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This Framework outlines the processes to investigate cross-border and cost-shifting disputes following a request by a health minister to ensure the timely, equitable and transparent management of these disputes.
The National Health Reform Act 2011 (the Act), section 131(1)(f), provides that IHPA will determine the public hospital functions that are to be funded in the states and territories by the Commonwealth, except where otherwise agreed between the Commonwealth and a state or territory.
The Pricing Framework for Australian public hospital services 2019-20 builds on the seven Pricing Frameworks from previous years. The Pricing Framework is the key strategic document underpinning the National Efficient Price (NEP) and National Efficient Cost (NEC) Determinations for the financial year 2019-20.
The purpose of the Framework is to guide the timely, equitable and transparent processes by which IHPA investigates both cross-border and cost-shifting disputes following a request by a Health Minister.
The Back-casting Policy outlines the process IHPA follows when back-casting the NEP or the NEC for the purpose of the calculation of the Commonwealth’s funding, as set out in the NHRA (clause A40).
The objective of the IHPA Impact of New Health Technology Framework (the Framework) is to outline the process by which IHPA, through the CAC, will monitor and review the impact of new health technologies on the existing classifications in order to accurately account for them in the pricing of public hospital services.
In consultation with the CAC, IHPA will:
A jurisdiction may request IHPA to consider any legitimate and unavoidable costs in the delivery of public hospital services. The purpose of this Framework is to assist jurisdictions in making submissions to IHPA on this issue, to layout the process which IHPA will follow in assessing submissions, and the process to determine adjustments to the NEP.