National Health Regulations 1954 - Federal Register of Legislation

National Health Regulations 1954 - C2004H02389 No longer in force View Series

National Health Regulations 1954 Statutory Rules 1954 No. 35 as amended made under the

National Health Act 1953 This compilation was prepared on 12 April 2001 taking into account amendments up to SR 2001 No. 67 Prepared by the Office of Legislative Drafting, Attorney-General’s Department, Canberra

Contents Page Part 1 Preliminary 1 Name of Regulations [see Note 1] 6 2 Interpretation 6 3 Prescribed matters — restricted membership organizations 6 4 Day hospital facility 7 4A Nursing home care — prescribed services 8 4B Domiciliary care — modification of the Act 9 Part 2 Adjusted fee government nursing homes 5 Prescribed nursing homes 12 Part 3 Provision of vaccines 6 Prescribed diseases 13 Part 4 Standards Review Panels Division 1 Preliminary 7 Interpretation 14 Division 2 Constitution of Panels 8 Establishment of Panels 14 9 Functions of Panels 14 10 Power of Panels 15 11 Pool of potential Panel members 15 12 Membership of Panels 16 13 Termination of appointments 17 14 Remuneration and allowances 18 15 Leave of absence 18 16 Disclosure of interests 19 Division 3 Meetings of Panels 17 Meetings of Panels 20 18 Presiding member 20 19 Quorum 20 20 Voting 20 21 Participation in meetings 21 22 Proceedings 21 23 Resolutions without meeting 21 Division 4 Performance of functions by Panels 24 General 22 25 Minister to notify proprietors 22 26 Minister may direct Panels 22 27 Proprietors to refer notices to Panels 22 28 Chairpersons to notify proprietors 23 29 Panels to deal with matters promptly 23 30 Reports and recommendations 23 31 Impartiality of Panels 24 32 Members’ duty of confidentiality 24 Division 5 Evaluation of Panels’ performance 33 Annual reports 24 34 Review of Panels’ performance 24 Part 5A Gap cover schemes 37A Definitions 26 37B Application for approval of a scheme (Act s 73BDD (5)) 26 37C Minister to decide each application (Act s 73BDD (5)) 26 37D Approval may be subject to conditions (Act s 73BDD (5)) 28 37E Measuring inflationary impact — cost of hospital treatment and associated professional attention (Act s 73BDD (5)) 29 37F Measuring inflationary impact — private health insurance premiums (Act s 73BDD (5)) 30 37G Annual report (Act s 73BDE (1) and (2)) 30 37H Application to vary or revoke a scheme (Act s 73BDE (5)) 31 37I Review of decisions by the AAT 32 Part 6 Procedure of Committees of Inquiry 38 Meetings of Committees of Inquiry 33 Part 7 Fees and allowances of members of Committees 39 Interpretation 34 40 Fees and allowances of members of Committees 34 41 Fares 35 Part 8 Prescribed medical or surgical aids, equipment and appliances 42 Prescribed medical or surgical aids etc for purposes of paragraph 9A (1) (a) of the Act 36 43 Prescribed medical or surgical aids etc for purposes of subsection 9A (2) of the Act 36 Part 9 Miscellaneous 44 Amounts prescribed for the purposes of subsection 47 (1) of the Act 37 45 Prescribed qualifications for the purposes of subsection 43A (3) of the Act 38 46 Prescribed amount for the purposes of subparagraph 47 (2) (b) (iii) of the Act 38 46A Rate of interest payable on repayments 38 47 Prescribed business — definition of accident and sickness insurance business in subsection 67 (4) of the Act 39 48 Prescribed business — definition of health insurance business in subsection 67 (4) of the Act 40 49 Prescribed rate for the purposes of subsection 73BC (9) of the Act 44 49A Hospital Casemix Protocol 44 49B List of Australian National Diagnosis Related Groups 44 49C Direction by Minister to registered organizations 45 50 Form of warrant for inspector to enter premises 46 51 Prescribed authority — Department of Veterans’ Affairs 46 52 Provision of information to Department of Veterans’ Affairs 46 52A Prescribed authority — Private Health Insurance Administration Council 47 52B Provision of information to Private Health Insurance Administration Council 47 53 Waiting period — applicable benefits arrangement 48 Schedule 1A Nursing home care — prescribed services 49 Schedule 1 Prescribed medical or surgical aids 56 Schedule 2 Search warrant under subsection 82V (3) 57 Schedule 3 Modifications of the Act 58 Part 1 Modification of section 5A for the St Francis Xavier Cabrini Domiciliary Palliative Care program 58 Part 2 Modification of section 5A for the South Australian Psychiatric Patient Trial 59 Part 3 Modification of section 5A for the Victorian Rehabilitation Patient Trial 59 Part 4 Modification of section 5A for Hornsby Ku-ring-gai Coordinated Care Trial 60 Part 5 Modification of section 5A for Hospital-to-Home Trial (Adelaide Community Healthcare Alliance) 62 Part 6 Modification of section 5A for Victorian Private Psychiatric Early Discharge Trial 63 Schedule 5 Adjusted fee government nursing homes 65 Part 1 Australian Capital Territory 65 Part 2 New South Wales 65 Part 3 Victoria 68 Part 4 Queensland 80 Part 5 South Australia 82 Part 6 Western Australia 82 Part 7 Tasmania 84 Schedule 6 Information which may be provided to the Department of Veterans’ Affairs 86 Schedule 7 Hospital Casemix Protocol 89 Part 1 Explanatory notes 89 Part 2 File structure: medical record 93 Part 3 File structure: hospital episode record 94 Part 4 Record content: medical record 97 Part 5 Record content: hospital episode record 99 Part 6 Registered health benefits organizations 114 Notes 117



Part 1 Preliminary

1 Name of Regulations

[see Note 1]

These Regulations are the National Health Regulations 1954. 2 Interpretation (1) In these Regulations, unless the contrary intention appears: approved form means a form approved in writing by the Secretary for the purposes of the provision in which the expression is used. the Act means the National Health Act 1953. (2) In these Regulations, unless the contrary intention appears, a reference to an actuary is to be read as a reference to a person who is ordinarily resident in Australia and is a Fellow, or an Accredited Member, of The Institute of Actuaries of Australia. 3 Prescribed matters — restricted membership organizations For the purposes of the definition of restricted membership organization in subsection 4 (1) of the Act, each of the following matters is a prescribed matter: (a) relationship, at some time, as a dependant, in accordance with the rules of the organization as then in force, of a person who at that time was a contributor to a health benefits fund, a hospital benefits fund or a medical benefits fund conducted by the organization; (b) employment by North Broken Hill Peko Limited or Amcor Limited at the time of becoming a contributor to a health benefits fund conducted by the organization. 4 Day hospital facility (1) For the purposes of paragraph (b) of the definition of day hospital facility in subsection 4 (1) of the Act, each of the following premises is prescribed: (a) the premises known as the Hornsby Day Surgery Centre and situated at 1A Northcote Road, Hornsby, New South Wales; (b) the premises known as the NIB Day Hospital Centre and situated at 182 Christo Road, Lambton, New South Wales; (c) the premises known as the Sydney Day Surgery and situated at 251-281 New South Head Road, Edgecliff, New South Wales; (d) the premises known as the Toowoomba Surgicentre and situated at 9 Scott Street, Toowoomba, Queensland; (e) the premises known as the Brisbane Endoscopy Centre and situated at 259 McCullough Street, Sunnybank, Queensland; (f) the premises known as Brockway House Day Theatre and situated at 82 Queen Street, Southport, Queensland; (g) the premises known as Lidia Perin Day Hospital and situated at 1-5 Grattan Court, Wanniassa, Australian Capital Territory; (h) the premises known as Mugga Wara Unit and situated at City Chambers, 47 East Row, Canberra, Australian Capital Territory; (i) the premises known as Canberra Ophthalmic Day Surgery Centre and situated at 13 Theodore Street, Curtin, Australian Capital Territory; (j) the premises known as Corinna Chambers Eye Clinic and situated at 48 Corinna Street, Phillip, Australian Capital Territory; (k) the premises known as SPORTSMED.SA and situated at 32 Payneham Road, Stepney, South Australia; (l) the premises known as the Adelaide Day Surgery and situated at 18 North Terrace, Adelaide, South Australia; (m) the premises known as the Launceston Eye Clinic and situated at 262 Charles Street, Launceston, Tasmania; (n) the premises known as the Northern Endoscopy Centre and situated at 127 Frost Road, Brahma Lodge, South Australia; (o) the premises known as the Glenelg Day Surgery and situated at 4 Gordon Street, Glenelg, South Australia; (p) the premises known as the Hamilton House Day Surgery and situated at Hamilton House, 470 Goodwood Road, Cumberland Park, South Australia; (q) the premises known as the Oxford Day Surgery Centre and situated at 54 Oxford Terrace, Unley, South Australia; (r) the premises known as Eastside Day Surgery and situated at 190 Glen Osmond Road, Fullarton, South Australia; (s) the premises known as Sach Day Surgery and situated at 341 South Terrace, Adelaide, South Australia. (2) For the purposes of paragraph (d) of the definition of day hospital facility in subsection 4 (1) of the Act, the following premises are prescribed: (a) the premises known as the Tweed Heads Medical Centre and situated at 127 Wharf Street, Tweed Heads, New South Wales. 4A Nursing home care — prescribed services (1) The services, of a kind provided in a nursing home, that are set out in column 2 in an item in Schedule 1A are prescribed for the purposes of the definition of nursing home care in subsection 4 (1) of the Act. (2) The services set out in column 2 in an item in Schedule 1A include or exclude, as set out in the direction in column 3 in the item, the provision of the goods and services set out in column 3 in the item. (3) In Schedule 1A, health professional includes the director of nursing, or other person in charge of nursing, at the nursing home. 4B

Domiciliary care — modification of the Act (1) Subsections 5A (1) and (3) of the Act, in their application to the following registered organizations, are affected by the modifications set out in Part 1 of Schedule 3 until 30 June 2001: (a) Australian Unity Health Limited; (b) Medibank Private Limited; (c) Medical Benefits Fund of Australia Ltd; (d) National Mutual Health Insurance Pty Ltd. (2) Subsections 5A (1) and (3) of the Act, in their application to the following registered organizations, are affected by the modifications set out in Part 2 of Schedule 3 until 30 June 2001: (a) Medibank Private Limited; (b) Medical Benefits Fund of Australia Ltd; (c) National Mutual Health Insurance Pty Ltd; (d) SGIC Health Pty Ltd. (3) Subsection 5A (1) and (3) of the Act, in their application to the following registered organizations, are affected by the modifications set out in Part 3 of Schedule 3 until 30 June 2001: (a) Australian Unity Health Limited; (b) Medibank Private Limited; (c) National Mutual Health Insurance Pty Ltd. (4) Subsections 5A (1) and (3) of the Act, in their application to the following registered organizations, are affected by the modifications set out in Part 4 of Schedule 3 until 30 June 2001: (a) The Hospitals Contribution Fund of Australia, Limited; (b) Medical Benefits Fund of Australia Ltd. (5) Subsections 5A (1) and (3) of the Act, in their application to the following registered organizations, are affected by the modifications set out in Part 5 of Schedule 3 until 30 June 2001: (a) Health-Partners Incorporated; (b) I.O.R. Australia Pty Ltd; (c) Medibank Private Limited; (d) National Mutual Health Insurance Pty Ltd; (e) South Australian Police Employees’ Health Fund Incorporated. (5A) Subsections 5A (1) and (3) of the Act, in their application to the following organizations, are affected by the modifications set out in Part 6 of Schedule 3 until 30 June 2001: (a) Australian Unity Health Limited; (b) CBHS Friendly Society Limited; (c) Geelong Medical and Hospital Benefits Association Limited; (d) IOR Australia Pty Ltd; (e) Medibank Private Limited; (f) Medical Benefits Fund of Australia Limited; (g) National Mutual Health Insurance Pty Ltd; (h) United Ancient Order of Druids Friendly Society Limited (5B) Subsections 5A (1) and (3) of the Act, in their application to the following registered organizations, are affected by the modifications set out in Part 7 of Schedule 3 until 30 June 2001: (a) Australian Unity Health Limited; (b) Geelong Medical and Hospital Benefits Association Limited; (c) Grand United Corporate Health Limited; (d) Latrobe Health Services Incorporated; (e) Medibank Private Limited; (f) Medical Benefits Fund of Australia Limited; (g) Mildura District Hospital Fund Limited; (h) National Mutual Health Insurance Pty Ltd; (i) St Luke’s Medical and Hospital Benefits Association Limited; (j) United Ancient Order of Druids Friendly Society Limited; (k) The Yallourn Medical and Hospital Society. (6) Parts 1, 2 and 3 of Schedule 3 have effect until 30 June 2001. (7) Part 4 of Schedule 3 has effect until 30 June 2001. (8) Part 5 of Schedule 3 has effect until 30 June 2001. (9) Part 6 of Schedule 3 has effect until 30 June 2001. (10) Part 7 of Schedule 3 has effect until 30 June 2001.

Part 2 Adjusted fee government nursing homes

5 Prescribed nursing homes (1) For the purposes of section 4AAAA of the Act, a nursing home specified in Schedule 5 is an adjusted fee government nursing home. (2) Item 3072A in Part 3 of Schedule 5 is taken to have commenced on 3 July 1994. (3) Item 7009A in Part 7 of Schedule 5 is taken to have commenced on 17 December 1994.

Part 3 Provision of vaccines

6

Prescribed diseases For paragraph 9B (d) of the Act, the following diseases are prescribed as diseases for which vaccines may be provided: (a) diphtheria; (b) Haemophilus influenzae type B; (c) hepatitis A; (d) hepatitis B; (e) influenza; (f) Japanese encephalitis; (g) meningococcal disease; (h) pertussis; (i) pneumococcal disease; (j) Q fever; (k) tetanus; (l) varicella.

Part 4 Standards Review Panels Division 1 Preliminary 7 Interpretation In this Part, unless the contrary intention appears: Chairperson, in relation to a Panel, means Chairperson of the Panel. meeting, in relation to a Panel, means meeting of the Panel. member, in relation to a Panel, means member of the Panel who is referred to in subregulation 12 (1). nursing home means approved nursing home. Panel means Standards Review Panel established by regulation 8. proprietor, in relation to a nursing home, means proprietor of the nursing home. recommendation means a recommendation: (a) that a declaration should or should not be made under subsection 45E (1) of the Act; and (b) specifying the action (if any) to be taken under subsection 45E (2) or (3) of the Act.

Division 2 Constitution of Panels 8 Establishment of Panels The Minister may establish a Standards Review Panel, or Standards Review Panels, for each State and Territory in which a nursing home is, or nursing homes are, situated. 9 Functions of Panels The functions of a Panel are to: (a) review the nursing home care provided in nursing homes; and (b) compare the provision of that care with standards determined under section 45D of the Act; and (c) inquire into matters for the purposes of a function referred to in paragraph (a) or (b); and (d) report the findings of the Panel, and the reasons for those findings, to the Minister; and (e) make recommendations to the Minister resulting from its reports; and (f) perform these functions: (i) at the direction of the Minister; or (ii) on a referral by a proprietor. 10 Power of Panels Subject to this Part, a Panel has power to do all things necessary or convenient to be done in connection with the performance of its functions. 11 Pool of potential Panel members (1) The Minister may appoint: (a) persons who have not less than 3 years’ experience in senior positions in the management of nursing homes, aged persons’ hostels or other establishments of that kind; or (b) persons who are members of not less than 3 years’ standing in professional or industrial organisations of persons who practise, or are employed, in nursing homes, aged persons’ hostels or other establishments of that kind; or (c) persons who have knowledge of, and experience in, consumer protection in a health or social welfare field; as potential members of a Panel for a State or Territory. (2) A person appointed under subregulation (1) may resign his or her appointment by writing signed by the member and given to the Minister and the appointment terminates on receipt by the Minister of the resignation. (3) Subject to this Division, an appointment under subregulation (1) is for 3 years. 12 Membership of Panels (1) A Panel consists of the following members: (a) a Chairperson appointed by the Minister; (b) a person appointed under paragraph 11 (1) (a); (c) a person appointed under paragraph 11 (1) (b); (d) a person appointed under paragraph 11 (1) (c); (e) an officer of the Department nominated by the Secretary. (2) A Chairperson holds office with effect from such day as the Minister specifies in the instrument of appointment of the Chairperson. (3) The Minister must not appoint a person as a Chairperson unless the Minister is satisfied that the person has experience at a professional or senior management level in, or broad knowledge of, health care administration or the provision of nursing home care or care in aged persons’ hostels or other establishments of that kind. (4) Subject to subregulation (5), the Chairperson of a Panel for a State or Territory may appoint a person referred to in paragraph 11 (1) (a), (b) or (c) who has been appointed for the State or Territory as a member of the Panel. (5) In the case of a Panel for: (a) the Australian Capital Territory, the member referred to in paragraph (1) (b) or (c) must be a person appointed under paragraph 11 (1) (a) or (b) for New South Wales; and (b) the Northern Territory, the member referred to in paragraph (1) (b) or (c) must be a person appointed under paragraph 11 (1) (a) or (b) for South Australia. (6) All members hold office on a part-time basis. (7) Subject to this Division, a member appointed by the Chairperson holds office from a day specified in the instrument of appointment until a day specified in the instrument, not being more than 3 years from the day of appointment of the member under subregulation 11 (1). (8) Subject to this Division, a Chairperson holds office for 3 years. (9) The member referred to in paragraph (1) (e) holds office during the pleasure of the Secretary. (10) A member may resign by writing signed by the member and given: (a) in the case of a Chairperson — to the Minister; and (b) in the case of a member appointed by the Chairperson — to the Chairperson; and (c) in the case of a member referred to in paragraph (1) (e) — to the Secretary; and his or her membership terminates on receipt by the Minister, Chairperson or Secretary, as the case may be, of the resignation. (11) The exercise of a power or the performance of a function of a Panel is not affected by a vacancy in its membership. 13 Termination of appointments (1) The appointment of a Chairperson or of a person who is appointed under subregulation 11 (1) may be terminated by the Minister for misbehaviour or for incapacity to participate in the performance of the functions, or the exercise of the powers, of a Panel. (2) The appointment of a Chairperson or of a person who is appointed under subregulation 11 (1) who: (a) holds, or performs the duties of, a senior position in the management of a nursing home, being a nursing home in respect of which a declaration under subsection 45E (1) of the Act is in force; and (b) is not the proprietor; may be terminated by the Minister. (3) If a Chairperson or a person who is appointed under subregulation 11 (1): (a) becomes bankrupt, applies to take the benefit of a law for the relief of bankrupt or insolvent debtors, compounds with his or her creditors or makes an assignment of his or her remuneration for their benefit; or (b) is convicted of an offence punishable by imprisonment for 1 year or longer; or, in the case of a member: (c) is absent without leave granted under regulation 15 from 3 consecutive meetings of the Panel; or (d) fails, without reasonable excuse, to comply with an obligation imposed by regulation 16; his or her appointment may be terminated by the Minister. (4) The appointment of a Chairperson or of a person appointed under subregulation 11 (1) whose: (a) application under subsection 39BA (1) of the Act is refused under subsection 39BA (5) of the Act; or (b) approval as an approved operator is revoked under subsection 39BB (3) of the Act; is terminated. (5) The appointment of a Chairperson or of a person appointed under subregulation 11 (1) who is the proprietor of a nursing home in respect of which a declaration under subsection 45E (1) of the Act is in force is terminated. (6) A member appointed under subregulation 11 (1) ceases to be a member on the termination of that appointment. 14 Remuneration and allowances A member, other than a member appointed under paragraph 12 (1) (e), must be paid such remuneration and allowances as are determined by the Remuneration Tribunal. 15 Leave of absence (1) The Minister may grant leave of absence to a Chairperson on such terms and conditions as the Minister determines. (2) A Chairperson may grant leave of absence to a member on such terms and conditions as the Chairperson determines. 16 Disclosure of interests (1) A Chairperson must give written notice to the Minister of all direct and indirect pecuniary interests that he or she has or acquires in: (a) a nursing home; or (b) a business that provides facilities, goods or services to nursing homes. (2) If a Chairperson has or acquires an interest referred to in subregulation (1) or another interest that could conflict with the proper performance of his or her functions, the interest must be disclosed in any report resulting from the performance of those functions. (3) If a member (other than the Chairperson) has or acquires an interest that could conflict with the proper performance of his or her functions: (a) he or she must disclose the interest to the Chairperson; and (b) except with the consent of the Chairperson, he or she must not take part, or continue to take part, in the performance of his or her functions. (4) If a member referred to in subregulation (3) takes part, or continues to take part, in the performance of his or her functions, the interest must be disclosed in any report resulting from the performance of the functions. (5) If a Chairperson: (a) becomes aware that another member has an interest referred to in subregulation (3); and (b) considers that the member should not take part, or should not continue to take part, in the performance of his or her functions; the Chairperson must give a direction to the member not to take part, or continue to take part, and the member must not take part, or continue to take part, accordingly.

Division 3 Meetings of Panels 17 Meetings of Panels (1) A Panel may hold such meetings as are necessary for the performance of its functions. (2) The Chairperson of a Panel may, at any time, by notice in writing to the other members, convene a meeting at the time and place specified in the notice. (3) The Minister may, by notice in writing to each member of a Panel, direct that a meeting be held at the time and place specified in the notice. (4) If, at any time, a majority of the members of a Panel requests the Chairperson in writing to convene a meeting, he or she must, as soon as practicable, convene a meeting in accordance with the request. (5) The Chairperson may invite a person to attend a meeting to advise or inform the Panel. 18 Presiding member (1) The Chairperson must preside at a meeting at which he or she is present. (2) In the absence of the Chairperson from a meeting, the members present constituting a quorum must elect 1 of their number to preside at the meeting. 19 Quorum At a meeting, the number of members constituting a quorum is the number of members constituting a majority of the members of the Panel. 20 Voting (1) A question arising at a meeting must be determined by a majority of the votes of the members present and voting. (2) The member referred to in paragraph 12 (1) (e) does not have a vote. 21 Participation in meetings (1) A member may participate in a meeting by means of telephone or closed-circuit television. (2) A member who participates in a meeting as provided by subregulation (1) is taken to be present at the meeting. 22 Proceedings (1) A Panel must keep a record of its proceedings. (2) Subject to this Part, the procedure of a meeting of a Panel is to be determined by the Panel. 23 Resolutions without meeting (1) If a majority of the members of a Panel sign a document containing a statement that they are in favour of a resolution in the terms set out in the document, a resolution in those terms is taken to have been passed at a meeting of the Panel in accordance with this Division on the day on which the document was signed, or, if the members signed the document on different days, on the day on which the document was signed by the member who makes up the majority. (2) 2 or more separate documents that are identical in all material respects, each of which is signed by 1 or more members, are taken for the purposes of subregulation (1) to constitute the same document.

Division 4 Performance of functions by Panels 24 General In the performance of its functions, a Panel: (a) must act with as little formality and as much expedition as the requirements of this Part and a proper consideration of the matter before the Panel permit; and (b) is not bound by the rules of evidence; and (c) may inform itself on any matter in any way it thinks fit; and (d) may receive information or submissions in the form of oral or written statements; and (e) may consult such persons as it thinks fit. 25 Minister to notify proprietors (1) If the Minister intends to give notice to a proprietor under subsection 45E (1) of the Act, the Minister is to inform the proprietor by notice in writing of his or her intention. (2) A notice must include a statement to the effect that the notice may be referred by the proprietor to a Panel. 26 Minister may direct Panels The Minister may, by notice in writing to the Chairperson, direct a Panel for a State or Territory to perform the functions of a Panel specified in paragraphs 9 (a), (b), (c) and (d) in relation to a matter in respect of a nursing home situated in the State or Territory, being a matter specified in the notice. 27 Proprietors to refer notices to Panels Within 14 days of receipt of a notice under regulation 25, the proprietor of a nursing home may refer the notice to the Chairperson of a Panel in the State or Territory in which the nursing home is situated. 28 Chairpersons to notify proprietors (1) On receipt by a Panel of: (a) a direction under regulation 26; or (b) a reference under regulation 27; in respect of a nursing home, the Chairperson must, as soon as practicable, inform the proprietor by notice in writing that the Panel will perform its functions in relation to the direction or reference. (2) A notice given under subregulation (1) must include statements to the following effect: (a) that the proprietor may, within 21 days of being given the notice, give the Panel documents or other material to which it must have regard in the performance of its functions in respect of the nursing home; and (b) that the proprietor will have the opportunity: (i) to inspect any other document or material to which the Panel proposes to have regard in reaching a decision; and (ii) to make submissions in relation to the other document or material. (3) If, at the end of the period referred to in paragraph (2) (a), a proprietor has not given a Panel a document or other material referred to in that paragraph, the Panel may proceed in respect of the nursing home in accordance with this Part. 29 Panels to deal with matters promptly A Panel the Chairperson of which has given notice under subregulation 28 (2) to a proprietor must report and make recommendations in respect of the nursing home to the Minister, except in exceptional circumstances, not more than 28 days after the end of the period referred to in paragraph 28 (2) (a). 30 Reports and recommendations A report and recommendations referred to in regulation 28 must: (a) be in writing; and (b) if the members were not in agreement concerning a matter, set out the differing points of view of the members. 31 Impartiality of Panels Subject to this Part, a member is not subject to the direction of any other person in respect of any act or thing done in his or her capacity as a member. 32 Members’ duty of confidentiality It is the duty of a member not to divulge or communicate to the proprietor of a nursing home information with respect to the identity of a resident of the nursing home if the member reasonably believes that it may be to the detriment of the resident if that information is divulged or communicated to the proprietor.

Division 5 Evaluation of Panels’ performance 33 Annual reports (1) The Chairperson of each Panel must, as soon as practicable after each 30 June, prepare and furnish to the Minister a report of the operations of the Panel (if any) during the year ending at the end of that day. (2) The Minister is to cause a copy of a report to be laid before each House of the Parliament within 15 sitting days of that House after the day when the report was furnished to the Minister. 34 Review of Panels’ performance At: (a) the end of each 2 of the years of the operations of a Panel referred to in regulation 33; or (b) the substantial completion by a Panel of its proceedings in respect of 5 nursing homes; whichever happens first, the Minister is to review the effectiveness and efficiency of the Panel in respect of that 2 year period or the period in which those proceedings were completed.

Part 5A Gap cover schemes

37A Definitions In this Part: criteria means the criteria set out in subregulation 37C (4). Note The following expressions used in this Part are defined in subsection 4 (1) of the Act: · Council · gap cover scheme · known gap policy · no gap policy.

37B Application for approval of a scheme (Act s 73BDD (5)) An application by a registered organization for approval of a gap cover scheme must: (a) be in writing; and (b) address the criteria. 37C Minister to decide each application (Act s 73BDD (5)) (1) As soon as practicable after receiving an application for approval of a gap cover scheme, the Minister must: (a) approve the scheme; or (b) refuse to approve the scheme. Note A decision to refuse to approve a scheme is reviewable under regulation 37I.

(2) In making a decision, the Minister must consider the extent to which the scheme meets the criteria. (3) Without limiting subregulation (2), the Minister must not approve a scheme unless paragraph (4) (c) of the criteria is complied with. (4) The criteria for a scheme are as follows: (a) the scheme must eliminate the cost of hospital treatment and associated professional attention provided to a person or persons insured under a no gap policy; (b) the scheme must cover all but a specified amount or percentage of the full cost of particular hospital treatment and associated professional attention provided to a person or persons insured under a known gap policy; (c) the registered organization must provide particulars sufficient to demonstrate to the satisfaction of the Minister that the scheme will not have an inflationary impact, for example, by: (i) providing for open-ended reimbursement of medical fees; or (ii) increasing the total cost borne by contributors; (d) the scheme must require that: (i) a person or persons insured under a known gap policy must be informed in writing, where the circumstances make it appropriate, of any amounts that the insured person or persons can reasonably be expected to pay for hospital treatment and associated professional attention: (A) if possible, before the hospital treatment and associated professional attention is provided; or (B) otherwise, as soon as practicable after the hospital treatment and associated professional attention is provided; and (ii) the person or persons must acknowledge receipt of the information; (e) the scheme should provide for a simplified billing arrangement, if practicable, in respect of a person or persons insured under a no gap policy or a known gap policy; (f) the scheme must ensure that a person or persons insured under a no gap policy or a known gap policy will not be disadvantaged if the scheme were to be revoked under subsection 73BDE (4) or paragraph 73BDE (5) (b) of the Act, for example, by: (i) transferring the insured person or persons to another insurance policy; and (ii) preserving any accrued benefits, such as waiting periods that have been served; (g) the scheme must require a person providing hospital treatment or associated professional attention to a person or persons insured under a no gap policy or a known gap policy to disclose to the insured person or persons any financial interest that the first-mentioned person has in the products or services recommended or provided to the insured person or persons; (h) the scheme must provide for the maintenance of the professional freedom of medical practitioners, within the scope of accepted clinical practice, to identify appropriate treatments when providing professional attention to a person or persons insured under a no gap policy or a known gap policy. Note The Minister must not approve a gap cover scheme unless the scheme provides for insured persons to be informed in writing, where the circumstances make it appropriate, of any amounts that the person can reasonably be expected to pay for treatment and the insured person acknowledges receipt of the advice: see subsection 73BDD (7) of the Act.

37D Approval may be subject to conditions (Act s 73BDD (5)) (1) The Minister may approve a gap cover scheme subject to such conditions as the Minister thinks appropriate to ensure that the scheme meets the criteria to the greatest practicable extent. (2) To ensure that the scheme continues to meet the criteria to the greatest practicable extent, the Minister may, at any time after approving a scheme: (a) impose conditions, or additional conditions, to which the continued operation of the scheme is subject; or (b) vary any condition to which the operation of the scheme is subject. Note A decision made under this regulation is reviewable under regulation 37I.

37E Measuring inflationary impact — cost of hospital treatment and associated professional attention (Act s 73BDD (5)) (1) The inflationary impact of a gap cover scheme on the total cost of hospital treatment and associated professional attention is measured, after the first year of operation of the scheme, using the following method: Step 1

Calculate the change in the cost of hospital treatment and associated professional attention incurred under the scheme averaged over the relevant period using data derived from information provided under the Hospital Casemix Protocol. Calculate the change in the cost of hospital treatment and associated professional attention incurred under hospital purchaser-provider agreements, medical purchaser-provider agreements and practitioner agreements averaged over the relevant period using data derived from information provided under the Hospital Casemix Protocol. Calculate the change in the cost of hospital treatment and associated professional attention incurred under all other services averaged over the relevant period using data derived from information provided under the Hospital Casemix Protocol. Calculate the change in the cost of all hospital treatment and associated professional attention averaged over the relevant period using data derived from information provided under the Hospital Casemix Protocol. Compare the result of step 1 with the result of step 2. Compare the result of step 1 with the result of step 3. Compare the result of step 1 with the result of step 4.

Step 2

Step 3

Step 4

Step 5 Step 6 Step 7

(2) If the result of step 1 is greater than the result of step 2, 3 or 4, this indicates that the scheme has had an inflationary impact in comparison to the agreements referred to in step 2, the services referred to in step 3 or the cost of all hospital treatment and associated professional attention. (3) However, if an inflationary impact is indicated, any effect on the comparative result caused by the scheme providing a different mix of services to that with which it is being compared must be taken into account by reference to the List of Australian National Diagnosis Related Groups in regulation 49B. (4) For subregulation (1): the relevant period means: (a) if the scheme has been operating for at least 2, but less than 3 years — the preceding 2 financial years; and (b) if the scheme has been operating for at least 3, but less than 4 years — the preceding 3 financial years; and (c) if the scheme has been operating for at least 4, but less than 5 years — the preceding 4 financial years; and (d) if the scheme has been operating for at least 5 years — the preceding 5 financial years. 37F Measuring inflationary impact — private health insurance premiums (Act s 73BDD (5)) The inflationary impact of a gap cover scheme on private health insurance premiums is measured by comparing the rise in the rate of premium attributable to the scheme for a financial year with the average weighted rise in the rate of all private health insurance premiums for the preceding 5 financial years. 37G Annual report (Act s 73BDE (1) and (2)) (1) An annual report in respect of a gap cover scheme must: (a) be in writing; and (b) set out particulars of how the scheme has met the criteria during the financial year (or substitute period provided for by subregulation (3) or (4)) to which it relates; and (c) be provided to the Minister and the Council on, or before, 31 July next after the end of that financial year or substitute period. (2) In particular, the report must state the proportion of cases in which information about the expected costs of hospital treatment and associated professional attention was given to persons insured under a known gap policy in advance of the hospital treatment and associated professional attention being provided. (3) If a scheme is approved by the Minister during the last 3 months of a financial year, the first annual report is to be for the period from the time of approval to the end of the next financial year. (4) If a scheme is approved by the Minister during the first 9 months of a financial year, the first annual report is to be for the period from the time of approval to the end of that financial year. (5) If a registered organization is unable to provide its report by the date specified in paragraph (1) (c), the Minister may grant an extension upon application in writing by the registered organization that sets out: (a) the reasons for seeking the extension; and (b) the length of extension required. Note A decision made under this subregulation is reviewable under subregulation 37I.

37H Application to vary or revoke a scheme (Act s 73BDE (5)) (1) If a registered organization decides that the gap cover scheme is not operating in the intended manner, the registered organization may apply in writing to the Minister to: (a) vary the scheme; or (b) revoke the scheme. (2) An application to vary a scheme must set out: (a) particulars of the variation sought; and (b) the reasons for the variation sought. (3) An application to revoke a scheme must set out: (a) the reasons for seeking revocation; and (b) particulars of the arrangements made by the registered organization to ensure that a person or persons insured under a no gap policy or a known gap policy to which the scheme relates will not be disadvantaged if the scheme is revoked. 37I Review of decisions by the AAT Application may be made to the Administrative Appeals Tribunal for review of a decision of the Minister: (a) under paragraph 37C (1) (b) to refuse to approve a scheme; or (b) under subregulation 37D (1) to impose a condition to which the operation of a scheme is subject; or (c) under paragraph 37D (2) (a) to impose a condition to which the continued operation of a scheme is subject; or (d) under paragraph 37D (2) (b) to vary a condition to which the continued operation of a scheme is subject; or (e) under subregulation 37G (5) to refuse to grant an extension or to grant an extension for a shorter period than that applied for by the registered organization. Note Under section 27A of the Administrative Appeals Tribunal Act 1975, the decision-maker must give to any person whose interests are affected by the decision notice, in writing or otherwise, of the making of the decision and of the person’s right to have the decision reviewed. In giving that notice, the decisionmaker must have regard to the Code of Practice determined under section 27B of that Act (see Gazette No. S 432, 7 December 1994).

Part 6 Procedure of Committees of Inquiry

38 Meetings of Committees of Inquiry (1) Meetings of a Committee of Inquiry shall be convened by the Chairperson. (2) At a meeting of a Committee of Inquiry 3 members constitute a quorum. (3) A Committee of Inquiry shall cause a record of its proceedings, including a transcript of all evidence given before it, to be kept.

Part 7 Fees and allowances of members of Committees

39 Interpretation In this Part: Chairperson, in relation to a Committee, does not include a person elected to preside at a meeting of the Committee. Committee means a Committee established under the Act. 40 Fees and allowances of members of Committees (1) This regulation does not apply to a Chairperson or a member of a Committee who is an officer of the Australian Public Service or the Public Service of a State or Territory. (2) Subject to subregulation (3), the fee payable to a member of a Committee is: (a) if the member is the Chairperson of the Committee — $40; or (b) in any other case — $35; for each day on which the member attends a meeting of the Committee. (3) Where the duration of a meeting of the Committee on a day is less than 3 hours, the fee payable to a member of the Committee, in respect of his or her attendance at the meeting on that day, is: (a) if the member is the Chairperson of the Committee — $25; or (b) in any other case — $20. (4) The Chairperson or a member of a Committee who is necessarily absent from his or her home overnight by reason of attendance at a meeting of the Committee shall be paid travelling allowance, in respect of that absence: (a) if the period of absence is a complete day or longer: (i) at the daily rate of $28 for each complete day in the period of absence; and (ii) at an hourly rate that is one-twenty-fourth part of the daily rate set out in subparagraph (i) for each hour, or part of an hour, in the remainder (if any) of the period of absence; or (b) if the period of absence is less than a complete day — at an hourly rate that is one-twenty-fourth part of the daily rate set out in subparagraph (a) (i) for each hour, or part of an hour, in the period of absence. 41 Fares The cost of return transport fares actually and necessarily incurred by a member of a Committee in travelling between his or her place of residence and the place where a meeting of the Committee is held shall be borne by the Commonwealth.

Part 8 Prescribed medical or surgical aids, equipment and appliances

42 Prescribed medical or surgical aids etc for purposes of paragraph 9A (1) (a) of the Act The medical or surgical aids, equipment and appliances specified in Schedule 1 are prescribed for the purposes of paragraph 9A (1) (a) of the Act. 43 Prescribed medical or surgical aids etc for purposes of subsection 9A (2) of the Act The medical or surgical aids, equipment and appliances specified in items 1, 2, 3 and 4 in Schedule 1 are prescribed for the purposes of subsection 9A (2) of the Act.

Part 9 Miscellaneous

44 Amounts prescribed for the purposes of subsection 47 (1) of the Act (1) The prescribed amount of Commonwealth benefit payable in respect of an approved nursing home, being a Government nursing home, is: (a) for the purposes of paragraph 47 (1) (a) of the Act — $33.35; (b) for the purposes of paragraph 47 (1) (b) of the Act — $48.50; (c) for the purposes of paragraph 47 (1) (c) of the Act — $28.10; (d) for the purposes of paragraph 47 (1) (d) of the Act — $39.05; (e) for the purposes of paragraph 47 (1) (e) of the Act — $31.55; (f) for the purposes of paragraph 47 (1) (f) of the Act — $27.80; (g) for the purposes of paragraph 47 (1) (g) of the Act — $33.35; and (h) for the purposes of paragraph 47 (1) (h) of the Act — $39.05. (2) The prescribed amount of Commonwealth benefit payable in respect of an approved nursing home other than a Government nursing home is: (a) for the purposes of paragraph 47 (1) (a) of the Act — $43.40; (b) for the purposes of paragraph 47 (1) (b) of the Act — $53.60; (c) for the purposes of paragraph 47 (1) (c) of the Act — $35.25; (d) for the purposes of paragraph 47 (1) (d) of the Act — $45.05; (e) for the purposes of paragraph 47 (1) (e) of the Act — $37.00; (f) for the purposes of paragraph 47 (1) (f) of the Act — $36.15; (g) for the purposes of paragraph 47 (1) (g) of the Act — $43.40; and (h) for the purposes of paragraph 47 (1) (h) of the Act — $45.05. 45 Prescribed qualifications for the purposes of subsection 43A (3) of the Act For the purposes of subsection 43A (3) of the Act, the prescribed qualifications are registration as a company auditor in a State or Territory. 46 Prescribed amount for the purposes of subparagraph 47 (2) (b) (iii) of the Act The amount of $15.15 is prescribed for the purposes of subparagraph 47 (2) (b) (iii) of the Act. 46A Rate of interest payable on repayments (1) For the purposes of subsections 65SA (1) and 65SB (1) of the Act, the rate of interest payable on a repayment that the Commonwealth is liable to make is the rate payable by the Commonwealth Bank of Australia on a term deposit, made on the day on which the relevant payment was made, of an amount equal to the relevant payment. (2) In subregulation (1): relevant payment means an amount paid to the Commonwealth by a person under section 65GT, 65H, 65J or 65K of the Act, as the case requires. repayment means an amount that the Commonwealth is liable to repay to a person under section 65GU, 65H, 65J, 65M, 65N, 65P, 65Q or 65S of the Act, as the case requires, after a relevant payment is paid to the Commonwealth. term deposit means a deposit for a period of 90 days on which interest is paid at maturity. 47 Prescribed business — definition of accident and sickness insurance business in subsection 67 (4) of the Act (1) For the purposes of paragraph (b) of the definition of accident and sickness insurance business in subsection 67 (4) of the Act, the following kinds of business are prescribed: (a) the business (other than excluded business) of underaking liability, by way of insurance, to pay a lump sum, or to make periodic payments, on the happening of a personal accident, disease or sickness, where the extent of the insurer’s liability is calculated by reference to, or is in any way contingent upon, a period of time during which a person is a patient in a hospital; (b) the business of undertaking liability, by way of insurance, to pay a lump sum, or to make periodic payments, on the happening of a personal accident, disease or sickness, where the business includes the offer, promotion or offer and promotion of a policy (or a group of policies) in which: (i) the amount of benefit varies according to the kind of insured event that occurs; and (ii) the insured event is defined in terms that involve the provision of hospital treatment or relevant health services; whether or not the insurer’s liability is in any way contingent on any treatment or services being provided to the insured, or on the payment of fees or charges for any treatment or services. (2) In subregulation (1), excluded business means the business referred to in subregulation (1) where liability is undertaken under a contract of insurance that: (a) is entered into before the commencement of this regulation; and (b) includes a condition under which renewal of the contract is guaranteed 48 Prescribed business — definition of health insurance business in subsection 67 (4) of the Act (1) For the purposes of paragraph (e) of the definition of health insurance business in subsection 67 (4) of the Act, business of the following kind is prescribed, namely, the business of undertaking liability, by way of insurance, with respect to matters referred to in paragraph (a), (ab) or (b) of that definition where the liability is undertaken by an organisation, other than a registered organisation, in respect of: (a) one of the following persons: (i) a person who, at the time of entering into the relevant contract of insurance: (A) is, or expects to be, temporarily present in Australia and is not an eligible person; or (B) is, or expects to be, temporarily present in Australia and is an eligible person by reason only of being treated as an eligible person under paragraph (3) (c); (ii) a person who is a resident of Australia and engaged in temporary employment outside Australia, or a dependant of that person, in respect of whom a contract of insurance provides that liability for hospital treatment or an ancillary health benefit may arise: (A) in Australia; or (B) outside Australia, if the absence of the person from Australia is due to the temporary employment; or (b) a person in respect of the occurrence, in relation to that person, of one of the following events: (i) an event occurring while the person is, without payment, providing services to an educational, religious, charitable or benevolent organisation or while that person is travelling to or from the place where those services are provided; (ii) an event occurring while the person: (A) is engaged in a sporting activity (in the capacity of a participant, adjudicator, judge, referee or umpire or in a similar capacity); or (B) is acting as an official at, or otherwise assisting in the conduct of, a sporting activity; or (C) is acting in his or her capacity as an elected or appointed official of a sporting organisation; or while that person is travelling to or from: (D) that activity; or (E) the place where that person acts in that capacity; (iii) an event occurring while the person is engaged in youth activities organised by a voluntary organisation (for example, the Girl Guides Association of Australia, the Scout Association of Australia, the Y.M.C.A. of Australia, the Y.W.C.A. of Australia or a police citizens youth club) or while that person is travelling to or from such activities; (iv) where the person is a student at an educational institution — an event occurring while that person: (A) is attending that institution in accordance with the requirements of that institution; or (B) is, in the course of such attendance, taking part in an activity organised and supervised by that institution; or (C) is travelling to or from such attendance at that institution; (v) where the person is a secondary school student — an event occurring while that person is undertaking, as part of his or her school curriculum, non-remunerative work in a work environment unconnected with the school in order to gain work experience or while that person is travelling to or from that work; (vi) if a law of a State or Territory relating to workers’ compensation does not apply to the person — an event occurring while the person: (A) is undertaking an activity that is part of an employment, education, training or youth program, or initiative, administered or funded by the Commonwealth, including specialist employment services for people with disabilities; or (B) is travelling to a place to undertake an activity mentioned in subsubparagraph (A) or travelling from a place after undertaking the activity at that place. (2) For the purposes of paragraph (e) of the definition of health insurance business in subsection 67 (4) of the Act, business of the following kind is prescribed, namely, the business of undertaking liability, by way of insurance, with respect to the provision of a service or services referred to in paragraph (b) of the definition of ancillary health benefit in that subsection by way of indemnity for damage to, or loss of, an item referred to in that paragraph (b), where the liability is undertaken by an organisation, other than a registered organisation, and where the contract of insurance under which that liability is undertaken is not primarily concerned with the business of undertaking liability, by way of insurance: (a) with respect to matters referred to in paragraph (a), (ab) or (b) of the definition of health insurance business in subsection 67 (4) of the Act; or (b) with accident and sickness insurance business. (2A) For paragraph (e) of the definition of health insurance business in subsection 67 (4) of the Act, health insurance business does not include the business of undertaking liability by way of insurance for: (a) death benefits; or (b) benefits payable if the insured is more likely than not to die within 2 years after making a claim for illness or injury; or (c) benefits payable if the insured has a disability caused by an illness or injury and, because of the disability: (i) is permanently unable to work in the category of occupation defined in the policy; or (ii) is accepted by the insurer as being unable to work because of loss of sight or limb; or (d) benefits payable as income replacement or as premium payments for a contract of insurance because the insured is disabled and restricted from earning income; or (e) if the insured is not employed — benefits payable by reference to the time for which the insured is disabled and cannot carry out domestic activities; or (f) benefits payable: (i) because of an event defined in the policy; and (ii) in a lump sum or in parts; and (iii) if the total benefit payable for each event defined in the policy is at least $10,000. (2B) For the purposes of paragraph (e) of the definition of health insurance business in subsection 67 (4) of the Act, health insurance business does not include the business of undertaking liability by way of insurance with respect to matters referred to in paragraph (a), (ab) or (b) of that definition if the liability is undertaken by a registered organisation under an overseas student health insurance contract. (3) In subregulation (1), eligible person means: (a) a person who is an eligible person within the meaning of the Health Insurance Act 1973; or (b) a person, or a person included in a class of persons, in relation to whom a declaration has been made under subsection 6 (1) of the Health Insurance Act 1973; or (c) a person who is to be treated as an eligible person under subsection 7 (2) of the Health Insurance Act 1973. (4) In subregulation (2), accident and sickness insurance business has the same meaning as in section 67 of the Act. (5) In subregulation (2B): overseas student means a person who is the holder of a student visa issued under regulations made under the Migration Act 1958. overseas student health insurance contract means a contract of insurance made in accordance with an agreement between a registered organisation and the Commonwealth that allows the registered organisation to pay benefits in respect of the whole or part of the fees and charges incurred by an overseas student, or by a dependant of an overseas student, in relation to the provision in Australia of any or all of the following: (a) relevant health services; (b) services involving the supply, alteration, maintenance or repair of hearing aids, spectacles, contact lenses, artificial teeth, eyes or limbs (including parts of teeth or limbs) or other medical, surgical, prosthetic or dental aids, equipment or appliances; (c) drugs or medicinal preparations; (d) ambulance services; (e) services by an attendant of a person who is sick or disabled; (f) professional services for which medicare benefits would otherwise be payable under the Health Insurance Act 1973; (g) hospital treatment. 49 Prescribed rate for the purposes of subsection 73BC (9) of the Act For the purposes of subsection 73BC (9) of the Act, the prescribed rate is 15 per cent per annum. 49A Hospital Casemix Protocol (1) For the purposes of paragraph 73BD (2) (c) of the Act, a Hospital Casemix Protocol is set out in Schedule 7. (2) A reference to a document in the Hospital Casemix Protocol is a reference to that document as in existence on the day the reference takes effect. 49B List of Australian National Diagnosis Related Groups (1) For the purposes of subparagraph 73BD (4) (a) (i) of the Act, the List of Australian National Diagnosis Related Groups consists of the contents of the following documents: (a) Australian National Diagnosis Related Groups Definitions Manual Version 1.0; (b) Australian National Diagnosis Related Groups Definitions Manual Version 2.0; (c) Australian National Diagnosis Related Groups Definitions Manual Version 2.1 — Addendum to ANDRG V2.0 Definitions Manual; (d) Australian National Diagnosis Related Groups Definitions Manual Version 3.0; (e) Australian National Diagnosis Related Groups Definitions Manual Version 3.1; (f) Australian Refined Diagnosis Related Groups Definitions Manual Version 4.0; (g) Australian Refined Diagnosis Related Groups Definitions Manual Version 4.1. (2) A reference to a document in a paragraph of subregulation (1) is a reference to that document as in existence on the day the paragraph commences. 49C Direction by Minister to registered organizations (1) For the purposes of paragraph 73BE (1) (e) of the Act, the Minister may give a direction to a registered organization with respect to: (a) discounted rates of contribution offered to contributors, or payable by, or in respect of, a contributor under section 3 of Schedule 1 to the Health Legislation Amendment Act (No. 2) 1999; and (b) discounted rates of contribution to be offered to contributors, or to be payable by, or in respect of, a contributor under paragraph (s) of Schedule 1 to the Act. (2) For the purposes of subregulation (1), a discounted rate of contribution includes: (a) a commission, brokerage fee, incentive payment, inducement or any other sum paid by a registered organization with respect to a discounted product; and (b) an arrangement under which a requirement to make a co-payment or excess payment may be waived or reduced, either at the time of making a claim or at any other time. 50 Form of warrant for inspector to enter premises For the purposes of subsection 82V (3) of the Act, the prescribed form is the form in Schedule 2. 51 Prescribed authority — Department of Veterans’ Affairs For the purposes of subparagraph 135A (3) (b) (i) of the Act, the Department of Veterans’ Affairs is a prescribed authority. 52 Provision of information to Department of Veterans’ Affairs (1) For the purposes of subparagraph 135A (3) (b) (ii) of the Act, information of the kinds specified in subregulation (2) may be provided to the Department of Veterans’ Affairs for the purpose of, and to the extent necessary for, ascertaining whether the Repatriation Commission is responsible for all or some of the cost of nursing home care of a patient if: (a) the patient is a Repatriation nursing home patient; or (b) the patient is an approved nursing home patient and either: (i) the patient has been funded for nursing home care by the Department of Veterans’ Affairs; or (ii) it has come to the notice of the Secretary that the patient may have an entitlement to be funded for nursing home care by the Department of Veterans’ Affairs. (2) The kinds of information mentioned in subregulation (1) are as follows: (a) the medical condition of the patient; (b) the reason for the patient’s admission to a nursing home; (c) information specified in Schedule 6. 52A Prescribed authority — Private Health Insurance Administration Council For the purposes of subparagraph 135A (3) (b) (i) of the Act, the Private Health Insurance Administration Council is a prescribed authority. 52B Provision of information to Private Health Insurance Administration Council (1) For the purposes of subparagraph 135A (3) (b) (ii) of the Act, information of the kinds mentioned in subregulation (2) may be provided to the Private Health Insurance Administration Council, for the purpose of, and to the extent necessary for, carrying out its functions under subsection 82G (1) of the Act. (2) The kinds of information for subregulation (1) are as follows: (a) information relating to discounted rates of contribution offered, or to be offered, to contributors by a registered organization; (b) information relating to discounted rates of contribution payable by, or in respect of, a contributor to a registered organization; (c) information provided to the Minister under paragraph (v) of Schedule 1 to the Act; (d) the rules of a registered organization; (e) aggregated data derived from information provided under the Hospital Casemix Protocol. (3) For the purposes of subregulation (2), a discounted rate of contribution includes: (a) a commission, brokerage fee, incentive payment, inducement or any other sum paid by a registered organization with respect to a discounted product; and (b) an arrangement under which a requirement to make a co-payment or excess payment may be waived or reduced, either at the time of making a claim or at any other time. 53 Waiting period — applicable benefits arrangement (1) For subparagraph (j) (iii) in Schedule 1 to the Act, the commencement of a waiting period for the provision of benefits to a contributor, or dependant of a contributor, under an applicable benefits arrangement is the day on which the contributor begins to be a contributor under the applicable benefits arrangement. (2) For subparagraph (j) (iv) in Schedule 1 to the Act, the following periods are specified as the maximum waiting period for the provision of benefits to a contributor, including a contributor to whom paragraph (bb) in Schedule 1 to the Act applies and a dependant of a contributor, under an applicable benefits arrangement: (a) for an ailment, illness or condition relating to an obstetric condition — 12 months; (b) for a pre-existing ailment, within the meaning of paragraph (kc) in Schedule 1 to the Act — 12 months; (c) for an ailment, illness or condition to which paragraph (a) or (b) does not apply — 2 months.

Schedule 1A Nursing home care — prescribed services (regulation 4A)

Column 1 Item

Column 2 Service

Column 3 Goods and services included or excluded

1

The administration of the

Includes:

nursing home

maintenance of resident documentation

2

The maintenance of buildings



and grounds 3

The provision of



accommodation The provision of goods to assist Includes:

4

residents to move themselves

crutches, quadruped walkers, walking frames, walking sticks, wheelchairs



Excludes:



motorised and special purpose wheelchairs and any equipment designed, or custom-made, for a particular resident The provision of goods to assist Includes:

5

persons to move residents

mechanical devices for lifting residents, stretchers, trolleys

6

The provision of furnishings

Includes:

that the resident chooses not to

bed-side lockers, chairs with

provide

arms, containers for personal laundry, dining, lounge and recreational furnishings, drawscreens (for ward residents), resident wardrobe space, over-bed tables, towel rails, other wardrobes

7

The provision of beds and

Includes:

bedding materials appropriate

absorbent or waterproof

to each resident’s condition

sheeting, bed linen and blankets, bed rails, hospitaltype beds and mattresses, incontinence sheets, restrainers, ripple mattresses, sheepskins, tri-pillows, water and air mattresses

8

The provision of basic cleaning

Includes:

services, goods and facilities

services, goods and facilities required to maintain cleanliness and tidiness of wards, individual rooms, other areas and the environment of the nursing home

9

The safe disposal of organic



and inorganic waste material 10

The provision of general and

Includes:

personal laundry services

laundering of clothing that can be machine washed at the nursing home or elsewhere



Exlcudes:



cleaning of clothing that requires dry cleaning or other special cleaning process 11

The provision of toiletry goods

Includes: bath towels, denture cleaning preparations, face washers, sanitary pads, shampoo and conditioner, soap, talcum powder, tissues, toilet paper, toothpaste

The provision of goods to assist Includes:

12

with the toileting, and

absorbent aids, catheter and

incontinence management, of

urinary drainage appliances,

residents

commode chairs, disposable bedpan and urinal covers, disposable enemas, disposable pads, over-toilet chairs, shower chairs, urodomes

13

The provision of assistance in

Includes:

the activities of daily living of

assistance to residents in:

residents

(a) bathing, showering, personal hygiene and grooming; and



(b) toileting and the



management of incontinence, the use of aids and appliances designed to assist incontinence management; and

(c) eating, use of eating



utensils and eating aids, actual feeding; and

(d) dressing, undressing and



the use of dressing aids; and

(e) moving, walking,



wheelchair use and the use of devices and appliances designed to aid mobility; and



the provision of eating and dressing aids





Excludes:





hairdressing

14

The provision of meals and

Includes:

nonalcoholic beverages

(a) the preparation and distribution of meals of adequate variety, quality and quantity for each resident, served each day at times generally acceptable to both residents and management, generally comprising 3 meals per day plus morning tea, afternoon tea and supper; and



(b) the supply of special



dietary requirements having regard to either medical need or religious observance; and

(c) the provision of



foodstuffs and nonalcoholic beverages including fruit juice and fruit of adequate variety, quality and quantity 15

The provision of basic medical,

Includes:

and pharmaceutical, supplies

analgesia, anti-nausea

and equipment

agents, bandages, creams, dressings, laxatives and aperients, mouthwashes, ointments, saline, skin emolients, swabs, urinary alkalising agents





Excludes:





any goods prescribed by a health practitioner for a particular resident and used only by the resident

16

The provision of oxygen and



oxygen equipment on a shortterm, episodic or emergency basis 17

The performance of nursing



procedures 18

The provision of emotional



support to, and supervision of, residents 19

The administration of

Includes:

medication

the ordering, reordering, control and dispensing of medications

20

Includes:

The provision of recreational therapy

(a) recreational activities suited to residents; and



(b) assistance to residents



in their participation in those activities; and

(c) the provision of



communal recreational equipment 21

Includes:

The provision of therapy services



(a) maintenance therapy



delivered by health professionals, or delivered by nursing and personal care staff as directed by health professionals, designed to maintain residents’ levels of independence in activities of daily living in accordance with individual care plans;

(b) more intensive therapy



delivered by health professionals, or delivered by nursing and personal care staff as directed by health professionals, on a temporary basis designed to allow residents to attain a level of independence at which maintenance therapy will meet their needs; and

(c) assistance with



sensory communication or with the fitting of, and arrangements to maintain, sensory communication aids



Excludes:





intensive, long-term rehabilitation services required following, for example, serious illness or injury, surgery or trauma

22

The provision of assistance in

Includes:

obtaining health practitioner

arrangements for aural,

services

community health, dental, medical, psychiatric and other health practitioners to visit residents whether the arrangements are made with the relatives of the resident, or other persons representing the resident’s interests, or are made direct with the practitioner

Schedule 1 Prescribed medical or surgical aids



(regulations 42 and 43)

Item

Description

1

Haemodialysis machines

2

Medical or surgical aids, equipment and appliances used in conjunction with haemodialysis machines

3

Peritoneal dialysis machines

4

Medical or surgical aids, equipment and appliances used in conjunction with peritoneal dialysis machines

5

Stoma appliances

6

Medical or surgical aids, equipment and appliances used in conjunction with stoma appliances

7

Wheelchairs

8

Orthoses

9

Wigs

10

Mammary prostheses

11

Electrolarynxes

12

Aids for incontinence

13

Walking aids

14

Equipment and appliances for personal use

15

Insulin syringes and needles

16

Equipment used for testing and monitoring the diabetic condition

Schedule 2 Search warrant under subsection 82V (3) (regulation 50)

National Health Act SEARCH WARRANT UNDER SUBSECTION 82V (3) To: [full name], a person appointed as an inspector under section 82R of the National Health Act 1953 to make an investigation in respect of the affairs of [name of organization]. WHEREAS, on an application under subsection 82V (2) of that Act in relation to premises at I, [full name], a Magistrate within the meaning of that expression in section 82V of that Act, am satisfied, by information on oath [or affirmation] — (a) that there is reasonable ground for believing that there are on those premises records relating to the affairs of that organization; and (b) that the issue of a warrant is reasonably required for the purposes of that Act; YOU ARE HEREBY AUTHORIZED, with such assistance as you think necessary, to enter the premises at , during the hours of [or at any time], if necessary by force, for the purpose of exercising the functions of an inspector under section 82V of that Act in relation to that organization, namely, to search for, inspect, take extracts from, or make copies of, any records that relate, or that you believe, on reasonable grounds, to relate, to the affairs of that organization. AND for so doing, this shall be your sufficient warrant. Dated this day of , 19 . Magistrate

Schedule 3 Modifications of the Act (regulation 4B)

Part 1 Modification of section 5A for the St Francis Xavier Cabrini Domiciliary Palliative Care program 1. Subsection 5A (1): Add at the end: “; or (c) for nursing care given to a patient after discharge from hospital as part of the St Francis Xavier Cabrini Domiciliary Palliative Care program, where the benefit payable is equal to the lesser of: (i) the fees or charges incurred for nursing care for each day on which it is given; and (ii) $130 for each day on which nursing care is given.”. 2. Subsection 5A (3): Insert the following definition: “St Francis Xavier Cabrini Domiciliary Palliative Care program means the domiciliary palliative care program operated by St Francis Xavier Cabrini Private Hospital, Melbourne, for patients who have received treatment in the hospital and who, after being discharged, continue to receive treatment from the hospital at home, or at any other mutually agreed location.”.

Part 2 Modification of section 5A for the South Australian Psychiatric Patient Trial 1. Subsection 5A (1): Add at the end: “; or (d) for psychiatric care given to a patient after discharge from hospital as part of the South Australian Psychiatric Patient Trial, where the benefit payable is equal to the lesser of: (i) the fees or charges incurred for psychiatric care for each day on which it is given; and (ii) the amount agreed between the registered organisation mentioned in paragraph 4B (2) (a), (b), (c) or (d) and The Adelaide Clinic, Kahlyn Private Hospital and Fullarton Private Hospital, for each day on which psychiatric care is given.”. 2. Subsection 5A (3): Insert the following definition: “South Australian Psychiatric Patient Trial means the trial operated by The Adelaide Clinic, Kahlyn Private Hospital and Fullarton Private Hospital (the hospitals), for patients who have received psychiatric treatment in one of the hospitals and who, after being discharged, continue to receive treatment from the hospital at home, or at any other mutually agreed location.”.

Part 3 Modification of section 5A for the Victorian Rehabilitation Patient Trial 1. Subsection 5A (1): Add at the end: “; or (e) for rehabilitation care given to a patient as part of the Victorian Rehabilitation Patient Trial, where the benefit payable is equal to the lesser of: (i) the fees or charges incurred for rehabilitation care for each session of rehabilitation care given; and (ii) $40 for each session of rehabilitation care given.”. 2. Subsection 5A (3): Insert the following definitions: “session of rehabilitation care, for paragraph 5A (1) (e), means a period of 30 minutes during which a patient is given rehabilitation therapy. Victorian Rehabilitation Patient Trial means the trial operated by the Cedar Court HealthSouth Rehabilitation Hospital, for patients who: (a) have received a rehabilitation service from the hospital and who, after being discharged, continue to receive treatment from the hospital at home, or at any other mutually agreed location; or (b) are receiving a rehabilitation service of a kind mentioned in paragraph (a), but do not have specific nursing needs requiring admission to the hospital.”.

Part 4 Modification of section 5A for Hornsby Ku-ring-gai Coordinated Care Trial 1. Subsection 5A (1): Add at the end: “; or (f) for preventative care or post discharge care provided to a patient after the commencement of this modification as part of the Hornsby Ku-ring-gai Coordinated Care Trial, where the benefit payable is the amount payable under the Reinsurance Pilot agreement; or (g) for a patient’s share, under the Reinsurance Pilot agreement, of the fees for care coordination or administration by Linked Care as part of the Hornsby Kuring-gai Coordinated Care Trial for the period between the commencement of this modification and 31 August 2000.”. 2. Subsection 5A (3): Insert the following definitions: “Hornsby Ku-ring-gai Coordinated Care Trial means the trial administered by Linked Care under which preventative care or post discharge care is provided to enable patients: (a) to live independently at home; or (b) to receive care away from hospital for their health problems or disabilities. Linked Care means the organization that administers, and coordinates care under, the Hornsby Ku-ring-gai Coordinated Care Trial. post discharge care means care: (a) that is arranged to be provided to a patient at home (or at any other mutually agreed location) immediately after discharge of the patient from a hospital, for the purpose of facilitating the patient’s early discharge from the hospital; and (b) that the patient would have otherwise received in the hospital if it had not been so arranged. Examples Domiciliary nursing care, live-in assistance, assistance at home in preparing meals and doing laundry, personal care, physiotherapy and the provision of mobility and personal safety equipment.

preventative care means care that is arranged to be provided to a patient at home (or at any other mutually agreed location) for a period of not more than 3 months for the purpose of preventing the need to admit the patient to a hospital. Examples Domiciliary nursing care, live-in assistance, assistance at home in preparing meals and doing laundry, personal care, review of a patient’s medication and the development of strategies to prevent injury.

Reinsurance Pilot agreement means the agreement entered into between Linked Care, The Hospitals Contribution Fund of Australia, Limited and Medical Benefits Fund of Australia Ltd on 11 February 1999 to allow the funds to participate in the Hornsby Ku-ring-gai Coordinated Care Trial.”.

Part 5 Modification of section 5A for Hospital-to-Home Trial (Adelaide Community Healthcare Alliance) 1. Subsection 5A (1): Add at the end: “; or (h) for nursing care or professional attention provided to a patient at home, as part of the Hospital-to-Home Trial, where the benefit payable is: (i) for episodically-funded benefits — the amount payable under the hospital purchaser-provider agreement between the registered organisation mentioned in paragraph 4B (5) (a), (b), (c), (d) or (e) and Adelaide Community Healthcare Alliance (the applicable agreement); and (ii) for benefits payable for each day on which nursing care or professional attention is provided — an amount equal to 85% of the fees or charges that would otherwise be payable for each day (up to 5 days) under the applicable agreement.”. 2. Subsection 5A (3): Insert the following definitions: “episodically-funded benefit means a benefit payable by a registered organisation for an episode of nursing care or professional attention. Hospital-to-Home Trial means the trial operated by Adelaide Community Healthcare Alliance under which the Aged Care and Housing Group Inc provides nursing care or professional attention on behalf of the hospital to patients in their homes.”.

Part 6 Modification of section 5A for Victorian Private Psychiatric Early Discharge Trial 1 After paragraph 5A (1) (h) insert ; or (i) for psychiatric care given to a patient after discharge from hospital as part of the Victorian Private Psychiatric Early Discharge Trial, where the benefit payable is the amount payable under a Victorian Psychiatric Project Agreement between a registered organization mentioned in subsection 4B (5A) and the hospital. 2 Subsection 5A (3) insert the following definition Victorian Private Psychiatric Early Discharge Trial means the trial operated by The Albert Road Clinic, Dandenong Pinelodge Clinic, Delmont Private Hospital and The Melbourne Clinic Private Hospital (the hospitals), for patients who: (a) have received psychiatric treatment in one of the hospitals; and (b) after being discharged, continue to receive treatment from the hospital at home, or at another agreed location.

Part 7 Modification of section 5A for Epworth Hospital-inthe-Home Pilot Project (Vic) 1 Paragraph 5A (1) (b) omit payable. insert payable; or 2 After paragraph 5A (1) (b) insert (c) for medical care given to a person as part of the Epworth Hospital-in-theHome Pilot Project, where the benefit payable is the amount payable under an agreement between the registered organization mentioned in paragraph 4B (5B) (a), (b), (c), (d), (e), (f), (g), (h), (i), (j) or (k) and Epworth Hospital. 3 Subsection 5A (3), before definition of medical practitioner insert Epworth Hospital-in-the-Home Pilot Project means the trial operated by Epworth Hospital under which the Hospital-in-the-Home Unit provides nursing care or professional attention on behalf of the hospital to patients in their homes.

Schedule 5 Adjusted fee government nursing homes (regulation 5)

Part 1 Australian Capital Territory Column 1 Item

Column 2 Name and address of nursing home

Column 3 Approval No.

1001

Jindalee Nursing Home,

2982 S

Goyder Street, Narrabundah, A.C.T. 2604

Part 2 New South Wales Column 1 Item

Column 2 Name and address of nursing home

Column 3 Approval No.

2001

Allandale Nursing Home,

1474 S

Allandale Road, Cessnock, N.S.W. 2325 2002

Bathurst Macquarie Nursing Home,

1455 S

Russell Street, Bathurst, N.S.W. 2795 2002A

Bethany Nursing Home,

1470 S

166 Balaclava Road, Eastwood, N.S.W. 2122 2003

Boddington Nursing Home,

1454 S

Kings Tablelands Road, Wentworth Falls, N.S.W. 2782 2004

Carrington Centennial Nursing Home,

1483 S

Werombie Road, Camden, N.S.W. 2570 2005

Cessnock House,

1479 S

Foster Street, Cessnock, N.S.W. 2325 2006

Corowa District Hospital Nursing Home,

1496 S

Guy Street, Corowa, N.S.W. 2646 2007

Dudley Unit Nursing Home,

1461 S

Ocean Street, Dudley, N.S.W. 2290 2008

Garrawarra Nursing Home,

1456 S

Princes Highway, Waterfall, N.S.W. 2233 2009

Glebe Annex Nursing Home,

1488 S

2A Hereford Street, Glebe, N.S.W. 2037 2010

Governor Phillip Nursing Home,

1457 S

Glebe Place, Penrith, N.S.W. 2750 2011

Graythwaite Nursing Home,

1451 S

10 Edwards Street, North Sydney, N.S.W. 2060 2012

Hillcrest Nursing Home,

1489 S

Church Street, Gloucester, N.S.W. 2422 2013

Holbrook District Hospital Nursing Home,

1497 S

Bowler Street, Holbrook, N.S.W. 2644 2014

Kurri Kurri Nursing Home,

1481 S

Lang Street, Kurri Kurri, N.S.W. 2327 2015

Lottie Stewart Nursing Home,

1473 S

40 Stewart Street, Dundas, N.S.W. 2117 2016

Lourdes House Nursing Home,

1484 S

Cobbora Road, Dubbo, N.S.W. 2830 2017

Mount St Joseph’s Nursing Home,

1467 S

Campbell Street, Young, N.S.W. 2594 2018

Murrumburrah Harden District Hospital,

1495 S

Swift Street, Murrumburrah, N.S.W. 2587 2019

Muswellbrook Hospital Nursing Home,

2797 S

Brentwood Street, Muswellbrook, N.S.W. 2333 2020

Our Lady of Loreto Nursing Home,

1486 S

167 Albert Road, Strathfield, N.S.W. 2135 2021

Queen Victoria Nursing Home,

1468 S

Kings Tablelands Road, Wentworth Falls, N.S.W. 2782 2022

Queen Victoria Nursing Home,

1476 S

Thirlmere Way, Picton, N.S.W. 2571 2024

St Joseph’s Nursing Home,

1494 S

Dalley Street, Lismore, N.S.W. 2480 2025

St Joseph’s Nursing Home,

1469 S

Maitland Road, Sandgate, N.S.W. 2304 2026

Strickland Villa Nursing Home,

1498 S

Prince of Wales Hospital, High Street, Randwick, N.S.W. 2031 2027

Wallsend District Nursing Home,

1500 S

Longworth Avenue, Wallsend, N.S.W. 2287 2028

War Memorial Nursing Home,

1499 S

Birrell Street, Waverley, N.S.W. 2024

Part 3 Victoria Column 1 Item

Column 2 Name and address of nursing home

Column 3 Approval No.

3001

Ararat and District Hospital

3476 S

(John Pickford House), Girdlestone Street, Ararat, Victoria 3377 3002

Anne Caudle Campus,

3403 S

100-104 Barnard Street, Bendigo, Victoria 3550 3003

Baala House Nursing Home,

3499 S

Katamatite Road, Numurkah, Victoria 3636 3004

Bacchus Marsh and District Nursing Home,

3444 S

123 Clarinda Street, Bacchus Marsh, Victoria 3340 3005

Bairnsdale Regional Health Service,

3408 S

McKean Street, Bairnsdale, Victoria 3875 3006

Benalla & District Memorial Hospital

3470 S

(Morrie Evans Wing), Coster Street, Benalla, Victoria 3672 3007

Boort and District Hospital Nursing Home,

4400 S

Kiniry Street, Boort, Victoria 3537 3008

Boyne Russell House,

4466 S

184-186 Victoria Street, Brunswick, Victoria 3056 3009

Caladenia Nursing Home,

4431 S

Rutledge Street, Kilmore, Victoria 3764 3010

Camperdown District Hospital

3461 S

Nursing Home Unit, York Street, Camperdown, Victoria 3260 3011

Casterton Memorial Hospital

3495 S

Nursing Home, Mt Gambier Road, Casterton, Victoria 3311 3013

Caulfield Hospital Nursing Home,

3433 S

294 Kooyong Road, Caulfield, Victoria 3162 3014

Central Gippsland Nursing Home,

3432 S

Garden Grove, Traralgon, Victoria 3844 3015

The Clunes and District Hospital

4388 S

(The Clunes and District Nursing Home), Ballarat Road, Clunes, Victoria 3370 3016

Cobram & District Hospital (Irvin House),

3487 S

Broadway Street, Cobram, Victoria 3644 3017

Cohuna District Hospital

4371 S

(Cohuna District Nursing Home), 144-158 King George Street, Cohuna, Victoria 3568 3018

Coleraine and District Nursing Home,

4406 S

McKebery Street, Coleraine, Victoria 3315 3019

Corio House Nursing Home,

3407 S

Nelson Street, Warrnambool, Victoria 3280 3020

Creswick District Nursing Home,

4467 S

Napier Street, Creswick, Victoria 3363 3021

Cyril Jewell House,

4465 S

Hassett Crescent, Keilor East, Victoria 3033 3022

Darlingford Upper Goulburn Nursing Home,

4430 S

Eildon Road, Eildon, Victoria 3713 3023

Daylesford Nursing Home,

4416 S

13 Hospital Street, Daylesford, Victoria 3460 3024

Dimboola District Hospital

3481 S

Nursing Home Unit, 156-158 Lloyd Street, Dimboola, Victoria 3414 3025

Donald and District Hospital

4364 S

(Donald and District Nursing Home), Aitkin Avenue, Donald, Victoria 3480 3026

Don-Wood Nursing Home,

4423 S

Lot 1-5 Mt Dandenong Road, Croydon, Victoria 3136 3027

Dumunkle-Rupanyup Hospital

4379 S

(Rupanyup District Nursing Home), 89 Cromie Street, Rupanyup, Victoria 3388 3028

Eastern Suburbs Geriatric Centre,

4408 S

Cnr Mahoney’s Road and Burwood Highway, Burwood East, Victoria 3151 3029

Echuca District Hospital

3469 S

(Lumeah Nursing Home), 9-27 Francis Street, Echuca, Victoria 3564 3030

Edenhope District Hospital

3498 S

(Kowree Nursing Home Unit), 128-132 Elizabeth Street, Edenhope, Victoria 3318 3031

Edward Street Nursing Home,

4428 S

2-4-6 Edward Street, Upper Ferntree Gully, Victoria 3156 3033

Evelyn Wilson Nursing Home,

3475 S

183 MacAlister Street, Sale, Victoria 3850 3035

Gippsland South Health Service

3485 S

(Korumburra Campus), Bridge Road, Korumburra, Victoria 3950 3036

Gippsland South Health Service

3419 S

(Leongatha Campus), Koonwarra Road, Leongatha, Victoria 3953 3037

Glenview Community Care Nursing Home,

4393 S

High Street, Rutherglen, Victoria 3685 3038

Goulburn Valley Base Hospital

3411 S

(Nathalia & District Nursing Home), Elizabeth Street, Nathalia, Victoria 3638 3039

Goulburn Valley Base Hospital

3464 S

(Tatura Nursing Home), Park Street, Tatura, Victoria 3616 3040

Goulburn Valley Base Hospital

3402 S

(Waranga District Nursing Home), Coyle Street, Rushworth, Victoria 3612 3041

Grace McKellar House,

3409 S

45-95 Ballarat Road, North Geelong, Victoria 3215 3042

Hamilton Base Hospital

3472 S

Nursing Home, Foster Street, Hamilton, Victoria 3300 3043

Hazledean Nursing Home,

3459 S

211 Osborne Street, Williamstown, Victoria 3016 3044

Heathcote & District Hospital Nursing Home,

4399 S

39 Hospital Street, Heathcote, Victoria 3523 3044A

Hesse Rural Health Service

4474 S

8 Gosney Street Winchelsea, Victoria 3241 3045

Heywood Nursing Home,

4412 S

21 Barclay Street, West Heywood, Victoria 3304 3046

Hilary Blakiston House,

4420 S

49-95 Ballarat Road, North Geelong, Victoria 3220 3047

Ian Brand Nursing Home,

4427 S

Plenty Road, Bundoora, Victoria 3083 3048

Inglewood District Hospital

3492 S

(Nursing Home Unit), Hospital Street, Inglewood, Victoria 3517 3049

Jack Lonsdale Lodge,

4414 S

Morgan Street, Sebastapol, Victoria 3356 3050

The Jean Turner Nursing Home,

4413 S

14 Cairns Road, Rosebud, Victoria 3939 3051

Jeparit and District Hospital (Jeparit and

4382 S

District Nursing Home), Edith Street, Jeparit, Victoria 3434 3052

John Robb House Nursing Home,

4445 S

17-25 Colac Road, Belmont, Victoria 3216 3053

Kaniva District Hospital

4365 S

(Archie Gray Nursing Home Unit), Roache Street, Kaniva, Victoria 3419 3054

Kelaston Home for the Blind

3438 S

(Rooms 1 to 20), 1300 Howitt Street, Wendouree, Victoria 3355 3055

Kerang & District Hospital

3486 S

(Glenarm Wing), Burgoyne Street, Kerang, Victoria 3579 3057

Kingston Centre

4439 S

(Yarraman Nursing Home), Yarraman Road, Noble Park, Victoria 3174 3058

Kingston Centre Nursing Home,

3417 S

Cnr Kingston & Warrigal Roads, Cheltenham, Victoria 3192 3059

Koroit and District Hospital

4403 S

(Nursing Home Annexe), Mills Street, Koroit, Victoria 3282 3060

Kyabram Nursing Home

3455 S

(A G Hutchinson and T J Tehan Wings), Fenaughty Street, Kyabram, Victoria 3620 3061

Kyneton District Hospital

3496 S

(Thomas Hogan Wing), Simpson Street, Kyneton, Victoria 3444 3062

Latrobe Valley Nursing Home,

3493 S

Ollerton Avenue, Moe, Victoria 3825 3063

Lismore and District Hospital

4404 S

(Nursing Home Annexe), High Street, Lismore, Victoria 3324 3064

Lorne Community Hospital

4368 S

(Lorne Nursing Home), Lot 1 Albert Street Lorne, Victoria 3232 3065

Lyndoch Nursing Home,

3460 S

Hopkins Road, Warrnambool, Victoria 3280 3066

Macarthur Nursing Home,

4411 S

12 Archonachie Street, Macarthur, Victoria 3286 3067

Maffra District Hospital

3462 S

(J H F McDonald Wing), 48 Kent Street, Maffra, Victoria 3860 3068

Maldon District Hospital

3484 S

Nursing Home Unit, Chapel Street, Maldon, Victoria 3463 3069

Manangatang & District Hospital

4415 S

Nursing Home Unit, Pioneer Street, Manangatang, Victoria 3546 3070

Mansfield District Hospital

3478 S

(Bentley House), Highett Street, Mansfield, Victoria 3722 3071

Maryborough District Health Service

4402 S

(Dunolly Nursing Home), Havelock Street, Dunolly, Victoria 3472 3072

Maryborough District Health Service

3468 S

Nursing Home Unit, Clarendon Street Maryborough, Victoria 3465 3072A

Merv Irvine Nursing Home

4469 S

1231 Plenty Road Bundoora, Victoria 3083 3073

Mildura Base Hospital,

3454 S

Thirteenth Street, Mildura, Victoria 3500 3074

Mildura Base Hospital

3451 S

(Red Cliffs — Nursing Home Unit), 39 Jamieson Avenue, Red Cliffs, Victoria 3496 3075

Mildura Base Hospital

4385 S

(Robinvale — Nursing Home Unit), Latje Road, Robinvale, Victoria 3549 3077

Mooroopna Geriatric Nursing Home,

3458 S

McLennan Street, Mooroopna, Victoria 3629 3078

Mt Alexander Hospital Nursing Home Unit

3401 S

Cornish Street, Castlemaine, Victoria 3450 3079

Mt Eliza Centre (Carinya Nursing Home),

4434 S

Golf Links Road, Frankston, Victoria 3199 3080

Mt Eliza Geriatric Nursing Home,

3445 S

Jacksons Road, Mt Eliza, Victoria 3930 3081

Myrtleford District Hospital

3426 S

(Barwidgee Lodge), 30 O’Donnell Avenue, Myrtleford, Victoria 3737 3081A

Namarra Nursing Home,

4493 S

294 Kooyong Road, Caulfield, Victoria 3162 3082

Nhill Hospital (Mira Nursing Home),

3474 S

51 Nelson Street, Nhill, Victoria 3418 3083

Northwest Hospital (Greenvale Campus),

3410 S

Providence Road, Greenvale, Victoria 3059 3084

Northwest Hospital (McLellan House —

4396 S

Psychogeriatric Nursing Home), 22-26 Robinson Street, Jacana, Victoria 3047 3085

Northwest Hospital (Mt Royal Campus),

3420 S

Poplar Road, Parkville, Victoria 3052 3086

Northwest Hospital

4405 S

(Weighbridge — Psychogeriatric Nursing Home), 72 Ascot Vale Road, Flemington, Victoria 3031 3087

Omeo Hospital (Nursing Home Unit),

4461 S

Eastern Street, Omeo, Victoria 3898 3088

Ouyen & District Hospital

3500 S

(Canon T Martin Wing), Britt Street, Ouyen, Victoria 3490 3089

Ovens and Murray Nursing Home,

3421 S

Warner Road, Beechworth, Victoria 3747 3090

Penshurst Nursing Home (W J Lewis Wing),

4392 S

Watton Street, Penhurst, Victoria 3289 3091

The Peter James Centre Nursing Home,

4433 S

Cnr Mahoney’s Road and Burwood Highway, Burwood East, Victoria 3151 3092

Polworth House,

3466 S

Corangamite Street, Colac, Victoria 3250 3093

Port Fairy Nursing Home,

4449 S

Villiers Street, Port Fairy, Victoria 3284 3094

Portland and District Hospital,

3467 S

Seymour Cundy Wing, Bentinck Street, Portland, Victoria 3305 3095

The Queen Elizabeth Centre,

3422 S

102 Ascot Street, Ballarat, Victoria 3350 3096

Queen Elizabeth Centre

4468 S

(Ripon Peace Memorial Hospital), Havelock Street, Beaufort, Victoria 3373 3097

Queen Elizabeth Centre

4459 S

(P S Hobson Nursing Home), Gillies Street, Wendouree, Victoria 3355 3098

Reg Geary House,

4464 S

Pinnacle Crescent, Melton, Victoria 3337 3099

Rochester & Elmore District Health Service

4398 S

(Elmore Nursing Home), Jeffrey Street, Elmore, Victoria 3558 3100

Rochester & Elmore District Health Service

3405 S

(Rochester Nursing Home Annexe), Pascoe Street, Rochester, Victoria 3561 3101

S C Crabham Nursing Home,

3491 S

Graham Street, Wonthaggi, Victoria 3995 3102

Seymour District Hospital

3489 S

Nursing Home Unit, Brettoneaux Street, Seymour, Victoria 3660 3102A

Skipton and District Memorial Hospital

4480 S

Nursing Home, Blake Street, Skipton, Victoria 3361 3103

St Arnaud District Hospital

3477 S

Nursing Home Unit, North Western Road, St Arnaud, Victoria 3478 3104

Stawell and District Hospital

3480 S

(W H Syme and H and F Perry Wings), Sloan Street, Stawell, Victoria 3380 3105

St Hilary’s Nursing Home,

4410 S

16 Elgin Street, Morwell, Victoria 3840 3106

Swan Hill District Nursing Home,

3483 S

Splatt Street, Swan Hill, Victoria 3585 3107

Tallangatta Hospital

4397 S

Nursing Home Annexe, Barree Street, Tallangatta, Victoria 3700 3108

Tawonga District General Hospital

4377 S

(Kiewa Valley House), Holland Street, Mt Beauty, Victoria 3699 3109

Terang and District Community Hospital

4391 S

(Norah Cosgrove Nursing Home), 1 Austin Avenue, Terang, Victoria 3264 3110

Victoria Parade Geriatric Centre,

3441 S

45 Victoria Parade, Collingwood, Victoria 3066 3111

Wangaratta and District Nursing Home,

3457 S

Green Street, Wangaratta, Victoria 3677 3112

Warracknabeal and District Hospital

3488 S

(JR and AE Landt Trust Nursing Home), Dimboola Road, Warracknabeal, Victoria 3393 3113

Western Hospital

4394 S

(Westside Lodge Psychogeriatric Nursing Home), Santiago Street, St Albans, Victoria 3021 3114

West Gippsland Nursing Home,

3473 S

Landsborough Road, Warragul, Victoria 3820 3115

Westernport Nursing Home,

3443 S

Rossiter Road, Koo-wee-rup, Victoria 3981 3116

Willaura and District Hospital

4387 S

Nursing Home Unit, Delacombe Way Willaura, Victoria 3291 3117

Wimmera Base Nursing Home,

3465 S

Baillie Street, Horsham, Victoria 3400 3118

Wonthaggi Nursing Home

4425 S

(Armitage House Wing), Graham Street, Wonthaggi, Victoria 3995 3119

Wycheproof Hospital

3490 S

Nursing Home Section, Grandview Street, Wycheproof, Victoria 3527 3120

Yarram and District Nursing Home,

4443 S

85 Commercial Road, Yarram, Victoria 3971 3121

Yarrawonga Nursing Home,

3482 S

Piper Street, Yarrawonga, Victoria 3730 3122

Yea & District Hospital

4380 S

(Rosebank Nursing Home), 45 Station Street, Yea, Victoria 3717

Part 4 Queensland Column 1 Item

Column 2 Name and address of nursing home

Column 3 Approval No.

4001

Ashworth House Nursing Home,

5458 S

Kolberg Street, Zillmere, Queensland 4034 4002

Bayhaven Nursing Home,

5436 S

Hervey Bay, Queensland 4655 4003

Dr E A F McDonald Nursing Home,

5448 S

Beale Street, Oakey, Queensland 4401 4004

Eventide Charters Towers,

5405 S

Dalrymple Road Charters Towers, Queensland 4820 4005

Eventide Nursing Home,

5406 S

Cnr North and Campbell Streets, Rockhampton, Queensland 4701 4006

Eventide Nursing Home,

5404 S

Beaconsfield Terrace, Sandgate, Queensland 4017 4007

Farrhome Nursing Care Unit,

5443 S

Youngman Street, Kingaroy, Queensland 4610 4008

The Gertrude E Moore Memorial Nursing

5459 S

Home, Anzac Parade, Yeppoon, Queensland 4703 4009

Karingal Nursing Home,

5442 S

c/- Dalby Health Services, Private Mail Bag No. 2, Dalby, Queensland 4405 4010

Maryborough Hospital Nursing Home,

5438 S

Maryborough Base Hospital, 185 Walker Street, Maryborough, Queensland 4650 4011

Moreton Bay Nursing Care Unit,

5432 S

2082 Wynnum Road, Wynnum West, Queensland 4178 4012

Mt Lofty Nursing Home,

5414 S

Stuart Street, Toowoomba, Queensland 4350 4013

Nambour Hospital Nursing Home,

5449 S

Hospital Road, Nambour, Queensland 4560 4014

North Rockhampton Nursing Home,

5446 S

Norman Road North, North Rockhampton, Queensland 4701 4015

The Oaks Nursing Home,

5462 S

56 Locke Street, Warwick, Queensland 4370 4016

Prince Charles Hospital Nursing Home Unit

5402 S

(Jacaranda Village), 500-600 Rode Road, Chermside, Queensland 4032 4017

Redcliffe Hospital Nursing Home Annexe,

5430 S

Sheehan Street, Redcliffe, Queensland 4020 4018

Townsville Nursing Home,

5445 S

220 Palmerston Street, Vincent, Queensland 4814 4019

Westhaven Nursing Home,

5439 S

PO Box 124, Roma, Queensland 4455 4020

Wienholt Nursing Care Unit,

5444 S

Bramston Street Wondai, Queensland 4606

Part 5 South Australia Column 1

Column 2

Column 3

Item

Name and address of nursing home

Approval No.

5001

Hampstead Nursing Centre,

6404 S

207 Hampstead Road, Northfield, South Australia 5085 5002

Julia Farr Centre,

6402 S

103 Fisher Street, Fullarton, South Australia 5063 5003

Makk and McLeay Nursing Home

6010 S

Fosters Road, Gilles Plains, South Australia 5086 5004

Minda Nursing Home

6011 S

King George Avenue Brighton, South Australia 5048 5005

St Basil’s Glandore Nursing Home,

6409 S

56 Pleasant Avenue, Glandore, South Australia 5037 5006

Strathmont Nursing Home,

6012 S

Grand Junction Road, Oakden, South Australia 5086 5007

Tregenza Avenue Aged Care Service,

6403 S.

21 Tregenza Avenue, Elizabeth South, South Australia 5112

Part 6 Western Australia Column 1 Item 6001

Column 2 Name and address of nursing home

Column 3 Approval No.

Albany Regional Hospital Nursing Home,

7429 S

Hardie Road, Albany, Western Australia 6330 6002

Alfred Carson Nursing Home,

7414 S

30 Bay Road, Claremont, Western Australia 6010 6003

Augusta Hospital Nursing Home,

7433 S

Blackwood Avenue, Augusta, Western Australia 6290 6004

Brookton Nursing Home,

7423 S

Lennard Street, Brookton, Western Australia 6306 6005

Bunbury Hospital Nursing Home,

7428 S

Clark Street, Bunbury, Western Australia 6230 6006

Esperance Nursing Home,

7912 S

P O Box 1350, Esperance, Western Australia 6450 6007

Homes of Peace Inglewood Nursing Home,

7415 S

4 Walter Road, Inglewood, Western Australia 6052 6008

Homes of Peace Subiaco Nursing Home,

7401 S

Thomas Street, Subiaco, Western Australia 6008 6009

Mount Henry Nursing Home,

7404 S

Cloister Avenue, Como, Western Australia 6152 6010

Northam Hospital Nursing Home,

7430 S

Duke Street, Northam, Western Australia 6401 6011

Numbala Nunga Nursing Home,

7426 S

Sutherland Street, Derby, Western Australia 6728 6012

Yulanya Nursing Home,

7425 S

Kingsmill Street, Port Hedland, Western Australia 6721 6013

Silver Chain Nursing Association Hospital,

7431 S

Laidlow Street, Hilton Park, Western Australia 6163



Part 7 Tasmania Column 1 Item

Column 2 Name and address of nursing home

Column 3 Approval No.

7001

Allambi Special Care Unit,

8414 S

Howick Street, Launceston, Tasmania 7250 7002

Rosary Gardens Nursing Home,

8416 S

St John’s Park, St John’s Avenue, New Town, Tasmania 7008 7003

Vaucluse Gardens Nursing Home,

8415 S

St John’s Park, St John’s Avenue, New Town, Tasmania 7008 7004

Strath Devon Nursing Home,

8405 S

Torquay Road, Latrobe, Tasmania 7307 7005

North East Soldiers Memorial Hospital

8412 S

(James Scott Nursing Home), 8 Cameron Street, Scottsdale, Tasmania, 7260 7006

Karingal Nursing Home,

8418 S

Lovett Street, Devonport, Tasmania 7310 7007

Smithton Nursing Home,

8407 S

Bass Highway, Smithton, Tasmania 7330 7008

Southern Region Nursing Home,

8417 S

St John’s Avenue, New Town, Tasmania 7008 7009

Spencer Nursing Home,

8419 S

Goldie Street, Wynyard, Tasmania 7325 7009A

Strathglen Nursing Home,

8420 S

Chardonnay Drive, Berriedale, Tasmania 7011 7010

Toosey Nursing Home,

8409 S

Archer Street, Longford, Tasmania 7301

Schedule 6 Information which may be provided to the Department of Veterans’ Affairs (regulation 52)

1. Patient details: (a) surname of patient; (b) first given name of patient; (c) other given names of patient (if any); (d) date of birth of patient; (e) sex of patient; (f) address (including postcode) of patient; (g) departmental computer code identifying patient; (h) departmental computer code identifying patient’s State or Territory of residence; (i) departmental computer code indicating that the patient is deceased (if applicable). 2. Nursing home details: (a) name of nursing home; (b) address (including postcode) of nursing home; (c) approval number of nursing home; (d) name of proprietor of nursing home; (e) type of nursing home: (i) private; or (ii) government; or (iii) charitable; or (iv) transferred; or (v) adjusted fee government; (f) departmental computer code indicating whether nursing home is an exempt nursing home; (g) period (if any) for which nursing home has been granted exempt status. 3. Patient admission details: (a) date of admission of patient to nursing home (year, month and day); (b) date of admission approval in accordance with form NH5 (authorised under subsection 40AB (1) of the Act) (year, month and day); (c) departmental computer code identifying delegated authority approving admission of patient; (d) type of care provided to patient: (i) non respite (continuing care); or (ii) benefit respite care; or (iii) leave respite care; (e) if the patient has been discharged from nursing home — the date of discharge (year, month and day); (f) if the patient has died, date of death (year, month and day). 4. Patient assessment details: (a) classification category of patient in accordance with form NH4 (authorised under subsection 40AFD (4) of the Act); (b) if the patient was approved for a particular category — the date of approval (year, month, day); (c) assessment of patient in accordance with form NH10 (authorised under subsection 40AF (1) of the Act): (i) ordinary care; or (ii) extensive care; (d) if the patient was approved for extensive care — the date of approval (year, month, day); (e) departmental computer code identifying delegated authority approving assessment. 5. Monthly payment record and category of patient: (a) monthly date for payment (year, month); (b) claimable occupied bed days; (c) non-claimable occupied bed days; (d) claimable social leave days; (e) non-claimable social leave days; (f) claimable hospital leave days; (g) non-claimable hospital leave days; (h) claimed monthly payment; (i) departmental computer code identifying occupied bed days and payments relating to exempt or non-exempt patients.

Schedule 7 Hospital Casemix Protocol (regulation 49A)

Part 1 Explanatory notes Hospital Casemix Protocol: object 1. The object of the Hospital Casemix Protocol is to specify the financial, clinical and demographic data that funds must give to the Department in respect of every episode of hospital treatment for which a charge is billed to a fund. Hospital Casemix Protocol: definitions 2. In this Protocol: blank filled means that where blank filling is a valid entry, the field is filled with blanks. CCU means the Coronary Care Unit of a hospital; CMBS means Commonwealth Medicare Benefits Schedule. contracted doctor means a doctor who has entered into a medical purchaserprovider agreement under section 73BDA of the National Health Act 1953. contracted hospital means a hospital that has entered into a purchaser-provider agreement under section 73BD of the National Health Act 1953. DRG means Diagnosis Related Group. episode means the period between admission and separation that a person spends in one hospital, and includes leave periods not exceeding 7 days. Note This definition of episode differs from the definition set out in the NHDD.

fund means a health benefits fund conducted by a registered organization. gap cover scheme has the same meaning as given in subsection 4 (1) of the National Health Act 1953. ICD-10-AM means The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification. ICU means the Intensive Care Unit of a hospital. MAA means mandatory for all, and fields identified with this flag must contain a valid entry regardless of whether the episode occurred in a contracted hospital or a non contracted hospital. MAC means mandatory for contracted hospitals, and fields identified with this flag must contain a valid entry. Where the episode occurred in a non contracted hospital, the field becomes optional. NHDD means version 8 of the National Health Data Dictionary, published in 1999. OPA means that fields identified with this flag are optional for all hospitals. OPH means optional for public hospitals, and fields identified with this flag are optional for public hospitals, whether contracted or not, and mandatory for private hospitals. OPO means optional for public hospitals overnight, and fields identified with this flag are optional for public hospitals, whether contracted or not, where the patient stayed overnight. overnight-stay patient means a person who is admitted to, and who separates from, a hospital on different dates. sameday patient means a person who is admitted to, and who separates from, a hospital on the same date. valid arrangement means an arrangement made under section 4C of the National Health Act 1953. Note NHTP (nursing home type patient) is defined in subsection 3 (1) of the Health Insurance Act 1973.

How to use the Protocol: the Parts of the Protocol 3. The medical record supplied to the Department by a fund must comply with the specification set out in the File Structure: Medical Record in Part 2, and with the contents set out in Record Content: Medical Record in Part 4. 4. The hospital episode record supplied to the Department by a fund must comply with the specification set out in the File Structure: Hospital Episode Record in Part 3, and with the contents set out in Record Content: Hospital Episode Record in Part 5. How to use the Protocol: format specifications and how the details must be sent 5. All fields are to be initialised to blanks. 6. Blanks are not a valid entry for some fields. These fields are identified in Column 5. 7. Where identified in Column 5, blanks are a valid entry under the following conditions: (a) the data item is optional; or (b) specific conditions apply and these are noted in Column 5. 8. A record will be rejected by the Department if any of the following data items is coded as blank: (a) Fund/Payer identifier in either Part 4 or 5; (b) Link identifier in either Part 4 or 5; (c) Provider (hospital) code in Part 5; (d) Date of birth in Part 5; (e) Postcode in Part 5; (f) Sex in Part 5; (g) Admission date in Part 5; (h) Separation date in Part 5; (i) Mode of separation in Part 5; (j) Principal diagnosis code in Part 5. 9. Records not containing valid entries for items in item 8 will be rejected. 10. If 10% of records in any transmission batch are rejected all records in that transmission batch will be returned to the fund. The fund will resubmit the rejected transmission within 4 weeks from the date of receipt of rejected records. 11. Where a hospital is required to provide data to a fund, the hospital episode record must comply with the specifications set out in the File Structure: Hospital Episode Record in Part 3. The hospital must reach an agreement with the fund as to the medium on which the data must be sent. 12. Where a fund gives data to the Department, the fund must give the data to the Department using: (a) DOS formatted floppy disks; or (b) magnetic tapes; or (c) MVS cartridges; or (d) other electronic media as agreed with the Department in writing. How to use the Protocol: data structure and specifications 13. A fund must give data to the Department in ASCII format with a record length as stated in Parts 2 and 3 of the Protocol. 14. For the purpose of the field size column (Column 3 in Parts 4 and 5): (a) D is a date field. Legal values are 0-9 and blanks. The format is DDMMCCYY; (b) N is a numeric field. N fields must be right justified and left blank filled. Legal characters are 0-9 and blanks; (c) C is a character field. C fields must be right justified and left blank filled. Legal characters are alpha, 0-9 and blanks; (d) I is for ICD-10-AM codes. I fields must be left justified and right blank filled and should not include decimal points. 15. Data items requiring rounding are noted in Column 5 in Parts 4 and 5. Rounding takes fractions to the nearest whole number. If the fraction is 0.5 acceptable rounding is up for an odd number and down for an even number. 16. All data items should reflect the completed discharge data set. How to use the Protocol: how will the data transfer work 17. A fund has the primary responsibility for giving the information set out in Column 2-Data item of Parts 4 and 5. 18. Where the fund gives data to the Department, the data must include all episodes, whether or not the episodes took place in a contracted hospital. 19. Where the hospital gives data to the fund: (a) the data set out in items 29-67 in Part 5, Record Content: Hospital Episode Record must be sent; and (b) the data sent in accordance with paragraph (a) must be sent using the structure set out in items 29-67 in Part 3, File Structure: Hospital Episode Record. Note The NHDD is published by the Australian Institute of Health and Welfare and aims to set out uniform definitions and data items to be used in the collection of health and welfare data. The definitions set out in the NHDD are endorsed by the National Health Information Management Group through the National Health Information Agreement.

Part 2 File structure: medical record Column 1 Item

Column 2 Data Item

Column 3 Start Position

Column 4 Field size

Column 5 Repetitions

1

Fund/Payer identifier

1

3

1

2

Link identifier

4

24

1

3

CMBS item/ code

28

14

1

4

Item charge

42

5

1

5

CMBS benefit

47

5

1

6

Fund benefit

52

5

1

7

CMBS date of service

57

8

1

8

Contracted doctor

65

1

1

9

Total record length

65





Miscellaneous service

Part 3 File structure: hospital episode record Column 1

Column 2

Column 3

Column 4

Column 5

Item

Data item

Start position

Field size

Repetitions

1

Fund/Payer identifier

1

3

1

2

Link identifier

4

24

1

3

Provider (hospital) code

28

8

1

4

Product code

36

8

1

5

Hospital contract status

44

1

1

6

Total days paid

45

4

1

7

Accommodation charge

49

6

1

8

Accommodation benefit

55

6

1

9

Theatre charge

61

5

1

10

Theatre benefit

66

5

1

11

Labour ward charge

71

5

1

12

Labour ward benefit

76

5

1

13

ICU charge

81

5

1

14

ICU benefit

86

5

1

15

Prosthesis charge

91

5

1

16

Prosthesis benefit

96

5

1

17

Pharmacy charge

101

5

1

18

Pharmacy benefit

106

5

1

19

Bundled charge

111

6

1

20

Bundled benefit

117

6

1

21

Other charges

123

5

1

22

Other benefits

128

5

1

23

Front end deductible

133

5

1

24

Ancillary cover status

138

1

1

25

Ancillary charges

139

5

1

26

Ancillary benefits

144

5

1

27

Item charges

149

6

1

28

Total CMBS and fund benefits

155

6

1

29

Date of birth

161

8

1

30

Postcode

169

4

1

31

Sex

173

1

1

32

Admission date

174

8

1

33

Separation date

182

8

1

34

Hospital type

190

1

1

35

ICU days

191

3

1

36

DRG code

194

4

1

37

DRG version

198

2

1

38

Admission time

200

4

1

39

Neonatal admission weight

204

4

1

40

Hours of mechanical ventilation

208

4

1

41

Mode of separation

212

2

1

42

Separation time

214

4

1

43

Source of referral

218

1

1

44

Service category on admission

219

1

1

45

Total leave days

220

4

1

46

Non-acute days of stay

224

4

1

47

Principal diagnosis 228 code

5

1

48

Additional diagnoses

233

5

19

49

Procedure codes

328

7

20

50

Sameday status

468

1

1

51

Principal CMBS item number/ Miscellaneous service code

469

14

1

52

Principal CMBS date

483

8

1

53

Time in theatre (Principal CMBS)

491

4

1

54

Secondary CMBS item numbers/ Miscellaneous service codes

495

14

9

55

Total days spent at 621 home

2

1

56

Total psychiatric care days

623

3

1

57

Mental health legal status

626

1

1

58

ICU hours

627

4

1

59

Admission status

631

1

1

60

Contract status on admission

632

1

1

61

Palliative care status

633

1

1

62

Unplanned 634 readmission within 28 days

1

1

63

Unplanned theatre visit during episode

635

1

1

64

Marital status

636

1

1

65

Provider number of hospital from which transferred

637

8

1

66

Provider number of hospital to which transferred

645

8

1

67

Discharge intention on admission

653

1

1

68

Total record length

653





Part 4 Record content: medical record Column 1

Column 2

Column 3

Column 4

Column 5

Item

Data item

Field size

Required

Description of data item

1

Fund/Payer

C(3)

MAA

See fund codes

C(24)

MAA

A unique identifier of

identifier 2

Link identifier

an episode that links data items from this Part (Part 4) to the hospital episode record (Part 5). The fund may encrypt the membership identifier for this purpose 3

CMBS item/ Miscellaneous service code

C(14)

MAA

The CMBS item number, miscellaneous service code or Australian Dental Association code









Blank = no CMBS item billed

4

Item charge

N(5)

MAA

The amount the patient was billed by the doctor or health service provider









0 = no amount billed

5

CMBS benefit

N(5)

MAA

The amount paid to the patient as the Medicare entitlement









An entry of 0 dollars means no amount was paid

6

Fund benefit

N(5)

MAA

An amount additional to the Medicare entitlement paid by the fund to the patient









An entry of 0 dollars means no amount was paid

7

CMBS date of

D(8)

MAA

service

DDMMCCYY Blank means there was no CMBS date of service

8

Contracted

C(1)

MAA

doctor

Y means the CMBS medical charge was billed by a doctor with whom the fund has a contract









N means a doctor with whom the fund has no contract









Blank means there was no CMBS item billed

Part 5 Record content: hospital episode record

Item

Data item

Field size

Required

Coding description

1

Fund/Payer identifier

C(3)

MAA

See fund codes

2

Link identifier

C(24)

MAA

A unique identifier of the episode linking data items from this Part (Part 5) to the medical record (Part 4)









The fund may encrypt the membership identifier for this purpose

3

Provider

C(8)

MAA

(hospital) code 4

Product code

The hospital provider number

C(8)

MAA

The product code for the patient’s insurance cover at separation









The fund must supply documentation of cover field values

5

Hospital

C(1)

MAA

contract status

Y = a hospital with which a fund has a contract N = a hospital with which the fund does not have a contract

6

Total days paid

N(4)

MAA

The total number of days benefits were paid for by the fund, including days benefits were paid for as an NHTP

7

Accommodation N(6)

MAA

charge

Accommodation charge rounded to the nearest dollar









0 = no accommodation charge billed









Blanks only valid if an accommodation charge was not separately identified but billed under another charge item

8

Accommodation N(6)

MAA

benefit

Accommodation benefit rounded to the nearest dollar









0 = no accommodation benefit paid









Blanks only valid if an accommodation benefit was not separately identified but paid under another benefit item

9

Theatre charge

N(5)

MAA

Theatre charge rounded to the nearest dollar









0 = no theatre charge billed









Blanks only valid if a theatre charge was not separately identified but billed under another charge item

10

Theatre benefit

N(5)

MAA

Theatre benefit rounded to the nearest dollar









0 = no theatre benefit paid









Blanks only valid if a theatre benefit was not separately identified but paid under another benefit item

11

Labour ward

N(5)

MAA

charge

Labour ward charge rounded to the nearest dollar









0 = no labour ward charge billed









Blanks only valid if a labour ward charge was not separately identified but billed under another charge item

12

Labour ward

N(5)

MAA

benefit

Labour ward benefit rounded to the nearest dollar









0 = no labour ward benefit paid









Blanks only valid if a labour ward benefit was not separately identified but paid under another benefit item

13

ICU charge

N(5)

MAA

ICU charge rounded to the nearest dollar









0 = no ICU charge billed









Blanks only valid if an ICU charge was not separately identified but billed under another charge item

14

ICU benefit

N(5)

MAA

ICU benefit rounded to the nearest dollar









0 = no ICU benefit paid









Blanks only valid if an ICU benefit was not separately identified but paid under another benefit item

15

Prosthesis

N(5)

MAA

charge

Prosthesis charge rounded to the nearest dollar









0 = no prosthesis charge billed









Blanks only valid if a prosthesis charge was not separately identified but billed under another charge item

16

Prosthesis

N(5)

MAA

benefit

Prosthesis benefit rounded to the nearest dollar









0 = no prosthesis benefit paid









Blanks only valid if a prothesis benefit was not separately identified but paid under another benefit item

17

Pharmacy

N(5)

MAA

charge

Pharmacy charge rounded to the nearest dollar









0 = no pharmacy charge billed









Blanks only valid if a pharmacy charge was not separately identified but billed under another charge item

18

Pharmacy

N(5)

MAA

benefit

Pharmacy benefit rounded to the nearest dollar









0 = no pharmacy benefit paid









Blanks only valid if a pharmacy benefit was not separately identified but paid under another benefit item

19

Bundled

N(6)

MAA

charges

Bundled charge rounded to the nearest dollar









0 = no bundled charge billed

20

Bundled

N(6)

MAA

benefits

Bundled benefit rounded to the nearest dollar









0 = no bundled benefit paid

21

Other charges

N(5)

MAA

Other charges rounded to the nearest dollar









0 = no other charge billed

22

Other benefits

N(5)

MAA

Other benefits rounded to the nearest dollar









0 = no other benefit paid

23

Front end

N(5)

MAA

deductible

The amount of FED deducted from the benefit, otherwise payable by the fund to the patient









Blank = there is a FED but the amount is unknown 0 = no FED applicable

24

Ancillary cover

C(1)

MAA

status

Y = patient has ancillary cover N = patient does not have ancillary cover

25

Ancillary

N(5)

OPA

charges

The ancillary charges incurred during the episode and billed against an ancillary table

26

Ancillary

N(5)

OPA

benefits

The ancillary benefits paid for charges billed as occurring during the episode

27

Item charges

N(6)

MAA

The total item charges as set out in Part 4

28

Total CMBS and N(6)

MAA

fund benefits

The total CMBS and fund benefits as set out in Part 4

29

Date of birth

D(8)

MAA

DDMMCCYY

30

Postcode

C(4)

MAA

The patient’s residential postcode

31

Sex

C(1)

MAA

1 = male 2 = female 0 = unknown

32

Admission date

D(8)

MAA

DDMMCCYY

33

Separation date

D(8)

MAA

DDMMCCYY

34

Hospital type

C(1)

MAA

1 = public 2 = private 3 = private day facility 4 = public day facility 9 = other

35

ICU days

N(3)

MAA

The number of days the patient spent in one or more of the following: • ICU • CCU • neonatal intensive care • paediatric intensive care









This does not include days spent in High Dependency Units

36

DRG code

C(4)

OPA

Blank filled if not known

37

DRG version

C(2)

OPA

10 = version 1 20 = version 2 21 = version 2.1 30 = version 3 31 = version 3.1 40 = version 4 41 = version 4.1

38

Admission time

N(4)

MAA

The admission time is

(sameday

based on a 24hour

patients

clock (for example,

only)

6:35AM is entered as 0635)

39

Neonatal

N(4)

MAA

The admission weight

admission

rounded to the nearest

weight

gram for a neonate (patient age less than 29 days old) or an older baby weighing less than 2500 grams

40

Hours of

N(4)

MAA

The number of hours,

mechanical

rounded to the nearest

ventilation

hour, that the patient received mechanical ventilation during the episode

41

Mode of

C(2)

MAA

separation

01 = separation or transfer of the patient to an acute care hospital 02 = separation or transfer of the patient to a nursing home 03 = separation or transfer of the patient to a psychiatric hospital 04 = separation or transfer of the patient to another health facility 05 = statistical separation/type change 06 = patient left the hospital against medical advice 07 = statistical separation from leave 08 = patient died 09 = patient went home/other

42

Separation time

N(4)

MAA

The separation time is

(sameday

based on a 24hour

patients

clock (for example,

only)

10:35PM is entered as 2235)

43

Source of

N(1)

MAA

referral

0 = born in hospital 1 = admitted patient transferred from another hospital 2 = statistical admission/type change 4 = from Accident/ Emergency 5 = from community health service 6 = from Outpatients department 7 = from nursing home 8 = by outside medical practitioner 9 = other

44

Service category N(1)

MAA

on admission

The type of service for which the patient was initially admitted









1 = acute care 2 = rehabilitative care 3 = palliative care 4 = non-acute care 5 = unqualified neonate 6 = other

45

Total leave days

N(4)

MAA

This data item is calculated as the sum of leave days for all leave periods during the episode









0 = no leave days









Leave days exclude 1 day leave periods for patients and are subject to the following conditions:









• a patient who does not require treatment over a weekend or another short period may leave the hospital temporarily with the approval of the hospital or treating medical practitioner









• if there is a decision that the patient will return to the same hospital within a short time to resume treatment, this absence is defined as leave

46

Non-acute days

N(4)

MAA

of stay

The number of days spent in the hospital, without certification, that exceeded 35 days

47

Principal

I(5)

MAA

diagnosis code

The ICD-10-AM code for the diagnosis or condition chiefly responsible for the hospital admission









A blank entry is not valid for this field

48

Additional

I(5)

MAA

diagnosis

19 times

ICD-10-AM diagnosis codes for conditions or complaints other than the principal diagnosis that arose during the patient’s stay in hospital or existed at the time of the patient’s admission to hospital

49

Procedure codes

I(7)

MAA

20 times

ICD-10-AM procedure codes for all procedures performed during the episode









Blank = no applicable ICD10AM procedure code

50

Sameday status

C(1)

MAA

0 = patient with a valid arrangement allowing overnight stay for procedure normally performed on a sameday basis 1 = sameday patient 2 = overnight patient other than type 0 above

51

Principal CMBS

C(14)

item number/



OPH

Principal CMBS item or miscellaneous service

Miscellaneous

code or ADA code

service code

related to the first procedure code referred to in item 49 of this Part









Blank = no applicable CMBS item

52

Principal CMBS

D(8)

OPH

date

The date when the principal CMBS procedure was carried out









Blank = no principal CMBS date

53

Time in theatre

N(4)

MAA

The time in minutes the

(Principal

(sameday

patient spent in the

CMBS)

patients

theatre, from the time

only)

the patient entered the theatre until the time the patient left the theatre









0 = no time spent in the theatre









Blank = no applicable CMBS item

54

Secondary

C(14)

OPH

Additional CMBS item

CMBS item

9 times

numbers or

numbers/



miscellaneous service

Miscellaneous

codes or ADA codes

service code

related to the procedure codes referred to in item 49 of this Part









Blank = no applicable CMBS item

55

Total days spent

N(2)

MAA

at home

The number of days the

(Hospital- patient spent at home in-home

where part of the

episodes

episode was provided

only)

through a hospital-inthe-home program

56

Total psychiatric N(3)

OPA

care days

The sum of the number of days and part days of stay that the person was an admitted patient or resident within a designated psychiatric unit, minus the sum of leave days occurring during the stay within the unit

57

Mental health

N(1)

OPA

legal status

An indication that the patient was treated under relevant mental health legislation at some point during the episode









1 = involuntary patient 2 = voluntary patient

58

ICU hours

N(4)

OPA

The number of hours spent by the patient in one or more of the following: • ICU • CCU • neonatal intensive care









This does not include hours spent in Special Care Nurseries or High Dependency Units

59

Admission

N(1)

OPA

status

An indication of the admission status of the patient









1 = emergency 2 = planned/ elective 3 = other

60

Contract status

N(1)

OPA

on admission

1 = service provided under contract on behalf of another hospital 2 = service other than 1

61

Palliative care

N(1)

OPA

status

1 = palliative care required during the episode 2 = no palliative care required during the episode

62

Unplanned

A(1)

OPA

Readmission of patient

readmission

to hospital within 28

within 28 days

days of the previous discharge for treatment of a similar or related condition









Y = unplanned readmission N = planned readmission Blank = no readmission

63

Unplanned

N(1)

OPA

Patient required a

theatre visit

theatre visit that was

during episode

not planned or anticipated at the time of admission









1 = unplanned theatre visit 2 = no unplanned theatre visit

64

Marital status

N(1)

OPA

1 = never married 2 = widowed 3 = divorced 4 = separated 5 = married (including de facto) 6 = not stated/ inadequately described

65

Provider

66

A(8)

transferred from

hospital from

another hospital, the

which

hospital provider

transferred

number of that hospital A(8)

OPA

If the patient was

number of

transferred to another

hospital to

hospital, the hospital

which

provider number of that

transferred

hospital

Discharge



If the patient was

number of

Provider

67

OPA

A(1)

OPA

The intended mode of

intention on

separation at time of

admission

admission







Discharge to: 1 = acute hospital 2 = nursing home 3 = psychiatric hospital 4 = palliative care unit/hospice 5 = other health care accommodation 6 = usual residence

68

Gap cover scheme identifier

C(5)

MAA

A unique identifier for an approved gap cover scheme Blank = service not provided under a gap cover scheme

Part 6 Registered health benefits organizations Column Item

1

Column 2 Name

Column 3 Identifier

1

A.C.A. Health Benefits Fund

ACA

2

A.M.A. Health Fund Limited

AMA

3

Army Health Benefits Society

AHB

4

Australian Health Management Pty Ltd

AHM

5

Australian Unity Friendly Society*

AUF

6

C.D.H. Benefits Fund

CDH

7

Commonwealth Bank Health Society (Friendly Society)

CBH

8

Credicare Health Fund

CHF

9

Eastern District Health Fund Ltd

WDH

10

Geelong Medical and Hospital Benefits Association Limited

GMH

11

Goldfields Medical Fund (Inc.)

GMF

12

Grand United Corporate Health Limited

GUC

13

Grand United Friendly Society

GUF

14

Health Care Insurance Ltd

HCI

15

Healthguard Health Benefits Fund Limited

HHB

16

Health Insurance Fund of WA

HIF

17

Hospital Benefits Association Limited**

HBA

18

Hospital Benefits Fund of Western Australia (Inc.), HBF The

19

Hospitals Contribution Fund of Australia, Limited, The

HCF

20

Independent Order of Odd Fellows of Victoria

IOF

21

I.O.R. Australia Pty Ltd

IOR

22

Latrobe Health Services, Inc.

LHS

23

Lysaght Hospital and Medical Club, The

LHM

24

Manchester Unity Independent Order of Oddfellows Friendly Society in New South Wales

MUI

25

Medibank Private (Health Insurance Commission)

MBP

26

Medical Benefits Fund of Australia Ltd

MBF

27

Mildura District Hospital Fund

MDH

28

MIM Employees Health Fund

MIM

29

Mutual Community Ltd**

MCL

30

National Mutual Health Insurance Pty Ltd**

NMH

31

Naval Health Benefits Society

NHB

32

New South Wales Teacher’s Federation Health Society

NTF

33

N.I.B. Health Funds Limited

NIB

34

Phoenix Welfare Association Limited, The

PWA

35

Queensland Teachers Union Health Society

QTU

36

Railway & Transport Employees’ Friendly Society Health Fund

RTE

37

Reserve Bank Health Society

RBH

38

S.G.I.C. Health Pty Limited

SGI

39

South Australian Police Employees’ Health Fund Incorporated

SPE

40

South Australian Public Servants

SPS

41

St Luke’s Medical & Hospital Benefits Association SLM

42

Transition Benefit Fund

TBF

43

Transport Friendly Society

TFS

44

United Ancient Order of Druids

UAD

45

United Ancient Order of Druids Registered Friendly Society Grand Lodge of New South Wales, The

UAF

46

Yallourn Medical and Hospital Society, The

YMH

Notes * Australian Natives’ Association and Manchester Unity Independent Order of Oddfellows Friendly Society in Victoria now trade as Australian Unity Friendly Society. ** Mutual Community is owned and operated by National Mutual. In Victoria, Mutual Community trades as HBA.

Notes to theNational Health Regulations 1954 Note 1 The National Health Regulations 1954 (in force under the National Health Act 1953) as shown in this compilation comprise Statutory Rules 1954 No. 35 amended as indicated in the Tables below.

Table of Statutory Rules Year and number

Date of notification in Gazette

Date of commencement

Application, saving or transitional provisions

1954 No. 35 1957 No. 71 1958 No. 63 1962 No. 55 1962 No. 70 1962 No. 113

14 Apr 1954 12 Dec 1957 2 Oct 1958 12 July 1962 16 Aug 1962 24 Dec 1962

— — — — —

1965 No. 17 1965 No. 94 1965 No. 185 1966 No. 99 1967 No. 86 1969 No. 91 1969 No. 220 1970 No. 70 1970 No. 166 1971 No. 28 1971 No. 76 1971 No. 103 1971 No. 138 1972 No. 79 1973 No. 17 1973 No. 75 1973 No. 111 1973 No. 221 1973 No. 225

4 Feb 1965 15 July 1965 16 Dec 1965 24 June 1966 29 June 1967 19 June 1969 30 Dec 1969 28 May 1970 29 Oct 1970 1 Mar 1971 24 June 1971 20 Aug 1971 29 Oct 1971 5 June 1972 2 Feb 1973 12 Apr 1973 15 June 1973 14 Nov 1973 22 Nov 1973

1973 No. 267 1974 No. 52 1974 No. 104 1974 No. 105 1974 No. 113 1974 No. 263 1975 No. 14 1975 No. 49 1975 No. 66 1975 No. 100 1975 No. 124 1975 No. 165 1975 No. 207 1976 No. 113 1976 No. 217 1976 No. 227 1977 No. 11 1977 No. 34 1977 No. 51 1977 No. 112 1978 No. 66 1978 No. 178 1978 No. 208 1978 No. 266 1979 No. 59 1979 No. 107 1979 No. 208 1979 No. 231 1980 No. 84 1980 No. 292 1980 No. 309 1981 No. 43 1981 No. 97 1981 No. 115 1981 No. 232 1981 No. 318 1982 No. 38

19 Dec 1973 11 Apr 1974 24 June 1974 24 June 1974 29 June 1974 23 Dec 1974 10 Feb 1975 1 Apr 1975 22 Apr 1975 30 May 1975 27 June 1975 6 Aug 1975 10 Nov 1975 4 June 1976 30 Sept 1976 15 Oct 1976 3 Feb 1977 21 Mar 1977 28 Apr 1977 5 July 1977 10 May 1978 26 Sept 1978 2 Nov 1978 21 Dec 1978 11 Apr 1979 29 June 1979 2 Oct 1979 31 Oct 1979 23 Apr 1980 30 Sept 1980 28 Oct 1980 20 Mar 1981 7 May 1981 29 May 1981 21 Aug 1981 4 Nov 1981 10 Feb 1982

1982 No. 82

23 Apr 1982

1982 No. 84 1982 No. 250 1982 No. 284 1983 No. 45

23 Apr 1982 1 Oct 1982 29 Oct 1982 29 Apr 1983

1983 No. 247 1983 No. 267 1984 No. 66

31 Oct 1983 10 Nov 1983 30 Apr 1984

1984 No. 161 1984 No. 200 1984 No. 308 1984 No. 322 1984 No. 427 1985 No. 86

25 July 1984 27 Aug 1984 26 Oct 1984 2 Nov 1984 14 Dec 1984 7 June 1985

1985 No. 136 1985 No. 186 1985 No. 187 1985 No. 206 1985 No. 288 1986 No. 47 1986 No. 53 1986 No. 208 1986 No. 330 1986 No. 353 1986 No. 360

28 June 1985 6 Aug 1985 6 Aug 1985 29 Aug 1985 7 Nov 1985 11 Apr 1986 18 Apr 1986 18 Aug 1986 12 Nov 1986 3 Nov 1986 19 Dec 1986

1987 No. 50 1987 No. 76 1987 No. 100 1987 No. 310 1989 No. 291 1989 No. 292 1989 No. 334 1990 No. 24 1990 No. 86 1990 No. 114 1990 No. 292

3 Apr 1987 19 May 1987 3 June 1987 22 Dec 1987 31 Oct 1989 31 Oct 1989 30 Nov 1989 13 Feb 1990 4 May 1990 5 June 1990 21 Sept 1990

1990 No. 335 1990 No. 396 1991 No. 40 1991 No. 41 1991 No. 232

18 Oct 1990 6 Dec 1990 28 Mar 1991 28 Mar 1991 31 July 1991

1991 No. 262 1991 No. 263 1991 No. 310 1991 No. 339 1992 No. 136 1992 No. 187 1993 No. 48 1993 No. 85 1993 No. 153 1993 No. 260 1993 No. 261 1993 No. 273 1993 No. 280 1993 No. 284 1994 No. 2 1994 No. 9 1994 No. 106 1994 No. 139 as amended by 1994 No. 201 1994 No. 201

30 Aug 1991 30 Aug 1991 16 Oct 1991 12 Nov 1991 9 June 1992 30 June 1992 21 Apr 1993 17 May 1993 29 June 1993 7 Oct 1993 7 Oct 1993 1 Nov 1993 5 Nov 1993 5 Nov 1993 28 Jan 1994 4 Feb 1994 29 Apr 1994 23 May 1994 28 June 1994 28 June 1994

1994 No. 253 1994 No. 256

13 July 1994 28 July 1994

1994 No. 296 1994 No. 349 1994 No. 451

31 Aug 1994 18 Oct 1994 30 Dec 1994

as amended by 1995 No. 1 1995 No. 1

31 Jan 1995 31 Jan 1995

1995 No. 14 1995 No. 34 1995 No. 52

10 Feb 1995 8 Mar 1995 29 Mar 1995

1995 No. 109 1995 No. 116 1995 No. 161 1995 No. 220 1995 No. 288 1995 No. 289 1995 No. 408 1995 No. 410

30 May 1995 6 June 1995 30 June 1995 5 July 1995 10 Oct 1995 10 Oct 1995 19 Dec 1995 19 Dec 1995

1996 No. 46 1996 No. 183 1996 No. 333 1997 No. 16 1997 No. 58 1997 No. 133 1997 No. 160 1997 No. 179 1997 No. 353 1998 No. 18 1998 No. 73 1998 No. 262 1999 No. 18 1999 No. 140 1999 No. 162 1999 No. 174 1999 No. 175 1999 No. 236 1999 No. 288

1 May 1996 21 Aug 1996 24 Dec 1996 26 Feb 1997 21 Mar 1997 17 June 1997 30 June 1997 1 July 1997 15 Dec 1997 25 Feb 1998 5 May 1998 18 Aug 1998 26 Feb 1999 30 June 1999 16 Aug 1999 1 Sept 1999 1 Sept 1999 20 Oct 1999 2 Dec 1999

1999 No. 289 2000 No. 2

2 Dec 1999 9 Feb 2000

2000 No. 218

11 Aug 2000

2000 No. 242 2000 No. 315 2001 No. 14 2001 No. 67

30 Aug 2000 29 Nov 2000 13 Feb 2001 12 Apr 2001

14 Apr 1954 1 July 1957 1 July 1958 12 July 1962 20 Aug 1962 R. 4: 1 Dec 1962 Remainder: 1 Jan 1963 4 Feb 1965 15 July 1965 16 Dec 1965 24 June 1966 29 June 1967 19 June 1969 30 Dec 1969 28 May 1970 1 Nov 1970 1 Mar 1971 1 July 1971 20 Aug 1971 1 Nov 1971 5 June 1972 2 Feb 1973 12 Apr 1973 15 June 1973 14 Nov 1973 R. 1: 2 Apr 1973 Remainder: 22 Nov 1973 19 Dec 1973 22 Apr 1974 24 June 1974 24 June 1974 1 July 1974 23 Dec 1974 10 Feb 1975 1 Apr 1975 1 May 1975 30 May 1975 1 July 1975 6 Aug 1975 13 Nov 1975 4 June 1976 30 Sept 1976 15 Oct 1976 3 Feb 1977 21 Mar 1977 28 Apr 1977 7 July 1977 11 May 1978 26 Sept 1978 9 Nov 1978 21 Dec 1978 11 Apr 1979 14 June 1979 2 Oct 1979 8 Nov 1979 8 May 1980 1 Oct 1980 6 Nov 1980 20 Mar 1981 7 May 1981 29 May 1981 21 Aug 1981 5 Nov 1981 R. 1: 11 Feb 1982 Remainder: 10 Feb 1982 R. 1: 6 May 1982 Remainder: 23 Apr 1982 23 Apr 1982 1 Oct 1982 4 Nov 1982 R. 1: 5 May 1983 Remainder: 29 Apr 1983 3 Nov 1983 10 Nov 1983 R. 1: 3 May 1984 Remainder: 30 Apr 1984 25 July 1984 27 Aug 1984 1 Nov 1984 2 Nov 1984 15 Dec 1984 R. 1: 13 June 1985 Remainder: 7 June 1985 1 July 1985 6 Aug 1985 6 Aug 1985 1 Sept 1985 14 Nov 1985 11 Apr 1986 1 May 1986 18 Aug 1986 13 Nov 1986 25 Dec 1986 Rr. 5 and 6: 1 Jan 1987 Remainder: 19 Dec 1986 3 Apr 1987 19 May 1987 3 June 1987 22 Dec 1987 31 Oct 1989 1 Dec 1989 30 Nov 1989 13 Feb 1990 4 May 1990 5 June 1990 Rr. 3 and 8: 1 Oct 1990 Remainder: 21 Sept 1990 18 Oct 1990 6 Dec 1990 28 Mar 1991 28 Mar 1991 R. 4: 1 Aug 1991 Remainder: 31 July 1991 30 Aug 1991 1 Sept 1991 16 Oct 1991 12 Nov 1991 9 June 1992 1 July 1992 1 May 1993 1 June 1993 1 July 1993 7 Oct 1993 7 Oct 1993 1 Nov 1993 1 July 1991 5 Nov 1993 28 Jan 1994 4 Feb 1994 1 May 1994 1 June 1994 (see 1994 No. 201 below) R. 4.1: 1 June 1994 Remainder: 1 July 1994 13 July 1994 R. 3: 1 July 1993 Remainder: 28 July 1994 1 Sept 1994 1 Nov 1994 R. 4: 1 Feb 1995 Remainder: 1 Jan 1995 (see 1995 No. 1 below) R. 3: 1 Feb 1994 Remainder: 31 Jan 1995 10 Feb 1995 8 Mar 1995 Rr. 4.1 and 4.2: 1 Apr 1995 R. 4.3: 3 Apr 1995 Remainder: 29 Mar 1995 30 May 1995 6 June 1995 1 July 1995 5 July 1995 10 Oct 1995 10 Oct 1995 19 Dec 1995 R. 3.2: 1 Jan 1996 Remainder: 1 Dec 1995 1 May 1996 1 July 1996 1 Jan 1997 1 Mar 1997 21 Mar 1997 17 June 1997 1 July 1997 1 July 1997 15 Dec 1997 25 Feb 1998 5 May 1998 18 Aug 1998 26 Feb 1999 1 July 1999 16 Aug 1999 1 Sept 1999 20 Oct 1999 1 Nov 1999 Rr. 1–3 and Schedule 1: 1 Nov 1999 Remainder: 2 Dec 1999 2 Dec 1999 Rr. 1–3 and Schedule 1: 1 Jan 2000 Remainder: 9 Feb 2000 11 Aug 2000 (see r. 2 and Gazette 2000, No. S435) 31 Aug 2000 29 Nov 2000 13 Feb 2001 12 Apr 2001

R. 2 R. 2 R. 2 (2) R. 1 (2) R. 2 R. 3 — R. 2 R. 3 (2) — R. 3 R. 3 (2) — — — R. 2 — Rr. 3 (2) and 4 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —

Table of Amendments The amendment history of the National Health Regulations 1954 after renumbering by the National Health Regulations (Amendment) (1990 No. 114) appears in the Table below. ad. = added or inserted am. = amended rep. = repealed rs. = repealed and substituted Provision affected

How affected

R. 1 ......................................... R. 2..........................................

rs. 1999 No. 18 am. 1958 No. 63; 1962 No. 70 rs. 1962 No. 113 am. 1969 No. 220; 1970 No. 166; 1971 Nos. 28, 103 and 138; 1973 No. 17; 1974 No. 52 rep. 1975 No. 124 ad. 1990 No. 24 ad. 1983 No. 267 am. 1985 No. 186 rs. 1994 No. 2 ad. 1991 No. 263 rep. 1992 No. 136 ad. 1986 No. 47 rs. 1986 No. 208 am. 1987 Nos. 50, 100 and 310; 1990 Nos. 86, 335 and 396; 1991 Nos. 40, 41 and 232; 1993 Nos. 260, 261 and 284; 1994 Nos. 9 and 253; 1995 Nos. 14, 34, 116 and 220 ad. 1990 No. 292 ad. 1992 No. 136 rep. 1995 No. 288 ad. 1997 No. 16 am. 1998 No. 18 rs. 1998 No. 262 am. 1999 Nos. 18, 174 and 288; 2000 Nos. 2 and 242; 2001 No. 14 ad. 1997 No. 353 rep. 1998 No. 262 ad. 1973 No. 17 rs. 1975 No. 165 rep. 1991 No. 232 ad. 1991 No. 310 ad. 1973 No. 17 am. 1973 No. 267; 1974 Nos. 104 and 263 rs. 1975 No. 165 rep. 1991 No. 232 ad. 1991 No. 310 rs. 1993 No. 48 am. 1995 No. 52 ad. 1986 No. 360 ad. 1986 No. 360 rs. 1997 No. 58; 1998, No. 73; 2000 No. 315 ad. 1990 No. 114

R. 3.......................................... R. 3E....................................... R. 4.......................................... R. 4A........................................ R. 4B....................................... R. 4C....................................... Part 2 (r. 5)............................. R. 5.......................................... Part 3 (r. 6)............................. R. 6.......................................... Part 4 ...................................... (rr. 7–34) Rr. 7, 8.................................... R. 9.......................................... Rr. 10–24............................... R. 25........................................ Rr. 26–28............................... R. 29........................................ R. 30........................................ R. 31........................................ R. 32........................................ R. 33........................................ R. 34........................................ Heading to Part 5.................. R. 35........................................ R. 36........................................ R. 37........................................ Part 5A.................................... (rr. 37A–37I) Rr. 37A–37I............................ R. 38........................................ R. 39........................................ R. 40........................................ R. 41........................................ Part 8 ...................................... (rr. 42, 43) Rr. 42, 43................................ Part 8A ................................... (rr. 43A–43D) Rr. 43A–43D.......................... Part 9 ...................................... (rr. 46, 50) R. 44........................................ R. 45........................................ R. 46........................................

R. 46A..................................... R. 47........................................ R. 48........................................ R. 49........................................ R. 49A..................................... R. 49B..................................... R. 49C..................................... R. 50........................................ Rr. 51, 52................................ R. 52A..................................... R. 52B..................................... R. 53........................................ Schedule 1A.......................... Schedule 1............................. Schedule 2............................. Heading to Schedule 3........ Schedule 3............................. Heading to Schedule 4........ Schedule 4............................. Schedule 5............................. Schedule 6............................. Schedule 7.............................

ad. 1990 No. 114 ad. 1990 No. 114 am. 1990 No. 292 ad. 1990 No. 114 ad. 1990 No. 114 am. 1991 No. 232 ad. 1990 No. 114 ad. 1990 No. 114 am. 1990 No. 292 ad. 1990 No. 114 ad. 1990 No. 114 am. 1990 No. 292 ad. 1990 No. 114 ad. 1990 No. 114 am. 1991 No. 232 ad. 1990 No. 114 rs. 1984 No. 322 rep. 2001 No. 67 am. 1976 No. 217; 1977 No. 51 rs. 1984 No. 322 am. 1985 No. 187; 1990 No. 24; 1995 No. 288 rep. 2001 No. 67 ad. 1990 No. 24 rep. 1995 No. 288 am. 1976 No. 217; 1977 No. 51; 1986 No. 360; 1990 No. 24; 1995 No. 288 rep. 2001 No. 67 ad. 2000 No. 218 ad. 2000 No. 218 am. 1986 No. 360; 1990 No. 292 rs. 1965 No. 185 am. 1986 No. 360 rs. 1957 No. 71; 1962 No. 55 am. 1965 Nos. 17 and 185; 1966 No. 99; 1970 No. 70; 1971 No. 103; 1973 Nos. 75 and 225; 1977 No. 51; 1986 No. 360 am. 1986 No. 360 ad. 1975 No. 124 ad. 1975 No. 124 am. 1977 No. 51 ad. 1991 No. 339 rep. 1992 No. 187 ad. 1991 No. 339 rep. 1992 No. 187 ad. 1977 No. 51 ad. 1978 No. 208 rs. 1979 No. 231; 1980 No. 309; 1981 No. 318 am. 1981 No. 318; 1982 No. 284; 1983 No. 247; 1984 Nos. 308 and 427 rs. 1985 No. 288 am. 1986 No. 330 ad. 1981 No. 43 ad. 1977 No. 51 am. 1977 No. 112 rs. 1978 No. 66 am. 1978 No. 208; 1979 No. 231; 1980 Nos. 84 and 309; 1981 Nos. 97 and 318; 1982 Nos. 38, 82 and 284; 1983 Nos. 45 and 247; 1984 Nos. 66 and 308; 1985 Nos. 86 and 288; 1986 Nos. 53 and 353 ad. 1994 No. 256 ad. 1989 No. 292 am. 1995 No. 408; 1997 No. 133 ad. 1989 No. 291 am. 1989 No. 334; 1991 No. 262; 1992 No. 136; 1995 No. 289; 1997 No. 133; 1999 Nos. 140 and 162 ad. 1978 No. 266 ad. 1995 No. 109 am. 1999 No. 236 ad. 1995 No. 109 am. 1997 No. 160; 1999 No. 236 ad. 1999 No. 289 ad. 1977 No. 51 ad. 1993 No. 280 ad. 1999 No. 289 ad. 1999 No. 289 am. 2000 No. 218 ad. 1999 No. 175 ad. 1990 No. 292 ad. 1977 No. 51 am. 1981 No. 115; 1987 No. 76 ad. 1977 No. 51 rs. 1992 No. 136 am. 1997 No. 353 ad. 1991 No. 263 am. 1992 No. 310 rep. 1995 No. 288 ad. 1997 No. 16 am. 1997 No. 353 rs. 1998 No. 262 am. 1999 Nos. 174 and 288; 2000 No. 2; 2001 No. 14 rs. 1992 No. 136 ad. 1991 No. 263 rep. 1995 No. 288 ad. 1993 No. 48 am. 1993 Nos. 85 and 153 rs. 1993 No. 273 am. 1994 No. 106; 1994 No. 139 (as am. by 1994 No. 201) rs. 1994 No. 201 am. 1994 Nos. 296 and 349; 1994 No. 451 (as am. by 1995 No. 1); 1995 Nos. 1, 52, 161 and 410; 1996 Nos. 46, 183 and 333; 1997 No. 179 ad. 1993 No. 28 ad. 1995 No. 109 am. 1997 No. 160; 1999 No. 236; 2000 No. 218

Repeal Table Certain provisions of the National Health Regulations 1954, as amended, were repealed prior to renumbering by the National Health Regulations (Amendment) (1990 No. 114) or by that Regulation. The amendment history of the repealed provisions appears in the Table below. ad. = added or inserted am. = amended rep. = repealed rs. = repealed and substituted Provision affected

How affected

R. 3........................................ R. 3A...................................... R. 3B...................................... R. 4........................................ Part IA (r. 4A) ....................... Part IA ................................... (rr. 4A, 4AB, 4BB) R. 4A...................................... R. 4AB................................... R. 4BB................................... Part II .................................... (rr. 5, 6, 6A–6D, 7–18) Part II .................................... (rr. 5–15) Part II .................................... (rr. 5–11) Part II .................................... (rr. 5, 5A, 5B, 6–12) R. 5........................................ R. 5A...................................... R. 5B...................................... R. 6........................................ Div. 1A of Part II ................... (rr. 6A–6D) Rr. 6A–6D............................. R. 7........................................ R. 8........................................ R. 9........................................ Rr. 10, 11.............................. R. 12...................................... Rr. 13–15.............................. Rr. 16–18.............................. Part IIIA (r. 20A).................... Part IIIA ................................. (rr. 20A, 20B, 20BA, 20C–20E) R. 20A.................................... R. 20B................................... R. 20BA................................. R. 20C................................... Rr. 20D, 20E........................ Part VI ................................... (rr. 25, 26) R. 25......................................

rs. 1973 No. 221 am. 1976 No. 217 rs. 1977 No. 51 rep. 1990 No. 24 ad. 1976 No. 227 rs. 1977 No. 34 rep. 1982 No. 250 ad. 1979 No. 208 rs. 1982 No. 84 am. 1986 No. 360 rep. 1990 No. 114 am. 1976 No. 217; 1986 No. 360 rep. 1990 No. 114 ad. 1971 No. 138 rep. 1974 No. 52 ad. 1974 No. 52 rep. 1977 No. 51 ad. 1971 No. 138 rs. 1974 No. 52 rep. 1977 No. 51 ad. 1974 No. 52 rep. 1977 No. 51 ad. 1974 No. 52 am. 1975 No. 49 rep. 1977 No. 51 rep. 1962 No. 113

R. 26...................................... R. 29AA................................. R. 31...................................... Heading to The Schedules................................................ First Schedule..................... Second Schedule............... Third Schedule.................... Schedule 3...........................

ad. 1962 No. 113 rep. 1977 No. 51 ad. 1978 No. 178 rep. 1986 No. 360 rs. 1962 No. 113 am. 1976 No. 217 rep. 1977 No. 51 ad. 1978 No. 178 rep. 1986 No. 360 ad. 1979 No. 107 rs. 1984 No. 200 rep. 1986 No. 360 ad. 1985 No. 136 rep. 1986 No. 360 rs. 1962 No. 113 am. 1966 No. 99 rep. 1977 No. 51 ad. 1978 No. 178 am. 1981 No. 232 rep. 1986 No. 360 ad. 1962 No. 70 rep. 1962 No. 113 ad. 1962 No. 70 rep. 1962 No. 113 rs. 1962 No. 113 am. 1966 No. 99 rep. 1977 No. 51 ad. 1978 No. 178 am. 1979 No. 59; 1980 No. 292; 1981 No. 232 rep. 1986 No. 360 rs. 1962 No. 113 am. 1966 No. 99 rep. 1977 No. 51 ad. 1978 No. 178 am. 1979 No. 59; 1980 No. 292; 1981 No. 232 rep. 1986 No. 360 rs. 1962 No. 113; 1969 No. 91 rep. 1977 No. 51 ad. 1978 No. 178 am. 1979 No. 59; 1980 No. 292; 1981 No. 232 rep. 1986 No. 360 rs. 1962 No. 113 rep. 1977 No. 51 ad. 1978 No. 178 rep. 1986 No. 360 rs. 1962 No. 113 am. 1976 No. 217 rep. 1977 No. 51 ad. 1979 No. 59 rep. 1986 No. 360 rs. 1962 No. 113 am. 1976 No. 217 rep. 1977 No. 51 rep. 1962 No. 113 ad. 1969 No. 220 rep. 1977 No. 51 ad. 1969 No. 220 rep. 1977 No. 51 ad. 1970 No. 166 am. 1973 No. 221 rep. 1977 No. 51 ad. 1975 No. 66 rs. 1975 No. 207; 1976 No. 113 am. 1977 No. 11 rep. 1977 No. 51 ad. 1971 No. 28 am. 1972 No. 79 rs. 1973 No. 111; 1974 No. 105 am. 1975 Nos. 14 and 100 rep. 1977 No. 51 ad. 1971 No. 103 rep. 1977 No. 51 ad. 1958 No. 63 rep. 1977 No. 51 ad. 1958 No. 63 am. 1962 No. 113; 1965 No. 94; 1966 No. 99; 1967 No. 86; 1969 No. 91; 1971 No. 76; 1973 No. 221; 1974 No. 113 rep. 1977 No. 51 ad. 1958 No. 63 am. 1966 No. 99 rep. 1977 No. 51 ad. 1985 No. 206 rep. 1990 No. 114 ad. 1984 No. 161 rep. 1990 No. 114 ad. 1971 No. 103 rep. 1990 No. 114 ad. 1971 No. 103 rep. 1977 No. 51 ad. 1971 No. 103 rep. 1977 No. 51 ad. 1975 No. 124 rep. 1977 No. 51 ad. 1978 No. 178 rs. 1979 No. 107 rep. 1986 No. 360

Renumbering Table Table showing new Part and Regulation numbers of the National Health Regulations 1954 after renumbering by the National Health Regulations (Amendment) (1990 No. 114). Note This Table does not form part of the National Health Regulations 1954 and is printed for convenience of reference only.



Old Number

New Number

Part 1

Part 1

Regulation

Regulation

1

1

2

2

3C

3

3D

4

Part IB

Part 2

4B

5

Part IC

Part 3

4C

6

Part II

Part 4

Division 1

Division 1

5

7

Division 2

Division 2

6

8

7

9

8

10

9

11

10

12

11

13

12

14

13

15

14

16

Division 3

Division 3

15

17

16

18

17

19

18

20

18A

21

18B

22

18C

23

Division 4

Division 4

Regulation

Regulation

18D

24

18E

25

18F

26

18G

27

18H

28

18J

29

18K

30

18L

31

18M

32

Division 5

Division 5

18N

33

18P

34

Part III

Part 5

19

35

19A

36

20

37

Part IV

Part 6

21

38

Part V

Part 7

22

39

23

40

24

41

Part VII

Part 8

27

42

28

43

Part VIII

Part 9

28A

44

28B

45

29

46

29AAA

47

29AAB

48

29A

49

30

50

Schedule 1

Schedule 1

Schedule 2

Schedule 2