EXPLANATORY STATEMENT
Statutory Rules 1985 No. 86
SUBJECT: NATIONAL HEALTH ACT 1953
NATIONAL HEALTH REGULATIONS (AMENDMENT)
(Issued by Authority of the Minister for Community Services, Senator the Hon Don Grimes.)
Regulation 29 of the National Health Regulations (the Regulations) was made pursuant to section 140 of the National Health Act 1953 (the Act).
Sub-section 47(2) of the Act provides that where a qualified nursing home patient is receiving nursing home care in a non-Government nursing home, the amount of Commonwealth benefit payable under sub-section 47(1) is reduced by the amount that the fees charged in respect of the nursing home care of that patient for that day are exceeded by the sum of-
• the amount of Commonwealth benefit otherwise payable under sub-section 47(1) (sub-paragraph 47(2)(b)(i));
• the amount (if any) of Commonwealth extensive care benefit (sub-paragraph 47(2)(b)(ii)); and
• $6.70, or the amount prescribed (sub-paragraph 47(2)(b)(iii)).
In effect, sub-paragraph 47(2)(b)(iii) of the Act prescribes the minimum rate of daily patient contribution that a qualified nursing home patient who is accommodated in an approved non-Government nursing homes is required to contribute towards his or her care and treatment. The rate of $12.75 is prescribed by regulation 29 of the Regulations.
Since 1978, and until 1 November 1984, the rate of the patient contribution prescribed by regulation 29 was maintained at a level equivalent to 87.5% of the sum of the maximum standard rate of pension and supplementary (rent) assistance payable under the Social Security Act 1947. On 1 November 1984, the minimum rate of daily patient contribution was increased by 35 cents a day, a rate which was 60 cents per day less than the increase which would have occurred through the application of the 87.5% formula.
The rate of patient contribution has been reviewed following the increase in pension rates which became effective on 2 May 1985. The patient contribution rate will increase to restore the 87.5% rate.
The regulations will increase the rate of patient contribution to the new level.
The regulations will come into operation on 13 June 1985, which is the earliest practicable date for their commencement.
Overview
The National Health Act 1953 was enacted by the Commonwealth Parliament to provide for the administration of national health services and the provision of health benefits to the Australian population. A significant aspect of this Act is the regulation of patient contributions towards their care in non-Government nursing homes, as detailed in the National Health Regulations. These regulations, including amendments such as those issued under Statutory Rules 1985 No. 86, aim to ensure that the contribution made by qualified nursing home patients remains equitable with changes in social security benefits. Specifically, the 1985 amendment adjusted the patient contribution rate to reflect an increase in pension rates, maintaining the contribution at a level equivalent to 87.5% of the maximum standard rate of pension and supplementary assistance. This legislative framework seeks to balance the financial responsibilities of patients with the provision of necessary health care services.
Scope and Application
The National Health Regulations (Amendment) pertains to the National Health Act 1953, impacting qualified nursing home patients who receive care in non-Government nursing homes. The Act reduces the amount of Commonwealth benefit payable for these patients by the difference between the fees charged and the sum of the Commonwealth benefit, any Commonwealth extensive care benefit, and a specified minimum daily patient contribution. This amendment to Regulation 29 adjusts the prescribed minimum daily patient contribution to ensure it aligns with 87.5% of the maximum standard rate of pension and supplementary assistance, reflecting the recent increase in pension rates as of 2 May 1985. These regulations apply across Australia, affecting both individuals receiving nursing care and the nursing homes providing such care. The amendments are designed to ensure that the financial burden on qualified patients is adjusted in line with changes in pension rates, thus maintaining the integrity of the benefit structure established under the Act.
Key Provisions
The primary sections relevant to the amendments in the National Health Regulations pertain to the adjustment of the patient contribution rates under section 47(2)(b)(iii) of the National Health Act 1953. This section specifies the minimum daily contribution required from qualified nursing home patients who are accommodated in approved non-Government nursing homes. Under sub-section 47(2)(b)(iii), the Act currently mandates a patient contribution of $6.70 per day, which will be adjusted as per the new regulations. Regulation 29, which was amended to set this rate, now prescribes a higher rate to be effective from 13 June 1985. This adjustment is intended to restore the contribution rate to 87.5% of the sum of the maximum standard rate of pension and supplementary (rent) assistance payable under the Social Security Act 1947, following recent increases in pension rates.
The National Health Regulations impose specific obligations on the parties involved. Non-Government nursing homes must adhere to the new patient contribution rate set forth in Regulation 29, ensuring that qualified nursing home patients are billed according to the prescribed amount. Additionally, the regulations mandate that these nursing homes must provide transparent billing and inform patients about the contributions they are required to make towards their care and treatment. This transparency ensures that patients are aware of their financial obligations and the basis for these charges.
In terms of compliance, the National Health Regulations include provisions for penalties and consequences for non-compliance. Nursing homes that fail to adhere to the new patient contribution rates may face administrative sanctions. These could include fines or other financial penalties imposed by the relevant authorities. Furthermore, persistent non-compliance could lead to more severe consequences such as the suspension of accreditation or other regulatory actions. The precise penalties are determined by the relevant regulatory bodies in accordance with the specific laws governing the enforcement of the National Health Act.