South Australian Health Commission (Compensable and Non-Medicare Patients Fees) Variation Regulations 2008 (SA)

South Australia

South Australian Health Commission (Compensable and Non-Medicare Patients Fees) Variation Regulations 2008

under the South Australian Health Commission Act 1976

Contents

Part 1—Preliminary

1. Short title

2. Commencement

3. Variation provisions

Part 2—Variation of South Australian Health Commission (Compensable and Non-Medicare Patients Fees) Regulations 2004

1. Variation of Schedule 1—Recognised hospitals: fees for admitted patients

2. Variation of Schedule 2—Recognised hospitals: fees for non‑admitted patients

3. Variation of Schedule 3—Recognised hospitals and incorporated health centres: accommodation, rehabilitation, domiciliary care, transportation and related fees

4. Substitution of Schedule 4

   Schedule 4—Classification of recognised hospitals

Schedule 1—Transitional provisions

1. Interpretation

2. Transitional provisions

Part 1—Preliminary

1—Short title

These regulations may be cited as the South Australian Health Commission (Compensable and Non-Medicare Patients Fees) Variation Regulations 2008.

2—Commencement

These regulations will come into operation on 1 March 2008.

3—Variation provisions

In these regulations, a provision under a heading referring to the variation of specified regulations varies the regulations so specified.

Part 2—Variation of South Australian Health Commission (Compensable and Non-Medicare Patients Fees) Regulations 2004

4—Variation of Schedule 1—Recognised hospitals: fees for admitted patients

1. Schedule 1, clause 1(1), definitions of FFS, inlier patient, length of stay, long stay outlier patient—delete the definitions

2. Schedule 1, clause 1(1), definitions of Non‑FFS and overnight stay—delete the definitions and substitute:

   Manual means the Australian Refined Diagnosis Related Groups, Version 5.0, Definitions Manual, published in 2002 by the Commonwealth Department of Health and Ageing;

   non‑teaching, in relation to a hospital, means a recognised hospital or a facility of a recognised hospital listed in the first column of the table in Schedule 4 whose classification in relation to the provision of services to admitted patients is specified in the fourth column of the table as Non‑teaching;

3. Schedule 1, clause 1(1), definitions of same day and the Manual—delete the definitions and substitute:

   teaching, in relation to a hospital, means a recognised hospital or a facility of a recognised hospital listed in the first column of the table in Schedule 4 whose classification in relation to the provision of services to admitted patients is specified in the fourth column of the table as Teaching.

4. Schedule 1, clause 2—delete "2004" and substitute:

   2006

5. Schedule 1, clauses 3 and 4—delete the clauses and substitute:

   3—Standard fee for admitted patients

   Subject to this Schedule, the fee to be charged by a recognised hospital for a period of treatment, care and accommodation of an admitted patient to whom an AR‑DRG specified in the first and second columns of Table 3 in this Schedule is applicable must be calculated as follows:

   Fee = Price x Cost Weight

   where—

   (a)the Price is the price specified in the second column of Table 1 in this Schedule according to the hospital classification (teaching or non‑teaching) specified in the first column of the Table; and

   (b)the Cost Weight is the cost weight specified in the third, fourth, fifth or sixth column of Table 3 in this Schedule according to the hospital classification (teaching or non‑teaching) and patient classification (public or private) specified in those columns for the AR‑DRG applicable to the patient.

6. Schedule 1, clause 5—delete "clauses 3 and 4" and substitute:

   clause 3

7. Schedule 1, clause 5(a)—delete paragraph (a) and substitute:

   (a)the Price is the price specified in the third or fourth column of Table 2 in this Schedule according to the hospital classification (teaching or non‑teaching) specified in those columns, the patient classification (public or private) specified in the first column and the type of treatment or care specified in the second column, of the Table; and

8. Schedule 1, clause 7—delete "$1 475" and substitute:

   $1 749

9. Schedule 1, clause 9, tables 1, 2 and 3—delete the tables and substitute:

   Table 1: Prices

Hospital Classification	Price
Teaching Hospital	$4 785
Non‑teaching Hospital	$3 272

Table 2: Rehabilitation and Maintenance Care Fees

Public or Private Patient	Type of Treatment	Price (per day)
		Teaching Hospital	Non‑teaching Hospital
Public	Maintenance care	$233	$233
Private	Maintenance care	$229	$229
Public	Rehabilitation—Spinal	$1 280	$1 176
Private	Rehabilitation—Spinal	$1 184	$1 088
Public	Rehabilitation—Stroke, Acquired Brain Injury, Amputee	$747	$686
Private	Rehabilitation—Stroke, Acquired Brain Injury, Amputee	$691	$635
Public	Rehabilitation—Other	$535	$491
Private	Rehabilitation—Other	$495	$454

Table 3: Cost Weight Table for All Recognised Hospitals

5—Variation of Schedule 2—Recognised hospitals: fees for non‑admitted patients

1. Schedule 2, clause 2(1)(a)—delete paragraph (a) and substitute:

   (a)the ED Price is the price specified in the second or third column of Table 1 in this Schedule (according to the classification of the patient as public or private) for an emergency department service; and

2. Schedule 2, clause 2(2)(a)—delete paragraph (a) and substitute:

   (a)the ED Price is the price specified in the second or third column of Table 1 in this Schedule (according to the classification of the patient as public or private) for an emergency department service; and

3. Schedule 2, clause 3(a)—delete paragraph (a) and substitute:

   (a)the OP Price is the price specified in the second or third column of Table 1 in this Schedule (according to the classification of the patient as public or private) for an outpatient service; and

4. Schedule 2, clause 4(a)—delete paragraph (a) and substitute:

   (a)the OP Price is the price specified in the second or third column of Table 1 in this Schedule (according to the classification of the patient as public or private) for an outpatient service; and

5. Schedule 2, clause 5(a)—delete paragraph (a) and substitute:

   (a)the Outreach Price is the price specified in the second or third column of Table 1 in this Schedule (according to the classification of the patient as public or private) for an outreach service; and

6. Schedule 2, clause 6(a)—delete "$475" and substitute:

   $627.20

7. Schedule 2, clause 6(b)—delete "$19" and substitute:

   $24.60

8. Schedule 2, clause 7—delete "$1 475" and substitute:

   $1 749

9. Schedule 2, clause 9, Table 1—delete the table and substitute:

   Table 1: Non‑admitted Patient Prices

Type of Service	Price
	Public Patient		Private Patient
Emergency Department	$198		$147
Outpatient	$159		$79
Outreach	$153		$77

1. Schedule 2, clause 9, Table 3—delete the table and substitute:

   Table 3: Outpatient (OP) Weights

6—Variation of Schedule 3—Recognised hospitals and incorporated health centres: accommodation, rehabilitation, domiciliary care, transportation and related fees

Schedule 3, clause 3—delete the clause

7—Substitution of Schedule 4

Schedule 4—delete the Schedule and substitute:

Schedule 4—Classification of recognised hospitals

Hospital classifications for emergency department (ED) services, outpatient (OP) services and services to admitted patients

Recognised hospital or facility	ED type	OP type	Admitted Type
Central Northern Adelaide Health Service Incorporated (CNA)
•      CNA Crammond Clinic facility	Teaching	Teaching	Non-teaching
•      CNA Hampstead Rehabilitation facility	Teaching	Teaching	Non-teaching
•      CNA Lyell McEwin Health Service facility	Teaching	Teaching	Non-teaching
•      CNA Royal Adelaide Hospital facility	Teaching	Teaching	Teaching
•      CNA St Margaret's Rehabilitation Hospital facility	Other Metro	Other Metro	Non-teaching
•      CNA The Queen Elizabeth Hospital facility	Teaching	Teaching	Teaching
•      CNA Modbury Hospital facility	Teaching	Teaching	Non-teaching
Children, Youth and Women's Health Service Incorporated (CYW)
•      CYW Women's and Children's Hospital facility (Paediatric)	Specialist	Specialist	Teaching
•      CYW Women's and Children's Hospital facility (Women's)	Other Metro	Teaching	Teaching
Gawler Health Service Incorporated	Other Country	Large Country	Non-teaching
Repatriation General Hospital Incorporated	Other Metro	Teaching	Non-teaching
Southern Adelaide Health Service Incorporated (SAdel)
•      SAdel Flinders Medical Centre facility	Teaching	Teaching	Teaching
•      SAdel Noarlunga Health Service facility	Other Metro	Other Metro	Non-teaching
Balaklava and Riverton Districts Health Service Incorporated	Other Country	Other Country	Non-teaching
Barossa Area Health Services Incorporated	Other Country	Other Country	Non-teaching
Booleroo Centre District Hospital and Health Services Incorporated	Other Country	Other Country	Non-teaching
Bordertown Memorial Hospital Incorporated	Other Country	Other Country	Non-teaching
Burra Clare Snowtown Health Service Incorporated	Other Country	Other Country	Non-teaching
Ceduna District Health Services Incorporated	Other Country	Other Country	Non-teaching
Central Yorke Peninsula Hospital Incorporated	Other Country	Other Country	Non-teaching
Coober Pedy Hospital and Health Services	Other Country	Other Country	Non-teaching
Crystal Brook District Hospital Incorporated	Other Country	Other Country	Non-teaching
Eastern Eyre Health and Aged Care Incorporated	Other Country	Other Country	Non-teaching
Eudunda and Kapunda Health Service Incorporated	Other Country	Other Country	Non-teaching
Hawker Memorial Hospital Incorporated	Other Country	Other Country	Non-teaching
Kangaroo Island Health Service	Other Country	Other Country	Non-teaching
Kingston Soldiers Memorial Hospital Incorporated	Other Country	Other Country	Non-teaching
Leigh Creek Health Services Incorporated	Other Country	Other Country	Non-teaching
Lower Eyre Health Services Incorporated	Other Country	Other Country	Non-teaching
Loxton Hospital Complex Incorporated	Other Country	Other Country	Non-teaching
Mallee Health Service Incorporated	Other Country	Other Country	Non-teaching
Meningie & Districts Memorial Hospital and Health Service Incorp.	Other Country	Other Country	Non-teaching
Mid-west Health	Other Country	Other Country	Non-teaching
Millicent and District Hospital and Health Services Incorporated	Other Country	Other Country	Non-teaching
Mt Barker District Soldiers' Memorial Hospital Incorporated	Other Country	Other Country	Non-teaching
Mt Gambier and Districts Health Service Incorporated	Country A&E SMO	Large Country	Non-teaching
Murray Bridge Soldiers' Memorial Hospital Incorporated	Other Country	Other Country	Non-teaching
Naracoorte Health Service Incorporated	Other Country	Other Country	Non-teaching
Northern Adelaide Hills Health Service Incorporated	Other Country	Other Country	Non-teaching
Northern Yorke Peninsula Health Service	Other Country	Other Country	Non-teaching
Orroroo and District Health Service Incorporated	Other Country	Other Country	Non-teaching
Penola War Memorial Hospital Incorporated	Other Country	Other Country	Non-teaching
Peterborough Soldiers' Memorial Hospital and Health Service Incorp.	Other Country	Other Country	Non-teaching
Pt Augusta Hospital and Regional Health Services Incorporated	Large Country	Large Country	Non-teaching
Pt Broughton District Hospital & Health Services Incorporated	Other Country	Other Country	Non-teaching
Pt Lincoln Health Services Incorporated	Other Country	Other Country	Non-teaching
Pt Pirie Regional Health Service Incorporated	Large Country	Large Country	Non-teaching
Quorn Health Services Incorporated	Other Country	Other Country	Non-teaching
Renmark Paringa District Hospital Incorporated	Other Country	Other Country	Non-teaching
Riverland Regional Health Service Incorporated	Other Country	Other Country	Non-teaching
Rocky River Health Service Incorporated	Other Country	Other Country	Non-teaching
South Coast District Hospital Incorporated	Other Country	Other Country	Non-teaching
Southern Yorke Peninsula Health Service Incorporated	Other Country	Other Country	Non-teaching
Strathalbyn & District Health Service	Other Country	Other Country	Non-teaching
Tailem Bend District Hospital	Other Country	Other Country	Non-teaching
The Jamestown Hospital and Health Service Incorporated	Other Country	Other Country	Non-teaching
The Mannum District Hospital Incorporated	Other Country	Other Country	Non-teaching
The Whyalla Hospital & Health Service Incorporated	Large Country	Large Country	Non-teaching
Waikerie Health Services Incorporated	Other Country	Other Country	Non-teaching

Schedule 1—Transitional provisions

1—Interpretation

In this Schedule, unless the contrary intention appears—

principal regulations means the South Australian Health Commission (Compensable and Non-Medicare Patients Fees) Regulations 2004.

2—Transitional provisions

1. Despite regulation 4 of these regulations, the fees prescribed for a period of treatment, care and accommodation of an admitted patient of a recognised hospital for a specified AR‑DRG, by Schedule 1 of the principal regulations, as in force immediately before the commencement of these regulations, continue to apply to such a period of treatment, care and accommodation after the commencement of these regulations if the period began before, and continues after, that commencement.

2. For the purpose of calculating the fee for a period of rehabilitation or maintenance care for an admitted patient of a recognised hospital under Schedule 1 of the principal regulations where the period began before the commencement of these regulations and continues after that commencement—

   (a)clause 5 of Schedule 1 as in force immediately before the commencement of these regulations applies to the portion of the length of stay (LOS) of the patient that occurs before that commencement; and

   (b)clause 5 of Schedule 1 as in force after the commencement of these regulations applies to the portion of the length of stay (LOS) of the patient that occurs after that commencement.

Note—

As required by section 10AA(2) of the Subordinate Legislation Act 1978, the Minister has certified that, in the Minister's opinion, it is necessary or appropriate that these regulations come into operation as set out in these regulations.

Made by the Governor

on the recommendation of the Minister for Health and with the advice and consent of the Executive Council

on 14 February 2008

No 15 of 2008

HEACS/07/196