DVA provides veterans and war widows and widowers (entitled persons) with access to quality hospital care in a range of hospital settings. This page provides information to services providers and hospital staff about DVA's hospital arrangements including services in public hospitals, private hospitals, private mental health hospitals and day procedure centres. Under the Repatriation Private Patient Principles DVA beneficiaries can be admitted to public or private hospitals as private patients, with the doctor of their choice.
The Group Accommodation and Theatre Banding Schedules and tables
DVA's private hospital agreements require that accommodation and operating theatre charges are claimed based on the Group Accommodation and Theatre Banding (GATB) Schedule.
The GATB Schedule comprises two tables: one based on the Commonwealth Medicare Benefits Schedule (CMBS) and the other on ICD 10 Medical Group Accommodation Banding Schedule diagnosis/ disease codes, as follows:
Only two additions to the 1 July 2019 version of the ICD 10 Medical Group Accommodation Banding Schedule - now includes banding for ICD Codes B95 and B97.
Surgically Implanted Prostheses Schedule
The Department of Health (DoH) provides a listing of the Surgically Implanted Prostheses Schedule. Refer to the section titled: "Arrangements for listing and setting benefits for prostheses" where you will find the schedule available in four different versions — PDF, Access, Word and Excel.
Hospital data submission
All private hospitals, mental health private hospitals and day procedure centres are required to submit HCP data using the Hospital Casemix Protocol (HCP) Data Upload link. The Hospital Casemix Protocol (HCP) Data Upload link connects to the DVA secure services login page.
- Hospital Admission Form
- Discharge Advice and Hospital Claim Form
- Acute Care Certificates are used by public and private hospitals to certify that patients are required to receive acute care continuously for a period of 35 days or more
- Critical Care Certificates clinically verify the need for accommodation in a Critical Care Facility and list the required interventions and level of nursing care. There are two certificates:
- The Rehabilitation Program Certificate is used when a patient is admitted for any of the following:
- inpatient rehabilitation
- admitted same day
- non-admitted sessional rehabilitation program
- The Rehabilitation Program certificate should be signed by a rehabilitation physician.
- Do not send original Coronary Care or Critical Care Certificates, or the rehabilitation program certificate to either Services Australia or DVA. They are to be kept on the patient file for audit purposes.
Effective discharge planning
Effective discharge planning optimizes positive post-hospital physical and mental health outcomes for patients, reduces hospital readmissions and improves patient independence.
DVA is committed to working with hospitals to facilitate the seamless transfer of Entitled Persons to their homes and communities. In order to assist hospital staff and those involved in the discharge planning process, DVA has developed an Effective Discharge Planning Resource Guide and a Discharge Planning Checklist (PDF 503 KB) which provide hospital and discharge planning staff with information on the broad range of health services available to DVA entitled persons.
DVA has agreements with all Australian State and Territory Governments to provide treatment and care to eligible members of the veteran community in their public hospitals.
Admissions to public hospitals for Veteran Gold Card holders, do not generally require prior financial approval. There are, however, some exceptions which include, but are not limited to, cosmetic and non-MBS procedures. Admissions for Veteran White Card holders need to be related to their accepted war-caused disabilities.
Quality reporting is not required by public hospitals.
Change to claiming for surgically implanted prostheses in Qld, NSW, ACT, Tas and NT
DVA's public hospital arrangements have moved to a new purchasing model that closely mirrors that of the Independent Hospital Pricing Authority (IHPA).
Under this model, the cost of surgically implanted prostheses is included in the activity based payment made to state or territory health departments for each admitted episode. Since 1 July 2016, hospitals in Qld, NSW, ACT, Tas and NT have not been able to claim separately through Services Australia for surgically implanted prostheses.
If you require any further information or clarification concerning your hospital's specific internal funding or payment arrangements, please contact your Local Health Network or your state or territory health department.
Should you have any DVA specific queries please contact dva.public.hospitals [at] dva.gov.au
Change to claiming for non-admitted services in Tasmania
Since 1 July 2016, Tasmanian public hospitals have not been able to claim for non-admitted services provided to DVA clients through Services Australia.
DVA now provides funding for non-admitted services to the Tasmanian Department of Health and Human Services. For 2015–16 and beyond non-admitted services provided to DVA clients should be reported to the Tasmanian Department of Health and Human Services.
DVA has agreements with a majority of Private hospitals and Private Mental Health hospitals throughout Australia to provide treatment and care to eligible members of the veteran community.
Admissions to Private hospitals for Veteran Gold Card holders do not require prior financial approval, however there are some exceptions which include admissions for non-approved programs, and some non-MBS procedure items. Veteran White Card holder admissions must be related to accepted war-caused disabilities. The Information Guide for Private and Mental Health Hospitals provides relevant information for hospital staff.
Quality reporting Private Hospitals and Private Mental Health Hospitals
All DVA contracted hospitals are required to complete and submit an annual quality report. The quality reporting period is 1 July to 30 June and is due within 4 months of the end of the reporting period (that is, annual reports are due no later than 31 October. The quality report is completed on a template which includes provision for hospitals to report on a range of quality measures, patient experience measures and the hospital's Safety and Quality Accreditation Outcome status. Veteran patient feedback and complaints are also captured.
The DVA Private Hospital quality report enables providers to use a single report template to report on the following services:
- private hospital services
- private mental health services
- better discharge planning services
Once completed, the Quality Report must be emailed to the Private Hospital Quality Reporting mailbox dvaprivatehospitalqualityreports [at] dva.gov.au
Program proposals for private-hospital based (including private mental health) services
DVA invites providers to submit proposals for programs that may improve health outcomes in the veteran population. In order to assist providers to draft their proposals, a set of Guidelines are provided to guide the process. It is recommended that proposal writers review the Guidelines for hospital-based program proposals (for new services) or Clinical Mental Health services and day programs before submitting a proposal to DVA.
To assist providers, DVA has developed guidelines and templates for reference. These are provided in the following downloadable files:
DVA's Better Discharge Planning Program
The DVA Better Discharge Planning (BDP) program is delivered by private hospitals who have been contracted to provide this service.
As an extension of the existing discharge planning services, the BDP program aims to improve health outcomes by providing additional and more coordinated support to entitled persons who are transferring from hospital into community or home based care.
The BDP information guide sets out the service delivery requirements for providers contracted to deliver these services. Quality Reporting for the BDP is now included as part of the Private hospital quality report.
DVA has agreements with a majority of Day Procedure Centres (DPCs) throughout Australia to provide services to eligible members of the veteran community. A list of contracted DPCs is available from the following:
Generally, for Veteran Gold Card holders, admissions to these centres do not require prior financial approval, however, there are some exceptions which include, but are not limited to, cosmetic and non-MBS procedures. Admissions for Veteran White Card holders need to be related to their accepted war-caused disabilities.
The Day Procedure Centre Information Guide provides important information for DPCs working with DVA.
DPC Quality Reporting
All DVA contracted Day Procedure Centres (DPCs) are required to complete and submit an annual DVA Quality Report. The quality reporting period is 1 July to 30 June and the annual report is due within 4 months of the end of the reporting period (that is, reports are due no later than 31 October).
The quality report is completed on the DPC Quality Reporting template which includes provision for DPCs to report on a range of quality measures, patient experience measures and the facility's Safety and Quality Accreditation Outcome status. Veteran patient feedback and complaints are also captured.
Completed reports are to be emailed to DVA using the following email address: dvaprivatehospitalqualityreports [at] dva.gov.au