Document ID: chunk:federal_register_of_legislation:F2024C00744:reg:18:p17
Version: federal_register_of_legislation:F2024C00744
Segment Type: reg
Provision Reference: reg 18 (pt 17/47)
Character Range: 217644–220588

treatment that takes place at the hospital for persons admitted in accordance with these Principles.

9.2.2 The Commission may accept financial responsibility for any usual and reasonable treatment that takes place outside the hospital if it is prescribed as a necessary part of inpatient treatment.

9.2.4 Subject to paragraph 9.2.5, the Commission will accept financial responsibility for hospital charges on the basis of:

(a) for a public hospital — an amount in accordance with arrangements made with the appropriate State/Territory authority; or

(b) for a contracted private hospital — the rate agreed between the Commission and the hospital;

(c) for a non‑contracted private hospital, when neither a public nor a contracted private hospital can provide the treatment required — the rate agreed from time to time between the Commission and the hospital; or

(d) for a non‑contracted hospital, when chosen by an entitled person in preference to a contracted private hospital — a rate to be determined by the Commission.

9.2.5 The Commission will not accept financial responsibility for the whole, or that portion, of:
(a) hospital charges; or

(b) charges for any surgically implanted prostheses; or

(c) charges paid by health fund benefits;or

in circumstances where the entitled person:

(d) is insured by private health insurance for hospital charges, or surgically implanted prostheses, and

(e) agrees to assign to the hospital or other institution the benefits available from private health insurance in respect of all or part of the hospital charges or surgically implanted prostheses.

9.3 Nursing‑home‑type care
9.3.1 Where:

(a) an entitled person remains an inpatient in excess of 35 consecutive days and there is no acute care certificate under section 3B of the Health Insurance Act 1973 in force stating reasons approved by the Commission for the continuing need for acute care; or

(b) the medical practitioner responsible for treating the entitled person agrees at any time after admission that the entitled person no longer requires acute care;
the person will be regarded as receiving nursing‑home‑type care.

9.3.2 If an entitled person:

              (a) is eligible for a residential care subsidy under the Aged Care Act 1997; and

               (b) is receiving nursing‑home‑type care as defined in paragraph 9.3.1;

    the Commission will accept financial responsibility for the standard hospital fee for nursing‑home‑type patients under the National Health Act 1973, or other agreed fee, less the daily care fee, unless:

              (c) the Commission has granted an exemption under paragraph 10.3.1; or

             (d) the entitled person is a former prisoner of war or an entitled veteran awarded the Victoria Cross;

    in which case the Commission will accept financial responsibility for the full amount of the hospital charge.

9.3.3  Nothing in this Part is to be taken to permit payments to be