Payment Pending Review (PPR) of decision to apply a penalty for non-compliance 001-10130010

Consideration should be given to the CDP participant's ability to voice what they wish to appeal. For example: if a CDP participant requests a review of a serious failure for persistent non-compliance, this should generally be interpreted as including all previously unreviewed failures that contributed towards the application of the serious failure.

Is the CDP participant currently serving, or yet to commence, a UNPP or serious failure penalty period?

• Yes, go to Step 2
• No, PPR provisions do not apply. Procedure ends here

Refer CDP participant to a PST SME via:

• PST phone if the CDP participant is in a service centre, or
• provide contact details for the CDP participant to call externally. See Participation Solutions team (PST) for contact details

When the request for review is received by a PST-skilled Service Officer with Participation Failure Decision (PFDEC) only, they will need to call the PST Virtual Support Queue to speak to a PST SME Eight Week Non-Payment Period Decision (WNPPD) who will conduct the quality check and review.

The PST SME is responsible for managing the PPR.

The PST SME records the reasons why the CDP participant is requesting a review of decision and any additional evidence provided. A priority review request due to no income is not required when PPR is granted.

Undertake the relevant review:

• for the first time the CDP participant has requested a review of the decision to apply the UNPP or serious failure, go to Step 5
• for Administrative Appeals Tribunal (AAT) first review, go to Step 3
• for an AAT second review, go to Step 4

Appeals to the AAT can be made in person, by phone, via an application form or online. Contact details are available on the AAT website. If an application form is lodged with Services Australia, forward it to the AAT as soon as it is received.

Confirmation that an application for an AAT first review has been lodged with the AAT is required prior to commencing PPR.

To record a PPR, go to Step 5.

Appeals to the AAT (AAT second review) are not covered in the Payment Pending Review Legislative Instruments. This means that unless the AAT has issued a stay order against the imposition of the penalty prior to the AAT second review, it is not appropriate to allow PPR for these appeals.

Stay orders issued for the entire UNPP or serious failure penalty period are referred to as full stay orders. Full stay orders are implemented by a PST-skilled Service Officer (WNPPD).

Stay orders issued for part of the UNPP or serious failure penalty period are referred to as partial stay orders. These stay orders are implemented by the Virtual Support Team (VST). See Implementing Administrative Appeals Tribunal (AAT second review) partial stay orders

If the AAT:

• has issued a stay order to continue payment pending their decision, PPR is coded as a workaround. Go to Step 5
• has not issued a stay order to continue payment pending their decision the CDP participant is not eligible to PPR provisions. Procedure ends here

If the CDP participant is currently serving, or due to commence, a UNPP or serious failure penalty period, payment must be continued under PPR provisions until the quality check or AAT first or second review (when a stay order has been granted) is completed.

Payment is payable from the date that the penalty period commenced, or is scheduled to commence, except if a CDP participant is serving other waiting or preclusion periods not subject to PPR provisions concurrently with a UNPP, in which case PPR begins once the concurrent waiting periods have finished.

When the quality check or review is requested after the non-payment period has been reinstated for not attending a compliance activity waiver appointment or attending but not entering into a new Job Plan, PPR applies to the reinstated penalty period.

Note: prior to completing PPR, check to see if the customer has had any change in circumstances which would impact on their payment. If changes have occurred, these updates must be recorded prior to finalising the PPR assessment.

Record PPR, which will generate arrears for any amount already withheld, by updating the UNPP or serious failure status:

• Go to the Participation Compliance Hub (BIPCW) screen
• Locate the failure under review in the Completed/Provider Compliance action table on the Participation Compliance Hub screen. Select Compliance action at the end of the row
• Select Review Decision from the Completed Compliance Action screen (BIACT)
• On the Review Decision workflow screen update the failure status to PPR and record the date the customer requested the review in the Status/Decision date
• Select Save/Submit. Select Assess to navigate to the Errors (SWE) screen. Select Assess again to navigate to the Entitlement (ELD) screen

During the period that the CDP participant is receiving PPR they are required to comply with their mutual obligation requirements.

Suspension of payment, connection, non-attendance failures and reconnection failures, No Show, No Pay failures or serious failures may also occur during the period the CDP participant is receiving PPR if they fail to meet requirements without reasonable excuse.

Advise the CDP participant:

• of the Payment Pending Review provisions, and
• of the requirement to continue to comply with all mutual obligation requirements and the consequences of further failures, including the impact that multiple non-payment periods may have

For information about the action required when a review/appeal has been completed, see Implementing the outcome of a failure review or appeal.

If this is the first time the CDP participant has requested a review of the decision to apply the UNPP or serious failure, a Subject Matter Expert (SME) review is required.

The SME will perform the quality assurance check of the decision and any new evidence that the CDP participant has presented.

The SME will:

• clearly document any new evidence/information that has been supplied by the CDP participant
• clearly document that the original decision had been explained to the CDP participant prior to a request for review
• complete the Internal Review/Explanation script, and
• perform the Quality Assurance (QA) check of the decision

Based on this review, is the UNPP or serious failure to be revoked?

• Yes, finalise the Review/Quality check using the Internal Review/Explanation script. For more details see Implementing the outcome of a failure review or appeal. Procedure ends here
• No, if the customer was:
• satisfied with the explanation and does not wish to proceed to an Authorised Review Officer (ARO) review, finalise the SME review/quality check using the Internal Review/Explanation Script. For more details see Implementing the outcome of a failure review or appeal. Procedure ends here
• unsatisfied with the explanation and wants to proceed with a review, refer to an ARO. In these cases, PPR is to continue. Procedure ends here