Protection to remain for private hospitals and day surgeries

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The Australian government has decided to retain the protection of the second tier default benefit for private hospitals and day surgeries and from 1 July 2004 to cease the rural and regional default benefit as all private hospitals and day surgeries will have equal access to the second tier benefit.

The government has in place a strong safety net for those hospitals and day surgeries that are unable to secure a contract with a health fund.

The basic default benefit is available to all hospitals and day surgeries and no changes have been made to these arrangements. The second tier benefit, as a generally higher payment, is available to private hospitals and day surgeries which reach and maintain quality, safety and administrative criteria.

All private hospitals and day surgeries will be able to apply for the second tier benefit and those facilities with existing approvals under the old system will have that approval continue uninterrupted for the next 12 months.

The government has also announced some changes to the second tier arrangements. To help reduce pressure on premiums, health funds will no longer be required to provide copies of their second rates to hospitals on request. Hospitals and health funds can still be confident that second tier benefits will be paid correctly because funds will have to give an audited report that confirms their second tier rates have been correctly calculated to the Department of Health and Ageing.

http://www.health.gov.au

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