What has changed?
From 1 September 2021, all Home Care Package care providers became subject to changes from the Commonwealth Government's Improved Payment Arrangements (IPA) reform (Phase 2). This reform changes how providers receive funding from the Commonwealth for your care and how that information needs to be reported to you.
The Lookout Way is updating our app and statements to meet these new requirements and provide you with clear oversight of your funds, including how they are being spent.
Why are these changes happening?
The changes to how your accounts, transactions and statements appear are being made to comply with the Commonwealth Government's Improved Payment Arrangements (IPA) reform. From 1 September 2021, the Government changed the way all providers of Home Care Packages are paid. Part of the intent of these changes is to provide care recipients with a clearer picture of your home care package and unspent funds.
Providers are now only paid for the care, services and goods they actually delivered to you. This means that the maximum amount of your package will go towards supporting you to remain in your own home for as long as possible or will be held for you by Government until you need it. These changes implement a key recommendation of the Royal Commission into Aged Care Quality and Safety.
For more information see these publications from the Department of Health:
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Understanding your new statements
Summary of care and services delivered for the statement period
The "summary of care and services delivered for the statement period" section shows both the total cost of care delivered and a summary of the payments for the statement period. Depending on your situation, payments can take several forms.
This section may include:
Net Cost: The total cost of care, services and goods for the billing period.
Payable by Income Tested Fee: The amount of your total cost payable based on your assessed Income Tested Fee, if any.
Payment by Government Subsidy and Supplements: The amount of your Home Care Package entitlement for the period paid to your provider by the Government, if any.
Payment by Home Care Account: The amount of your previously unspent Home Care Package entitlement from prior periods held by the Government in your Home Care Account paid to your provider, if any.
Payment by Income Tested Fee Account: The amount of your previously unspent Income Tested Fees from prior periods used in this billing period, if any.
Payment by Provider held Commonwealth Unspent Funds Account: The amount of your previously unspent Provider-held portion of Commonwealth funds from prior periods used in this billing period, if any.
Payable by Client Contributions: The amount of your total cost payable as a Client Contribution, if any.
Summary of account balances
The "summary of the account balances" section shows an overview of any unspent funds and where those funds are held.
This section may include the balance of the following accounts:
Home Care Account: unspent funds from your Home Care Package entitlement held by the Government on your behalf.
Provider held Commonwealth Unspent Funds Account: unspent Commonwealth funds held by your provider on your behalf.
Income Tested Fee Account: the net closing balance of Income Tested Fees paid or payable.
Client Contributions Account: the net closing balance of Client Contributions paid or payable.
Care and services
The "care and services" section lists all the transactions related to care and services delivered during the claim period.
Home care account
This section provides a detailed list of all transactions related to any unspent funds held by Services Australia on your behalf.
What is the Home Care Account?
Services Australia manages a Home Care Account on your behalf. Any unspent funds from your Home Care Package entitlement accrued from 1 September 2021 on are held by the Government in this account for you until you need them.
Provider held Commonwealth unspent account
This section provides a detailed list of all transactions related to any Commonwealth portion of unspent funds held by your provider.
What is the Provider held Commonwealth Unspent Funds Account?
Any unspent funds from your Home Care Package entitlement accrued before 1 September 2021 are held by your provider for you until you need them. These are the unspent Commonwealth funds held by your provider on your behalf.
Income Tested Fee account
This section provides a detailed list of all transactions paid or payable related to the Income Tested Fee account.
What is the Income Tested Fee Account?
If you have been assessed a mandated contribution in the form of an Income Tested fee, you will have an Income Tested Fee account managed on your behalf by your provider.
Any accrued unspent funds collected from Income Tested Fees are held by your provider for you until you need them. If a change is made to your assessed Income Tested Fee and results in an adjustment to your Income Tested Fee balance, the adjustment will be shown here.
Client contribution account
This section provides a detailed list of all transactions paid or payable related to client contributions.
What is the Client Contributions Account?
Your provider manages an account on your behalf related to client contributions. Client contributions can include an amount you have agreed to pay above your Home Care Package entitlement, for example.
Any accrued unspent funds collected as Client Contributions are held by your provider for you until you need them. If the total of care and services delivered in the billing period was greater than the funds available, a negative adjustment will be shown here.
FAQs
Q: Why are the dates of the transactions different to the date a visit or service happened?
A: Transactions for visits and services are batched and collected weekly by the finance system and therefore the date that appears on the statement is the date of the billing run as opposed to the date the visit or service was delivered.
Q: Why are some unspent funds held by the Government and some held by the Provider?
A: The Government has changed how your provider is paid your Home Care Package subsidy and any supplements under the IPA reform. Providers now are paid only for the care, services and goods they actually delivered to you. That means that the amount your provider is paid may be different than your total available home care package subsidy and supplements.
However, you are still entitled to the full amount of your package. Any amount that was not spent in a given month will be held for you by Government in your Home Care Account until you need it.
Q: My statement says I have a negative balance in my Client Contribution Account. What does this mean?
A: A negative balance in the Client Contribution Account is most likely due to a situation where the total of care and services delivered in the billing period was greater than total of all funds available. Your Care Manager will be in touch about managing your Home Care Package budget.
Q: My statement says I have a negative balance in my Income Tested Fee Account. What does this mean?
A: A negative balance in the Income Tested Fee Account is most likely due to a change in the Income Tested Fee you have been assessed to pay. If you owe any money relating to a backdated change to your assessed Income Tested Fee, this will be included on your next invoice.
Q: Why is the amount the Government paid less than my full Home Care Package subsidy and supplements amount?
A: The Government has changed how your provider is paid your Home Care Package subsidy and any supplements under the IPA reform. Providers now are paid only for the care, services and goods they actually delivered to you. That means that the amount your provider is paid may be different than your total available home care package subsidy and supplements. Funds that are not used by your care provider accrue and are held by the government.
Glossary
Care and services — All care, services and goods delivered during the billing period.
Client Contributions Account— Your provider manages an account on your behalf related to client contributions. Client contributions can include an amount you have agreed to pay above your Home Care Package entitlement, for example.
Any accrued unspent funds collected as Client Contributions are held by your provider for you until you need them. If the total of care and services delivered in the billing period was greater than the funds available, a negative adjustment will be shown here.
Government Subsidy and Supplements — The total of your Home Care Package entitlement for the period, consisting of your Home Care Package subsidy and any supplements you recieved.
Home Care Account — Services Australia manages a Home Care Account on your behalf. Any unspent funds from your Home Care Package entitlement accrued from 1 September 2021 on are held by the Government in this account for you until you need them.
Income Tested Fee — A Government assessed and mandated contribution that may be required as determined through an income assessment. This fee is based on your individual income, including your pension. You can read more at https://www.myagedcare.gov.au/home-care-package-costs-and-fees#income-tested-fee
Income Tested Fee Account — If you have been assessed a mandated contribution in the form of an Income Tested fee, you will have an Income Tested Fee account managed on your behalf by your provider.
Any accrued unspent funds collected from Income Tested Fees are held by your provider for you until you need them. If a change is made to your assessed Income Tested Fee and results in an adjustment to your Income Tested Fee balance, the adjustment will be shown here.
Net cost — the total cost of the care and services delivered during the billing period. This includes all care, services and goods.
Provider-held Commonwealth Unspent Funds Account — Any unspent funds from your Home Care Package entitlement accrued before 1 September 2021 are held by your provider for you until you need them in this account. These are the unspent Commonwealth funds held by your provider on your behalf.
I have a question about this. How can I get help?
The Lookout Way team are happy to answer any questions you have about these changes. If you have any questions, feel free to get in touch with our team via the chat box in the bottom right-hand corner of this screen.