Hospitals

Page last updated: 24 October 2018

Commonwealth Hospital Declaration

Hospital declarations are made by the Minister for Health pursuant to section 121-5(6) of the Private Health Insurance Act 2007 (“the PHI Act”). The declaration takes effect on the date it is signed and cannot be made retrospectively. The PHI Act specifies a number of matters to which the Minister must have regard in granting or revoking a hospital declaration. Section 121-7(f) of the PHI Act provides that hospital declarations are subject to conditions specified in the Private Health Insurance (Health Insurance Business) Rules. The Rules specifies a number of additional matters to which the Minister must have regard in granting hospital declarations.

Please allow up to 10 business days for the processing of hospital declaration requests.

Requirements for a new hospital declaration

A facility (public or private) must obtain a declaration that it is a hospital when it commences or when two hospitals amalgamate in order to receive payments of health benefits from health insurers, following treatment of insured patients..

To assist the Minister for Health (or Minister’s delegate) in deciding whether to declare that a facility is a hospital, the facility is required to provide the following evidence:

For Public Hospitals

Word version: Public Hospital Information Form (Word 524 KB)
  • A letter or email from the State/Territory Department of Health advising of either a new public hospital or any changes that need to be made.
  • Copy of an accreditation certificate (or evidence that accreditation process has commenced)

For Private Hospitals

Word version: Private Hospital Information Form (Word 1026 KB)
  • Copy of state/territory hospital licence, and
  • Copy of an accreditation certificate (or evidence that accreditation process has commenced)

For further information regarding the hospital declaration process, please email phi@health.gov.au

Any question on provider numbers must be directed to the Department of Human Services at CO.Medicare.Provider.Eligibility@humanservices.gov.au

Data submission requirements for private hospitals

Under the Private Health Insurance Act 2007, private hospitals are required to provide:

1) Hospital Casemix Protocol (HCP) data to insurers, for each episode of admitted hospital treatment for which a benefit has been paid.

2) Private Hospital Data Bureau (PHDB) data to the Commonwealth Department of Health for all episodes of hospital treatment for admitted patients.

Here are data specifications for Private Hospital Data Bureau (PHDB) also for Hospital Casemix Protocol (HCP).

Please also look at the document entitled ‘Reporting requirements for Hospitals/Insurers’ which is contained in each of those links.

For new hospitals, please contact us at hcp@health.gov.au and we will arrange for an IT account to be created for a data submitter to submit data electronically to the Department’s Data Submission Portal (DSP). The DSP is a web-based interface through which all Private Health Insurance Act data should be submitted to the Department of Health.

If you have any questions or require further assistance please contact the Department of Health on 02 6289 9430

Current Listing of Commonwealth declared hospitals

The current list of all hospitals is below:

Commonwealth declared public hospitals, private hospitals and day hospital facilities (Excel 334 KB)


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