National Health Act 1953 Determination under Schedule 1, paragraph (bj) (HIB 03/2006) (Cth)

AUSTRALIAN GOVERNMENT

NATIONAL HEALTH ACT 1953

Determination made under Schedule 1, paragraph (bj)

(HIB 03/2006)

I, LINDA JANE ADDISON, delegate of the Minister for Health and Ageing acting under Schedule 1, paragraph (bj) of the National Health Act 1953 (the Act):

AMEND, the determination made under Schedule 1, paragraph (bj) of the Act dated 24 June 2005 (as amended) (the Determination), by OMITTING Schedule 2 of that Determination and SUBSTITUTING the attached Schedule 2.

This determination takes effect on the day following registration on the Federal Register of Legislative Instruments.

Dated this    2                 day of   February   2006.

Signed Linda Jane Addison

……………………………………………

Linda Jane Addison

Assistant Secretary

Private Health Insurance Branch

Position No: 01202874

Delegate of the Minister for Health and Ageing

SCHEDULE 2 – OVERNIGHT ACCOMMODATION

Shared ward accommodation in RECOGNISED HOSPITALS IN THE AUSTRALIAN CAPITAL TERRITORY, NEW SOUTH WALES, NORTHERN TERRITORY, QUEENSLAND, SOUTH AUSTRALIA AND WESTERN AUSTRALIA

In respect of hospital treatment provided to patients (other than nursing-home type patients or patients in situations of emergency) in shared ward accommodation in a hospital in a State or Territory for the purpose of permitting the provision to them at the hospital of hospital treatment for a period that includes part of an overnight stay for a continuous period of hospitalisation (as specified hereunder), benefits will be as follows:

STATE/TERRITORY	BENEFIT PAYABLE PER NIGHT
Australian Capital Territory	$261
New South Wales	$261
Northern Territory	$261
Queensland	$261
South Australia	$261
Western Australia	$261

In counting days, a continuous period of hospitalisation is deemed to be any two periods, being periods during which a patient was, or is, a patient in a hospital (whether or not the same hospital), that are separated from each other by a period of not more that seven days during which a patient was not a patient in any hospital.

Overnight benefits in relation to Type B procedures:

Overnight accommodation benefits are not payable for Type B professional attention (as specified in Part 1 of Schedule 3) unless overnight certification is provided.  In order for an overnight benefit to be payable to a patient in receipt of a Type B procedure requiring overnight hospitalisation, the:

(a)     practitioner providing professional attention; or

(b)     a professional employed by a hospital or day hospital facility who is involved in the provision of the professional attention provided by that hospital or day hospital facility;

must certify in writing that:

(a)     because of the medical condition of the patient specified in the certificate; or

(b)     because of the special circumstances specified in the certificate;

it would be contrary to accepted medical practice to provide the professional attention to the patient unless the patient were given hospital treatment in the hospital for a period that included part of an overnight stay.

This is page 1 of 2 pages of Schedule 2 attached to the Determination under Schedule 1 paragraph (bj) National Health Act 1953 (Determination HIB 11/2005) as amended and signed by the Delegate for the Minister for Health and Ageing on 24 June 2005, being Schedule 2 inserted by Determination HIB 03/2006 signed by the Delegate of the Minister for Health and Ageing on 2 February 2006.

Signed Fatimah Scott

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Witness

Overnight benefits in relation to Type C procedures:

Overnight accommodation benefits are not payable for Type C professional attention (as specified in Part 2 of Schedule 3) unless overnight certification, in addition to day certification, is provided.  In order for an overnight benefit to be payable to a patient in receipt of a Type C procedure requiring hospitalisation, the practitioner providing the professional attention must certify in writing that:

(a)     because of the medical condition of the patient specified in the certificate; or

(b)     because of the special circumstances specified in the certificate;

it would be contrary to accepted medical practice to provide the professional attention to the patient unless the patient were given hospital treatment in the hospital for a period that included part of an overnight stay.

This is page 2 of 2 pages of Schedule 2 attached to the Determination under Schedule 1 paragraph (bj) National Health Act 1953 (Determination HIB 11/2005) as amended and signed by the Delegate for the Minister for Health and Ageing on 24 June 2005, being Schedule 2 inserted by Determination HIB 03/2006 signed by the Delegate of the Minister for Health and Ageing on 2 February 2006

Signed Fatimah Scott

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Witness