Commonwealth Numbered Regulations - Explanatory Statements

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NATIONAL HEALTH REGULATIONS (AMENDMENT) 1998 NO. 262

STATUTORY RULES 1998 No. 262

Issued by authority of the Minister for Health and Family Services

National Health Act 1953

National Health Regulations (Amendment)

Section 140 of the National Health Act 1953 (the Act) provides that the Governor-General may make Regulations for the purposes of the Act.

Subsection 140(2) of the Act makes provision to preclude or modify, by National Health Regulation, certain benefit arrangements to permit pilot or demonstration schemes which could lead to an enhancement of the health insurance industry.

The purpose of the Regulations is to establish two new trial programs for patients to be paid health insurance benefits for hospital type treatment rendered to them in community settings. The first trial relates to selected psychiatric patients in South Australia and the second relates to selected rehabilitation patients of Cedar Court Health South Hospital in Victoria. At present health funds cannot pay benefits from their hospital tables for hospital type treatment when it is rendered out of hospital. The Regulations will enable specified health funds to use their hospital tables to pay benefits for hospital type treatment.

Regulation 3 omits the current regulation 4B and substitutes a new regulation 4B (Domiciliary caremodification of the Act). This new Regulation includes the existing St Francis Xavier Cabrini Domiciliary Palliative Care Program that is in operation until 28 February 1999 and sets up the two additional trial programs. It specifies the health funds that are participating in each of the trials and the duration of each trial. Schedule 3 of the Regulations provides the mechanism for the funds to pay benefits for participating patients from their hospital tables. It specifies the amount of benefit that is payable.

The trials have been proposed in order to examine the patient satisfaction and cost benefits associated with allowing patients to undergo hospital type treatment in out of hospital settings. Patients will benefit by being able to access a continuum of care across different service settings instead of all care being delivered in clinical settings; hospitals will benefit from the increased flexibility of health insurance funding to cover innovative treatment programs., and participating health funds will benefit by paying rebates that are lower than would otherwise be payable for patients in a hospital environment.

The new trials will run until 31 August 1999. They will be subject to ongoing monitoring and evaluation. The trials will provide the opportunity to evaluate an alternative method of health care, that appears to offer considerable advantages over traditional health care delivery, with a view to encompassing it into mainstream care.

Regulation 4 omits regulation 4C (No out-of-pocket expense for patient - modification of Act).

This regulation ceased to have effect on 24 April 1998 as a result of amendments to the Act. The Regulations commenced on gazettal.