Contraceptive treatment

The TAC Medical Excess may apply to these services 

 

 

This policy must be read in conjunction with the Medical PractitionersPharmacy (Chemist Medications) and the Surgery Requests Elective policies.

Policy

The TAC can fund the reasonable cost of contraceptive treatment and services for an injury or condition resulting from a transport accident.

Transport Accident Act 1986 reference: s.3 'medical service' and s.60

Definition

In this policy, contraceptive treatment refers to medical services provided by a medical practitioner for the purposes of birth control which includes; consultations, treatment and prescribed medications.

Guidelines

When can the TAC fund contraceptive treatment?

The TAC can fund contraceptive treatment and services when the client has a capacity to make his/her own decisions, has provided informed consent and where medical opinion indicates that: 

  • contraceptive treatment is required as part of the overall management of a transport accident related injury
  • a pregnancy may place a client at risk of serious complications or be life threatening as a result of the transport accident injuries, e.g. serious pelvic injuries
  • a foetus may be harmed or be at serious risk as a result of the client's transport accident injuries, i.e. medication the client is taking (as a result of transport accident injuries) such as anti-epileptics, can place the foetus at risk
  • a client has sustained a brain injury, as a result of the transport accident, resulting in serious clinical complications or behavioural issues such as disinhibited sexual activity, which result in an increased potential for unplanned pregnancy, or the inability of the client to care for him/herself and/or an unborn child during pregnancy, or following a potential birth.

What if the client does not have capacity to make his/her own decisions?

Any request on behalf of a client without capacity to make his/her own decision(s) must comply with the guidelines of the Office of the Public Advocate (OPA), Victoria.

Refer to the 'Enduring power of attorney (medical treatment) - FAQs' section of the OPA website.

See also the Clients Turning 18 Years of Age policy.

What information does the TAC require before funding a request for contraceptive treatment?

A written request should outline the clinical need for contraceptive treatment and its direct relationship to the transport accident-related injury.

To expedite payment of accounts and ensure the most appropriate services are provided to the client, the TAC encourages prior approval to be sought by the client's treating registered medical practitioner.

Can the TAC fund services/treatment by a member of a client's immediate family?

Refer to the Funding Treatment by a Member of a Client's Immediate Family policy.

In relation to contraceptive treatment what will the TAC not fund?

The TAC will not fund:

  • treatment or services for a person other than the injured client
  • treatment, services or equipment where there is no published evidence in a recent peer-reviewed journal article that the treatment, service or equipment is safe and effective. Refer to the Non-Established, New or Emerging Treatments and Services policy 
  • treatment or services for a condition that existed before the transport accident or that is not a direct result of the transport accident
  • fees associated with non-attendance
  • the cost of telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals
  • treatment or services received outside the Commonwealth of Australia
  • treatment or services received more than 2 years prior to the request for funding except where the request for payment is made within 3 years of the transport accident. Refer to the Time Limit for the Application for Payment of Medical and Like Expenses policy.

Medical Services Reimbursement Rates

The TAC has adopted the Medicare Benefits Schedule (MBS) items, explanations, definitions, rules and conditions for services provided by medical practitioners.  When invoicing for medical services, medical practitioners are expected to adhere to the MBS rules unless otherwise specified by the TAC in the Reimbursement Rates for Medical Services booklet or its medical policies.

The Reimbursement Rates for Medical Services booklet below must be read in conjunction with:

Current Rates

Previous Rates

At the time of production this publication contained up to date information as released by Medicare Australia (Medicare).  The relevant publication will be updated to reflect any further changes that are implemented by Medicare each year.  Please check our website for the latest version.

If you have any questions about these publications or the reimbursement rates, please contact the TAC on 1300 654 329. Alternatively, e-mail info@tac.vic.gov.au.