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Rules/Other as made
This instrument amends the Private Health Insurance (Benefit Requirements) Rules 2011 to include update to minimum benefits, NHTP rates, STAC list update and MBS item changes
Administered by: Health
Made 21 Jun 2015
Registered 24 Jun 2015
Tabled HR 10 Aug 2015
Tabled Senate 10 Aug 2015
Date of repeal 02 Jul 2015
Repealed by Division 1 of Part 5A of the

 

Private Health Insurance (Benefit Requirements) Amendment Rules 2015 (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

21 June 2015

 

 



Part 1        Preliminary

 

1.               Name of Rules

 

These Rules are the Private Health Insurance (Benefit Requirements) Amendment Rules 2015 (No. 2).

 

2.               Commencement

 

These Rules commence on 1 July 2015.

 

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Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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

$410

- over 14 days

$285

Surgical patient or obstetric patient

 

- first 14 days

$381

- over 14 days

$285

Psychiatric patient

 

- first 42 days

$381

- 43 – 65 days

$330

- over 65 days

$285

Rehabilitation patient

 

- first 49 days

$381

- 50 - 65 days

$330

- over 65 days

$285

Other patients

 

- first 14 days

$330

- over 14 days

$285

 

 


2         Schedule 1, Part 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

$410

- over 14 days

$285

Surgical patient or obstetric patient

 

- first 14 days

$381

- over 14 days

$285

Psychiatric patient

 

- first 42 days

$381

- 43 – 65 days

$330

- over 65 days

$285

Rehabilitation patient

 

- first 49 days

$381

- 50 - 65 days

$330

- over 65 days

$285

Other patients

 

- first 14 days

$330

- over 14 days

$285

 


3         Schedule 1, Part 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

$410

- over 14 days

$285

Surgical patient or obstetric patient

 

- first 14 days

$381

- over 14 days

$285

Psychiatric patient

 

- first 42 days

$381

- 43 – 65 days

$330

- over 65 days

$285

Rehabilitation patient

 

- first 49 days

$381

- 50 - 65 days

$330

- over 65 days

$285

Other patients

 

- first 14 days

$330

- over 14 days

$285

 


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

$339

NSW

$339

Northern Territory

$339

Queensland

$346

South Australia

$339

Western Australia

$339

 

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

$246

$275

$302

$339

ACT

$246

$275

$302

$339

Northern Territory

$246

$281

$326

$339

Queensland

$251

$282

$310

$346

South Australia

$246

$281

$310

$339

Tasmania

$239

$284

$329

$381

Victoria

$241

$285

$331

$381

Western Australia

$279

$279

$279

$279

 

 

 


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

$213

$267

$326

$381

 


Schedule B ― Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

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

 

 

Delete:

             South Australia                            $114.00

 

Insert:

             South Australia                            $115.00

 

Delete:

             ACT                                             $111.20

            

Insert:

             ACT                                             $117.65

 

Delete:

             Western Australia                        $133.20

 

Insert:

             Western Australia                        $138.10

Schedule C ― Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

 

1         Schedule 3, Part 3 Type C procedures, Clause 8 Interpretation, Category 3 Therapeutic Procedures, T11

 

After “18351” delete “18352” and insert “18353”

 

After “18362” delete “18364” and insert “18365”

 

After “18368” insert “18369”

 

After “18370” delete “18371”

 

After “18372” delete “18373” and insert “18374”

 

 

 


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 2015 (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