Document ID: chunk:federal_register_of_legislation:F2015L01344:body:0:p4
Version: federal_register_of_legislation:F2015L01344
Segment Type: other
Provision Reference: 
Character Range: 9720–12595

the nearest suitable hospital.

3. Prior approval not required

3.1 Medical specialist treatment

A medical specialist or Local Medical Officer may, without prior approval, refer an entitled person to a medical specialist for treatment as a private patient (whether that medical specialist works at a hospital or at consulting room facilities) only if the fee to be charged by that medical specialist for that treatment is no greater than the fee the medical specialist could charge for the treatment pursuant to the Treatment Principles.

3.2 Non-emergency Tier 1 hospital treatment

An entitled person may be admitted to a Tier 1 hospital for non-emergency treatment without prior approval.

3.3. Non-emergency Tier 2 hospital treatment

An entitled person may be admitted to a Tier 2 hospital for non-emergency treatment without prior approval only in those circumstances where the arrangements relating to that hospital specifically exclude the need for prior approval.

3.4. Emergency hospital treatment

An entitled person may be treated at, and admitted through, the accident and emergency centre of a Tier 1, 2, or 3 hospital for emergency treatment without prior approval.

    3.5            Notification of admission

If an entitled person is admitted to a Tier 2 or Tier 3 hospital under paragraph 3.4, the hospital must notify the Department of that admission the next working day in the State or Territory in which the admission occurred, or as soon as practicable afterwards.

    3.6 Urgent treatment for Vietnam veterans and their dependants

A Vietnam veteran or a dependant of a Vietnam veteran may be admitted to:

  (a) a former Repatriation Hospital; or
      (b) a public hospital in a State or Territory;

for in-patient treatment without prior approval if such treatment is certified by a medical practitioner as being urgently required.

4. Prior approval required

4.1 Tier 2 hospital admission and treatment

Subject to Principle 3, an entitled person may be admitted to, and have continuing treatment in, a Tier 2 hospital only if a suitable Tier 1 hospital is unavailable and prior approval has been obtained for the admission.

4.2 Tier 3 hospital admission and treatment

Subject to paragraph 3.4, an entitled person may be admitted to, and have continuing treatment in, a Tier 3 hospital only if no suitable Tier 1 or Tier 2 hospital is available and prior approval has been obtained.

4.3 Criteria for Tier 2 or Tier 3 hospital admission and treatment

In deciding whether prior approval will be given under paragraph 4.1 or 4.2 for:

      (a) admission to; or
      (b) continued, non-emergency, treatment in;
      a Tier 2 or Tier 3 hospital, the Commission must consider where the person's needs can most appropriately be met within a reasonable time, having regard to:
           (c) advice from the person's treating