Federal Register of Legislation - Australian Government

Primary content

Rules/Other as made
These rules amend the Private Health Insurance (Benefit Requirements) Rules 2011 to update the listing of Medicare Benefits Schedule item numbers, to increase hospital accommodation minimum benefits, to update minimum benefits for Nursing Home Type Patients in some States and Territories, and to update the reference to the list of Second Tier facilities.
Administered by: Health
Made 21 Jun 2013
Registered 27 Jun 2013
Tabled HR 12 Nov 2013
Tabled Senate 28 Jun 2013
Date of repeal 02 Jul 2013
Repealed by Division 1 of Part 5A of the

 

Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 2)

 

I, RICHARD BARTLETT, delegate of the Minister for Health, make these Rules under item 3A of the table in section 333-20 of the Private Health Insurance Act 2007.

 

 

 

Dated  21 June 2013

 

 

 

 

____________________________________

 

Richard Bartlett

First Assistant Secretary

Medical Benefits Division

Department of Health and Ageing

 

 

 



Part 1        Preliminary

 

1.               Name of Rules

 

These Rules are the Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 2).

 

2.               Commencement

 

These Rules commence on 1 July 2013, or if registered after 1 July 2013, the day after registration.

 

3.               Authority

 

These rules are made under item 3A of the table in section 333-20 of the Private Health Insurance Act 2007.

 

4.               Schedule

 

Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms. 

 

 


Schedule A – Amendments

 

Private Health Insurance (Benefit Requirements) Rules 2011

 

1         Schedule 1, Subclause 2(2) Minimum benefit, Table 1

 

Delete:

 

             Schedule 1, Subclause 2(2) Minimum benefits, Table 1 –   Accommodation at private hospitals in all States/Territories

 

Insert:

Table 1―Accommodation at private hospitals in all States/Territories

Class of patient

Minimum benefit payable per night

Advanced surgical patient

 

- first 14 days

$394

- over 14 days

$273

Surgical patient or obstetric patient

 

- first 14 days

$365

- over 14 days

$273

Psychiatric patient

 

- first 42 days

$365

- 43 – 65 days

$317

- over 65 days

$273

Rehabilitation patient

 

- first 49 days

$365

- 50 - 65 days

$317

- over 65 days

$273

Other patients

 

- first 14 days

$317

- over 14 days

$273

 

 


2         Schedule 1, Subclause 2(2) Minimum benefit, Table 2

 

Delete:

 

             Schedule 1, Subclause 2(2) Minimum benefit, Table 2 - Victoria:  shared ward accommodation at a public hospital

 

Insert:

 

Table 2― Victoria:  shared ward accommodation at a public hospital

Class of patient

Minimum benefit payable per night

Advanced surgical patient

 

- first 14 days

$394

- over 14 days

$273

Surgical patient or obstetric patient

 

- first 14 days

$365

- over 14 days

$273

Psychiatric patient

 

- first 42 days

$365

- 43 – 65 days

$317

- over 65 days

$273

Rehabilitation patient

 

- first 49 days

$365

- 50 - 65 days

$317

- over 65 days

$273

Other patients

 

- first 14 days

$317

- over 14 days

$273

 


3         Schedule 1, Subclause 2(2) Minimum benefit, Table 3

 

Delete:

 

             Schedule 1, Subclause 2(2) Minimum benefit, Table 3 - Tasmania:  shared ward accommodation at a public hospital

 

Insert:

 

Table 3― Tasmania:  shared ward accommodation at a public hospital

Class of patient

Minimum benefit payable per night

Advanced surgical patient

 

- first 14 days

$394

- over 14 days

$273

Surgical patient or obstetric patient

 

- first 14 days

$365

- over 14 days

$273

Psychiatric patient

 

- first 42 days

$365

- 43 – 65 days

$317

- over 65 days

$273

Rehabilitation patient

 

- first 49 days

$365

- 50 - 65 days

$317

- over 65 days

$273

Other patients

 

- first 14 days

$317

- over 14 days

$273

 


4         Schedule 2, Clause 2 Minimum benefit, Table

 

Delete:

                           Schedule 2, Clause 2 Minimum benefit, Table      

 

             Insert:

 

Table

 

State/Territory

Minimum benefit payable per night

ACT

$326

NSW

$326

Northern Territory

$318

Queensland

$331

South Australia

$326

Western Australia

$326

 

5         Schedule 3, Part 1, Subclause 2(2) Minimum benefit, Table 1:

 

Delete:

 

Schedule 3, Part 1, Subclause 2(2) Minimum benefit, Table 1

            

Insert:  

Table 1

Public hospitals

Band 1

Band 2

Band 3

Band 4

 

 

 

 

 

NSW

$236

$263

$290

$326

ACT

$236

$263

$290

$326

Northern Territory

$230

$262

$305

$318

Queensland

$241

$270

$297

$331

South Australia

$236

$269

$297

$326

Tasmania

$229

$272

$316

$365

Victoria

$231

$273

$318

$365

Western Australia

$267

$267

$267

$267

 

 

 


6         Schedule 3, Part 1, Subclause 2(2) Minimum benefit, Table 2:

 

Delete:

Schedule 3, Part 1, Subclause 2(2) Minimum benefit, Table 2

            

Insert:  

Table 2

 

Band 1

Band 2

Band 3

Band 4

Private Hospitals

$204

$257

$313

$365

 


Schedule B ― Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

1      Schedule 4, Clause 6 Minimum benefit, Table 1:

 

 

Delete:

             South Australia                            $108.00

 

Insert:

             South Australia                            $111.00

 

Delete:

             ACT                                             $107.40

 

Insert:

             ACT                                             $111.20

 

Delete:

             Western Australia                        $116.05

 

Insert:

             Western Australia                        $125.45

 

 


Schedule C ― Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

1         Schedule 1, Part 2 Type A procedures, Clause 4 Advanced surgical patient, subclause (3)

 

After “30509” delete “30512”

 

2         Schedule 1, Part 2 Type A procedures, Clause 6 Surgical patient, subclause (3)

 

After “30505” delete “30511”

 

3         Schedule 3, Part 3 Type C procedures, Clause 8 Interpretation, Category 3 Therapeutic Procedures, T8

 

After “32522” insert “32523  32526”

 

 

 


Schedule D ― Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

 

1           Schedule 5, Clause 4 Facilities, subclause (1)

 

Substitute

 

A hospital is a facility for the purposes of this Schedule if it is included in the list of second-tier eligible facilities approved by the Second Tier Advisory Committee existing at the time that the Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 2) commence.