Document ID: chunk:federal_register_of_legislation:F2024C00800:reg:18:p15
Version: federal_register_of_legislation:F2024C00800
Segment Type: reg
Provision Reference: reg 18 (pt 15/42)
Character Range: 191780–194710

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 10.2.1;

    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 made by the Commonwealth under both the Act and either the Aged Care Act 1997 or the National Health Act 1953 in respect of the same amount for which the Commonwealth has become liable in respect of nursing‑home‑type care under these Principles or the Aged Care Act 1997 or the National Health Act 1953.

9.5 Convalescent care
    convalescent care in institutions other than hospitals

9.5.1 Subject to prior approval and subject to paragraph 9.2.5 (health insurance etc), the Commission will accept financial responsibility for the costs of convalescent care for an entitled person at an institution other than a private hospital or public hospital for a maximum of 21 days during any financial year.

    convalescent care in institutions that are private or public hospitals

9.5.2 Subject to paragraph 9.2.5 (health insurance etc), the Commission may accept financial responsibility for the costs of convalescent care for an entitled person at a private hospital or public hospital.

    Note (1) prior approval is not a requirement in these circumstances.
Note (2) there is no express time limit in these circumstances but the Commission has a discretion to accept financial responsibility.  It could exercise its discretion not to accept financial responsibility if it considered the length of convalescent care to be excessive.

9.6 Other matters
9.6.1 The Commission may withdraw its approval, at any time, for an entitled person's continued inpatient treatment in a hospital or other institution.

PART 10 — RESIDENTIAL CARE, HOME CARE AND TRANSITION CARE CO‑PAYMENT
Part A — residential care