131Functions of the Pricing Authority—public hospitals and health care pricing and costing

131 Functions of the Pricing Authority—public hospitals and health care pricing and costing

(1) The Pricing Authority has the following functions: (a) to determine the national efficient price for health care services provided by public hospitals where the services are funded on an activity basis; (b) to determine the efficient cost for health care services provided by public hospitals where the services are block funded; (c) to develop and specify classification systems for health care and other services provided by public hospitals; (d) to determine adjustments to the national efficient price to reflect legitimate and unavoidable variations in the costs of delivering health care services; (e) to determine data requirements and data standards to apply in relation to data to be provided by States and Territories, including: (i) data and coding standards to support uniform provision of data; and (ii) requirements and standards relating to patient demographic characteristics and other information relevant to classifying, costing and paying for public hospital functions; (f) except where otherwise agreed between the Commonwealth and a State or Territory—to determine the public hospital functions that are to be funded in the State or Territory by the Commonwealth; (g) to publish a report setting out the national efficient price for the coming year and any other information that would support the efficient funding of public hospitals; (h) to advise the Commonwealth, the States and the Territories in relation to funding models for hospitals; (i) to provide confidential advice to the Commonwealth, the States and the Territories in relation to the costs of providing health care services in the future; (j) such functions as are conferred on the Pricing Authority by Part 4.3 of this Act (cost‑shifting disputes and cross‑border disputes); (k) to publish (whether on the internet or otherwise) reports and papers relating to its functions; (l) to call for and accept, on an annual basis, public submissions in relation to the functions set out in paragraphs (a) to (f); (m) such functions (if any) as are specified in a written instrument given by the Minister to the Chair of the Pricing Authority with the agreement of the First Ministers’ Council; (n) to do anything incidental to or conducive to the performance of any of the above functions. (1A) The Pricing Authority also has the following functions: (a) if the Minister or the Secretary requests, in writing, the Pricing Authority to do so—to advise the Commonwealth in relation to one or more health care pricing or costing matters (whether or not the matters relate to health care services provided by public hospitals); (b) to conduct, or arrange for the conduct of, costing and other studies: (i) for the purpose of performing the function mentioned in paragraph (a); or (ii) if the Minister or the Secretary requests, in writing, the Pricing Authority to do so; (c) to publish (whether on the internet or otherwise) reports and papers relating to the functions mentioned in paragraphs (a) and (b); (d) to do anything incidental to or conducive to the performance of any of the above functions. (2) The First Ministers’ Council is to give its agreement for the purposes of paragraph (1)(m) by a written resolution of that Council passed in accordance with the procedures determined by that Council. (3) In performing the functions mentioned in subsection (1), the Pricing Authority must have regard to the following: (a) relevant expertise and best practice within Australia and internationally; (b) submissions made at any time by the Commonwealth, a State or a Territory; (c) the need to ensure: (i) reasonable access to health care services; and (ii) safety and quality in the provision of health care services; and (iii) continuity and predictability in the cost of health care services; and (iv) the effectiveness, efficiency and financial sustainability of the public hospital system; (d) the range of public hospitals and the variables affecting the actual cost of providing health care services in each of those hospitals. (4) A request under paragraph (1A)(a) or subparagraph (1A)(b)(ii) is not a legislative instrument.