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Hospital Circular 19/2001

Date Issued: 31 October 2001
Publication: 19/2001
Distribution: Subscribers (Acute Health Circular 7/2001 refers)
Attention: Public Hospitals, Extended Care Centres, Metropolitan Health Services, Regional Offices
Enquiries: Regional Office
Subjects:

  1. Surgically Implanted Prostheses Items:
    1. Default supply charge
    2. Amendments to the August 2001 schedule 5
    3. Application forms for new items Application forms for new items to be included in the February 2002 Schedule 5
  2. Nursing Home Type Patients (NHTPs) in public hospitals - change in Default Benefits and Patient Contribution
  3. Administrative items

1. SURGICALLY IMPLANTED PROSTHESES ITEMS

  1. Hospital Supply Charge

    See Commonwealth HBF Circular 723 and its attachments (including the Schedule 5 determination).

    Key points include: The definition of the supply charge is defined as a charge made by the hospital for the purposes of covering costs in relation to instrument kit hire, account processing, associated item storage, and freight only. The Commonwealth Department of Health and Aged Care (DHAC) has set a default supply charge where there is no other written agreement in place as to the amount of the supply charge.

    The default supply charge is 5% of the agreed fee or charge that is payable on all prostheses items by all health funds for private patients in both private and public hospitals. If an agreement exists between the hospitals and a health fund, the supply charge must not exceed 10% of the fee or charge agreed. (Refer the Schedule 5 determination for details).

    The 5% supply charge will be in place for one year from 31 July 2001 with the expectation that contracts will be renegotiated to take into account any agreed costs associated with the supply of prostheses before 20 June 2002. DHAC's expectation is that industry will honour the effective date from DHAC's advice to industry on 6 July 2001. DHAC recommends this would be an appropriate approach to honouring any earlier supply costs incurred by hospitals.

    Note that Commonwealth HBF Circular 723 (and attachments) also includes matters such as no gaps for patients, prostheses billing codes, and the Report from the Private Health Industry Medical Devices Expert Committee, dated 7 June 2001.

  2. Amendments to the August 2001 schedule 5 - benefits payable in respect of surgically implanted prostheses and human tissue items list

    Refer Commonwealth Circular HBF 734 and its attachments for details. Other key points include: the Department of Health and Aged Care has placed a new version of the database onto its web site, which incorporates the amendments to the August 20001 Schedule 5. Those changes are effective from 20 September 2001.

  3. Application forms for new items to be included in the February 2002 Schedule 5

    1. Appendix A - Application Form for Inclusion of New Prostheses Items; and Appendix B - Application Form for Inclusion of New Human Tissue Items

      Refer Commonwealth Circular HBF 739 and its attachments. Key points include: the application form for Appendix A contains an attachment that should be completed for any changes to existing items. The deadline for applications for new items to be considered for listing on the February 2002 Schedule is COB Monday 12 November 2001.

    2. Appendix C-Other Medical Devices.

      Refer Commonwealth HBF 726 and its attachment for details. Key points include: a) there is no deadline for the submission of applications for Appendix C; and b) items accepted by Private Health Industry Medical Devices Expert Committee (PHIMDEC) for inclusion of Appendix C will be included on the next Schedule 5 (February or August as applicable) following the PHIMDEC meeting at which they are considered.

2. NURSING HOME TYPE PATIENTS (NHTPS) IN PUBLIC HOSPITALS - CHANGE IN PATIENT CONTRIBUTION AND DEFAULT BENEFITS

Refer Commonwealth Circular HBF 742 which reflects that:

  1. the Victorian Department of Human Services (DHS) increased the daily patient contribution charge for NHTPs in public hospitals, by 60 cents to $29.80. This is in accordance with earlier advice from the Commonwealth of an increase in the pension;
  2. the number of benefit categories for NHTPs in Victorian public hospitals has now been reduced to one. There were previously two benefit categories ('ordinary care' and 'extended care'); and
  3. the default benefit is $80.80 per day - a daily increase of $13.24 compared to the now defunct 'extended care' rate effective from March 2001; and a daily increase of $19.24 from the now defunct 'ordinary care' rate.

The new default benefit for NHTPs in public hospitals is now in closer alignment to some other States. The changes above are effective 15 October 2001.

3. ADMINISTRATIVE ITEMS

  1. Contacts

    For enquiries about prostheses, mail the Commonwealth Department's Prostheses team at the electronic mailbox with the e-mail address: Prostheses@health gov.au or telephone 0262899405 or 0262899461 or 0262899411.

  2. Commonwealth HBF Circulars - new website

    The above Commonwealth HBF Circulars are now available from the Private Heath Industry Branch, Commonwealth Department of Health and Aged Care website.

    For enquiries about Commonwealth HBF Circular content please telephone: (02) 6289 9853 24 hr answering machine or e-mail the enquiry to PrivateHealth@health.gov.au

  3. Access

    To access the updates to the Fees and Charges for Acute Health Services in Victoria: A Handbook for Public Hospitals ('State's Fees Manual') in accordance with this Circular advice, please go to the Fees Manual website and refer to:

    Section A: Fees for Admitted Patients
    9.Nursing Home Type Patients

    Appendices

    Appendix A: Surgically Implanted Prostheses and Human Tissue Items Fees
CHRIS BROOK
DIRECTOR
ACUTE HEALTH

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