EmailHospital Circular 03/1999 Part 2 (Part 1)
3. DEPARTMENT OF VETERANS' AFFAIRS PATIENTS
Acute Health Circular No. 17/1998 issued on 5 November 1998, covered arrangements for eligible veterans. The elements relating to fees and charge have now been incorporated in the State’s Fees Manual as detailed below.
To access the updates to the Fees and Charges for Acute Health Services in Victoria: A Handbook for Public Hospitals go to the Fees Manual website and refer to:
Section A: Fees for Admitted Patients4. Department of Veterans' Affairs Patients
4.1 DVA Funding Arrangements from 1 July 1998; and
4.2 DVA Funding Arrangements from 1 January 1995 to 30 June 1998
4.?COMMONWEALTH DEFAULT BENEFITS
4.1 Public hospital prostheses fees
Commonwealth Circulars HBF 554 Benefits Payable in Respect of Surgically Implanted Prostheses & Homograft Items - February 1999 Review; and HBF 562 Default Table-Schedule 5 (surgically implanted prostheses list) Industry Update are incorporated in the State’s Fees Manual as detailed below. In particular you should note:
- that the February 1999 Prostheses Determination referred to in Circular HBF 554, is effective from 3 February 1999
- that from February 1999 the Commonwealth will only issue one Determination each year
- that a considerable number of items have been earmarked for removal in February 2000, and others identified for possible removal
- information on the additional vetting procedures and their impact on average benefit increases.
To access the updates to the Fees and Charges for Acute Health Services in Victoria: A Handbook for Public Hospitals please go to the Fees Manual website and refer to:
Appendix A: Surgically Implanted Prostheses and Homograft Items Fees
4.2 Patient classification schedule
4.2.1 The Commonwealth advised of the following change to the surgical patient classification schedule as a result of an amendment to the Medicare Benefits Schedule (MBS):
NEW SURGICAL ITEMFrom 1 January 1999
41880 TRACHEOSTOMY by a percutaneous technique using sequential dilation or partial splitting method to allow insertion of a cuffed tracheostomy tube.
4.2.2 Commonwealth Circular HBF 558 Patient Classification for Fund Benefit Purposes is incorporated in the State’s Fees Manual. Its includes the patient classification schedule effective 1 March 1999. To access this update in the Fees and Charges for Acute Health Services in Victoria: A Handbook for Public Hospitals, please go to the: Fees Manual website and refer to:
Appendix C: Patient Classification Schedule
4.3 Day Only Arrangements
Refer attached Commonwealth Circular HBF 557. It includes the Type B (Day Only) and Type C (Exclusions) lists effective 1 March 1999, and related information.
To access this update in the Fees and Charges for Acute Health Services in Victoria: A Handbook for Public Hospitals, please go to the Fees Manual website and refer to:
Appendix D: Type B (Day Only) and Type C (Exclusions) Lists
5. APPROVAL OF NEO-NATAL FACILITY FOR HEALTH BENEFIT PURPOSES
The Commonwealth has advised that the following public hospital has had its neo-natal facility approved for health benefit purposes for three years from 8 February 1999:
Royal Women’s & Children’s Health Care Network
Provider Number: 031040A
C/o Sunshine Hospital
176 Furlong Road
ST ALBANS VIC 3021
6. MEDICARE ELIGIBILITY FOR CHILDREN FROM THE CHERNOBYL REGION
The Commonwealth advises that a group of 19 sponsored children from the Chernobyl region will be arriving in Australia from the Ukraine on 12 April 1999. The majority will be staying in Melbourne, with one or two staying "in surrounding areas". (At this stage, the Commonwealth does not know for how long, but last year the children were here for 7 weeks.)
Public hospitals are advised that that during the period of the visit, these children, and the carers accompanying them from Chernobyl, are entitled under Medicare to immediately necessary medical and public hospital treatment for any ill health or injury they have while in Australia which requires treatment before returning home.
In the past there have been very few situations of the visiting children requiring hospitalisation. Following are some points that may be of assistance to you:
- A child/carer will probably not be carrying any type of identification other than his/her passport. As the benefits available to these children/carers are not widely known, it is reasonable to assume that those persons presenting at a hospital requesting treatment as a child/carer from Chernobyl are genuine.
- If a situation arises where clarification is sought regarding the eligibility of a patient then it is recommended that the Commonwealth Department of Health and Aged Care be contacted on (02) 6289 8607. Where the situation arises over a weekend and the Department cannot be contacted, an account may be raised if necessary pending confirmation of a patient's identity. Once clarification is received, the account is not to be pursued. Under NO circumstances are the children from Chernobyl to receive an account for any treatment that is considered to be clinically necessary.
-Hospitals should admit the child/carer as an eligible patient who is entitled to receive treatment in a public hospital as a public patient (ie without cost). If the hospital has a problem with declaring the child/carer as eligible, the Commonwealth Department of Health and Aged Care should be contacted.
-For a child/carer visiting a general practitioner, the procedure in the past has been that the host family takes the child/carer to the GP, who is then presented with an invoice, or the account is paid on the spot. The family then sends the receipt/invoice to the Victims of Chernobyl Fund, who forward it on to the Department. The Department then issues a Ministerial Order, and the Health Insurance Commission issues a temporary Medicare number which is relevant ONLY to the invoice/account received. This information is then sent back to the Victims of Chernobyl Fund, who relay it on to the family who make the claims as appropriate.
If you have any enquiries, please contact Ms Tanya Taylor, Ph: (02) 6289 8607 or Mr Barry Weatherburn, Ph: (02) 6289 6840, Medicare Eligibility Section, Commonwealth Department of Health and Aged Care.
7. COMPENSABLE NON-ADMITTED PATIENTS
The compensable non-admitted patients fees for ancillary services provided in public hospitals to all compensable outpatients including TAC and VWA have been amended effective 1 April 1999.
Advice about the Facility Fee has been expanded as follows: A facility fee is not payable when, on the same day, the claimant is subsequently admitted to hospital (including same day patient admissions). Multiple facility fees will only be paid where treatment of a time critical condition is provided. The account must be annotated with a statement of the circumstances necessitating the subsequent emergency treatment.
The contact for obtaining copies of TAC outpatient Standard Rehabilitation Plans has been updated.
Also, added to the Fees Manual are two fee schedules for outpatient / casualty / accident & emergency services provided by salaried medical practitioners in public hospitals provided to compensable non-admitted patients. One is applicable to compensable patients excluding VWA patients, and is effective 1 April 1999; the other only applies to VWA compensable patients and is effective 1 November 1998.
To access these updates in the Fees and Charges for Acute Health Services in Victoria: A Handbook for Public Hospitals, please go to the Fees Manual website and refer to:
Section B: Fees for Non-Admitted Patients 5. Compensable Non-admitted Patient Fees
8. NURSING HOME TYPE PATIENTS (NHTPs) IN PUBLIC HOSPITALS-CHANGE IN PATIENT CONTRIBUTION
The Commonwealth Government recently advised of an increase in the combined rate of pension and rent assistance of $2.35 per week. As a result the Victorian Department of Human Services has increased its NHT patient contribution from $27.05 to $27.35 per day, effective 20 March 1999. To access this update in the Fees and Charges for Acute Health Services in Victoria: A Handbook for Public Hospitals, please go to the Fees Manual website and refer to:
Section A: Fees for Admitted Patients9. Nursing Home Type Patients
9. PHARMACEUTICAL FEES
9.1 For clarification and accuracy, Section B of the State’s Fees Manual with regard to Pharmaceutical Fees for Non-Admitted Patients, has been amended as follows:
Changed from ....
"The following charges apply to all Pharmaceutical Benefits Scheme items (other than those items dispensed after reaching the safety net threshold) dispensed to non-admitted patients, including nursing home and hostel residents."
To read.....
"The following charges apply to all pharmaceutical items (other than those items dispensed after reaching the safety net threshold) dispensed to non-admitted patients, including nursing home and hostel residents."
To access this change in the Fees and Charges for Acute Health Services in Victoria: A Handbook for Public Hospitals, please go to the Fees Manual website and refer to:
Section B: Fees for Non-Admitted Patients
3 Pharmaceutical Fees
9.2 The Pharmaceutical Benefits Safety Net Scheme
The safety net threshold for general patients has increased from $612.60 to $620.60 for the 1999 calender year. To access this update in the Fees and Charges for Acute Health Services in Victoria: A Handbook for Public Hospitals, please go to the Fees Manual website and refer to:
Section B: Fees for Non-Admitted Patients3 Pharmaceutical Fees
3.1 Pharmaceutical Benefits Safety Net Scheme
CHRIS BROOK
DIRECTOR
ACUTE HEALTH
