Aged Care Act 2024

A registered provider may apply to the Pricing Authority for approval for the provider to agree to, and charge, an accommodation payment that is higher than the maximum accommodation payment amount prescribed by rules made for the purposes of section 289.

The application may relate to:

an approved residential care home of the provider, including a home that is being, or is proposed to be, refurbished; or

a distinct part of an approved residential care home of the provider, including a distinct part that is being, or is proposed to be, constructed or refurbished; or

a residential care home, or a proposed residential care home, that the provider has applied, or intends to apply, for approval of under section 111; or

a distinct part of a residential care home, or a proposed residential care home, that the provider has applied, or intends to apply, for approval of under section 111.

Although applications may be made under this section in relation to residential care homes that are not approved residential care homes, only a registered provider delivering funded aged care services through the service group residential care in an approved residential care home may charge, under this Part, an amount of accommodation payment.

The application:

must comply with the requirements prescribed by the rules; and

must not be made:

within the period prescribed by the rules after the Pricing Authority last made a decision under this section in relation to the residential care home, or the distinct part of the residential care home; or

if no period is prescribed—within 12 months after that last decision.

If the Pricing Authority needs further information to determine the application, the Pricing Authority may give the registered provider a notice requiring the provider to give the further information:

within 28 days after the notice is given; or

within such other period as is specified in the notice.

The application is taken to have been withdrawn if the information is not given within whichever of those periods applies. The notice under subsection (4) must contain a statement setting out the effect of this subsection.

The Pricing Authority must, in accordance with the rules:

consider an application made in accordance with subsection (3), and any further information given in accordance with the rules or a notice given under subsection (4); and

make a decision to approve or not approve the higher maximum accommodation payment amount specified in the application; and

notify the registered provider, in writing, of the decision.

A decision not to approve a higher maximum accommodation payment amount is a reviewable decision.

If the Pricing Authority approves a higher maximum accommodation payment amount specified in an application that relates to a residential care home, or a distinct part of a residential care home, that is being, or is proposed to be, constructed or refurbished, the Pricing Authority must include the conditions prescribed by the rules on the approval.

Subject to subsection (9), if the Pricing Authority approves the higher maximum accommodation payment amount, the amount applies in relation to an individual only if:

at the date of the approval, the individual had not entered into an accommodation agreement with the registered provider; and

the provider starts delivering ongoing funded aged care services to the individual through the service group residential care in an approved residential care home on or after the date of the approval.

The higher maximum accommodation payment amount approved by the Pricing Authority also applies in relation to an individual if:

the individual’s start day occurred before the date of the approval; and

the individual had entered into an accommodation agreement with the registered provider before the date of the approval; and

the individual moves to another bed, whether in another room (the new room) or another part of a room (the new part), in the residential care home and the move is voluntary; and

the higher maximum accommodation payment amount applies in relation to the part of the residential care home that includes the new room or the new part of a room.

The rules must prescribe:

when a higher maximum accommodation payment amount is to be indexed; and

a method for the indexation of such a payment.

Without limiting this section, the rules may:

prescribe the period within which the Pricing Authority must make, and give notice of, a decision in relation to an application made under this section; and

prescribe conditions, relating to particular circumstances, that must be met for an approval of a higher maximum accommodation payment amount to take effect; and

make provision for and in relation to the time when, or the period during which, a decision of the Pricing Authority in relation to an approval of a higher maximum accommodation payment amount is to have effect.