Document ID: chunk:federal_register_of_legislation:F2017L00179:schedule:4:p1
Version: federal_register_of_legislation:F2017L00179
Segment Type: schedule
Provision Reference: sch 4 (pt 1/4)
Character Range: 846–3969

Schedule    4

Part 1 Preliminary

         1.                    Name of Direction

This Instrument is the Direction to the Independent Hospital Pricing Authority on the performance of its functions under section 226 of the National Health Reform Act 2011 - No. 2/2016.

     2.                      Commencement

This Direction takes effect on the day after it is registered on the Federal Register of Legislation.

     3.                      Authority

     This Direction is made under section 226 of the National Health Reform Act 2011.

     4.                      Definition

     In this Direction:

     Act means the National Health Reform Act 2011.

     avoidable hospital readmission means readmission to hospital for a condition or conditions arising from complications of the management of the condition for which the patient was originally admitted.

     hospital acquired complication means a hospital acquired patient complication, as defined by the national list developed, and amended from time to time, by the Australian Commission on Safety and Quality in Health Care[1], for which clinical risk mitigation strategies may reduce (but not necessarily eliminate) the risk of that complication occurring.

     sentinel event means one of a subset of adverse events that result in death or serious harm to a patient.

     5.                      Schedule

The Schedule to this Instrument describes the direction given to the Independent Hospital Pricing Authority on the performance of its functions and exercise of its powers.

Schedule

   1. Functions

(i)                 The Independent Hospital Pricing Authority, in relation to its functions under s. 131(1)(a) and (h) of the Act, is to undertake implementation of agreed recommendations of COAG Health Council (on 20 January 2017) on pricing for safety and quality to give effect to:

       (a)     nil funding for a public hospital episode including a sentinel event which occurs on or after 1 July 2017, applying to all relevant episodes of care (being admitted and other episodes) in hospitals where the services are funded on an activity basis and hospitals where services are block funded; and

            Note: For hospitals where the services are funded on an activity basis and hospitals where services are block funded see Chapter 4 of the Act.

       (b)     an appropriate reduced funding level for all hospital acquired complications, in accordance with Option 3 of the draft Pricing Framework for Australian Public Hospital Services 2017-18, as existing on 30 November 2016, to reflect the additional cost of a hospital admission with a hospital acquired complication, to be applied across all public hospitals; and

       (c)     undertake further public consultation to inform a future pricing and funding approach in relation to avoidable hospital readmissions, based on a set of definitions to be developed by the Australian Commission on Safety and Quality in Health Care.

  2.      Matters the Independent Hospital Pricing Authority is to have regard to

    (i)                 In performing the activity referred to