Health (Fees) Regulations 2017

Health (Fees) Regulations 2017

I, the Governor in and over the State of Tasmania and its Dependencies in the Commonwealth of Australia, acting with the advice of the Executive Council, make the following regulations under the Health Act 1997 .

C. WARNER

Governor

By Her Excellency's Command,

MICHAEL DARREL JOSEPH FERGUSON

Minister for Health

1.   Short title

These regulations may be cited as the Health (Fees) Regulations 2017 .

2.   Commencement

These regulations take effect on 17 October 2017.

3.   Interpretation

In these regulations –[Regulation 3 Amended by No. 23 of 2022, s. 15, Applied:24 Oct 2022]

compensable patient means an admitted patient, or a non-admitted patient, who is receiving care or treatment for an injury, illness or disease for which he or she –

(a) has received or established his or her right to receive payment for care or treatment by way of a settled or unsettled claim for compensation or damages under –

(i) a law that is or has been in force in a State or a Territory; or

(ii) the Workers Rehabilitation and Compensation Act 1988 ; or

(iii) the Asbestos-Related Diseases (Occupational Exposure) Compensation Act 2011 ; or

(iv) the Motor Accidents (Liabilities and Compensation) Act 1973 ; or

(b) on attendance at a public hospital, appears to have the right to receive a payment referred to in paragraph (a) ;

day-admitted patient has the same meaning as in the Pharmaceutical Reform Agreement, dated 21 December 2010, in force between the Commonwealth and the State, as amended from time to time;

diagnostic imaging services table means the table prescribed under section 4AA of the Commonwealth Act;

EFC arrangement means the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 made under section 100(1) of the National Health Act 1953 of the Commonwealth, relating to pharmaceuticals specified in the Schedule of Pharmaceutical Benefits Efficient Funding of Chemotherapy supplement as amended or substituted from time to time;

general medical services table means the table prescribed under section 4 of the Commonwealth Act;

Health Care Card means a health care card –

(a) within the meaning of the Social Security Act 1991 of the Commonwealth; and

(b) issued to a person eligible under that Act;

hospital means a public hospital or a private hospital;

ineligible person means a person who is not an eligible person;

nursing-home-type patient – see regulation 4;

pathology services table means the table prescribed under section 4A of the Commonwealth Act;

Pensioner Concession Card means a pensioner concession card –

(a) within the meaning of the Social Security Act 1991 of the Commonwealth; and

(b) issued to a person eligible under that Act;

private hospital means a private hospital within the meaning of the Commonwealth Act;

public hospital means a hospital maintained and operated by the State;

public patient means an eligible person who receives or elects to receive a public hospital service, free of charge;

Seniors Health Card means a seniors health card –

(a) within the meaning of the Social Security Act 1991 of the Commonwealth; and

(b) issued to a person eligible under that Act.

4.   Meaning of nursing-home-type patient

(1)  For the purposes of these regulations, a person is a nursing-home-type patient on a day if he or she is in a public hospital being provided with accommodation and nursing care on that day and the day is a chargeable day.

(2)  For the purposes of subregulation (1) , a person is in a public hospital being provided with accommodation and nursing care on a day that is a chargeable day if he or she is a patient in a public hospital being provided with accommodation and nursing care on that day and the day –

(a) occurs in a continuous period of more than 35 days in which the patient is in a hospital being provided with accommodation and nursing care; and

(b) is not a day in the first 35 days of that continuous period; and

(c) is not a day to which relates a certificate from a medical practitioner to the effect that the patient is in need of acute care.

(3)  For the purpose of ascertaining whether a patient is in a public hospital being provided with accommodation and nursing care on a day that occurs in a continuous period, there is to be taken into account –

(a) any period, during which that patient was provided with accommodation and nursing care as a patient in that hospital, or in another hospital, that occurs before that day and that forms one continuous period with that day; or

(b) if there are 2 or more periods, during which that patient was provided with accommodation and nursing care as a patient in that hospital, or in another hospital, that occur before that day and that form one continuous period with one another and with that day – those earlier periods.

(4)  For the purposes of subregulation (3)(a) and (b) , 2 periods –

(a) that are periods during which a patient isprovided with accommodation and nursing care as a patient in a hospital (whether or not the same hospital); and

(b) that are separated from each other by a period of not more than 7 days during which the patient was not provided with accommodation and nursing care as a patient in any hospital –

are to be taken to form one continuous period with one another.

5.   Fees for non-nursing-home-type patients

(1)  The fees specified in Parts 1 , 2 and 4 of Schedule 1 are prescribed as the fees payable by or on behalf of a person for hospital services provided to the person in a public hospital on a day on which the person is not a nursing-home-type patient.

(2)  The fees specified in Part 3 of Schedule 1 are prescribed as the fees payable by or on behalf of a person for pharmaceutical items supplied to the person in a public hospital on a day on which the person is not a nursing-home-type patient.

6.   Fees for nursing-home-type patients

The fees specified in Schedule 2 are prescribed as the fees payable by or on behalf of a patient for hospital services provided in a public hospital to the patient on a day on which the patient is a nursing-home-type patient.

7.   Fees for surgically implanted prostheses

(1)  In this regulation –

gap-permitted prosthesis means a gap-permitted prosthesis within the meaning of the Private Health Insurance (Prostheses) Rules (No. 1) 2017 of the Commonwealth;

no-gap prosthesis means a no-gap prosthesis within the meaning of the Private Health Insurance (Prostheses) Rules (No. 1) 2017 of the Commonwealth.

(2)  The fees payable by or on behalf of a person for providing the person in a public hospital with –

(a) a surgically implanted prosthesis that is a no-gap prosthesis, is an amount not exceeding the minimum amount specified in relation to the no-gap prosthesis in the Schedule to the Private Health Insurance (Prostheses) Rules (No. 1) 2017 of the Commonwealth; or

(b) a surgically implanted prosthesis that is a gap-permitted prosthesis, is an amount not exceeding the maximum amount specified in relation to the gap-permitted prosthesis in the Schedule to the Private Health Insurance (Prostheses) Rules (No. 1) 2017 of the Commonwealth.

8.   Fees for dental services

(1)  In this regulation –

prescribed fee schedule means the Fee Schedule of Dental Services for Dentists and Dental Specialists published by the department administering the Veterans’ Entitlements Act 1986 of the Commonwealth on 1 November 2010, as amended or substituted from time to time.

(2)  The fees payable by or on behalf of a person for dental services provided to the person in a public hospital are –

(a) for a person who holds a valid Health Care Card or Pensioner Concession Card, the greater of the following:

(i) [Regulation 8 Subregulation (2) amended by S.R. 2018, No. 30, Applied:01 Jul 2018] [Regulation 8 Subregulation (2) amended by S.R. 2019, No. 40, Applied:01 Jul 2019] $45;

(ii) 40% of the fees set out in relation to the dental services in the prescribed fee schedule; or

(b) for any other person, 100% of the fees set out in relation to the dental services in the prescribed fee schedule.

9.   Fees not payable by certain asylum seekers

(1)  In this regulation –

medicare-ineligible asylum seeker means a person who –

(a) has applied for a protection visa under the Migration Act 1958 of the Commonwealth and whose application has not been withdrawn or finally determined in accordance with that Act; and

(b) is not entitled to medicare benefits under the Commonwealth Act; and

(c) is not entitled to a pension, benefit or allowance under the Social Security Act 1991 of the Commonwealth; and

(d) is not permitted under the conditions of the person's visa granted under the Migration Act 1958 of the Commonwealth to engage in work in Australia;

protection visa means a permanent or temporary visa included in a class of visas under Part 4 of Schedule 1 to the Migration Regulations 1994 of the Commonwealth.

(2)  A medicare-ineligible asylum seeker is not required to pay a fee prescribed by these regulations for any facility or service provided by or on behalf of the State.

SCHEDULE 1 - Fees payable by non-nursing-home-type patients

Regulation 5

PART 1 - Admitted patients

PART 2 - Non-admitted patients

PART 3 - Supply of pharmaceutical items

PART 4 - Other services

SCHEDULE 2 - Fees payable by nursing-home-type patients

Regulation 6

1.   Interpretation

In this Schedule –

prescribed formula, in relation to the calculation of a payable fee, means –

(a) in the case of the patient contribution payable by all nursing-home-type patients, the following formula:

where –
"F"	is the fee rounded down to the nearest 5 cents;
"B"	is the daily equivalent of the maximum basic rate of age pension prescribed for the purposes of section 1064 of the Social Security Act 1991 of the Commonwealth plus the maximum rate of rent assistance prescribed for the purposes of that section of that Act; and

(b) in the case of the default benefit payable by health funds on behalf of their privately insured contributors, the following formula:

where –
"F"	is the fee rounded down to the nearest 5 cents;
"B"	is the daily equivalent of the maximum basic rate of age pension prescribed for the purposes of section 1064 of the Social Security Act 1991 of the Commonwealth plus the maximum rate of rent assistance prescribed for the purposes of that section of that Act.

2.   Fees payable by nursing-home-type patients in public hospitals

The fee payable for hospital services for each day that a nursing-home-type patient is an admitted patient in a public hospital is to be calculated in accordance with the prescribed formula.

Displayed and numbered in accordance with the Rules Publication Act 1953.

Notified in the Gazette on 17 October 2017

These regulations are administered in the Department of Health and Human Services.