Important changes to Aged Care Legislation: Cheat Sheet and FAQs

Important changes to Aged Care legislation - Cheat sheet and frequently asked questions for the upcoming changes

As you may already know, the Aged Care Act 2024 has been briefly deferred to now commence on 1 November 2025, introducing major reforms to Australia’s aged care system. These reforms affect both Support at Home (or home-based care) and residential aged care services, with a strong emphasis on rights, safety, and quality of care for older Australians.
Read on for a detailed summary of what these changes mean for you as an osteopath working in aged care.

Why has the Act been deferred?

The Department of Health, Disability and Ageing (the department) are using the additional time to:

Help prepare older Australians for the changes
Finalise key operational and digital processes
Produce implementation guidance and training.

For Support at Home reforms, the additional time will be used to ensure older Australians accessing home care services continue to receive care and understand their service agreements and plans as well as service lists, prices and contributions to non-clinical services.

What does the deferral mean for osteopaths?

We anticipate this time may be used for additional consultation with the sector. We will continue to advocate for osteopathy’s inclusion under the right categories for Support at Home and residential care.

Support at Home changes

What does this mean for osteopaths?

Osteopathy has been moved out of the traditional ‘allied health and therapy’ service type into ‘therapeutic services for independent living’.
This is more than a terminology change - it fundamentally alters funding pathways and service recognition meaning that:
- Osteopaths are not eligible to refer older Australians to the restorative care program, which attracts funding enabling 100% of care to be covered by government. Other allied health professionals have access to refer to this program.
- It may cause some confusion with the public, potentially causing them to think that osteopathy is an alternative therapy type.
By moving osteopathy into the ‘therapeutic services for independent living’ service type, older Australians will be required to pay out of pocket for the care provided by osteopaths, rather than having government fund 100% of the clinical care they provide.
Other programs that include allied health and exclude osteopathy are the Short-Term Restorative Care (STRC) Programme and Assistive Technology and Home Modifications Scheme.
This creates a gap in continuity of care for patients who benefit from osteopathic treatments.

What have we done about these changes?

Osteopathy Australia has expressed concern over our omission from the ‘allied health and therapy’ service type for the Support at Home service list. Our concerns have been expressed to the department in several meetings and submissions. A brief summary of our advocacy work to date is below:

We requested clarity from the department about osteopathy being considered as ‘clinical care’ as well as lobbying for the inclusion of osteopathy under the ‘allied health and therapy’ service type on the Support at Home service list. We were advised that there is no scope to change the service list ahead of the implementation of the Act.
To date there has been no further departmental clarification or confirmation about osteopathy’s status under the Support at Home service list or for residential care.
Without clear guidance, osteopaths and older Australians face confusion about practice and billing requirements under potentially separate classification categories for Support at Home and residential care. Additionally, these separate categories add to the uncertainty for older Australians who may have pre-existing conditions like dementia.

Financial implications for older Australians

The new price cap on the ‘therapeutic services for independent living’ category (which now includes osteopathy) will result in more out-of-pocket expenses for older Australians.
Older Australians on fixed incomes may be forced to reduce or discontinue osteopathic treatments due to the out-of-pocket cost of treatment.
The increased financial barrier contradicts the Act's aim of improved accessibility for older Australians.
A calculator will be published soon to assist with estimating co-contributions: https://www.health.gov.au/our-work/support-at-home/features#participant-contributions

Administrative requirements

Osteopaths must learn and adopt new claiming processes via the Aged Care Provider Portal. These digital processes will continue to be refined during the additional time before the Act commences on 1 November 2025.
Monthly and more detailed outcome-focused reporting replaces the previous paper-based, individual claim submissions, manual and less integrated electronic systems. New reporting requirements include more detailed service descriptions and outcomes measurement.
These changes require significant time investment and potential practice management software updates.

Residential care impacts

What does this mean for osteopaths?

We are still trying to seek clarification about where osteopathy sits for residential care. Our recent submission to the Aged Care Rules – Release 4B highlighted that there has been no further clarification or confirmation about osteopathy’s status under the service list or for residential care. This consultation draft also provides no further clarity on the matter.

What have we done about these changes?

Osteopathy Australia has expressed concern over our omission from the ‘allied health and therapy’ service type for the residential aged care service list. Our concerns have been expressed to the department in several meetings and submissions. A brief summary of our advocacy work to date is below:

The department’s Residential Entitlements and Restorative Care Section gave us assurance that it was not their intention for osteopaths to be excluded from the ‘allied health and therapy’ service type on the service list and feedback provided was that the guidelines would be updated to reflect our inclusion.
The department feedback also requested further clarity on osteopathy’s role in aged care and commended Osteopathy Australia, which was provided.
To date there has been no further departmental clarification or confirmation about osteopathy’s status under the service list or for residential care.
Without clear guidance, osteopaths and older Australian’s face confusion about practice and billing requirements under potentially separate classification categories for Support at Home and residential care. Additionally, these separate categories add to the uncertainty for older Australians who may have pre-existing conditions like dementia.

Financial implications for older Australians

Older Australians living in residential care will continue to receive government subsidies per their care plans.

Quality Standards enhancement

Osteopathy Australia has provided feedback on the open consultation for the Strengthened Aged Care Quality Standards, advocating for clearer recognition of osteopaths in multidisciplinary care teams.
There are seven reinforced Quality Standards with explicit requirements for documenting compliance. While all seven strengthened Quality Standards apply broadly across aged care, osteopaths primarily engage with standards related to clinical care and allied health services. The new standards mean osteopaths must rigorously document compliance and clinical outcomes, but current policy exclusions limit the ability for older Australians to access fully funded osteopathy care.
The Quality Standards that may be directly applicable to osteopaths include:
- QS 1: The Individual – Sets the foundation for how aged care workers and providers should treat older Australians to ensure their dignity and autonomy are respected in all aspects of care. An individual’s right to engage in their own care decisions has direct bearing on choice of care and services including for osteopaths.
- QS 3: The Care and Services – Osteopaths contribute to assessment, planning and coordination of care, ensuring older Australians receive appropriate musculoskeletal treatment.
- QS 4: The Environment – Osteopaths may assist in identifying environmental factors that impact mobility and safety.
- QS 5: Clinical Care – Osteopaths as registered allied health professionals, play a role in delivering safe, high quality clinical care, specifically in pain management and rehabilitation.
Specific emphasis on dignity, respect, and cultural safety must be demonstrated in treatment notes.
Clinical excellence expectations are more rigorously defined with measurable outcomes like patient reported outcome measures (PROMs) and patient reported experience measures (PREMs).

Personal Accountability Framework

Individual health practitioners working in leadership roles must ensure their organisation meets all regulatory, clinical governance, and quality standards obligations under the new Act, with personal liability arising if they fail to do so.
Significant financial penalties can apply to both organisations and individuals if there is non-compliance.
New whistleblower protections increase the likelihood of reported non-compliance.
Documentation of decision-making processes becomes essential for liability protection. For osteopaths and other aged care workers, documenting the decision-making processes is not just best practice but a legal requirement under the new Act. It safeguards the rights of older Australians, supports ethical and lawful care delivery, and protects from personal and organisational liability. Robust documentation is a cornerstone of compliance, quality care, and accountability in the reformed aged care system.

Changes to documentation requirements

More comprehensive care planning documentation is required. For example, care plans must be detailed and clearly reflect the older Australian’s clinical needs, personal preferences, goals, risks, and their wellbeing. Documentation should include thorough assessments, evidence-based interventions, and demonstrate how care is coordinated and tailored to the older Australian. It must also show regular reviews and updates with input from the older Australian, ensuring their rights and choices are central. Additionally, cultural safety considerations must be explicitly addressed and recorded to respect and support diverse cultural identities.
Documentation must clearly show how each treatment supports the older Australian’s individual care plan and health goals. Clinical notes should explain the purpose of treatments and how they will help to achieve the specific outcomes identified for the older Australian, ensuring care is personalised and goal-oriented.
Regular reviews and updates with documented resident input are mandatory meaning that during care plan reviews, the resident’s views, preferences, and decisions must be actively sought, discussed, and clearly recorded. If the older Australian cannot communicate or make decisions independently, input from their authorised substitute decision-maker or support person should be documented. This ensures that care remains person-centred, respects the older Australian’s autonomy, and complies with all legal requirements and the Quality Standards.

Person-centred care

Rights-based framework

The legally binding Statement of Rights must be operationalised in every interaction.
Each treatment provided by an osteopath must demonstrate respect for autonomy, privacy, and dignity.
Documentation through clinical notes must show how these rights are upheld in practice.

Shared decision-making practices

Evidence of the older Australian’s involvement in all care decisions must be recorded clearly and comprehensively in the care documentation. This includes documenting discussions, options presented, the older Australian’s preferences and choices, and any consent given.
Options presented and discussed with the older Australian must be documented in clinical notes, including how their preferences were incorporated.
There must be a regular review process in place that captures evolving goals and preferences of the older Australian.

Informed consent

More detailed informed consent processes are required beyond simple signature collection. These processes include providing timely, accurate, and tailored information about treatments and alternatives; supporting the individual’s decision-making capacity by allowing time to answer questions and involving advocates or substitute decision-makers when needed; and comprehensively documenting the entire consent process-including discussions, understanding, and voluntary agreement-to ensure legal compliance and respect for the person’s autonomy. Always check with your professional indemnity insurer if you are unsure about informed consent.
There must be ongoing consent validation throughout treatment courses.
Capacity assessment must be documented (where required).'

What support and training is available?

Comprehensive understanding of the new regulatory framework is essential. The department will produce further implementation guidance and training.
Cultural safety training is now mandatory.
Osteopaths must understand legal obligations and personal liability requirements. Always check with your professional indemnity insurer if you are unsure.
Training on the new portal and claiming systems aims to assist aged care providers, administrative staff, care coordinators, finance teams and other personnel responsible for submitting claims and managing payments to navigate the updated system. This training helps staff understand how to updated GPM use the new Support at Home Provider Portal, and comply with revised claiming, reporting, and payment processes effective from 1 November 2025.
Training may also benefit clinical staff and managers seeking to understand how care planning and service delivery documentation integrates with the new digital systems to support accurate claims and compliance.

MyAgedCare: Fee Estimator

The Department of Health, Ageing and Disability has released a fee estimator to assist older Australians in determining what they will pay based on the cover they require. If you are working with older Australians in developing a plan, this fee estimator is a useful tool.

https://www.myagedcare.gov.au/how-much-will-i-pay

Member FAQs: Aged Care Act 2024 - What osteopaths need to know

What is the Aged Care Act 2024?

It is new legislation that reforms Australia's aged care system, focusing on a rights-based, person-centered approach to improve quality, safety, and access for older Australians. It replaces the Aged Care Act 1997 and commences on 1 November 2025.

How are osteopaths impacted by the changes to the Support at Home program?

The Support at Home program replaces previous home care packages with a single, streamlined system. However, osteopathy has been omitted from the ‘allied health and therapy’ service type and classified under "therapeutic services for independent living", which limits older Australians from accessing 100% government-funded clinical care and excludes osteopaths from referring to some key programs like the restorative care pathway.

What is Osteopathy Australia doing on the above matter?

Please refer to the ‘what have we done about these changes’ in the Support at Home and residential care sections above.

What are the new Quality Standards?

The Act introduces seven strengthened Quality Standards focusing on dignity, respect, cultural safety, clinical care, and person-centered approaches. Osteopaths must ensure their practice aligns with the strengthened Quality Standards, primarily focusing on those most relevant to their role-such as Consumer Dignity and Choice; Ongoing Assessment and Planning with Consumers; Personal and Clinical Care; Human Resources; and Organisational Governance - while also supporting the broader aged care provider’s compliance with all seven standards.

What legal responsibilities do osteopaths have under the new Act?

Under the new Act, providers and individuals in leadership or responsible roles have increased obligations related to ensuring compliance with care quality and safety requirements. Osteopaths working in such roles should be aware of these enhanced duties and the importance of adhering to regulatory expectations, as failure to meet these obligations may lead to regulatory action or penalties. Understanding these responsibilities supports professional accountability and helps promote high standards of care.

How will claims and payments work under the new Support at Home program?

Claims must be submitted via the Aged Care Provider Portal using updated templates and processes. Osteopaths providing home-based care need to familiarise themselves with these administrative changes.

What training is available to help osteopaths prepare for the upcoming changes?

Visit the Aged Care Quality and Safety Commission eLearning portal and the Department of Health Aged Care Act Preparation resources.

How can osteopaths ensure they provide culturally safe care?

Osteopaths should engage with cultural safety training, respect diverse backgrounds, and tailor care to meet the needs of Aboriginal and Torres Strait Islander peoples and other vulnerable groups.

What should osteopaths do now to prepare?

Stay engaged with Osteopathy Australia updates, complete relevant training, review practice policies, and engage in multidisciplinary collaboration. You can also stay up to date with Departmental changes on their website.