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The purpose of the Alterations to the National Pricing Model Framework is to outline the guiding principles and consultative mechanisms that IHPA follows when proposing and implementing changes that materially impact the application of the national funding model.
As prescribed in Section 225 of the National Health Reform Act 2011, the objectives of the IHPA Work Program are to:
- set out IHPA’s work program for the coming year; and
- invite interested persons (including states and territories) to make submissions to the Pricing Authority about the Work Program up to 30 days after publication.
An extract of Section 225 of the Act is attached at Appendix 1.
Chimeric antigen receptor T cell therapy (CAR-T cell): guidelines for costing, counting and reconciliation of funding18 June 2020
The guidelines set out the scope, funding, costing, counting and reconciliation of funding for the chimeric antigen receptor T cell therapy (CAR-T cell) immunotherapy program using the Novartis CAR-T product Kymriah. The CAR-T program is for paediatric and young adults (up to 25 years) with Acute Lymphoblastic Leukaemia (ALL) who relapse or do not respond to initial therapy.
IHPA is responsible for relevant data collections to enable activity based funding. IHPA’s Data Access and Release Policy outlines the principles and processes adopted by IHPA in the discretionary access and release of data collected under the National Health Reform Act 2011. The Policy provides guidance as to how IHPA will determine whether to release data.
The purpose of the Management of Confidential Jurisdictional Information Protocol is to advise jurisdictions of the processes and controls adopted by IHPA in managing confidential jurisdictional information as part of its rolling Three Year Data Plan.
IHPA recognises the need for the pricing of public hospital services to respond in a timely manner to the introduction of new health technologies and innovations in models of care.
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.
IHPA has a role to investigate and make recommendations concerning cross-border disputes between states and territories, and to make assessments of cost-shifting disputes. This Framework outlines the processes to investigate these disputes following a request by a health minister to ensure the timely, equitable and transparent management of these disputes.
Each year, IHPA publishes the General List of In-Scope Public Hospital Services (the General List) as part of the National Efficient Price Determination.
The General List defines public hospital services eligible for Commonwealth funding, except where funding is otherwise agreed between the Commonwealth and a state or territory.