Act admission
Commission contracted private hospital
Department emergency entitled person former Repatriation Hospital
Local Medical Officer medical specialist
MRCA Treatment Principles
Principles
Prior approval private hospital private patient public hospital
Repatriation Commission
Repatriation Private Patient Principles veteran partnering private hospital
2. Order of preference for admission to hospital
3. Prior approval not required
3.3. Non-emergency Tier 2 hospital treatment
3.4. Emergency hospital treatment
4. Prior approval required
5. Treatment Monitoring
1. Preliminary
1.1.1 These Principles are the MRCA Private Patient Principles 2004.
1.1.2 These Principles commence when the Repatriation Private Patient Principles (Instrument 2015 No. R33) commences.
Note: the Repatriation Private Patient Principles commence on the day after registration.
For the purposes of these Principles, unless a contrary intention appears:
Act means the Military Rehabilitation and Compensation Act 2004 in force from time to time.
admission means admission for treatment as an in-patient or day-patient upon the referral of a medical specialist or a Local Medical Officer.
Commission means the Military Rehabilitation and Compensation Commission established under section 361 of the Act.
consultative forum means the forum in each State established by the Department of Veterans' Affairs for the purpose of, among other functions, monitoring the treatment of entitled persons and consisting of representatives of the Military Rehabilitation and Compensation Commission, the Repatriation Commission and the ex-service community.
contracted private hospital means a private hospital in respect of which the Commission has entered into arrangements under section 285 of the Act for the treatment of entitled persons.
Department means the Australian Government Department of Veterans' Affairs.
emergency means a situation in which a person requires immediate treatment because of a serious threat to the person's life or health.
entitled person means a person entitled to treatment under Part 3 of Chapter 6 of the Act former Repatriation Hospital means a hospital or other institution that was formerly operated by the Repatriation Commission under paragraph 89(1)(a) of the Veterans' Entitlements Act 1986.
Note: see the Repatriation Institutions (Transfer) Act 1992
Local Medical Officer means a medical practitioner who:
is registered under the Notes for Local Medical officers as a Local Medical Officer and who treats an entitled person in accordance with the terms, and subject to the conditions, in the MRCA Treatment Principles and in the "Notes for Local Medical Officers"; and
has been given a provider number by Medicare, in respect of being a medical practitioner, that has not been suspended or revoked.
medical practitioner means a person registered or licensed as a medical practitioner under a law of a State or Territory that provides for the registration or licensing of medical practitioners but does not include a person so registered or licensed:
whose registration, or licence to practise, as a medical practitioner in any State or Territory has been suspended, or cancelled, following an inquiry relating to his or her conduct; and
who has not, after that suspension or cancellation, again been authorised to register or practise as a medical practitioner in that State or Territory.
medical specialist means a medical practitioner who is recognised as a consultant physician or specialist in the appropriate specialty for the purposes of the Health Insurance Act 1973.
Medicare means the Chief Executive Medicare under Part IIA of the Human Services (Medicare) Act 1973.
MRCA Treatment Principles means the determination by the Commission under paragraph 286(1)(a) of the Act that sets out the circumstances in which, and conditions subject to which, treatment may be provided to entitled persons.
Notes for Local Medical Officers has the same meaning it has in the MRCA Treatment Principles.
Principles means the current MRCA Private Patient Principles determined by the Commission under paragraph 286(1)(b) of the Act that sets out, among other things, the circumstances in which treatment may be provided to entitled persons as private patients.
prior approval means:
in relation to treatment-approval by the Commission for treatment before the treatment was given or commenced to be given; and
in relation to admission to a hospital-approval by the Commission for admission to that hospital before the person is admitted.
private hospital means premises that have been declared to be:
a private hospital for the purposes of the Health Insurance Act 1973; or
a day hospital facility for the purposes of the National Health Act 1953.
private patient has the meaning given by subsection 286(7) of the Act.
private health insurer has the meaning it has in the Private Health Insurance Act 2007.
public hospital means a hospital operated by a State or Territory or by the Commonwealth.
Repatriation Commission means the body continued in existence by section 179 of the Veterans' Entitlements Act 1986.
Repatriation Private Patient Principles means the principles determined by the Repatriation Commission under section 90A of the Veterans' Entitlements Act 1986.
veteran partnering private hospital means a contracted private hospital that is described as a "veteran partnering private hospital" in its arrangement with the Commission.
Note: other Tier 1 status hospitals which have similar partnering arrangements are public hospitals and former Repatriation Hospitals.
An entitled person is to receive hospital care as a private patient - which entitles the person to:
the patient's choice of doctor, subject to the doctor having practising rights at the relevant hospital; and
shared accommodation; or
if medically necessary, private accommodation; or
private accommodation, if available, where the person's private health insurer will pay the difference between the cost of shared accommodation and the cost of private accommodation for the person; or
on and after 1 July 2016, private accommodation, if available, in a contracted private hospital.
2. Order of preference for admission to hospital
Preference for admission is to be in accordance with the following table:
Level Preference Hospital
Tier 1 first former Repatriation Hospital, public hospital, or veteran partnering private hospital
Tier 2 (special authorisation) second The Contracted private hospital is not required to seek prior approval for a referral for services specified in the contract, chargeable to DVA, from a Tier 1 hospital. The Contracted private hospital must seek prior approval for all other admissions.
Tier 2 second Contracted private hospital
Tier 3 third Non-Contracted private hospital
The main objective of these Principles is to provide an entitled person with access to the nearest suitable hospital.
3. Prior approval not required
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