Victoria - Public Hospitals Policy and Funding Guidelines 1997-1998
Section B: Standard Conditions of Funding

Acute Health Program

The standard conditions of funding, which are not program specific, are detailed in Schedule 1 of the Health Service Agreement 1997/98. The conditions below apply to the Acute Health Program.

1. Medicare Framework

1.1 Hospital to work within Medicare Framework

1.1.1
The hospital will operate within the framework of the Medicare Agreement between
Victoria and the Commonwealth. The Medicare Principles and Commitments for the
delivery of Public Hospital Services are enshrined in the Health Services Act 1988.

1.1.2

Eligible persons (as defined in the Medicare Agreement) must be given the choice
to receive services free of charge as public patients except as provided in clause 3.6.

1.1.3

Access to public hospital services is to be determined on the basis of clinical need.
None of the following factors is to be a determinant of an eligible person's priority for
receiving hospital services:

(a) whether or not an eligible person has health insurance;
(b) an eligible person's financial status or place of residence; and
(c) whether or not an eligible person intends to elect or elects
to be treated as a public or private patient.

1.1.4

The hospital that admits an eligible person accepts responsibility for referring or
transferring the eligible person to any other hospital, for meeting the costs of the
transfer, and for providing necessary patient care during transit.

1.2 Admission of Patients

1.2.1
The hospital will ensure that:

(a) an eligible person, at the time of admission, or as soon as practicable thereafter, elects or confirms whether he or she wishes to be treated as a public patient or a private patient and this election is recorded on the approved Patient Election form;
(b) in making the election referred to above, the eligible person is informed of the consequences of electing to be treated as a public patient and not as a private patient or vice versa;
(c) an eligible person's health insurance status or financial status or intention in respect of an election will not be a determinant in the priority for receiving hospital services; and
(d) any ineligible person is appropriately identified as such in the VIMD.

1.2.2
The hospital will only admit patients in accordance with the Minimum Criteria for Admission as specified in the PRS/2 Manual version 7.0 dated July 1996 and shall set in place administrative procedures for the certification of all patients admitted for
Type C Professional Attention Procedures (exclusion list) or admitted overnight for designated Band 1 procedures of the Health Insurance Basic Table as defined by subsection 4 (1) of the National Health Act 1953 (Cth).

1.2.3

The hospital will make every effort to verify the place of residence of
interstate patients.

1.2.4
The hospital will ensure that all patients admitted to hospital are asked whether they
are of Aboriginal or Torres Strait Islander descent. The identification of Aboriginality
is a mandatory data item to be reported by hospitals to the Victorian Inpatient
Minimum Database.

1.3 Claims for Medicare Benefits
The hospital will ensure that aftercare services for public patients and outpatients and accident and emergency services do not attract claims for Medicare benefits or claims for benefits under Veterans' Affairs Legislation.

1.4 Pharmaceutical Benefits

The hospital will ensure that except in an emergency, it does not issue a prescription to an admitted patient on discharge, an outpatient or an accident and emergency patient, that would attract pharmaceutical benefits as defined in the National Health Act 1953 or Veterans' Affairs Legislation.

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