3. Overview of licensing fees

How HCSA fees are charged

Under HCSA, all fees are based on a standard 2-year licence tenure, and the applicable regulatory fees have been adjusted to ensure that they remain commensurate with the regulatory costs of a 2-year licence. The purpose of this standardisation is to help licensees reduce the administrative complexity of managing multiple licences with different licence expiry dates.

Renewal timeline for a clinical laboratory licencee

Licence tenure and fees on transition from PHMCA to HCSA

Under Private Hospitals and Medical Clinics Act (PHMCA), Medical Clinic and Laboratory licensees could be eligible for 5-year licences. We have adjusted the fees for these licence categories to be based on a 2-year tenure under HCSA. However, licensees whose remaining PHMCA licence tenure exceeds 2 years at the time of transition to HCSA, will have their full remaining PHMCA licence tenure ported over to HCSA.

Licence fees and MOSD fees

Your HCSA licence fees will include the approval of one MOSD under the said licence. For the MOSDs beyond the first, MOSD fees will be charged based on per-premises or conveyance basis, i.e. separate fees will apply for services provided at each premises and conveyance. MOSD fees also apply to temporary premises and remote delivery where these are allowed. However, there are exceptions which are further explained below.

Total fees payable for a licensee

Capacity-based fees

However, there are licence categories that are not charged based on per premises/conveyance basis but are tiered by capacity, such as:

• Blood Banking Service, which is tiered based on the total number of permanent premises and conveyances (i.e., sites) held by the licensee (i.e. 10 or fewer sites, more than 10 sites);

• Emergency Ambulance Service and Medical Transport Service, which is tiered by the total number of vehicles (i.e., 10 or fewer vehicles, more than 10 vehicles)

Licence fee for an ambulance operator

For these licence categories, licensees will only need to hold a single licence regardless of the number of vehicles in a fleet or sites.

Fees shown in Table 1 are with respect to offering the service via any one allowable Mode of Service Delivery (MOSD).

^ Sites may include either permanent premises or conveyances

Fee bundles

Fee bundles were also introduced to help licensees lower costs when licensees need to hold several HCSA licences and MOSD approvals. The available fee bundles are as below:

a. Acute Hospital Service bundle

Acute hospital service providers will not incur any additional licence fee for the licences for Outpatient Medical Service, Clinical Laboratory Service, Radiological Service, and Ambulatory Surgical Centre Service (Table 2) when these services are provided on the same premises.

b. Ambulance bundle

Providers offering both Emergency Ambulance Service (EAS) and Medical Transport Service (MTS) will enjoy a bundled licence fee, instead of having to pay for the respective licence fees of the EAS and MTS licences (Table 3).

c. Mode of Service Delivery (MOSD) bundle

Providers offering Assisted Reproduction Service, Outpatient Medical Service, Outpatient Dental Service, and Outpatient Renal Dialysis Service will not be charged for any additional MOSD approval fee for the provision of temporary premises and/or remote provision (where applicable), if provided in conjunction with a permanent premises or conveyance (where applicable) (Table 4).

d. Specified Services (SS) bundle

In most cases, licensees who offer SSes will incur an SS fee that is in addition to the LHS fee indicated in Table 1 above. The SS fee is dependent on whether the SS is categorized as “simple” or “complex”. SS fees are charged as set out in the Healthcare Services (Fees) Regulations 2021. Licensable Healthcare Services where SS fees are not applicable include Clinical Laboratory Service or Radiological Service.

Providers who offer more than one simple SS will be able to enjoy a bundled fee if the simple SSes are offered under the same LHS category (Table 5). Similarly, providers who offer two complex SSes under the same LHS category will also qualify for a bundled fee (Table 6). SSes under different LHS categories will not be bundled together (Table 7).

These bundles are applicable only when the services and MOSDs approved are provided (i) by the same licensee, (ii) out of the same premises, (iii) have the same end-dates for all licences, and (iv) can be inspected together.

View the summary of all the LHS and SS fees applicable [PDF, 233KB].

Standard administrative fees

Application fees

All fees are inclusive of a non-refundable application fee of $100 per service licence which will be retained in the event an application is withdrawn or rejected.

Combining the above principles, this is how the HCSA licensing fees would work:

A licensee who provides Clinical Laboratory and Radiological Service at Site A will pay $1,016 for a Clinical Laboratory licence and $1,016 for a Radiological Service licence (i.e. total of $2,032).

• Both the Clinical Laboratory and Radiological Service licences held for Site A will be valid for 2 years.

• Each licence fee includes a non-refundable application fee of $100.

• Should the licensee withdraw their application before the start of the licence, they will be refunded $916 for the Clinical Laboratory licence and $916 for the Radiological Service licence. $200 will be retained as the non-refundable application fee (i.e. $100 for each licence).

Late fee and amendment fee charges

Please also note that in addition to the licensing fees described above, the fees chargeable for late renewals and amendments are similar to what is currently charged under PHMCA, and will continue to apply:

• Renewal applications which are received less than 2 months before the licence expiry, will be charged a late fee equivalent to 20% of their full licence fees.

• Over the 2-year tenure of a licence, if there are changes to the licence that require an amendment of the licence, a $100 administrative fee will be charged.

Impact on licensees

While you may need to hold multiple HCSA licences and approvals, most licensees will see no change, or a reduction in their licence fees, unless you provide newly introduced Licensable Healthcare Services (e.g. Cord Blood Banking, Human Tissue Banking, Assisted Reproduction) or Specified Services.

To help you manage these changes, we have introduced:

• Licence Fee Bundles: to help you lower costs when you need to hold multiple HCSA licences and MOSD approvals.

• Gradual Fee Increase Mechanism: to spread the increase in fees by gradually increasing fees over three renewal cycles, for those who meet the eligibility conditions.

Gradual fee increase (GFI) mechanism

The GFI is a mechanism put in place to help mitigate the impact of an increase in licensing fees on licensees, when transiting from PHMCA to HCSA, by gradually increasing fees over three renewal cycles, for those who meet the eligibility conditions.

The GFI will be applied when you make a licence renewal/application on the new IT system, within 1 year of the service being rolled out under HCSA.