9.2Financial Responsibility For Treatment In Hospital

9.2 Financial Responsibility For Treatment In Hospital

9.2.1 Subject to paragraph 9.2.5, the Commission will accept financial responsibility for any usual and reasonable hospital treatment, for malignant neoplasia, that takes place at the hospital for persons admitted in accordance with these Principles.

9.2.2 The Commission may accept financial responsibility for any usual and reasonable treatment, for malignant neoplasia, that takes place outside the hospital if it is prescribed as a necessary part of inpatient treatment.

9.2.4 Subject to paragraph 9.2.5, the Commission will accept financial responsibility for hospital charges on the basis of:

(a) for a public hospital — an amount in accordance with arrangements made by the Commission with the appropriate State/Territory authority, or, in the absence of such arrangements, an amount in accordance with arrangements made by the Commission under Part V VEA with the appropriate State/Territory authority, for the purposes of the VEA; or

(b) for a contracted private hospital — the rate agreed between the Commission and the hospital or, in the absence of such an agreement, the rate agreed between the Commission and the hospital under Part V VEA for the purposes of the VEA;

(c) for a non-contracted private hospital, when neither a public nor a contracted private hospital can provide the treatment required — the rate agreed from time to time between the Commission and the hospital or, in the absence of such an agreement, the rate agreed between the Commission and the hospital under Part V VEA for the purposes of the VEA; or

(d) for a non-contracted hospital, when chosen by an entitled person in preference to a contracted private hospital — the rate agreed from time to time between the Commission and the hospital or, in the absence of such an agreement, the rate agreed between the Commission and the hospital under Part V VEA for the purposes of the VEA.

9.2.5 The Commission will not accept financial responsibility for the whole, or that portion, of:

(a) hospital charges; or

(b) charges for any surgically implanted prostheses; or

(c) charges paid by health fund benefits;or

in circumstances where the entitled person:

(d) is insured by private health insurance for hospital charges, or surgically implanted prostheses, and

(e) agrees to assign to the hospital or other institution the benefits available from private health insurance in respect of all or part of the hospital charges or surgically implanted prostheses.