Federal Register of Legislation - Australian Government

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Rules/Other as made
This instrument amends the Private Health Insurance (Benefit Requirements) Rules 2011 to update the minimum benefit accommodation rates at private and public hospitals to reflect an increase in CPI. The Rules also increase the minimum benefits for Nursing Home Type Patients in South Australa and Western Australia, update the list of MBS items and update the list of second-tier eligible facilities.
Administered by: Health
Made 19 Jun 2014
Registered 24 Jun 2014
Tabled HR 26 Jun 2014
Tabled Senate 26 Jun 2014
Date of repeal 02 Jul 2014
Repealed by Division 1 of Part 5A of the Legislative Instruments Act 2003

 

Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (No. 2) 1

 

I, SHANE PORTER, 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.

 

 

 

 

 

 

 

____________________________________

 

Shane Porter

Assistant Secretary

Private Health Insurance Branch

Medical Benefits Division

Department of Health

19 June 2014

 

 



Part 1        Preliminary

 

1.               Name of Rules

 

These Rules are the Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (No. 2).

 

2.               Commencement

 

These Rules commence on 1 July 2014, or if registered after 1 July 2014, 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Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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 Minimum benefit, Table 1

 

Delete:

 

             Schedule 1, Subclause 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

$405

- over 14 days

$281

Surgical patient or obstetric patient

 

- first 14 days

$376

- over 14 days

$281

Psychiatric patient

 

- first 42 days

$376

- 43 – 65 days

$326

- over 65 days

$281

Rehabilitation patient

 

- first 49 days

$376

- 50 - 65 days

$326

- over 65 days

$281

Other patients

 

- first 14 days

$326

- over 14 days

$281

 

 


2         Schedule 1, Subclause 2 Minimum benefit, Table 2

 

Delete:

 

             Schedule 1, Subclause 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

$405

- over 14 days

$281

Surgical patient or obstetric patient

 

- first 14 days

$376

- over 14 days

$281

Psychiatric patient

 

- first 42 days

$376

- 43 – 65 days

$326

- over 65 days

$281

Rehabilitation patient

 

- first 49 days

$376

- 50 - 65 days

$326

- over 65 days

$281

Other patients

 

- first 14 days

$326

- over 14 days

$281

 


3         Schedule 1, Subclause 2 Minimum benefit, Table 3

 

Delete:

 

             Schedule 1, Subclause 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

$405

- over 14 days

$281

Surgical patient or obstetric patient

 

- first 14 days

$376

- over 14 days

$281

Psychiatric patient

 

- first 42 days

$376

- 43 – 65 days

$326

- over 65 days

$281

Rehabilitation patient

 

- first 49 days

$376

- 50 - 65 days

$326

- over 65 days

$281

Other patients

 

- first 14 days

$326

- over 14 days

$281

 


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

$335

NSW

$335

Northern Territory

$335

Queensland

$341

South Australia

$335

Western Australia

$335

 

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

 

Delete:

 

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

            

Insert:  

Table 1

Public hospitals

Band 1

Band 2

Band 3

Band 4

 

 

 

 

 

NSW

$243

$271

$298

$335

ACT

$243

$271

$298

$335

Northern Territory

$243

$277

$322

$335

Queensland

$248

$278

$306

$341

South Australia

$243

$277

$306

$335

Tasmania

$236

$280

$325

$376

Victoria

$238

$281

$327

$376

Western Australia

$275

$275

$275

$275

 

 

 


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

 

Delete:

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

            

Insert:  

Table 2

 

Band 1

Band 2

Band 3

Band 4

Private Hospitals

$210

$264

$322

$376

 


Schedule B ― Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

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

 

 

Delete:

             South Australia                            $111.00

 

Insert:

             South Australia                            $114.00

 

Delete:

             Western Australia                        $125.45

 

Insert:

             Western Australia                        $133.20

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 “38272” insert “38273  38274”

 

             After “42656” delete “42659”

 

             After “42734” delete “42737”

 

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

 

After “31515” delete “31518  31521  31527”

 

After “31515” insert “31519  31525”

 

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

 

After “42794” delete “42797”

 

4         Schedule 3, Part 3 Type C procedures, Clause 8 Interpretation, Category 5 Diagnostic Imaging Services, I1

 

             After “55039” delete “55044  55045”

 

             After “55054” insert “55065  55067  55068  55069”

 

             After “55729” delete “55731  55733”

 


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 2014 (No. 2) commence.  

Notes

1.       All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See www.comlaw.gov.au