assisted person has a legal representative, or representation by a person referred to in paragraph 17(2)(a) or (b) or 19(1)(a) or (b)—the representative does not oppose the approval; and
(a)                    the individual provides care or assistance to the person; and
(b)                   the arrangement for the receipt of CAPS payments is for the benefit of the person; and
(c)                    the individual seeking approval will use the funds only for the purpose for which they are provided.
(3)        The Secretary may revoke an approval if satisfied that it is appropriate to do so in the circumstances, having regard to the matters mentioned in this section.
21.                  Organisations authorised to receive CAPS payments
(1)        In paragraphs (4)(c), (d), (e) and (f) and subsections (5) and (6), a reference to a “participating person” includes a former participating person and, where the context permits, an authorised representative or correspondence nominee.
(2)        An applicant, participating person, or assisted person’s legal representative, authorised representative or authorised payment recipient, other than an organisation, may authorise, in the approved form, an organisation to receive CAPS payments, or instalments of CAPS payments, as the authorised payment recipient for a person entitled to the payment.
(3)        If the organisation agrees to receive the CAPS payments as agent, the organisation must provide details to the Medicare CEO for the payments in the approved form.
(4)        The organisation must comply with the following obligations:
(a)                    assist the participating person to obtain continence aids that are appropriate to his or her needs; and
(b)                   assist the participating person to use the CAPS payment as a contribution towards to the cost of purchasing continence aids; and
(c)                    inform the participating person of any unused CAPS payment amount 30 days before the end of the financial year to which the payment relates; and
(d)                   refund to the estate of a participating person who has died any unused portion of a CAPS payment; and
(e)                    refund to the participating person any unused portion of a CAPS payment if notified, in writing, that:
(i)                      the person has ceased to  meet the eligibility criteria; or
(ii)                     the person wishes to terminate the payment arrangement with the organisation; and
(f)                     refund to the participating person any unused portion of a CAPS payment if the participating person was not entitled to the payment at the time it was made; and
(g)                    inform the Medicare Australia CEO promptly on becoming aware that the participating person does not meet the eligibility criteria.
(5)        An organisation which receives a CAPS payment as agent for a participating person must maintain records in a collated and accessible form containing details of the amounts received, the date received and how the amount was used.
(6)        An organisation must provide details on the use of a CAPS payment if requested to do so by the participating person or his or her authorised representative.
(7)        The Secretary may direct, in writing, the Medicare Australia CEO to decline to make a CAPS payment to an organisation if the Secretary is satisfied that the arrangement for the payment:
(a)                    is not operating to the benefit of the participating person; or
(b)                   the organisation has not complied with an obligation imposed by this Scheme in respect of any participating person.
(8)        If a direction is given under subsection (7):
(a)                    the Medicare Australia CEO must comply with the direction; and
(b)                   the Secretary must inform the participating person and the organisation in writing that the organisation is no longer able to act as an authorised payment recipient.
Part 5        Miscellaneous
22.                  Debts
If a participating person or former participating person has received, either directly or through an agent, a CAPS payment to which the person was not entitled, the amount paid is a debt due to the Commonwealth, recoverable by the Medicare Australia CEO.
23.                  Investigations
The Medicare Australia CEO may conduct investigations, as he or she thinks appropriate, in order to ensure that an applicant or a participating person meets the eligibility criteria.
24.                  Review of decisions
(1)        For sections 14 and 15 of the Act, a person aggrieved by a decision under section 5 or 7 of this Scheme may apply, in the way set out in subsection (2), to the Medicare Australia CEO for review of the decision.
(2)        The application for review must:
(a)                    be made by written notice given to the Medicare Australia CEO within 28 days, or such longer period as the Medicare Australia CEO allows, after the day on which the person received notice of the decision; and
(b)                   set out the reasons for making the request.
Note:  Sections 14 and 15 of the Act provide for the reconsideration of decisions by the Medicare Australia CEO and review of such decisions by the Administrative Appeals Tribunal.
 
 
 
Schedule
 
Part 1 - Eligible neurological condition
Category 1
SPINA BIFIDA and SYRINGOMYELIA

 
Arnold-Chiari Syndrome

 
Arthrogryposis

 
Caudal Regression Syndrome

 
Developmental Cord Disorder

 
Holoprosencephaly

 
Malformation of Spinal Cord

 
Sacral Agenesis

 
Spinal Agenesis

 
Spinal Cord Congenital Abnormality

 
Spinal Dysraphism

 
Spinal Hemangioma

 
Vater Syndrome/Vacterl Syndrome

 
 

Category 2
CEREBRAL PALSY

 
Dystonic Cerebral Palsy

 
Hereditary Spastic Paralysis

 
Spastic Quadriplegia

 
 

Category 3
INTELLECTUAL DISABILITY

 
2-Hydroxyglutaric Aciduria

 
Agenesis of Corpus Callosum

 
Angelman Syndrome

 
Apert Syndrome

 
ATRX Syndrome

 
Bardot Biedl Syndrome

 
Batten Disease

 
Beare-Stevenson Syndrome

 
Cats Cry Syndrome/Cri Du Chat Syndrome

 
Cerebral Migration Disorders

 
Charge Syndrome

 
Chime Syndrome

 
Chromosomal Abnormalities/Disorders

 
Chromosome 1 Deletion

 
Chromosome 13q Deletion Syndrome

 
Chromosome 15q Duplication Syndrome

 
Chromosome 18q Deletion Syndrome

 
Chromosome 1p36 Deletion Syndrome/Mono 1p36

 
Chromosome 22 Ring

 
Chromosome 2q Deletion Syndrome

 
Chromosome 9p Deletion Syndrome

 
Chromosome 9q Deletion Syndrome

 
Chromosome Xp Duplication

 
Cockayne Syndrome

 
Coffin-Lowry Syndrome

 
Cognitive Impairment

 
Cohen Syndrome

 
Congenital Hydrocephalus

 
Congenital Neurological Infections

 
Cornelia de Lange Syndrome

 
Costello Syndrome

 
Cowden Disease

 
Developmental Delay

 
Developmental Delay associated with Autism, Autism Spectrum Disorder and Aspergers Syndrome

 
Down Syndrome/Trisomy 21

 
Dravet Syndrome

 
Edwards Syndrome/Trisomy 18

 
Fragile X Syndrome

 
Fumarase Deficiency

 
GLUT1-DS Condition

 
Glutaric Aciduria Type 1

 
Goldenhar’s Syndrome

 
Hunter Syndrome

 
Hurler-Scheie Syndrome

 
Hypomyelination

 
Incomplete Corpus Callosum/Aicardi Syndrome

 
Inversion Duplication of Chromosome 8

 
Jacobsen Syndrome/11q Chromosome Deletion

 
Joubert Syndrome

 
Kabuki Syndrome

 
Langer-Gideon Syndrome

 
Lawrence Moon Biedel Syndrome

 
Lennox-Gastaut Syndrome

 
Lesch-Nyhan Syndrome

 
Lissencephaly

 
Lowe Syndrome

 
Mannosidosis

 
Maple Syrup Urine Disease

 
Meningitis

 
Menkes Syndrome

 
Microcephaly

 
Mitochondrial Deficiency

 
Mowat-Wilson Syndrome

 
Mucolipidosis IV

 
Myotonic Dystrophy (Type 1)

 
Neonatal Hypoxia

 
Neonatal Onset Multi-system Inflammatory Disease

 
Normal Pressure Hydrocephalus

 
OHDO Syndrome

 
Opitz Trigonocephaly Syndrome

 
Ohtahara Syndrome

 
Ouvrier Syndrome

 
Pallister-Killian Mosaic Syndrome

 
Periventricular Leukomalacia

 
Peroxisome Biogenesis Disorder

 
Phelan McDermid Syndrome/22q 13 Deletion Syndrome

 
Phenylketonuria

 
Polymicrogyria

 
Pontocerebellar Hypoplasia

 
Prader-Willi Syndrome

 
Pyruvate Dehydrogenase Deficiency/Leigh's Disease

 
Rare Congenital Neurological Syndromes and Conditions

 
Rasmussen's Disease

 
Rett Syndrome

 
Rubinstein-Taybi Syndrome

 
Schizencephaly

 
Sensory Integration Disorder/Dysfunction

 
Smith-Lemli-Opitz Syndrome

 
Smith-Magenis Syndrome

 
Sotos Syndrome

 
Sturge-Weber Syndrome

 
Subcortical Band Heterotopia

 
Translocation of Chromosome 2

 
Translocation Trisomy 5/18

 
Trichothiodystrophy

 
Trisomy 10

 
Trisomy 13

 
Trisomy 20p

 
Trisomy 47

 
Trisomy 4p

 
Trisomy 9

 
Tuberous Sclerosis

 
Turner Syndrome

 
Urea Cycle Defect

 
Valproate Embryopathy

 
Velocardiofacial Syndrome

 
West Syndrome

 
Williams Syndrome

 
Wolf-Hirschhorn Syndrome

 
X-Linked Adrenoleukodystrophy

 
Young-Simpson Syndrome

 
 

Category 4
PARAPLEGIA and QUADRIPLEGIA

 
Paraparesis

 
Spinal Cord Compression

 
Spinal Cord Infarction

 
Spinal Damage

 
Syringomyelia

 
Tetraplegia

 
Transverse Myelitis

 
 

Category 5
ACQUIRED NEUROLOGICAL CONDITIONS

 
Acquired Brain Injury

 
Adhesive Arachnoiditis

 
Alcoholic Encephalopathy

 
Alzheimer's Disease

 
Arachnoiditis

 
Ascending Polyneuropathy

 
Astrocytoma

 
Autonomic Neuropathy Disease

 
Basal Ganglia Infarction

 
Benign Meningioma

 
Brown-Sequard Syndrome

 
Cauda Equina Lesion

 
Cerebral Abscess (Cryptococcus)

 
Cerebral Aneurysm

 
Cerebral Anoxia

 
Cerebral Toxoplasmosis

 
Cerebral Tumour

 
Cerebrovascular Disease

 
Chronic Hypoxia

 
Chronic Inflammatory Demyelination Polyneuropathy (CIDP)

 
Cortical-Basal Ganglionic Degeneration

 
Dementia

 
Developmental/Motor Dyspraxia

 
Diabetic Autonomic Neuropathy

 
Diabetic Neuropathic Bladder

 
Dorsal Pontine Band Syndrome

 
Encephalitis

 
Ependymoma

 
Epilepsy

 
Focal Cerebral Degeneration

 
Glioblastoma Multiforme

 
Glioblastoma of Spine

 
Hepatic Encephalopathy

 
Hydrocephalus

 
Hypoxic Brain Damage

 
Inoperable Neurogenic Incontinence

 
Intracerebral Haemorrhage

 
Korsakoff’s Syndrome

 
Leuco Posterior Encephalopathy

 
Lewi Body Disease

 
Macroencephaly

 
Malignant Meningioma

 
Metastatic Carcinoma with Neurological Syndrome

 
Multiple Systems Atrophy

 
Myopathy

 
Nemaline Myopathy

 
Oligodendroglioma

 
Pachymeningitis

 
Picks Disease

 
Pilocytic Astrocytoma

 
Poliomyelitis

 
Polymyoneuropathy

 
Primary Dystonia (case by case)

 
Progressive Systemic Sclerosis

 
Sacral Neuroplexy

 
Sacral Plexopathy

 
Schizophrenia (Catatonic)

 
Spinal Canal Disease

 
Spinal Chordoma

 
Spinal Ependymoma

 
Spinal Sacral Chordoma

 
Spinal Tumour

 
Stroke/Cerebrovascular Accident (CVA)

 
Subarachnoid Haemorrhage

 
Subdural Haematoma

 
Vascular Dementia

 
 

Category 6
DEGENERATIVE NEUROLOGICAL DISEASES

 
Alexander Disease

 
Amyotrophic Lateral Sclerosis

 
Ataxia Telangiectasia

 
Cauda Equina Syndrome

 
Cervical Canal Stenosis

 
Cervical Myelopathy

 
Creutzfeldt-Jakob Disease (CJD)

 
Cytochrome C Oxidase Deficiency

 
Dejerine-Sottas Disease

 
Demyelinating Neuropathy

 
Demyelination of White Matter

 
Fahr's Disease

 
Friedreich’s Ataxia

 
Guillain Barre Syndrome

 
Huntington Chorea/Disease

 
Hypoxic Ischaemic Encephalopathy

 
Idiopathic Axonal Neuropathy

 
Kugelberg-Welander Syndrome

 
Machado Joseph Disease

 
Metachromatic Leukodystrophy

 
Mitochondrial Myopathy with Encephalopathy

 
Morquio Syndrome

 
Motor Neurone Disease

 
Multiple Sclerosis

 
Muscular Dystrophy

 
Myoneural Disorders

 
Neuroaxonal Dystrophy

 
Neurofibromatosis NF

 
Neurogenic Bowel

 
Niemann-Pick Disease Type C

 
Pallister-Hall Syndrome

 
Parkinson Disease

 
Parkinsonism

 
PEHO Syndrome (Progressive encephalopathy with oedema, hypsarrhythmia and optic atrophy)

 
Pelizaeus Merzbacher Disease

 
Primary Lateral Sclerosis

 
Progressive Supranuclear Palsy/Steele Richardson Syndrome

 
Sanfilippo Syndrome

 
Sarcoidosis of the Brain

 
Shy-Drager Syndrome

 
Spinal Cord Syndrome

 
Spinal Degeneration

 
Spinal Muscular Atrophy Type 1

 
Spinal Muscular Atrophy Type 2

 
Spinocerebellar Degeneration

 
Stiff-Mans Syndrome

 
Striato-Nigral Degeneration

 
Vascular Myelopathy

 
Wallerian Degeneration of White Matter

 
Wilson's Disease

 
 

Category 7
BLADDER (BOWEL) INNERVATION DISORDERS

 
Atonic Bladder/Hypotonic Bladder

 
Bladder Exstrophy

 
Bladder Innervation Urgency

 
Cloacal Exstrophy

 
Cystocele (not suitable for surgery)

 
Dystonic Bladder

 
Ectopia Vesica

 
Hirschsprung's Disease

 
Linear Sebaceous Nevus Genetic

 
Myasthenia Gravis

 
Neurogenic Bladder

 
Neuronal Intestinal Dysplasia

 
Neuropathic Bladder

 
Post Bladder Surgery

 
Prostatectomy with nerve removal

 
Prune Belly Syndrome

 
Pudendal Nerve Palsy

 
Radical Prostatectomy

 
Schmidli Autonomic Neuropathy

 
Smooth Muscle Myopathy

 
Sphincter Deficiency

 
Spinal Stenosis

 
Part 2 - Eligible other condition
Code 8
OTHER

 
Anal Carcinoma

 
Anal Fistula

 
Anorectal Malformation

 
Anterior Prolapse

 
Bilateral Nephrostomy Tubes

 
Bladder Cancer

 
Bladder Instability

 
Bladder Muscle Dysfunction

 
Bladder Neck Dysfunction

 
Bladder Neck Fibrosis

 
Bladder Prolapse

 
Bowel Cancer

 
Bowel Prolapse

 
Cervical Cancer

 
Chronic Urinary Retention

 
Congenital Epispadias

 
Detrusor Instability

 
Detrusor Overactivity

 
Enterocutaneous Fistula

 
Hypertonic Bladder

 
Imperforate Anus

 
Irradiated Rectum/Radiation Proctitis

 
Posterior Urethral Valve Syndrome

 
Prostate Cancer

 
Prostate Disease

 
Rectal Prolapse

 
Rectal Ulcer Syndrome

 
Severe Ulcerative Proctitis/Ulcerative Colitis

 
Spastic Bladder

 
TURP

 
Urethral Stenosis

 
Urinary Fistula

 
Uterine Cancer

 
Uterine Prolapse

 
Vaginal Prolapse

 
Vesico-Vaginal Fistula

 
Vulva Cancer

 
 
 

Related Laws