National Health Reform Act 2011 (Cth)
This is a compilation of the
The notes at the end of this compilation (the
The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Register ( The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the Register for the compiled law.
If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.
For more information about any editorial changes made in this compilation, see the endnotes.
If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the Register for the compiled law.
If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.
Contents
This Act may be cited as the
National Health Reform Act 2011.
This Act commences on 1 July 2011.
The object of this Act is to establish:
(a) the Australian Commission on Safety and Quality in Health Care; and
(c) the Independent Health and Aged Care Pricing Authority; and
(d) the office of Administrator of the National Health Funding Pool; and
(e) the National Health Funding Body.
The following is a simplified outline of this Act:
• This Act sets up:
(a) the Australian Commission on Safety and Quality in Health Care; and
(b) the Independent Health and Aged Care Pricing Authority; and
(c) the office of Administrator of the National Health Funding Pool; and
(d) the National Health Funding Body.
• The Australian Commission on Safety and Quality in Health Care has functions relating to health care safety and quality matters.
• The main functions of the Independent Health and Aged Care Pricing Authority in relation to public hospitals and health care pricing and costing are as follows:
(a) to determine the national efficient price for health care services provided by public hospitals where the services are funded on an activity basis;
(b) to determine the efficient cost for health care services provided by public hospitals where the services are block funded;
(c) to publish this, and other information, for the purpose of informing decision makers in relation to the funding of public hospitals;
(d) if requested by the Minister or the Secretary, to advise the Commonwealth in relation to certain health care pricing and costing matters.
• The main functions of the Independent Health and Aged Care Pricing Authority in relation to aged care are as follows:
(a) to provide advice about certain aged care pricing and costing matters to each relevant Commonwealth Minister;
(b) to perform such functions as are conferred on the Independent Health and Aged Care Pricing Authority by the Aged Care Act.
• The main function of the Administrator of the National Health Funding Pool is to administer the National Health Funding Pool.
• The function of the National Health Funding Body is to assist the Administrator of the National Health Funding Pool.
In this Act:
Administrator means the Administrator of the National Health Funding Pool appointed under section 232 and under the corresponding provision of the laws of the States and Territories.
Aged Care Act means theAged Care Act 1997 .
Aged Care Act function has the meaning given by paragraph 131A(1)(e).
aged care information means information (including protected information within the meaning of the Aged Care Act) obtained in the course of:
(a) the performance of the following functions, or the exercising of powers for or in connection with the performance of the following functions:
(i) a function of the Pricing Authority mentioned in subsection 131A(1) (other than an Aged Care Act function);
(ii) a function of the Aged Care Advisory Committee (other than a function that relates to an Aged Care Act function of the Pricing Authority);
(iii) a function of a subcommittee established under section 204V to advise or assist the Aged Care Advisory Committee in the performance of a function of the Aged Care Advisory Committee covered by subparagraph (ii) of this paragraph;
(iv) a function of a committee established under section 205 to advise or assist the Pricing Authority in the performance of a function of the Pricing Authority mentioned in subsection 131A(1) (other than an Aged Care Act function); or
(b) assisting, under section 204Y or 207, in the performance of a function covered by paragraph (a) of this definition.
Aged Care Minister means the Minister administering the Aged Care Act.
Clinical Advisory Committee member means a member of the Clinical Advisory Committee, and includes the Chair of the Clinical Advisory Committee.
clinician means an individual who provides diagnosis, or treatment, as a professional:
(a) medical practitioner; or
(b) nurse; or
(c) allied health practitioner; or
(d) health practitioner not covered by paragraph (a), (b) or (c).
Commission means the Australian Commission on Safety and Quality in Health Care.
Commission Board means the Board of the Commission.
Commission Board Chair means the Chair of the Commission Board.
Commission Board member means a member of the Commission Board, and includes the Commission Board Chair.
Commission CEO means the Chief Executive Officer of the Commission.
cost‑shifting dispute has the meaning given by subsection 138(1).
cross‑border dispute has the meaning given by subsection 138(2).
First Ministers’ Council means a body (however described) that consists only of, or that includes, the following:
(a) the Prime Minister;
(b) the Premiers of each State;
(c) the Chief Ministers of the Australian Capital Territory and Northern Territory.
function , in Part 5.2, includes a power, authority or duty.
Funding Body means the National Health Funding Body.
Funding Body CEO means the Chief Executive Officer of the Funding Body.
health care pricing and costing information means information obtained in the course of:
(a) the performance of the following functions, or the exercising of powers for or in connection with the performance of the following functions:
(i) a function of the Pricing Authority mentioned in subsection 131(1A);
(ii) a function of the Clinical Advisory Committee mentioned in paragraph 177(ba);
(iii) a function of a subcommittee established under section 191 to advise or assist the Clinical Advisory Committee in the performance of a function of the Clinical Advisory Committee mentioned in paragraph 177(ba);
(iv) a function of the Jurisdictional Advisory Committee mentioned in subparagraph 196(1)(a)(va);
(v) a function of a committee established under section 205 to advise or assist the Pricing Authority in the performance of a function of the Pricing Authority mentioned in subsection 131(1A); or
(b) assisting, under section 194, 204 or 207, in the performance of a function mentioned in paragraph (a) of this definition.
health care safety and quality matter means:
(a) a matter relating to the safety of health care services; or
(b) a matter relating to the quality of health care services; or
(c) a matter specified in the regulations.
Health Chief Executives Forum means a body (however described) that consists of:
(a) the Secretary; and
(b) each head (however described) of the Health Department of a State or Territory.
Health Department , of a State or Territory, means a Department of State that:
(a) deals with matters relating to health; and
(b) is administered by the State/Territory Health Minister of the State or Territory.
Health Minister means:
(a) the Minister; or
(b) a State/Territory Health Minister.
intergovernmental agreement means:
(a) a written agreement between the Commonwealth and one or more States or Territories; or
(b) a written resolution of the First Ministers’ Council passed in accordance with the procedures determined by that Council.
Jurisdictional Advisory Committee member means a member of the Jurisdictional Advisory Committee, and includes:
(a) the Chair of the Jurisdictional Advisory Committee; and
(b) a person attending a meeting in place of a Jurisdictional Advisory Committee member.
local hospital network means an organisation that is a local hospital network (however described) for the purposes of the National Health Reform Agreement.
member of the Aged Care Advisory Committee includes the Chair of the Aged Care Advisory Committee.
member of the Pricing Authority includes:
(a) the Chair of the Pricing Authority; and
(b) each Deputy Chair of the Pricing Authority.
Ministerial Council means a body (however described) that consists of the Minister of the Commonwealth, and the Minister of each State and Territory, who is responsible, or principally responsible, for matters relating to health.
National Health Funding Pool means the combined State Pool Accounts for each State and Territory.
National Health Reform Agreement means the National Health Reform Agreement between the Commonwealth and the States that was agreed to by the Council of Australian Governments on 2 August 2011, as amended from time to time.
National Health Reform law , of a State or Territory, means a law of the State or Territory that gives effect to the National Health Reform Agreement.
official of the Commission means:
(a) a Commission Board member; or
(b) the Commission CEO; or
(c) a member of the staff of the Commission; or
(d) a person whose services are made available to the Commission under section 48; or
(e) a person engaged as a consultant under section 49.
official of the Funding Body means:
(a) the Funding Body CEO; or
(b) a member of the staff of the Funding Body; or
(c) a person whose services are made available to the Funding Body under section 265; or
(d) a person engaged as a consultant under section 266.
official of the Pricing Authority means:
(a) a member of the Pricing Authority; or
(b) the Pricing Authority CEO; or
(c) a member of the staff of the Pricing Authority; or
(d) a person whose services are made available to the Pricing Authority under section 174; or
(e) a person engaged as a consultant under section 175.
participating State/Territory Health Minister : if:
(a) there is in force an agreement between the Commonwealth and:
(i) a State; or
(ii) the Australian Capital Territory; or
(iii) the Northern Territory; and
(b) under the agreement, the State or Territory undertakes to make financial contributions to the Commission;
the State/Territory Health Minister of the State or Territory is a
participating State/Territory Health Minister .
partner of a person means:
(a) the person’s spouse; or
(b) the person’s de facto partner (within the meaning of the
Acts Interpretation Act 1901 ).
Premier :
(a) the Chief Minister of the Australian Capital Territory is taken to be the Premier of that Territory for the purposes of this Act; and
(b) the Chief Minister of the Northern Territory is taken to be the Premier of that Territory for the purposes of this Act.
Pricing Authority means the Independent Health and Aged Care Pricing Authority.
Pricing Authority CEO means the Chief Executive Officer of the Pricing Authority.
private hospital means a facility specified in a legislative instrument made by the Minister for the purposes of this definition.
protected Administrator information means information that was obtained by a person in the person’s capacity as the Administrator.
protected Commission information means information that:
(a) was obtained by a person in the person’s capacity as an official of the Commission; and
(b) relates to the affairs of a person other than an official of the Commission.
protected Funding Body information means information that:
(a) was obtained by a person in the person’s capacity as an official of the Funding Body; and
(b) relates to the affairs of a person other than an official of the Funding Body.
protected Pricing Authority information means information that:
(a) was obtained by a person in the person’s capacity as an official of the Pricing Authority; and
(b) relates to the affairs of a person other than an official of the Pricing Authority;
but does not include protected information (within the meaning of the Aged Care Act) that is not aged care information.
public hospital means a facility specified in a legislative instrument made by the Minister for the purposes of this definition. If a facility is situated in a State, the Australian Capital Territory or the Northern Territory, the Minister must not specify the facility in such an instrument without the written agreement of the State/Territory Health Minister of the State or Territory, as the case may be.
relevant Commonwealth Minister means the following:
(a) the Minister;
(b) if the Minister is not also the Aged Care Minister—the Aged Care Minister.
responsible Minister for a jurisdiction means the relevant Minister with portfolio responsibility for the administration of the provision of this Act in which the expression occurs (or of the corresponding provision of the laws of the States).
Royal Commission has the same meaning as in theRoyal Commissions Act 1902 .
Secretary means the Secretary of the Department.
staff of the Commission means the staff described in section 47.
staff of the Funding Body means the staff described in section 264.
staff of the Pricing Authority means the staff described in section 173.
State , in Parts 5.1 and 5.2, includes the Australian Capital Territory and the Northern Territory.
State Managed Fund of a State or Territory means a bank account or fund established or designated by the State or Territory for the purposes of health funding under the National Health Reform Agreement that is required to be undertaken in the State or Territory through a State Managed Fund.
State Pool Account of a State or Territory means the bank accounts opened under the laws of the States and Territories as State Pool Accounts for the purposes of the National Health Reform Agreement.
State/Territory government body means:
(a) the government of a State or Territory; or
(b) an agency or authority of a State or Territory.
State/Territory Health Minister means:
(a) the Minister of a State;
(b) the Minister of the Australian Capital Territory; or
(c) the Minister of the Northern Territory;
who is responsible, or principally responsible, for the administration of matters relating to health in the State, the Australian Capital Territory or the Northern Territory, as the case may be.
Treasurer means the Minister administering theFederal Financial Relations Act 2009 .
vacancy , in relation to the office of:
(a) a Commission Board member; or
(c) a member of the Pricing Authority; or
(d) a member of the Clinical Advisory Committee;
has a meaning affected by section 6.
(1) For the purposes of a reference in:
(a) this Act to a
vacancy in the office of a Commission Board member; or(b) the
Acts Interpretation Act 1901 to avacancy in the membership of a body;there are taken to be 9 offices of Commission Board member in addition to the Commission Board Chair.
(3) For the purposes of a reference in:
(a) this Act to a
vacancy in the office of a member of the Pricing Authority; or(b) the
Acts Interpretation Act 1901 to avacancy in the membership of a body;there are taken to be 6 offices of members of the Pricing Authority in addition to the Chair of the Pricing Authority and the 2 Deputy Chairs of the Pricing Authority.
(4) For the purposes of a reference in:
(a) this Act to a
vacancy in the office of a member of the Clinical Advisory Committee; or(b) the
Acts Interpretation Act 1901 to avacancy in the membership of a body;there are taken to be 8 offices of members of the Clinical Advisory Committee in addition to the Chair of the Clinical Advisory Committee.
(1) This Act binds the Crown in each of its capacities.
(2) This Act does not make the Crown liable to a pecuniary penalty or to be prosecuted for an offence.
(3) The protection in subsection (2) does not apply to an authority of the Crown.
The following is a simplified outline of this Chapter:
• This Chapter sets up the Australian Commission on Safety and Quality in Health Care.
• The Commission has functions relating to health care safety and quality matters.
• There is to be a Board of the Commission.
• There is to be a Chief Executive Officer of the Commission.
• Committees may be established to assist the Commission.
(1) The Australian Commission on Safety and Quality in Health Care is established by this section.
Note: In this Act,
Commission means the Australian Commission on Safety and Quality in Health Care—see section 5.(2) The Commission:
(a) is a body corporate; and
(b) must have a seal; and
(c) may acquire, hold and dispose of real and personal property; and
(d) may sue and be sued.
Note: The
Public Governance, Performance and Accountability Act 2013 applies to the Commission. That Act deals with matters relating to corporate Commonwealth entities, including reporting and the use and management of public resources.(3) The seal of the Commission is to be kept in such custody as the Commission Board directs, and is not to be used except as authorised by the Commission Board.
(4) All courts, judges and persons acting judicially must:
(a) take judicial notice of the imprint of the seal of the Commission appearing on a document; and
(b) presume that the document was duly sealed.
(1) The Commission has the following functions:
(a) to promote, support and encourage the implementation of arrangements, programs and initiatives relating to health care safety and quality matters;
(b) to collect, analyse, interpret and disseminate information relating to health care safety and quality matters;
(c) to advise the Minister about health care safety and quality matters;
(d) to publish (whether on the internet or otherwise) reports and papers relating to health care safety and quality matters;
(e) to formulate, in writing, standards relating to health care safety and quality matters;
(f) to formulate, in writing, guidelines relating to health care safety and quality matters;
(g) to formulate, in writing, indicators relating to health care safety and quality matters;
(h) to promote, support and encourage the implementation of:
(i) standards formulated under paragraph (e); and
(ii) guidelines formulated under paragraph (f);
(i) to promote, support and encourage the use of indicators formulated under paragraph (g);
(j) to monitor the implementation and impact of:
(i) standards formulated under paragraph (e); and
(ii) guidelines formulated under paragraph (f);
(k) to advise:
(i) the Minister; and
(ii) each participating State/Territory Health Minister;
about which standards formulated under paragraph (e) are suitable for implementation as national clinical standards;
(l) to formulate model national schemes that:
(i) provide for the accreditation of organisations that provide health care services; and
(ii) relate to health care safety and quality matters;
(m) to consult and co‑operate with other persons, organisations and governments on health care safety and quality matters;
(n) such functions (if any) as are specified in a written instrument given by the Minister to the Commission Board Chair;
(o) to promote, support, encourage, conduct and evaluate training programs for purposes in connection with the performance of any of the Commission’s functions;
(p) to promote, support, encourage, conduct and evaluate research for purposes in connection with the performance of any of the Commission’s functions;
(q) to do anything incidental to or conducive to the performance of any of the above functions.
Note 1: See also section 57 (compliance with standards and guidelines is voluntary).
Note 2: Sections 10 and 11 impose consultation requirements on the Commission.
(2) Before making an instrument under paragraph (1)(n), the Minister must consult each participating State/Territory Health Minister.
Legislative instruments
(3) A standard formulated under paragraph (1)(e) is not a legislative instrument.
(4) Guidelines formulated under paragraph (1)(f) are not a legislative instrument.
(5) An indicator formulated under paragraph (1)(g) is not a legislative instrument.
(6) A model national scheme formulated under paragraph (1)(l) is not a legislative instrument.
(7) An instrument made under paragraph (1)(n) is not a legislative instrument.
Scope
(1) This section applies to the following:
(a) standards formulated by the Commission under paragraph 9(1)(e);
(b) guidelines formulated by the Commission under paragraph 9(1)(f);
(c) indicators formulated by the Commission under paragraph 9(1)(g).
Consultation
(2) Before formulating standards, guidelines or indicators, the Commission must consult:
(a) clinicians; and
(b) bodies known as lead clinician groups; and
(c) each head (however described) of a Department of State of:
(i) a State; or
(ii) the Australian Capital Territory; or
(iii) the Northern Territory;
where the Department:
(iv) deals with matters relating to health; and
(v) is administered by a participating State/Territory Health Minister; and
(d) any other persons or bodies who, in the Commission’s opinion, are stakeholders in relation to the formulation of the standards, guidelines or indicators; and
(da) carers; and
(db) consumers; and
(e) the public.
(3) If the Commission is of the opinion that:
(a) there is an urgent need to formulate particular standards, guidelines or indicators; and
(b) because of that urgent need, it is not reasonably practicable to comply with subsection (2) in relation to the formulation of those standards, guidelines or indicators;
the Commission is not required to comply with subsection (2) in relation to the formulation of those standards, guidelines or indicators.
Application or adoption of other instruments etc.
(4) Standards, guidelines or indicators may apply, adopt or incorporate, with or without modification, any matter contained in any other instrument or writing, as existing:
(a) at a particular time; or
(b) from time to time.
Information
(5) Before formulating standards, guidelines or indicators, the Commission must collect, analyse and interpret such information as the Commission considers relevant.
Rules to be complied with by Commission
(6) The Minister may, by legislative instrument, make rules to be complied with by the Commission in formulating standards, guidelines or indicators.
(7) Before making rules under subsection (6), the Minister must consult each participating State/Territory Health Minister.
(8) The Commission must comply with rules in force under subsection (6).
Scope
(1) This section applies to a model national accreditation scheme formulated by the Commission under paragraph 9(1)(l).
Consultation
(2) Before formulating a scheme, the Commission must consult:
(a) each head (however described) of a Department of State of:
(i) a State; or
(ii) the Australian Capital Territory; or
(iii) the Northern Territory;
where the Department:
(iv) deals with matters relating to health; and
(v) is administered by a participating State/Territory Health Minister; and
(b) persons or bodies who, in the Commission’s opinion, are stakeholders in relation to the formulation of the scheme; and
(ba) carers; and
(bb) consumers; and
(c) the public.
Rules to be complied with by Commission
(3) The Minister may, by legislative instrument, make rules to be complied with by the Commission in formulating a scheme.
(4) Before making rules under subsection (3), the Minister must consult each participating State/Territory Health Minister.
(5) The Commission must comply with rules in force under subsection (3).
The Commission may perform its functions only:
(a) for purposes related to:
(i) the provision of pharmaceutical, sickness or hospital benefits; or
(ii) the provision of medical or dental services; or
(b) for purposes related to the granting of financial assistance to a State on such terms and conditions as the Parliament thinks fit; or
(c) for purposes related to the executive power of the Commonwealth; or
(d) for purposes related to statistics; or
(e) in, or for purposes related to, a Territory; or
(f) in or with respect to a Commonwealth place (within the meaning of the
Commonwealth Places (Application of Laws) Act 1970 ); or(g) for purposes related to trade and commerce:
(i) between Australia and places outside Australia; or
(ii) among the States; or
(iii) within a Territory, between a State and a Territory or between 2 Territories; or
(h) for purposes related to a corporation to which paragraph 51(xx) of the Constitution applies; or
(i) by way of the use of a postal, telegraphic, telephonic or other like service within the meaning of paragraph 51(v) of the Constitution; or
(j) by way of the provision of a service to:
(i) the Commonwealth; or
(ii) an authority of the Commonwealth;
for a purpose of the Commonwealth; or
(k) for purposes related to matters that are peculiarly adapted to the government of a nation and that cannot otherwise be carried on for the benefit of the nation; or
(l) for purposes related to matters incidental to the execution of any of the legislative powers of the Parliament or the executive power of the Commonwealth.
The Commission has power to do all things necessary or convenient to be done for or in connection with the performance of its functions.
Fees
(1) The Commission may charge fees for things done in performing its functions, so long as rules are in force under subsection (2).
Rules to be complied with by Commission
(2) The Minister may, by legislative instrument, make rules to be complied with by the Commission in charging fees under subsection (1).
(3) Before making rules under subsection (2), the Minister must consult each participating State/Territory Health Minister.
(4) The Commission must comply with rules in force under subsection (2).
The Commission has the privileges and immunities of the Crown in right of the Commonwealth.
(1) The Minister may give directions to the Commission in relation to the performance of its functions and the exercise of its powers.
(2) A direction under subsection (1) must be of a general nature only.
(3) Before making a direction under subsection (1), the Minister must consult each participating State/Territory Health Minister.
(4) The Commission must comply with a direction under subsection (1).
The Commission Board of the Commission is established by this section.
Note: In this Act,
Commission Board means the Board of the Commission—see section 5.
(1) The Commission Board is responsible for ensuring the proper and efficient performance of the Commission’s functions.
(2) The Commission Board has power to do all things necessary and convenient to be done for or in connection with the performance of its duties.
(3) Anything done in the name of, or on behalf of, the Commission by the Commission Board, or with the authority of the Commission Board, is taken to have been done by the Commission.
(4) If a function or power of the Commission is dependent on the opinion, belief or state of mind of the Commission in relation to a matter, the function or power may be exercised upon the opinion, belief or state of mind of a person or body acting as mentioned in subsection (3) in relation to that matter.
The Commission Board consists of the following members:
(a) the Chair of the Commission Board;
(b) not fewer than 7, and not more than 9, other members.
Note: In this Act,
Commission Board Chair means the Chair of the Commission Board andCommission Board member means a member of the Commission Board (including the Commission Board Chair)—see section 5.
(1) The Commission Board members are to be appointed by the Minister.
(2) The appointments are to be made by written instrument.
(3) A person is not eligible for appointment as a Commission Board member unless the Minister is satisfied that the person has:
(a) substantial experience or knowledge; and
(b) significant standing;
in at least one of the following fields:
(c) public administration in relation to health care;
(d) provision of professional health care services;
(e) management of companies, or other organisations, that are involved in the provision of health care services outside the hospital system;
(f) general management of public hospitals;
(g) general management of private hospitals;
(ga) primary health care services;
(gb) management of general practice;
(h) financial management;
(i) corporate governance;
(j) improvement of safety and quality;
(k) representation of the interests of consumers;
(l) law;
(m) a field that is specified in a legislative instrument made by the Minister.
(4) The Minister must ensure that the Commission Board members collectively possess an appropriate balance of experience and knowledge in each of the fields covered by subsection (3).
(5) A Commission Board member is to be appointed on a part‑time basis.
(6) Before:
(a) appointing a Commission Board member under subsection (1); or
(b) making an instrument under paragraph (3)(m);
the Minister must consult each participating State/Territory Health Minister.
A Commission Board member holds office for the period specified in the instrument of appointment. The period must not exceed 5 years.
Note: For re‑appointment, see the
Acts Interpretation Act 1901 .
Acting Commission Board Chair
(1) The Minister may appoint a person to act as the Commission Board Chair:
(a) during a vacancy in the office of the Commission Board Chair (whether or not an appointment has previously been made to the office); or
(b) during any period, or during all periods, when the Commission Board Chair:
(i) is absent from duty or Australia; or
(ii) is, for any reason, unable to perform the duties of the office.
Acting Commission Board member (other than Commission Board Chair)
(2) The Minister may appoint a person to act as a Commission Board member (other than the Commission Board Chair):
(a) during a vacancy in the office of a Commission Board member (other than the Commission Board Chair), whether or not an appointment has previously been made to the office; or
(b) during any period, or during all periods, when a Commission Board member (other than the Commission Board Chair):
(i) is absent from duty or Australia; or
(ii) is, for any reason, unable to perform the duties of the office.
(3) An appointment under subsection (1) or (2) is to be made by written instrument.
Eligibility
(4) A person is not eligible for appointment to act as:
(a) the Commission Board Chair; or
(b) a Commission Board member (other than the Commission Board Chair);
unless the person is eligible for appointment as a Commission Board member.
Note 1: For qualifications of Commission Board members, see subsection 20(3).
Note 2: For rules that apply to acting appointments, see sections 33AB and 33A of the
Acts Interpretation Act 1901 .
(1) A Commission Board member is to be paid the remuneration that is determined by the Remuneration Tribunal. If no determination of that remuneration by the Tribunal is in operation, a Commission Board member is to be paid the remuneration that is prescribed by the regulations.
(2) A Commission Board member is to be paid the allowances that are prescribed by the regulations.
(3) This section has effect subject to the
Remuneration Tribunal Act 1973 .
(1) The Minister may grant the Commission Board Chair leave of absence on the terms and conditions that the Minister determines.
(2) The Commission Board Chair may grant leave of absence to any other Commission Board member on the terms and conditions that the Commission Board Chair determines.
(3) The Commission Board Chair must notify the Minister if the Commission Board Chair grants to a Commission Board Member leave of absence for a period exceeding 6 months.
(1) A Commission Board member may resign his or her appointment by giving the Minister a written resignation.
(2) The resignation takes effect on the day it is received by the Minister or, if a later day is specified in the resignation, on that later day.
(1) The Minister may terminate the appointment of a Commission Board member for misbehaviour or physical or mental incapacity.
(2) The Minister must terminate the appointment of a Commission Board member if:
(a) the Commission Board member:
(i) becomes bankrupt; or
(ii) applies to take the benefit of any law for the relief of bankrupt or insolvent debtors; or
(iii) compounds with his or her creditors; or
(iv) makes an assignment of his or her remuneration for the benefit of his or her creditors; or
(b) the Commission Board member is absent, except on leave of absence, from 3 consecutive meetings of the Commission Board;
Note: The appointment of a Commission Board member may also be terminated under section 30 of the
Public Governance, Performance and Accountability Act 2013 (which deals with terminating the appointment of an accountable authority, or a member of an accountable authority, for contravening general duties of officials).(3) Before terminating the appointment of a Commission Board member under subsection (1), the Minister must consult each participating State/Territory Health Minister.
A Commission Board member holds office on the terms and conditions (if any) in relation to matters not covered by this Act that are determined by the Minister.
(1) The Commission Board Chair must convene 3 meetings of the Commission Board in each calendar year.
(2) The Commission Board Chair may convene such additional meetings (if any) as are, in his or her opinion, necessary for the conduct of the Commission’s affairs.
(3) The Commission Board Chair must convene a meeting of the Commission Board if directed to do so by the Minister.
(1) The Commission Board Chair must preside at all meetings of the Commission Board at which he or she is present.
(2) If the Commission Board Chair is not present at a meeting, the Commission Board members present must elect one of their number to preside at the meeting.
At a meeting of the Commission Board, a quorum is constituted by:
(a) if the total number of Commission Board members is 8 or 9—5 Commission Board members; or
(b) if the total number of Commission Board members is 10—6 Commission Board members.
(1) At a meeting of the Commission Board, a question is decided by a majority of the votes of Commission Board members present and voting.
(2) The Commission Board member presiding at the meeting has:
(a) a deliberative vote; and
(b) in the event of an equality of votes, a casting vote.
(1) The Commission Board is taken to have made a decision at a meeting if:
(a) without meeting, a majority of the Commission Board members entitled to vote on the proposed decision indicate agreement with the decision; and
(b) that agreement is indicated in accordance with the method determined by the Commission Board under subsection (2); and
(c) all the Commission Board members were informed of the proposed decision, or reasonable efforts were made to inform all the Commission Board members of the proposed decision.
(2) Subsection (1) does not apply unless the Commission Board:
(a) has determined that it may make decisions of that kind without meeting; and
(b) has determined the method by which Commission Board members are to indicate agreement with proposed decisions.
(3) For the purposes of paragraph (1)(a), a Commission Board member is not entitled to vote on a proposed decision if the Commission Board member would not have been entitled to vote on that proposal if the matter had been considered at a meeting of the Commission Board.
Subject to this Act and the
Public Governance, Performance and Accountability Act 2013 , the Commission Board may regulate the conduct of its meetings as it thinks fit.Note: Section 33B of the
Acts Interpretation Act 1901 contains further information about the ways in which Commission Board members may participate in meetings.
The Commission Board must keep minutes of its meetings.
(1) The Commission Board may, by writing, delegate any or all of its functions and powers to:
(a) a Commission Board member; or
(b) the Commission CEO; or
(c) a person who is:
(i) a member of the staff of the Commission; and
(ii) an SES employee or acting SES employee.
Note: The expressions
SES employee andacting SES employee are defined in theActs Interpretation Act 1901 .(2) A delegate must comply with any written directions of the Commission Board.
There is to be a Chief Executive Officer of the Commission.
Note: In this Act,
Commission CEO means the Chief Executive Officer of the Commission—see section 5.
(1) The Commission CEO is responsible for the day‑to‑day administration of the Commission.
(2) The Commission CEO has power to do all things necessary or convenient to be done for or in connection with the performance of his or her duties.
(3) The Commission CEO is to act in accordance with the policies determined, and any directions given, by the Commission Board.
(1) The Commission CEO is to be appointed:
(a) in the case of the first appointment made under this subsection—by the Minister; or
(b) otherwise—by the Commission Board.
(2) If the appointment is covered by paragraph (1)(a), then before the Minister makes the appointment, the Minister must consult each participating State/Territory Health Minister.
(3) If the appointment is covered by paragraph (1)(b), then before the Commission Board makes the appointment:
(a) the Commission Board must consult the Minister; and
(b) the Minister must consult each participating State/Territory Health Minister.
(4) The appointment is to be made by written instrument.
(5) The Commission CEO holds office on a full‑time basis.
(6) The Commission CEO holds office for the period specified in the instrument of appointment. The period must not exceed 5 years.
Note: For re‑appointment, see the
Acts Interpretation Act 1901 .(7) The Commission CEO must not be a Commission Board member.
(1) The Commission Board may appoint a person to act as the Commission CEO:
(a) during a vacancy in the office of the Commission CEO (whether or not an appointment has previously been made to the office); or
(b) during any period, or during all periods, when the Commission CEO:
(i) is absent from duty or from Australia; or
(ii) is, for any reason, unable to perform the duties of the office.
(2) An appointment under subsection (1) is to be made by written instrument.
Note: For rules that apply to acting appointments, see sections 33AB and 33A of the
Acts Interpretation Act 1901 .
(1) The Commission CEO must not engage in paid employment outside the duties of his or her office without the Commission Board Chair’s approval.
(2) The Commission Board Chair must notify the Minister of any approval given under subsection (1).
(1) The Commission CEO is to be paid the remuneration that is determined by the Remuneration Tribunal. If no determination of that remuneration by the Tribunal is in operation, the Commission CEO is to be paid the remuneration that is prescribed by the regulations.
(2) The Commission CEO is to be paid the allowances that are prescribed by the regulations.
(3) This section has effect subject to the
Remuneration Tribunal Act 1973 .
(1) The Commission CEO has the recreation leave entitlements that are determined by the Remuneration Tribunal.
(2) The Commission Board Chair may grant the Commission CEO leave of absence, other than recreation leave, on the terms and conditions as to remuneration or otherwise that the Commission Board Chair determines.
(3) The Commission Board Chair must notify the Minister if the Commission Board Chair grants the Commission CEO leave of absence for a period exceeding 2 months.
(1) A disclosure by the Commission CEO under section 29 of the
Public Governance, Performance and Accountability Act 2013 (which deals with the duty to disclose interests) must be made to the Commission Board.(2) Subsection (1) applies in addition to any rules made for the purposes of that section.
(3) For the purposes of this Act and the
Public Governance, Performance and Accountability Act 2013 , the Commission CEO is taken not to have complied with section 29 of that Act if the Commission CEO does not comply with subsection (1) of this section.
(1) The Commission CEO may resign his or her appointment by giving the Commission Board Chair a written resignation.
(2) The resignation takes effect on the day it is received by the Commission Board Chair or, if a later day is specified in the resignation, on that later day.
(3) If the Commission CEO resigns, the Commission Board Chair must notify the Minister of the resignation.
(1) The Commission Board may terminate the appointment of the Commission CEO for misbehaviour or physical or mental incapacity.
(2) The Commission Board may terminate the appointment of the Commission CEO if the Commission Board is satisfied that the Commission CEO’s performance has been unsatisfactory.
(3) Before the Commission Board terminates the appointment of the Commission CEO under subsection (1) or (2):
(a) the Commission Board must consult the Minister; and
(b) the Minister must consult each participating State/Territory Health Minister.
(4) The Commission Board must terminate the appointment of the Commission CEO if:
(a) the Commission CEO:
(i) becomes bankrupt; or
(ii) applies to take the benefit of any law for the relief of bankrupt or insolvent debtors; or
(iii) compounds with his or her creditors; or
(iv) makes an assignment of his or her remuneration for the benefit of his or her creditors; or
(b) the Commission CEO is absent, except on leave of absence, for 14 consecutive days or for 28 days in any 12 months; or
(c) the Commission CEO fails, without reasonable excuse, to comply with section 29 of the
Public Governance, Performance and Accountability Act 2013 (which deals with the duty to disclose interests) or rules made for the purposes of that section; or(d) the Commission CEO engages, except with the Commission Board Chair’s approval, in paid employment outside the duties of his or her office (see section 40).
(5) If the Commission Board terminates the appointment of the Commission CEO, the Commission Board must notify:
(a) the Minister; and
(b) each participating State/Territory Health Minister;
of the termination.
The Commission CEO holds office on the terms and conditions (if any) in relation to matters not covered by this Act that are determined by the Commission Board.
(1) The staff of the Commission are to be persons engaged under the
Public Service Act 1999 .(2) For the purposes of the
Public Service Act 1999 :
(a) the Commission CEO and the staff of the Commission together constitute a Statutory Agency; and
(b) the Commission CEO is the Head of that Statutory Agency.
The Commission may also be assisted:
(a) by officers and employees of Agencies (within the meaning of the
Public Service Act 1999 ); or(b) by officers and employees of authorities of the Commonwealth; or
(c) by officers and employees of a State or Territory; or
(d) by officers and employees of authorities of a State or Territory;
whose services are made available to the Commission in connection with the performance of any of its functions.
The Commission may engage consultants to assist in the performance of its functions.
(1) The Commission may establish committees to advise or assist it in the performance of its functions.
(2) A committee may be constituted:
(a) wholly by Commission Board members; or
(b) wholly by persons who are not Commission Board members; or
(c) partly by Commission Board members and partly by other persons.
(3) The Commission may determine, in relation to a committee established under this section:
(a) the committee’s terms of reference; and
(b) the terms and conditions of appointment of the members of the committee; and
(c) the procedures to be followed by the committee.
Scope
(1) This section applies if a committee is established under section 50.
Remuneration and allowances
(2) A committee member is to be paid the remuneration that is determined by the Remuneration Tribunal. If no determination of that remuneration by the Tribunal is in operation, the member is to be paid the remuneration that is prescribed by the regulations.
(3) However, a committee member is not entitled to be paid remuneration if he or she holds an office or appointment, or is otherwise employed, on a full‑time basis in the service or employment of:
(a) a State; or
(b) a corporation (a public statutory corporation) that:
(i) is established for a public purpose by a law of a State; and
(ii) is not a tertiary education institution; or
(c) a company limited by guarantee, where the interests and rights of the members in or in relation to the company are beneficially owned by a State; or
(d) a company in which all the stock or shares are beneficially owned by a State or by a public statutory corporation.
Note: A similar rule applies to a committee member who has a similar relationship with the Commonwealth or a Territory. See subsection 7(11) of the
Remuneration Tribunal Act 1973 .(4) A committee member is to be paid the allowances that are prescribed by the regulations.
(5) This section (other than subsection (3)) has effect subject to the
Remuneration Tribunal Act 1973 .
If:
(a) a report about a matter relating to the performance of the Commission’s functions; or
(b) a document setting out information relating to the performance of the Commission’s functions;
is given to the Minister under paragraph 19(1)(b) of the
Public Governance, Performance and Accountability Act 2013 , the Minister may cause the report or document to be published (whether on the internet or otherwise).
The annual report prepared by the Commission Board and given to the Minister under section 46 of the
Public Governance, Performance and Accountability Act 2013 for a period must include:
(a) an assessment of the impact of the performance of each of the Commission’s functions during the period; and
(b) an assessment of:
(i) the safety of health care services provided during the period; and
(ii) the quality of health care services provided during the period.
Work plan
(1) The Commission must prepare a work plan during each financial year and give it to the Minister.
(2) The work plan must set out the Commission’s priorities for work to be undertaken during the next 3 financial years.
(3) As soon as practicable after receiving a work plan under subsection (1), the Minister must give a copy of the work plan to each participating State/Territory Health Minister.
Consultation on draft work plan
(4) Before preparing a work plan under subsection (1) during a financial year, the Commission must:
(a) prepare a draft of the work plan and give it to the Minister; and
(b) do so during the period that starts at the beginning of the financial year and ends:
(i) at the end of 31 October in the financial year; or
(ii) if another day in the financial year is specified in a written instrument made by the Minister—at the end of that other day.
(5) As soon as practicable after receiving a draft work plan under subsection (4), the Minister must:
(a) give a copy of the draft work plan to each participating State/Territory Health Minister; and
(b) invite each participating State/Territory Health Minister to make a written submission to the Commission about the draft work plan within:
(i) 90 days after the invitation is given; or
(ii) if another period is specified in the invitation—that other period.
(6) In preparing a work plan under subsection (1), the Commission must have regard to any submissions made by participating State/Territory Health Ministers under paragraph (5)(b) in relation to the draft of the work plan.
Legislative instrument
(7) An instrument under subparagraph (4)(b)(ii) is not a legislative instrument.
(1) A work plan prepared under section 54 is not a corporate plan for the purposes of section 35 of the
Public Governance, Performance and Accountability Act 2013 .Note: The Commission Board must also prepare a corporate plan under that section.
(2) Subsection 35(3) of the
Public Governance, Performance and Accountability Act 2013 (which deals with the Australian Government’s key priorities and objectives) does not apply to a corporate plan prepared by the Commission Board.
(1) A person commits an offence if:
(a) the person is, or has been, an official of the Commission; and
(b) the person has obtained protected Commission information in the person’s capacity as an official of the Commission; and
(c) the person:
(i) discloses the information to another person; or
(ii) uses the information.
Penalty: Imprisonment for 2 years or 120 penalty units, or both.
Exceptions
(2) Each of the following is an exception to the prohibition in subsection (1):
(a) the disclosure or use is authorised by this Part;
(b) the disclosure or use is in compliance with a requirement under:
(i) a law of the Commonwealth; or
(ii) a prescribed law of a State or a Territory.
Note: A defendant bears an evidential burden in relation to a matter in subsection (2) (see subsection 13.3(3) of the
Criminal Code ).(3) Except where it is necessary to do so for the purposes of giving effect to this Act, a person who is, or has been, an official of the Commission is not to be required:
(a) to produce to a court or tribunal a document containing protected Commission information; or
(b) to disclose protected Commission information to a court or tribunal.
An official of the Commission may disclose or use protected Commission information if:
(a) the disclosure or use is for the purposes of this Act; or
(b) the disclosure or use is for the purposes of the performance of the functions of the Commission under this Act; or
(c) the disclosure or use is in the course of the official’s employment or service as an official of the Commission.
(1) An official of the Commission may disclose protected Commission information to a committee established under section 50.
(2) A person commits an offence if:
(a) the person is a member of a committee established under section 50; and
(b) protected Commission information has been disclosed under subsection (1) to the committee; and
(c) the person:
(i) discloses the information to another person; or
(ii) uses the information.
Penalty: Imprisonment for 2 years or 120 penalty units, or both.
(3) Subsection (2) does not apply if:
(a) the disclosure or use is for the purposes of this Act; or
(b) the disclosure or use is for the purposes of the performance of the functions of the committee under this Act; or
(c) the disclosure or use is in the course of the person’s service as a member of the committee.
Note: A defendant bears an evidential burden in relation to a matter in subsection (3) (see subsection 13.3(3) of the
Criminal Code ).
An official of the Commission may disclose protected Commission information to the Minister.
An official of the Commission may disclose protected Commission information to the Treasurer.
An official of the Commission may disclose protected Commission information to:
(a) the Secretary; or
(b) an APS employee in the Department who is authorised by the Secretary, in writing, for the purposes of this section.
(1) An official of the Commission may disclose protected Commission information to a Royal Commission.
(2) The Commission Board Chair may, by writing, impose conditions to be complied with in relation to protected Commission information disclosed under subsection (1).
(3) An instrument under subsection (2) is not a legislative instrument.
Scope
(1) This section applies if the Commission Board Chair is satisfied that particular protected Commission information will enable or assist any of the following agencies, bodies or persons:
(aa) the Pricing Authority;
(ab) the Administrator;
(ac) the Funding Body;
(b) the Ministerial Council;
(c) Health Chief Executives Forum;
(d) the Australian Institute of Health and Welfare;
(e) the Australian Statistician;
(f) a State/Territory government body that has functions relating to health care;
(g) a professional disciplinary body specified in a legislative instrument made by the Minister;
(h) an agency, person or body specified in a legislative instrument made by the Minister;
to perform or exercise any of the functions or powers of the agency, body or person.
Disclosure
(2) If an official of the Commission is authorised by the Commission Board Chair, in writing, for the purposes of this section, the official may disclose that protected Commission information to the agency, body or person concerned.
(3) If protected Commission information is disclosed under subsection (2) to an agency, body or person, the agency, body or person must not disclose or use the information for a purpose other than the purpose for which the information was given to the agency, body or person.
Scope
(1) This section applies if the Commission Board Chair is satisfied that particular protected Commission information will enable or assist:
(a) the Secretary of the Department administered by the Minister administering the
My Health Records Act 2012 (theMy Health Records Secretary ); or(b) the System Operator (within the meaning of the
My Health Records Act 2012 );to monitor, investigate or enforce compliance with a share by default provision (within the meaning of the
My Health Records Act 2012 ).
Disclosure
(2) If an official of the Commission is authorised by the Commission Board Chair, in writing, for the purposes of this section, the official may disclose that protected Commission information to the My Health Records Secretary or the System Operator.
(3) If protected Commission information is disclosed under subsection (2) to the My Health Records Secretary or the System Operator (the
recipient ), the recipient must not disclose or use the information for a purpose other than the purpose for which the information was given to the recipient.
Scope
(1) This section applies if the Commission Board Chair is satisfied that particular protected Commission information will assist an agency, body or person to conduct research.
Disclosure
(2) If an official of the Commission is authorised by the Commission Board Chair, in writing, for the purposes of this section, the official may disclose that protected Commission information to the agency, body or person concerned.
(3) An official of the Commission must not disclose information under subsection (2) if the information is likely to enable the identification of a particular patient.
An official of the Commission may disclose protected Commission information that relates to the affairs of a person if:
(a) the person has consented to the disclosure; and
(b) the disclosure is in accordance with that consent.
An official of the Commission may disclose protected Commission information if it has already been lawfully made available to the public.
(1) The Commission Board Chair may, by writing, delegate any or all of his or her functions and powers under this Part to the Commission CEO.
(2) A delegate must comply with any written directions of the Commission Board Chair.
To avoid doubt, the Commission CEO is not subject to direction by the Commission Board in relation to the Commission CEO’s performance of functions, or exercise of powers, under the
Public Service Act 1999 , in relation to the Commission.
The Commission is not subject to taxation under any law of the Commonwealth or of a State or Territory.
(1) Compliance with a standard formulated under paragraph 9(1)(e), or a guideline formulated under paragraph 9(1)(f), is voluntary.
(2) Subsection (1) does not prevent compliance with a standard formulated under paragraph 9(1)(e), or a guideline formulated under paragraph 9(1)(f), from being a term or condition of:
(a) a grant; or
(b) a contract or other legally enforceable agreement.
(3) Subsection (1) does not prevent a standard formulated under paragraph 9(1)(e), or a guideline formulated under paragraph 9(1)(f), from being applied or adopted by or under:
(a) a law of a State or Territory; or
(b) a law of the Commonwealth other than this Act.
The following is a simplified outline of this Chapter:
• This Chapter sets up the Independent Health and Aged Care Pricing Authority.
• The main functions of the Independent Health and Aged Care Pricing Authority in relation to public hospitals and health care pricing and costing are as follows:
(a) to determine the national efficient price for health care services provided by public hospitals where the services are funded on an activity basis;
(b) to determine the efficient cost for health care services provided by public hospitals where the services are block funded;
(c) to publish this, and other information, in a report each year for the purpose of informing decision makers in relation to the funding of public hospitals;
(d) if requested by the Minister or the Secretary, to advise the Commonwealth in relation to health care pricing and costing matters.
• The main functions of the Independent Health and Aged Care Pricing Authority in relation to aged care are as follows:
(a) to advise each relevant Commonwealth Minister in relation to aged care pricing and costing matters;
(b) to perform such functions as are conferred on the Independent Health and Aged Care Pricing Authority by the Aged Care Act.
• This Chapter also sets up the following committees to assist the Independent Health and Aged Care Pricing Authority:
(a) the Clinical Advisory Committee;
(b) the Jurisdictional Advisory Committee;
(c) the Aged Care Advisory Committee.
(1) The body known immediately before the commencement of this subsection as the Independent Hospital Pricing Authority is continued in existence with the new name, the Independent Health and Aged Care Pricing Authority.
Note 1: See also section 25B of the
Acts Interpretation Act 1901 .Note 2: In this Act,
Pricing Authority means the Independent Health and Aged Care Pricing Authority—see section 5.(2) In establishing the Pricing Authority, the Parliament intends to give effect to the agreement between the Commonwealth, the States and the Territories to establish a body to give independent and transparent advice in relation to funding for public hospitals.
(3) The Parliament also intends for the body to perform functions relating to:
(a) health care pricing and costing matters; and
(b) aged care matters.
(1) The object of the Pricing Authority is to promote improved efficiency in, and access to, public hospital services by:
(a) providing independent advice to governments in relation to the efficient costs of such services, and
(b) developing and implementing robust systems to support activity based funding for such services.
(2) The object of the Pricing Authority is also to:
(a) on request, give independent advice to the Commonwealth in relation to health care pricing and costing matters; and
(b) give independent advice to the Commonwealth in relation to aged care pricing and costing matters; and
(c) perform other functions conferred on the Pricing Authority by the Aged Care Act or legislative instruments made under that Act.
(1) The Pricing Authority has the following functions:
(a) to determine the national efficient price for health care services provided by public hospitals where the services are funded on an activity basis;
(b) to determine the efficient cost for health care services provided by public hospitals where the services are block funded;
(c) to develop and specify classification systems for health care and other services provided by public hospitals;
(d) to determine adjustments to the national efficient price to reflect legitimate and unavoidable variations in the costs of delivering health care services;
(e) to determine data requirements and data standards to apply in relation to data to be provided by States and Territories, including:
(i) data and coding standards to support uniform provision of data; and
(ii) requirements and standards relating to patient demographic characteristics and other information relevant to classifying, costing and paying for public hospital functions;
(f) except where otherwise agreed between the Commonwealth and a State or Territory—to determine the public hospital functions that are to be funded in the State or Territory by the Commonwealth;
(g) to publish a report setting out the national efficient price for the coming year and any other information that would support the efficient funding of public hospitals;
(h) to advise the Commonwealth, the States and the Territories in relation to funding models for hospitals;
(i) to provide confidential advice to the Commonwealth, the States and the Territories in relation to the costs of providing health care services in the future;
(j) such functions as are conferred on the Pricing Authority by Part 4.3 of this Act (cost‑shifting disputes and cross‑border disputes);
(k) to publish (whether on the internet or otherwise) reports and papers relating to its functions;
(l) to call for and accept, on an annual basis, public submissions in relation to the functions set out in paragraphs (a) to (f);
(m) such functions (if any) as are specified in a written instrument given by the Minister to the Chair of the Pricing Authority with the agreement of the First Ministers’ Council;
(n) to do anything incidental to or conducive to the performance of any of the above functions.
(1A) The Pricing Authority also has the following functions:
(a) if the Minister or the Secretary requests, in writing, the Pricing Authority to do so—to advise the Commonwealth in relation to one or more health care pricing or costing matters (whether or not the matters relate to health care services provided by public hospitals);
(b) to conduct, or arrange for the conduct of, costing and other studies:
(i) for the purpose of performing the function mentioned in paragraph (a); or
(ii) if the Minister or the Secretary requests, in writing, the Pricing Authority to do so;
(c) to publish (whether on the internet or otherwise) reports and papers relating to the functions mentioned in paragraphs (a) and (b);
(d) to do anything incidental to or conducive to the performance of any of the above functions.
(2) The First Ministers’ Council is to give its agreement for the purposes of paragraph (1)(m) by a written resolution of that Council passed in accordance with the procedures determined by that Council.
(3) In performing the functions mentioned in subsection (1), the Pricing Authority must have regard to the following:
(a) relevant expertise and best practice within Australia and internationally;
(b) submissions made at any time by the Commonwealth, a State or a Territory;
(c) the need to ensure:
(i) reasonable access to health care services; and
(ii) safety and quality in the provision of health care services; and
(iii) continuity and predictability in the cost of health care services; and
(iv) the effectiveness, efficiency and financial sustainability of the public hospital system;
(d) the range of public hospitals and the variables affecting the actual cost of providing health care services in each of those hospitals.
(4) A request under paragraph (1A)(a) or subparagraph (1A)(b)(ii) is not a legislative instrument.
(1) The Pricing Authority also has the following functions:
(a) to provide advice to each relevant Commonwealth Minister in relation to one or more aged care pricing or costing matters, including in relation to methods for calculating amounts of subsidies to be paid under the Aged Care Act or the
Aged Care (Transitional Provisions) Act 1997 ;(b) such functions relating to aged care (if any) as are specified in regulations made for the purposes of this paragraph;
(c) to conduct, or arrange for the conduct of, one or more of the following activities for the purpose of performing a function mentioned in paragraph (a) or (b):
(i) the collection and review of data;
(ii) costing and other studies;
(iii) consultations;
(d) to do anything incidental to or conducive to the performance of the above functions;
(e) such functions (an
Aged Care Act function ) as are:
(i) conferred on the Pricing Authority by the Aged Care Act or a legislative instrument made under that Act; or
(ii) specified in regulations made for the purposes of this subparagraph; or
(iii) incidental to or conducive to the performance of the functions mentioned in subparagraph (i) or (ii).
(2) In performing a function mentioned in subsection (1), the Pricing Authority must have regard to:
(a) the objects of the Aged Care Act (as mentioned in section 2‑1 of that Act); and
(b) the objects of the
Aged Care (Transitional Provisions) Act 1997 (as mentioned in section 2‑1 of that Act).
Scope
(1A) This section applies in relation to the functions of the Pricing Authority mentioned in subsection 131(1).
Pricing Authority must have regard to intergovernmental agreements
(1) If an intergovernmental agreement is relevant to the performance of a function of the Pricing Authority, the Pricing Authority must have regard to the agreement in performing the function.
(2) Subsection (1) does not limit the matters to which regard may be had.
Pricing Authority must follow processes in National Health Reform Agreement
(3) Where the National Health Reform Agreement sets out processes to be followed, or conditions or requirements to be met, by the Pricing Authority in performing a function, the Pricing Authority must follow the processes, or meet the conditions or requirements, in performing the function.
(1A) This section applies in relation to the functions of the Pricing Authority mentioned in subsection 131(1).
(1) The First Ministers’ Council may give written policy principles to the Pricing Authority about the performance of the Pricing Authority’s functions.
Note: For variation and revocation, see subsection 33(3) of the
Acts Interpretation Act 1901 .(2) The policy principles are to be given in accordance with a written resolution of the First Ministers’ Council passed in accordance with the procedures determined by that Council.
(3) The Pricing Authority must publish a copy of the policy principles on its website.
(4) The Pricing Authority must not perform its functions in a manner that is inconsistent with the policy principles (if any).
(5) The policy principles are not legislative instruments.
(1) The Pricing Authority may perform its functions only:
(a) with respect to:
(i) the provision of pharmaceutical, sickness or hospital benefits; or
(ii) the provision of medical or dental services; or
(b) with respect to a corporation to which paragraph 51(xx) of the Constitution applies; or
(c) with respect to the granting of financial assistance to a State on such terms and conditions as the Parliament thinks fit; or
(d) with respect to matters that are peculiarly adapted to the government of a nation and that cannot otherwise be carried on for the benefit of the nation; or
(e) with respect to the executive power of the Commonwealth; or
(f) with respect to statistics; or
(g) with respect to, or in, a Territory; or
(h) with respect to, or in, a Commonwealth place (within the meaning of the
Commonwealth Places (Application of Laws) Act 1970 ); or(i) with respect to trade or commerce:
(i) between Australia and places outside Australia; or
(ii) among the States; or
(iii) within a Territory, between a State and a Territory or between 2 Territories; or
(j) with respect to the use of a postal, telegraphic, telephonic or other like service within the meaning of paragraph 51(v) of the Constitution; or
(k) with respect to the provision of a service to:
(i) the Commonwealth; or
(ii) an authority of the Commonwealth;
for a purpose of the Commonwealth; or
(l) with respect to insurance to which paragraph 51(xiv) of the Constitution applies; or
(m) with respect to matters incidental to the execution of any of the legislative powers of the Parliament or the executive power of the Commonwealth.
(2) A term used in this section and the Constitution has the same meaning in this section as it has in the Constitution.
(1) The Pricing Authority has power to do all things necessary or convenient to be done for or in connection with the performance of its functions.
(2) The powers of the Pricing Authority include, but are not limited to, the power to enter into contracts.
The Pricing Authority has the privileges and immunities of the Crown in right of the Commonwealth.
Meaning of cost‑shifting dispute
(1) A
cost‑shifting dispute arises if:
(a) a Health Minister believes that costs to his or her jurisdiction in relation to health care services are attributable to one or more changes that have been made to the policies, programs or practices of another jurisdiction (the
second jurisdiction ); and(b) within 2 months after being requested to do so, the second jurisdiction has not reimbursed those costs.
Meaning of cross‑border dispute
(2) A
cross‑border dispute arises if:
(a) a State/Territory Health Minister believes that:
(i) costs to his or her jurisdiction in relation to health care services are attributable to the provision of public hospital services to residents of another jurisdiction (the
second jurisdiction ); and(ii) an intergovernmental agreement, or an agreement between States or States and Territories, provides for those costs to be reimbursed, wholly or partly, by the second jurisdiction; and
(b) after being requested to do so, the second jurisdiction has not reimbursed those costs:
(i) within 2 months after the jurisdictions agree on the number of health care services involved; or
(ii) within 6 months after the last of those services was provided.
Request for assessment
(1) A Health Minister may request the Pricing Authority to make an assessment about a cost‑shifting dispute between his or her jurisdiction (the
first jurisdiction ) and another jurisdiction (thesecond jurisdiction ).(2) The request must be:
(a) in writing; and
(b) accompanied by a written submission in support of the request.
(3) The Pricing Authority must investigate the dispute if it is satisfied that the jurisdictions have:
(a) complied with any relevant requirements set out in intergovernmental agreements, or agreements between States or States and Territories; and
(b) made other reasonable efforts to resolve the dispute.
(4) As soon as practicable after starting to investigate the dispute, the Pricing Authority must give the Health Minister of the second jurisdiction:
(a) the following in writing:
(i) notice of the request;
(ii) an invitation to make a written submission to the Pricing Authority about the dispute within 60 days after receiving the invitation; and
(b) a copy of the submission that accompanied the request.
(5) Following the investigation, the Pricing Authority must:
(a) prepare a draft assessment and give them to the Health Ministers; and
(b) invite the Health Ministers to give the Pricing Authority written comments on the draft assessment within 30 days after receiving them.
The draft assessment must be accompanied by a copy of any submissions received by the Pricing Authority.
Final assessment
(6) The Pricing Authority must prepare a final assessment and give it to the Health Ministers.
(7) If the assessment is that costs to the first jurisdiction in relation to health care services are attributable to one or more changes that have been made to the policies, programs or practices of the second jurisdiction, the Pricing Authority must publish the final assessment on the Pricing Authority’s website.
Request for recommendations
(1) A Health Minister may request the Pricing Authority to make recommendations about a cross‑border dispute between his or her jurisdiction and another jurisdiction.
(2) The request must be:
(a) in writing; and
(b) accompanied by a written submission in support of the request.
(3) The Pricing Authority must investigate the dispute if it is satisfied that the jurisdictions have:
(a) complied with any relevant requirements set out in intergovernmental agreements, or agreements between States or States and Territories; and
(b) made other reasonable efforts to resolve the dispute.
(4) As soon as practicable after starting to investigate the dispute, the Pricing Authority must give the Health Minister of the other jurisdiction:
(a) the following in writing:
(i) notice of the request;
(ii) an invitation to make a written submission to the Pricing Authority about the dispute within 60 days after receiving the invitation; and
(b) a copy of the submission that accompanied the request.
(5) Following the investigation, the Pricing Authority must:
(a) prepare draft recommendations and give them to the Health Ministers; and
(b) invite the Health Ministers to give the Pricing Authority written comments on the draft recommendations within 30 days after receiving them.
Final recommendations
(6) The Pricing Authority must prepare final recommendations and give them to the Health Ministers.
The Pricing Authority may advise the Commonwealth of adjustments to the Commonwealth’s funding in relation to health care services that would be necessary to give effect to final recommendations in relation to a cross‑border dispute if:
(a) 3 months have passed since the recommendations were given; and
(b) the recommendations have not been compiled with; and
(c) the Health Minister who requested the recommendations requests the advice to be given.
(1) The Pricing Authority:
(a) is a body corporate with perpetual succession; and
(b) must have a seal; and
(c) may acquire, hold and dispose of real and personal property; and
(d) may sue and be sued in its corporate name.
(2) The seal of the Pricing Authority is to be kept in such custody as the Pricing Authority directs and must not be used except as authorised by the Pricing Authority.
(3) All courts, judges and persons acting judicially must:
(a) take judicial notice of the imprint of the seal of the Pricing Authority appearing on a document; and
(b) presume that the document was duly sealed.
The Pricing Authority consists of the following members:
(a) a Chair;
(b) a Deputy Chair (Hospital Pricing);
(ba) a Deputy Chair (Aged Care Pricing);
(c) 6 other members.
Note: In this Act,
member of the Pricing Authority includes the Chair of the Pricing Authority and each Deputy Chair of the Pricing Authority—see section 5.
(1) Each member of the Pricing Authority is to be appointed by the Minister by written instrument.
Note: The member of the Pricing Authority is eligible for reappointment: see the
Acts Interpretation Act 1901 .(2) The Deputy Chair (Hospital Pricing) is to be appointed with the agreement of the Premiers of:
(a) the States; and
(b) the Australian Capital Territory; and
(c) the Northern Territory.
(3) A member of the Pricing Authority (other than the Chair or a Deputy Chair) is to be appointed with the agreement of:
(a) the Prime Minister; and
(b) the Premiers of:
(i) the States; and
(ii) the Australian Capital Territory; and
(iii) the Northern Territory.
(3A) The Minister must ensure that the Deputy Chair (Hospital Pricing) and at least one other member of the Pricing Authority have:
(a) substantial experience or knowledge; and
(b) significant standing;
in either or both of the following fields:
(c) public hospital strategic leadership or operational management;
(d) public hospital pricing and costing.
(3B) The Minister must ensure that the Deputy Chair (Aged Care Pricing) and at least one other member of the Pricing Authority have:
(a) substantial experience or knowledge; and
(b) significant standing;
in either or both of the following fields:
(c) aged care strategic leadership or operational management;
(d) aged care pricing and costing.
(4) The Minister must ensure that at least one member of the Pricing Authority has:
(a) substantial experience or knowledge; and
(b) significant standing;
in the following fields:
(c) the health care needs of people living in regional or rural areas;
(d) the provision of health care services in regional or rural areas.
(5) A member of the Pricing Authority may hold office on either a full‑time or a part‑time basis.
A member of the Pricing Authority holds office for the period specified in the instrument of appointment. The period must not exceed 5 years.
Note: For reappointment, see the
Acts Interpretation Act 1901 .
Acting Chair of the Pricing Authority
(1) The Minister may appoint a person to act as the Chair of the Pricing Authority:
(a) during a vacancy in the office of the Chair of the Pricing Authority (whether or not an appointment has previously been made to the office); or
(b) during any period, or during all periods, when the Chair of the Pricing Authority:
(i) is absent from duty or Australia; or
(ii) is, for any reason, unable to perform the duties of the office.
Acting Deputy Chair (Hospital Pricing) of the Pricing Authority
(2) The Minister may appoint a person to act as the Deputy Chair (Hospital Pricing) of the Pricing Authority:
(a) during a vacancy in the office of the Deputy Chair (Hospital Pricing) of the Pricing Authority (whether or not an appointment has previously been made to the office); or
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s. 263......................................... | ad. No. 62, 2012 |
s. 264......................................... | ad. No. 62, 2012 |
s. 265......................................... | ad. No. 62, 2012 |
s. 266......................................... | ad. No. 62, 2012 |
Division 4 heading...................... | ad. No. 62, 2014 |
s. 267......................................... | ad. No. 62, 2012 |
rs No 62, 2014 | |
s 267A....................................... | ad No 62, 2014 |
s 268.......................................... | ad No 62, 2012 |
am No 54, 2024 | |
s. 269......................................... | ad. No. 62, 2012 |
s. 270......................................... | ad. No. 62, 2012 |
s. 271......................................... | ad. No. 62, 2012 |
s. 272......................................... | ad. No. 62, 2012 |
s. 273......................................... | ad. No. 62, 2012 |
s. 274......................................... | ad. No. 62, 2012 |
s 275.......................................... | ad No 62, 2012 |
am No 55, 2016; No 54, 2024 | |
s. 276......................................... | ad. No. 62, 2012 |
s. 277......................................... | ad. No. 62, 2012 |
s. 278......................................... | ad. No. 62, 2012 |
Chapter 6................................... | ad. No. 62, 2012 |
s 279.......................................... | ad No 62, 2012 |
am No 55, 2016; No 34, 2022 | |
s. 280......................................... | ad. No. 62, 2012 |
s. 281......................................... | ad. No. 62, 2012 |
rep No 62, 2014 | |
s 282.......................................... | ad No 62, 2012 |
am No 54, 2024 |
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