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Applying greater rigour to certification for hospital admissions

On 11 May 2021, as part of measures to improve the affordability and sustainability of private health insurance, the Australian Government announced improvements to the certification process for admitting patients to hospital for procedures normally provided out of hospital.

The Government will work with Australia’s medical colleges and other stakeholders to establish specific guidance around when hospitalisation is clinically required. Additionally, the Professional Standards Review will be allowed to review inappropriate practices around certifications by doctors or associated hospitals to ensure the integrity of the current arrangements that safeguard patients’ access to treatments needed to be delivered in hospital.

The Office of Best Practice Regulation assessed the quality of the Regulation Impact Statement (RIS) prepared by the Department of Health as adequate to meet the Government’s RIS requirements. The RIS would have benefitted from greater depth of analysis of the potential impacts of the options presented, and could have provided a stronger evidence base to support a number of the assertions made.

The RIS estimated an average annual regulatory saving of approximately $427,830.

OIA assessment of the Impact Analysis
Insufficient
Adequate
Good practice
Exemplary
Attachment File type Size
Regulation Impact Statement docx 534.12 KB
Regulation Impact Statement pdf 385.04 KB
OBPR Assessment Advice docx 43.53 KB
OBPR Assessment Advice pdf 266.19 KB
Certification Letter docx 32.45 KB
Certification Letter pdf 46.29 KB