New Zealand Legislation: Regulations

18 Elective surgery costs

• (1) This regulation applies if the Corporation is liable to pay for elective surgery for a claimant.

  (2) The Corporation may nominate a provider to perform the surgery (nominated provider).

  (3) Subject to subclause (4), the claimant must then—

  • (a) decide to accept the nominated provider; or

  • (b) decide not to accept the nominated provider and choose a provider (chosen provider); or

  • (c) choose a provider (because the Corporation has not nominated a provider under subclause (2)).

  (4) Before the claimant decides whether to accept the nominated provider, the Corporation must tell the claimant that the Corporation would be liable to pay the full cost of the surgery if it was performed by the nominated provider.

  (5) The Corporation is liable to pay the full cost of surgery under this regulation if it is performed by—

  • (a) a district health board; or

  • (b) a nominated provider; or

  • (c) a provider described in subclause (3)(c).

  (6) The Corporation is liable to pay 60% of the amount that would have been payable under this regulation had the surgery been performed by the nominated provider, if—

  • (a) the Corporation nominated a provider under subclause (2); and

  • (b) the surgery is performed by the chosen provider; and

  • (c) the chosen provider is not a district health board.