Necessary and reasonable medical and rehabilitation expenses
4D Necessary and reasonable medical and rehabilitation expenses
(1) For section 12(1A) of the Act, in determining whether medical and rehabilitation services are reasonable and necessary in relation to an eligible person under section 18(1) of the Act, the Commission must consider each of the following:
(a) the extent to which the services will be of benefit to the person;
the appropriateness of the services having regard to:
the nature and severity of the injury; and
the likely effectiveness of the services;
any alternatives to the provision of the services;
(d) whether the service provider is appropriate to provide the services;
the cost effectiveness of providing the services to the person;
how long the services are to be provided for;
any other relevant considerations.
(2) In considering the extent to which services will be of benefit to the person, the Commission must consider each of the following:
the extent to which the services are likely to:
promote or maintain the person's recovery or independence; or
improve the person's functional autonomy;
the short- and long-term benefits of the services;
(c) the extent of any potential risks related to the provision of the services.
(3) In considering whether the service provider is appropriate to provide the services to the person, the Commission must consider each of the following:
(a) whether the provider possesses the necessary qualifications and experience to provide the services;
the accessibility of the provider to the person.
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