National Health Amendment Regulations 1999 (No. 7) 1999 No. 288
EXPLANATORY STATEMENT
STATUTORY RULES 1999 No. 288
Issued by Authority of the Minister for Health and Aged Care
National Health Act 1953
National Health Amendment Regulations 1999 (No. 7)
Section 140 of the National Health Act 1953 (the Act) provides that the Governor-General may make Regulations for the purposes of the Act.
Subsection 140(2) of the Act makes provision to preclude or modify, by regulation, a specified provision of the Act relating to an applicable benefits arrangement, for a specified registered health benefits organisation. This provision has been used to permit pilot or demonstration schemes which could lead to an enhancement of the health insurance industry.
Regulation 4B of the National Health Regulations modifies the operation of the Act in relation to applicable benefits arrangements provided for specified registered health benefits organisations participating in the programs. In other words, it allows for patients to be paid health insurance benefits for hospital type treatment rendered to them in community settings.
The Amending Regulations amend regulation 4B to:
* modify the hospital participating in the Hospital-to-Home Trial from Ashford Community Hospital Incorporated to Adelaide Community Healthcare Alliance. This reflects a change in name following the merger of Ashford Community Hospital with Western Community Hospital to form the new Adelaide Community Healthcare Alliance (Schedule 1); and
* extend the arrangements to include a further trial, the Victorian Psychiatric Patient Trial, to 30 September 2000. This trial allows private psychiatric patients, currently utilising inpatient services, with a history of frequent admissions and those patients who have previously had frequent admissions to benefit from a continuum of care using a case management approach to reduce the length of stay in hospital, the number of admitted patients and the number of readmissions for psychiatric services (Schedule 2).
Details of the Amending Regulations are set out in the Attachment.
Amending Regulations 1, 2 and 3 and Schedule 1 commenced on 1 November 1999, the day on which the merger took place. The retrospective commencement of these provisions does not disadvantage any person. On the contrary, had these amendments not been made retrospective patients participating in the trial may have been disadvantaged in that the participating funds would not be legally permitted to pay health insurance benefits.
The remaining regulations commenced on gazettal.
ATTACHMENT
NOTES ON CLAUSES
Regulation 1 provides that the Regulations may be cited as the National Health Amendment
Regulations 1999 (No. 7).
Regulation 2 provides that Regulations 1, 2 and 3 and Schedule 1. commenced on 1 November 1999
and the remainder commence on gazettal.
Regulation 3 provides that the National Health Regulations 1954 are amended by Schedule 1.
Item 1 of Schedule 1 substitutes, under Schedule 3, Part 5 the heading Modification of section 5A for Hospital-to-Home Trial (Adelaide Community Healthcare Alliance).
Item 2 of Schedule 1 omits Ashford Community Hospital Incorporated and inserts Adelaide Community Healthcare Alliance.
Item 1 of Schedule 2 inserts a new subregulation 5A(1) which specifies the funds participating in the Victorian Psychiatric Patient Trial and provides that they are affected by the modifications to subsections 5A(1) and (3) of the Act that are set out in Part 6 of Schedule 3 until 30 September 2000.
Item 2 of Schedule 2 inserts a new subregulation 4B(9) which specifies the time limits for the Victorian Psychiatric Patient Trial.
Item of Schedule 2 inserts a new Part 6 into Schedule of the Regulations. New Part 6 outlines the modifications to section 5A of the Act in respect of the funds participating in the Victorian Psychiatric Patient Trial and defines some of the key terms used in those modifications.
Overview
The National Health Amendment Regulations 1999 (No. 7) were enacted to address specific operational modifications within the National Health Act 1953, allowing for the enhancement of health insurance industry practices. The Regulations were issued by authority of the Minister for Health and Aged Care and were aimed at ensuring that the legislative framework could accommodate changes in healthcare delivery models, such as the trial of hospital-to-home treatment and psychiatric patient care continuity. These amendments were designed to streamline the administration of health benefits and to enable the trials that could potentially lead to improved patient outcomes and efficiency within the health system. The policy objective was to facilitate pilot and demonstration schemes that could benefit the broader health insurance industry and improve patient care through innovative healthcare delivery methods.
Scope and Application
The National Health Amendment Regulations 1999 (No. 7) are subordinate legislation made under section 140 of the National Health Act 1953, which empowers the Governor-General to make regulations for the purposes of the Act. These regulations primarily modify the National Health Regulations 1954 by updating the hospital participating in the Hospital-to-Home Trial from Ashford Community Hospital Incorporated to Adelaide Community Healthcare Alliance, reflecting a recent merger, and extending the arrangements to include the Victorian Psychiatric Patient Trial until 30 September 2000. This extension allows for a continuum of care using a case management approach for private psychiatric patients with a history of frequent admissions, aiming to reduce hospital stays and readmissions. The application of these regulations is targeted at registered health benefits organisations participating in the specified trials and applies across the Commonwealth of Australia. The regulations commenced on different dates, with certain provisions made retrospective to 1 November 1999 to ensure continuity and legal compliance for the trials.
Key Provisions
The National Health Amendment Regulations 1999 (No. 7) introduce significant modifications to the National Health Regulations 1954, as authorised by section 140 of the National Health Act 1953. Regulation 4B, which pertains to applicable benefits arrangements, is specifically amended to update the entity participating in the Hospital-to-Home Trial from Ashford Community Hospital Incorporated to Adelaide Community Healthcare Alliance, reflecting the merger that formed the latter entity (Regulation 3 and Schedule 1). Additionally, a new trial, the Victorian Psychiatric Patient Trial, is introduced and set to run until 30 September 2000 (Schedule 2). This trial aims to benefit private psychiatric patients who have a history of frequent admissions, by providing a continuum of care through a case management approach to reduce hospital stays and readmissions.
The Amending Regulations impose specific obligations on the registered health benefits organisations participating in these trials. These organisations must comply with the modified arrangements as outlined in the Regulations, ensuring that they are legally permitted to pay health insurance benefits to patients under these new trials. For the Hospital-to-Home Trial, the Adelaide Community Healthcare Alliance must now operate under the updated name, reflecting the merger. Similarly, the participating funds in the Victorian Psychiatric Patient Trial must adhere to the new provisions, which include modifications to the applicable benefits arrangements and the specified time limits for the trial.
Failure to comply with the provisions of the Amending Regulations may result in legal consequences. Although the specific offences, penalties, or civil/criminal consequences are not detailed in the explanatory statement, breaches of regulations under the National Health Act 1953 can generally lead to enforcement actions by the Minister for Health and Aged Care. This may include fines, corrective orders, or other administrative measures. The severity of the penalties would depend on the nature and extent of the breach, but they are intended to ensure adherence to the regulatory framework governing health benefits arrangements.