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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 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.
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.
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.
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 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.
Following the completion of the 2016 Inter-Rater Reliability (IRR) study to test the consistency of clinician application of the mental health phase of care, the poor to fair reliability outcome led to the commencement of the refinement project.
The purpose of the Policy is to outline the processes by which IHPA adjusts for instability in the year-on-year price weights and adjustments.
The purpose of the Assessing Materiality of Changes Proposed to the National Pricing Model document is to outline the process IHPA follows when assessing the materiality of proposed changes to the national pricing models such as the introduction of new adjustments or alternative pricing policy approaches.
The Pricing Framework for Australian Public Hospital Services 2020-21 (the Pricing Framework) is the key strategic document underpinning the National Efficient Price (NEP) and National Efficient Cost (NEC) Determinations for the financial year 2020-21.
IHPA has issued the Pricing Framework prior to releasing the NEP20 and NEC20 Determinations, which will be publicly available in March 2020, with the intention of providing an additional layer of transparency and accountability.
There is a growing discussion in Australia and internationally about the need to increase focus on delivering value-based health care with a focus on patient outcomes and experience.
IHPA’s Pricing Guidelines and the National Health Reform Agreement include provisions for IHPA to consider the impact on its work of evidence‑based, effective new technologies and innovations in models of health care.
The Clinical Coding Practice Framework aims to support national consistency in clinical coding practice, by providing guidance in defining and promoting good practices for those involved in the clinical coding process.
It was developed by the Health Information Management Association of Australia in conjunction with the Clinical Coders’ Society of Australia, and incorporated feedback from public consultation.
The IHPA Data Access and Release Policy (formerly Information Release Policy) outlines the principles and processes adopted by IHPA in the discretionary access and release of data under the National Health Reform Agreement and the National Health Reform Act 2011.