National Health Reform Agreements

In total, the Commonwealth is expected to invest $131.4 billion in demand-driven public hospital resources to improve health outcomes for all Australians and ensure the sustainability of our health care system now and in the future. The new national health reform agreement 2020-25 provides for an additional $131.4 billion in funding for public hospitals over five years between 2020 and 21. This is in addition to the more than $8 billion in health investments made by the Commonwealth during the covid-19 response. Given the enhanced oversight of Medicare`s rights and private health insurance for public hospital services, it is time to review Medicare`s billing rules, procedures and training to ensure that fees are invoked only in the circumstances authorized by the new addition. In addition, public health service providers have the opportunity to participate in the development of data reconciliation rules with the administrator and any rule changes proposed by the Commonwealth community. In an amendment to Schedule G (Business Rules), it is noted that the Commonwealth, as regulators of private insurers, will annually verify compliance with the minimum standards of the New Amendment, Rules and Private Health Insurance Act 2007 (Cth), present all relevant results to the COAG Health Council and publish the review. It is important that public health changes are beneficial, such as the new addition: from 1 July 2020, Calendar J – agreeing to the national agreement on health reform: revised public funding of hospitals and reform of the health system. [PDF 2.71MB | DOCX 182KB] Public hospitals across the country will receive record funding over the next five years after all states and territories sign the Morrison government`s new health care reform agreement. The NHRA codifies the common intention of Commonwealth, state and territory governments to work in partnership to improve health outcomes for all Australians and ensure the sustainability of Australia`s health care system. The first NHRA was signed in 2011 and introduced major changes in the way public hospitals should be funded by Commonwealth, state and territory governments. The most significant change was the shift from bulk financing to an essentially “activity-based” funding model (ABF). In July 2017, some changes were made to the NHRA regarding public funding of hospitals between July 1, 2017 and June 30, 2020. These changes have preserved the ABF model and have focused on reducing unnecessary hospitalizations and improving patient safety and quality of services.

On 29 May, the Council of Australian Governments (COAG) approved several amendments to the National Health System Reform Agreement (NHRA), which will come into force on 1 July 2020. Compliance with the provisions of the NHRA is essential for public health institutions that benefit from Medicare reductions for private health services in these facilities in both. The amendments include strengthening oversight and reporting of rights to private services in public hospitals. In February 2018, COAG drew up an agreement on new public hospital funding schemes for the period 2020/21-2024/25. As part of these agreements, COAG has negotiated a new addition to the NHRA, which will come into force on July 1, 2020 (new addition). An external review of the new amendment will be completed by December 2023. The Commonwealth is committed to discussing with the states changes to these rules that affect the practices of public hospitals. It is recognized that changes to data provision requirements should avoid excessive additional administrative burdens for public hospitals. Under the rules, private insurers cannot ask public hospitals for certification documents that go beyond those prescribed in the application form for private patient hospitals, or delay or deny payment of eligible hospital care requests.