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 health facilities, including those 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. The Australian Commission on Safety and Quality in Health Care (ACSQHC) has developed resources to assist health service organisations to align with the NSQHS Standards.
When granting or revoking a hospital declaration, the minister must consider:
- the nature of the facility
- the range and scope of services the facility provides, or plans to provide
- the management or control of the facility
- whether the relevant state or territory authority has approved the facility
- whether the facility has met accreditation requirements
- any issues the facility has providing information to private health insurers, as set out 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 can take up to 60 days to process a fully completed and correct hospital declaration application.
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
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
Before submitting your application
Do a self-check of your facility’s details. Make sure they are consistent across:
- licence or registration from your state or territory authority
- NSQHS Standards accreditation certification
- Australian Business Number (ABN)
- Australian Registered Business Name
- Australian Company Name and company number (ACN), if applicable
- ABN Lookup, the free public view of the Australian Business Register (ABR)
- ASIC Connect Register Business Names Index
All levels of government will use these details to verify your hospital as correctly registered for the purposes of payments and online services.
Updating facility details in the Australian Business Register (ABR)
If your ABN, business or company name or other details are not correct and linked when viewed in ABN Lookup and the ASIC Connect Register Business Names Index we will ask you to update them.
Update your business details at business.gov.au
Update your ABN details with the ABR
If you registered your business name before 28 May 2012, you may not have an ABN linked to your business name. Adding an ABN to your business name allows verification of your business details.
Learn how to link an ABN to your existing business, company or trust name
If your business does not operate under your own entity name including any legal parts of a company name (eg, ‘Pty Ltd’), then you must register a business name with the Australian Securities and Investments Commission (ASIC).
This means that if Australian company ‘Happy Hospital Pty Limited’ conducts business as ‘Happy Hospital’ they must register the business name ‘Happy Hospital’.
Find out how to register your business name with ASIC
Read the ASIC business and company name frequently asked questions (FAQs)
What it means when a hospital is declared
Once the minister declares a facility to be a hospital for health insurance business, the hospital:
- will be assigned a unique Hospital Provider Number (HPN) by Services Australia
- will appear on the publicly available List of declared hospitals
- is announced to the health sector in a private health insurance circular
- can receive health benefit payments from health insurers, for hospital treatment of private patients
- needs to 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
See all our hospital announcements.