Health
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Hospital Circular 6/1998

Date Issued: 8 May 1998
Publication: 6/1998
Contact: Regional Office
Distribution:

Public Hospitals
Extended Care Centres

Subjects:

  1. Nursing Home Type Patients (NHTPs) in Recognised Hospitals - changes in fees
  2. Public Hospital Prostheses Fees
  3. Day Only Arrangements
  4. Cessation of Day Only Procedures Form (Form 1830) - new arrangements
  5. Other administrative matters

1. Nursing Home Type Patients (NHTPs) in Recognised Hospitals - changes in fees

The Commonwealth Government has advised that in March 1998 the standard rate pension increased. As a result the Victorian Department of Human Services has increased its NHT patient contribution rate to an amount of $26.85 per day, effective 1 May 1998.

As a result of this change, please make the following update to the State Fees Manual Fees and Charges for Acute Health Services in Victoria: A Handbook for Public Hospitals:

Nursing Home Type Patients - replace page 23 in part 1, Fees for Admitted Patients (attached). This change is effective 1 May 1998.

2. Public Hospital Prostheses Fees

The Commonwealth advises it is in the process of preparing a Basic Table Benefits for Surgically Implanted Prosthesis and Homograft Items for release in July 1998. It will include an update of some items which have been reviewed. Accordingly there is no March 1998 schedule.

If you require further information, please telephone (02) 62898786 24 hour answering service - Health Insurance Section, Commonwealth Department of Health and Family Services or E-Mail the enquiry to his@health.gov.au

3. Day Only Arrangements

For consistency with DHS Circular 18/1997 issued 25/11/97, please amend the State fees manual Fees and Charges for Acute Health Services in Victoria: A Handbook for Public Hospitals as follows:

Private Admitted patients - Patient classifications - replace page 3, Fees for Admitted Patients.

4. Cessation of Day Only Procedures Form (Form 1830) - new arrangements

The Commonwealth advises that the Day Only Procedures Form (Form 1830) is being phased out. One option is to adopt the Private Patient Hospital Claim Form which incorporates both overnight stay and day-only-stay details which are currently included on Form 1830. In cases where hospitals are not completing the full Private Patient Hospital Claim Form, the relevant parts that cover the requirements of the Form 1830 may be used. The other alternative is for hospitals to continue to use photocopied versions of form 1830 once printed stocks are exhausted.

In order to reduce the number of different forms required, it is also proposed that hospitals complete the relevant portions of the Private Patient Hospital Claim Form for Medicare and Veterans’ Affairs patients instead of using form 1830. The new forms are already used for private patients in place of Form 1830. The Australian Health Insurance Association (AHIA) has no objections to hospitals using a photocopied version of the Private Patient Hospital Claim Form for other patients. Hospitals can contact the larger health funds, or else contact the AHIA on telephone (02) 6285 2977 for Private Patient Hospital Claim Form forms.

5. Other administrative matters

Medicare Benefits Schedule (MBS) book

Copies of the 1 November MBS book (Cat. No. 96 1041 3) and computer disk, both PC (Cat. No. 97 0523 6) and Mac (Cat No. 97 0524 4) formats, are available from the Australian Government Publishing Service (AGPS) for $24.95 each, or $40 for one book and one disk. Please see AGPS purchase order form attached. The AGPS toll free line for more information, is TeleInfo 132447. For enquiries about the Schedule itself the contact is Mr Paddy Forbutt, Assistant Director, Financial and Schedule Review Section, Medicare Benefits Branch, Commonwealth Department of Health and Family Services Ph 0262896815, Fax 0262894996.

Private Patients’ Hospital Charter

The Commonwealth had advised that copies of the Commonwealth Department of Health and Family Service’s Private Patients’ Hospital Charter and its accompanying pamphlet and posters will be fundamentally reviewed late in 1998. Accordingly only a short print run has been scheduled for the Charter in its present form. Please contact Vivien Hinton, Commonwealth DH&FS Health Insurance Section on (02) 62897317 or at vivien.hinton @health.gov.au to place an order.

Commonwealth Circular information/enquires - Web site

Copies of circulars produced by the Health Insurance Services Section of the Commonwealth Department of Health and Family Services can be obtained from the Australian Commonwealth Department of Health and Family Services homepage as follows:

Commonwealth Circulars

Internet Address

  • Commonwealth Circulars
  • Most commonly requested Commonwealth Circulars and List of Special Interests Circulars.

For examples:

  • Latest Type B (day only) and Type C exclusion lists
  • Nursing Home Type Patient Benefits & Patient Contributions
  • *Neo-natal facilitates including approvals
  • Latest Prosthesis Schedule (surgically implanted)
  • *Private/Public/Day Hospital provider numbers
  • Day Only Procedures Manual
Commonwealth/State Highly Specialised Drugs Program Guidelines website.

For enquiries please contact the Commonwealth’s Health Insurance Services Section via their 24 hour answering machine service (02) 6289 8786.

*Please note in Victoria all private hospitals and private day procedure centers (day facilities) are registered with the State Government. The State Government also conducts inspections of neo-natal facilities for the Commonwealth. For information and enquiries regarding all these you can contact: Private Hospitals Unit, Victorian Department of Human Services ph: (03) 9616 8079.

CHRIS BROOK
DIRECTOR
ACUTE HEALTH

Date: 8/5/1998 Publication No: 6/1998 Contact: Regional Office


Ineligible Patients

Hospitals may set fees for patients who are not covered by Medicare, including overseas patients. In setting fees, hospitals should be aware that some overseas patients are entitled to free care because of reciprocal health care agreements.

Fees for ineligible patients should be set to achieve full cost recovery, unless specifically authorised by the Regional Director.

Nursing Home Type Patients

The following fees are charged daily for nursing home type patients in public hospitals:

Standard Fees - Ordinary Care

Basic Benefit (private patients) $61.56

*Patient Contribution (all patients) $26.85


Total revenue for hospital $88.41

Standard Fees - Extended Care

Basic Benefit (private patient) $61.56

Extensive Care (private patients - where applicable) $6.00

*Patient Contribution (all patients) $26.85


Total revenue for hospital   $94.41

(See section on Compensable Patients re: compensable nursing home patients)

*Date of effect: 1 May 1998

Reference: Circular No.6/1998, issued 8 May 1998

Department of Veterans' Affairs, nursing home type patients in public hospitals:

Refer to this Manual: DVA Funding Arrangements from 1 January 1995 - Fees for Admitted Patients, page 10.

Fees for Admitted Patients 23

 

Patient Classifications

The classifications advanced surgical, surgical and other (medical) are defined in the Commonwealth's declarations which are made under sub-sections 3(1) and 3(14) of the Health Insurance Act 1973 (Cth). The declarations are based on the Medicare Benefits Schedule (MBS) fees for any surgical procedures undertaken during a patient's hospital stay. The declarations contain lists of MBS item numbers for professional services under each patient classification.

For the classification of patients for the purposes of basic health insurance benefits, the threshold amounts are:

advanced surgical: surgical procedures with an MBS fee greater than $636.95

surgical: surgical procedures with an MBS fee between $189.65 and $636.95

other (medical): procedures with an MBS fee less than $189.65

Attached is the Patient Classification Schedule.

IF YOU REQUIRE FURTHER INFORMATION
PLEASE TELEPHONE:(02) 62898786 - 24 HOUR ANSWERING SERVICE - Health Insurance Services Section, Commonwealth Department of Health and Family Services.