Hospital declarations

The hospital declaration process

The Minister for Health and Aged Care declares facilities to be hospitals for health insurance business under section 121–5(6) of the Private Health Insurance Act 2007. The declaration takes effect on the date the minister signs it – we cannot backdate it.

State and territory governments license and regulate all facilities that have been declared as hospitals for health insurance business.

Hospitals must also meet the National Safety and Quality Health Service (NSQHS) Standards. This process is known as accreditation.

When granting or revoking a hospital declaration, the minister must consider:

whether the relevant state or territory authority has approved the facility
the nature of the facility
the range and scope of services the facility provides, or plans to provide
whether the facility has met accreditation requirements
any issues the facility has providing information to private health insurers, as specified in the Private Health Insurance (Health Insurance Business) Rules (PHI Rules)
when deciding to revoke a declaration, any failure to meet required conditions
any other matters specified in the PHI Rules.

It takes about 10 business days to process a fully completed and correct hospital declaration request.

How to apply

To receive private health insurance benefits the Minister for Health and Aged Care must declare a facility (public or private) as a hospital:

before it starts to operate
when it joins with one or more existing hospitals.

Facilities must supply supporting evidence to help the minister decide whether to declare them a hospital for private health insurance business.

Public hospitals

Facilities applying for declaration as a public hospital for private health insurance business must:

complete the public hospital declaration form
provide a letter or email from their state or territory health department advising of a new public hospital, or any updates
provide a copy of an accreditation certificate, or evidence that they have applied for accreditation.

Hospital declaration form – Public hospital

Facilities applying to be declared as a public hospital must use this form to provide information.

Private hospitals

Facilities applying for declaration as a private hospital for private health insurance business must:

complete the private hospital declaration form
provide a copy of their state or territory hospital licence, or any updates
provide a copy of their accreditation certificate, or evidence that they have applied for accreditation, or any updates.

Hospital declaration form – Private hospital

Facilities applying to be declared as a private hospital must use this form to provide information.

What it means when a hospital is declared

Once the minister declares a facility to be a hospital for health insurance business it:

can receive health benefit payments from health insurers, for treating insured patients
must submit data about hospital treatments and patients
- both public and private hospitals must submit Hospital Casemix Protocol (HCP) data to health insurers
- private hospitals must also submit Private Hospital Data Bureau (PHDB) data to us (Health and Aged Care)
must keep contact details up to date
must email us when closing down.

Updating hospital details

Hospitals must email us with updated details including:

name
address
ownership
bed numbers
new or amended licence
new or amended accreditation.

List of declared hospitals

View the current list of declared hospitals for health insurance business.

List of declared hospitals

The Minister for Health and Aged Care must declare a facility to be a hospital under section 121–5(6) of the Private Health Insurance Act 2007. View the current list of declared hospitals.

See all our hospital announcements.

Contact