{"id":"F2015L01344","name":"Repatriation Private Patient Principles","slug":"repatriation-private-patient-principles","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":438405,"registerId":"F2015L01344-fast-fetch-1775954847385","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Repatriation Private Patient Principles","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 20.2\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n \n\n# Australian Government\n\n# Veterans’ Entitlements Act 1986\n\n \n\n# Repatriation Private Patient Principles\n\nInstrument 2015 No.R33\n\n \n\n- I, Michael Ronaldson, Minister for Veterans’ Affairs, approve this instrument under subsection 90A(4) of the Veterans’ Entitlements Act 1986. Dated this 18th day of August 2015Michael RonaldsonMICHAEL RONALDSON\n- The Repatriation Commission makes this instrument under subsection 90A(1) of the Veterans’ Entitlements Act 1986. Dated this 6th day of August 2015The Seal of the )Repatriation Commission ) SEALwas affixed hereto in the )presence of: ) Simon Lewis Craig Orme................................................................................................................................................................... SIMON LEWIS CRAIG ORME AM CSC PRESIDENT DEPUTY PRESIDENT\n\n\n\n\n\n \n\n![](image.002.png)\n\n \n\n \n\n \n\nRepatriation Private Patient Principles\n\n \n\n \n\nInstrument 2015 No. R33\n\n \n\nmade under the\n\n \n\nVeterans' Entitlements Act 1986\n\n \n\n\nContents\n\n \n\n[1. Preliminary. 1](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843937#_Toc162843937)\n\n[1.1 Principles. 1](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843938#_Toc162843938)\n\n1.1A Commencement\n\n[1.2 Defined terms. 1](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843939#_Toc162843939)\n\n[1.3 Private patient status. 5](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843940#_Toc162843940)\n\n[2. Order of preference for admission to hospital 6](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843941#_Toc162843941)\n\n[2.1 Order of preference. 6](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843942#_Toc162843942)\n\n[2.2 Objective. 6](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843943#_Toc162843943)\n\n[3. Prior approval not required.. 7](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843944#_Toc162843944)\n\n[3.1 Medical specialist treatment 7](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843945#_Toc162843945)\n\n[3.2 Non-emergency Tier 1 hospital treatment 7](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843946#_Toc162843946)\n\n[3.3. Non-emergency Tier 2 hospital treatment 7](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843947#_Toc162843947)\n\n[3.4. Emergency hospital treatment 7](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843948#_Toc162843948)\n\n[3.5 Notification of admission. 7](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843949#_Toc162843949)\n\n[3.6 Urgent treatment for Vietnam veterans and their dependants 8](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843950#_Toc162843950)\n\n[4. Prior approval required.. 8](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843952#_Toc162843952)\n\n[4.1 Tier 2 hospital admission and treatment 8](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843953#_Toc162843953)\n\n[4.2 Tier 3 hospital admission and treatment 8](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843954#_Toc162843954)\n\n[4.3 Criteria for Tier 2 or Tier 3 hospital admission and treatment 9](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843955#_Toc162843955)\n\n[4.4 Admission to Tier 3 hospital of choice. 10](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843956#_Toc162843956)\n\n[4.5 Commonwealth liability if Tier 3 admission by choice 10](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843957#_Toc162843957)\n\n[5. Treatment Monitoring 10](http://www.frli.gov.au/ComLaw/Legislation/LegislativeInstrumentCompilation1.nsf/previewlodgmentattachments/5F5333922A7EA494CA25731C001BB5F5/$file/RepatriationPrivatePatientPrinciplesconsolidated11July2007.htm#_Toc162843958#_Toc162843958)\n\n5.1 Consultative Forum\n\n \n\n# 1. Preliminary\n\n## 1.1 Principles\n\nThese Principles are the Repatriation Private Patient Principles.\n\nCommencement\n\n1.1A These Principles commence on the day after registration.\n\n## 1.2 Defined terms\n\nFor the purposes of these Principles, unless a contrary intention appears:\n\n \n\nAct means the Veterans’ Entitlements Act 1986 in force from time to time.\n\n \n\nadmission means admission for treatment as an in-patient or day-patient upon the referral of a medical specialist or a Local Medical Officer.\n\n \n\nCommission means the Repatriation Commission, continued in existence by section 179 of the Act.contracted private hospital\n\n \n\nconsultative 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 Repatriation Commission, the Military Rehabilitation and Compensation Commission and the ex-service community.\n\ncontracted private hospital means a private hospital in respect of which the Commission has entered into arrangements for the treatment of entitled persons.\n\n \n\nDepartment means the Australian Government Department of Veterans’ Affairs.\n\n \n\ndependant of a Vietnam veteran means a person described in subsection 86(5) of the Act.\n\n \n\nDeputy Commissioner means the person appointed by the Secretary of the Department to manage the affairs of the Department in a State or Territory.\n\n \n\nemergency means a situation in which a person requires immediate treatment because of a serious threat to the person’s life or health.\n\n \n\nentitled person means a person eligible for treatment under Part V of the Act but does not include a Vietnam veteran, or a dependant of a Vietnam veteran, who is eligible only under subsection 85(9) or subsection 86(5) of the Act, respectively, for urgent treatment.\n\n \n\nformer Repatriation Hospital means a hospital or other institution that was formerly operated by the Commission under paragraph 89(1)(a) of the Act.\n\n \n\n Note:  see the Repatriation Institutions (Transfer) Act 1992\n\n \n\nLocal Medical Officer means a medical practitioner who:\n\n \n\n(a) 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 Treatment Principles and in the “Notes for Local Medical Officers”; and\n\n \n\n  (b) has been given a provider number by Medicare, in respect of being a medical practitioner, that has not been suspended or revoked.\n\n \n\nmedical 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:\n\n \n\n(a)  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\n\n(b) who has not, after that suspension or cancellation, again been authorised to register or practise as a medical practitioner in that State or Territory.\n\n \n\nmedical 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.\n\n \n\nMedicare means the Chief Executive Medicare under Part IIA of the Human Services (Medicare) Act 1973.\n\n \n\nNotes for Local Medical Officers has the same meaning it has in the Treatment Principles.\n\n \n\nPrinciples means the current Repatriation Private Patient Principles determined by the Commission under subsection 90A(1) of the Act.\n\n \n\nprior approval means:\n\n  (a) in relation to treatment—approval by the Commission for treatment before the treatment was given or commenced to be given; and\n\n  (b) in relation to admission to a hospital—approval by the Commission for admission to that hospital before the person is admitted.\n\n \n\nprivate hospital means premises that have been declared to be:\n\n  (a) a private hospital for the purposes of the Health Insurance Act 1973; or\n\n  (b) a day hospital facility for the purposes of the National Health Act 1953.\n\n \n\nprivate health insurer has the meaning it has in the Private Health Insurance Act 2007.\n\n \n\nprivate patient has the meaning given by subsection 90A (8) of the Act.\n\n \n\npublic hospital means a hospital operated by a State or Territory or by the Commonwealth.\n\n \n\nrevoked Repatriation Private Patient Principles means the Repatriation Private Patient Principles 2004 No.R17.\n\n \n\nTreatment Principles means the document prepared by the Commission under section 90 of the Act that sets out the circumstances in which, and conditions subject to which, treatment may be provided to entitled persons.\n\n \n\nveteran partnering private hospital means a contracted private hospital that is described as a “veteran partnering private hospital” in its arrangement with the Commission under subsection 89(1) of the Act.\n\n \n\nNote:  other Tier 1 status hospitals which have similar partnering arrangements are public hospitals and former Repatriation Hospitals.\n\n \n\nVietnam veteran means a person described in subsection 85(9) of the Act.\n\n \n\n## 1.3 Private patient status\n\nAn entitled person is to receive hospital care as a private patient — which entitles the person to:\n\n(a) the patient’s choice of doctor, subject to the doctor having practising rights at the relevant hospital; and\n\n(b) shared accommodation; or\n\n(c) if medically necessary, private accommodation; or\n\n(d) private accommodation, if available, where the entitled person or the person’s private health insurer agrees to pay the difference between the cost of shared accommodation and the cost of private accommodation for the person; or\n\n(e) on and after 1 July 2016, private accommodation, if available, in a contracted private hospital.\n\n \n\n# 2. Order of preference for admission to hospital\n\n## 2.1 Order of preference\n\nPreference for admission is to be in accordance with the following table:\n\n \n\n| Level | Preference | Hospital |\n| --- | --- | --- |\n| Tier 1 | first | former Repatriation Hospital, public hospital, or veteran partnering private hospital |\n| Tier 2<br>(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. |\n| Tier 2 | second | Contracted private hospital |\n| Tier 3 | third | Non-Contracted private hospital |\n\n\n## 2.2 Objective\n\nThe main objective of these Principles is to provide an entitled person with access to the nearest suitable hospital.\n\n# 3. Prior approval not required\n\n## 3.1 Medical specialist treatment\n\nA medical specialist or Local Medical Officer may, without prior approval, refer an entitled person to a medical specialist for treatment as a private patient (whether that medical specialist works at a hospital or at consulting room facilities) only if the fee to be charged by that medical specialist for that treatment is no greater than the fee the medical specialist could charge for the treatment pursuant to the Treatment Principles.\n\n## 3.2 Non-emergency Tier 1 hospital treatment\n\nAn entitled person may be admitted to a Tier 1 hospital for non-emergency treatment without prior approval.\n\n## 3.3. Non-emergency Tier 2 hospital treatment\n\nAn entitled person may be admitted to a Tier 2 hospital for non-emergency treatment without prior approval only in those circumstances where the arrangements relating to that hospital specifically exclude the need for prior approval.\n\n## 3.4. Emergency hospital treatment\n\nAn entitled person may be treated at, and admitted through, the accident and emergency centre of a Tier 1, 2, or 3 hospital for emergency treatment without prior approval.\n\n## 3.5            Notification of admission\n\nIf an entitled person is admitted to a Tier 2 or Tier 3 hospital under paragraph 3.4, the hospital must notify the Department of that admission the next working day in the State or Territory in which the admission occurred, or as soon as practicable afterwards.\n\n## 3.6 Urgent treatment for Vietnam veterans and their dependants\n\nA Vietnam veteran or a dependant of a Vietnam veteran may be admitted to:\n\n  (a) a former Repatriation Hospital; or\n\n  (b) a public hospital in a State or Territory;\n\nfor in-patient treatment without prior approval if such treatment is certified by a medical practitioner as being urgently required.\n\n# 4. Prior approval required\n\n## 4.1 Tier 2 hospital admission and treatment\n\nSubject to Principle 3, an entitled person may be admitted to, and have continuing treatment in, a Tier 2 hospital only if a suitable Tier 1 hospital is unavailable and prior approval has been obtained for the admission.\n\n## 4.2 Tier 3 hospital admission and treatment\n\nSubject to paragraph 3.4, an entitled person may be admitted to, and have continuing treatment in, a Tier 3 hospital only if no suitable Tier 1 or Tier 2 hospital is available and prior approval has been obtained.\n\n## 4.3 Criteria for Tier 2 or Tier 3 hospital admission and treatment\n\nIn deciding whether prior approval will be given under paragraph 4.1 or 4.2 for:\n\n  (a) admission to; or\n\n  (b) continued, non-emergency, treatment in;\n\na Tier 2 or Tier 3 hospital, the Commission must consider where the person’s needs can most appropriately be met within a reasonable time, having regard to:\n\n  (c) advice from the person’s treating medical practitioner concerning:\n\n  (i) the injury or disease being treated; and\n\n (ii) the clinical need for the proposed treatment; and\n\n(iii) the degree of pain or discomfort; and\n\n(iv) the effect on the person’s quality of life; and\n\n(d) in light of the severity of the entitled person’s clinical condition:\n\n  (i) the waiting time, if any, at that hospital compared with waiting times, if any, at relevant Tier 1 or Tier 2 hospitals, as the case may be; and\n\n (ii) the distance that the entitled person would have to travel; and\n\n  (e) reasonable control over Commonwealth expenditure; and\n\n  (f) the extent of a clinical need for continuity of care by a particular medical practitioner; and\n\n(g) any other relevant requirement in these Principles or in the Act.\n\n## 4.4 Admission to Tier 3 hospital of choice\n\nIf prior approval has been given for an entitled person to be admitted to a Tier 2 hospital for the purpose of particular treatment, or an entitled person has been admitted for treatment to a Tier 2 hospital in accordance with paragraph 3.3, the person may elect to be admitted to a Tier 3 hospital of his or her choice for that treatment.\n\n## 4.5 Commonwealth liability if Tier 3 admission by choice\n\nIf an entitled person, in accordance with paragraph 4.4, elects to be admitted to a Tier 3 hospital, the Commonwealth will be liable only for:\n\n  (a) accommodation costs; and\n\n  (b) pharmaceutical fees; and\n\n  (c) theatre fees; and\n\n  (d) certain incidental expenses;\n\n \n\nprovided such costs, fees or expenses are, in the Commission’s opinion, reasonable.\n\n# 5. Treatment Monitoring\n\n## 5.1 Consultative Forum\n\n5.1.1 A consultative forum is given the function of monitoring these Principles, especially in respect of access to, and quality of, the care, welfare and treatment provided to entitled persons.  In particular, the consultative forum has the role of receiving and considering comments and concerns, and providing information relating to these issues to the ex-service community. \n","sortOrder":0}],"analysis":{"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"The instrument appears consistent with its original purpose of setting out principles for private patient hospital treatment for veterans. The three-tier system, prior approval mechanisms, and cost-control measures align with the stated objective of providing access to the nearest suitable hospital while maintaining reasonable control over Commonwealth expenditure. No significant scope creep is evident."},"complexity_factors":["Moderate defined terms section with approximately 20 defined terms, some cross-referencing other legislation (Health Insurance Act 1973, Veterans' Entitlements Act 1986, Treatment Principles)","Three-tier hierarchical hospital classification system with different rules applying to each tier","Multiple exceptions to general rules (emergency exceptions, Vietnam veteran exceptions, contractual exceptions for Tier 2)","Conditional approval requirements that vary by tier and circumstance (prior approval required vs not required)","Nested conditions in section 4.3 with 7 sub-factors for approval decisions","Cross-references to external documents (Treatment Principles, Notes for Local Medical Officers) that aren't fully reproduced in the instrument","Specific date-triggered provision (1 July 2016 accommodation rule in section 1.3)"],"plain_english_summary":"This instrument sets rules for how Australian veterans and eligible family members access hospital care as private patients, establishing a three-tier hospital priority system (preferred repatriation/public/partnering private hospitals; contracted private hospitals; non‑contracted private hospitals). Emergency care is allowed at any tier; non‑emergency treatment generally requires approval for lower tiers. Vietnam veterans get urgent Tier 1 access with a doctor’s certification. If a patient elects a non‑contracted hospital when a contracted one is suitable, the government only pays basic costs."},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"The instrument replaces the prior Repatriation Private Patient Principles (referenced as the revoked 2004 instrument) and restates eligibility, hospital preference and approval processes. It introduces/clarifies specific entitlements such as private accommodation availability from 1 July 2016 (s 1.3(e)) and formalises prior-approval criteria and Commonwealth liability limits for elective Tier 3 choices (s 4.3, s 4.5). The text does not quantify any broader expansion or contraction of eligibility beyond these specified clarifications; the stated objective remains to provide access to the nearest suitable hospital (s 2.2)."},"complexity_factors":["Tiered admission framework with different rules for Tier 1, 2 and 3 hospitals and conditional exceptions (s 2.1, s 3.3, s 4.1–4.2)","Extensive defined terms and cross-references to the Act and to separate Treatment Principles and Notes for Local Medical Officers (s 1.2)","Multiple prior-approval rules plus exceptions for emergency and authorised contracted services (s 3.1–3.4, s 4.1–4.2)","Administrative discretion for the Commission in approval decisions, including cost control and clinical judgment trade-offs (s 4.3(e), s 4.3(c)–(d))","Specific Commonwealth liability limits where a patient elects Tier 3 care (accommodation, pharmaceuticals, theatre fees and certain incidentals) subject to reasonableness (s 4.5)","Operational compliance obligations on hospitals to notify admissions the next working day (s 3.5)","Interactions with private health insurers, provider numbers and private hospital contracting arrangements that affect eligibility and prior-approval needs (s 1.2 definitions; s 2.1)","Monitoring and stakeholder engagement role for consultative forums, adding procedural oversight beyond case-by-case decision-making (s 5.1)"],"plain_english_summary":"These Principles set when and where a person eligible under Part V of the Veterans’ Entitlements Act may be treated as a private patient, establish a three-tier hospital preference, and specify when the Repatriation Commission must give prior approval. They name who decides (Commission, treating practitioners, Deputy Commissioners), what the Commonwealth will pay in elective choices, and the official aim of providing access to the nearest suitable hospital (see Principles 1.3, 2.1, 4.3, 4.5). Compliance steps include hospital notification and consultative monitoring."}},"importantCases":[],"_links":{"self":"/api/acts/repatriation-private-patient-principles","history":"/api/acts/repatriation-private-patient-principles/history","analysis":"/api/acts/repatriation-private-patient-principles/analysis","conflicts":"/api/acts/repatriation-private-patient-principles/conflicts","importantCases":"/api/acts/repatriation-private-patient-principles/important-cases","documents":"/api/acts/repatriation-private-patient-principles/documents"}}