Hospital Circular 10/1998
3 July 1998
Contact: Regional Office
Distribution: Public Hospitals Health Insurance Organisations
- TAC & VWA invoices
- Public Hospital Fees - private admitted patients
- Reciprocal Health Care
- Neo-natal facilities - approvals
1. TAC & VWA INVOICES
Effective immediately, all Victorian public hospitals are requested not to bill (ie do not submit (send) invoices to) TAC and VWA for casemix funded separations until further notice resulting from recent advice received by the Department from Commonwealth Department of Health and Family Services of possible further refinements to the ICD-10-AM to ICD-9-CM mapping tables that have the potential to alter the DRG assignment of TAC and VWA patients.
Note: hospitals can continue to submit invoices for bedday funded and out-patient services to TAC and VWA.
The Department recognises that this request will affect the cashflow of your hospitals. As an interim measure the Department will adjust your cashflow to ensure that this action does not adversely affect your cashflow.
Rural hospitals are requested to provide advice of the estimated financial impact of this request on your cashflow (by month) to your regional office, and for metropolitan hospitals to your network account manager.
The Department will provide regular updates (monthly) on the progress of the resolution of this (ICD-10-AM to ICD-9-CM mapping) issue. The Department will issue another circular to advise hospital when to resume billing for compensable patients.
2. PUBLIC HOSPITAL FEES - PRIVATE ADMITTED PATIENTS
2.1 For your information only
- Basic private table or basic table has been replaced by paragraph (bj) of Schedule 1 (also known as "default benefits") of the National Health Act 1953 and allows the Commonwealth to determine health fund benefits without reference to "standard hospitals fees". Accordingly the definition "standard hospitals fees" was recently repealed from the Health Insurance Act 1973. (In previous years the Commonwealth Government determined maximum standard hospital fees).
- There was no increase in the March 1998 Quarter Australian CPI compared to the corresponding period last year.
2.2 Interim Fees
The State Department of Human Services has determined that the interim fees for 1998/99 for admitted private overnight-stay and same day patients in public hospitals will not increase from the 1997/98 level (Reference: Circular 10/97, issued 1 July 1997), pending the review of a number of public hospital fees. If as a result of that review, there are adjustments to fees, you will be informed in the usual way by Hospital Circular.
3. Reciprocal Health Care Agreements - Malta update
The Commonwealth Department of Health and Family Services has requested that public health services be made aware that the Republic of Malta has agreed to amendments to the Reciprocal Health Care Agreement (RHCA) effective 1 June 1998.
The first amendment more clearly defines the level of health care available to Maltese visitors in Australia, which is that of a public patient in the public health system. The second amendment excludes foreign students from the Agreement and gives effect to a Government decision that, from 1 July 1993, foreign students in Australia be insured under Overseas Student Health Cover (OSHC) through Medibank Private.
The amendments are solely of a technical nature to update the wording of the Agreement and simply clarify aspects of the Agreement. The Commonwealth advises they do not alter the scope or operations of the Agreement, and do not impose further obligations on Australia.
4. Neo-natal facilities - approvals
The Commonwealth Department of Health and Family Services advises that:
- the following
public hospitals have had their neo-natal facilities approved for
health benefit purposes for three years effective from 1 June
Public hospital Provider No Ballarat Base Hospital, Sturt Street, BALLARAT VIC 3350 030090Y Bendigo & Northern District Hospital, Lucan Street, BENDIGO VIC 3550 030120J Gippsland Base Hospital, Guthridge Parade, SALE VIC 3850 030480H Latrobe Regional Hospital, Ollerton Avenue, MOE VIC 3825 030610L St Georges Hospital, 283 Cotham Road, KEW VIC 3101 031130Y Warrnambool & District Hospital, Ryot Street, WARRNAMBOOL VIC 3280 031280H
- the following
public hospitals have had their neo-natal facilities approved for health
benefit purposes for three years effective from 10 June 1998.
Public hospital Provider No Wodonga District Hospital, Vermont Street, WODONGA VIC 3690 031390A Geelong Hospital, Ryrie Street, GEELONG VIC 3220 030470J Wangaratta District Base Hospitals, Green Street, WANGARATTA VIC 3677 031250L Goulburn Valley Base Hospital, Graham Street, SHEPPARTON VIC 3630 030710J
ACUTE HEALTH SERVICES