Federal Register of Legislation - Australian Government

Primary content

Rules/Other as made
This instrument amends the Private Health Insurance (Benefit Requirements) Rules 2011 to make changes to the minimum benefits for hospital accommodation to reflect an increase in Consumer Price Index, updates Nursing Home Type Patient rates at public hospitals in the Australian Capital Territory and South Australia, updates the listing of 13 new Medicare Benefits Schedule item numbers and updates the reference to the Second Tier Advisory Committee approved facility list.
Administered by: Health
Registered 28 Jun 2018
Tabling HistoryDate
Tabled HR13-Aug-2018
Tabled Senate13-Aug-2018
Date of repeal 02 Jul 2018
Repealed by Division 1 of Part 3 of Chapter 3 of the Legislation Act 2003


 

Private Health Insurance (Benefit Requirements) Amendment Rules 2018 (No. 3)

 

 

 

 

I, SUSAN AZMI, delegate of the Minister for Health, make these Rules under item 3A of the table in subsection 333-20(1) of the Private Health Insurance Act 2007.

 

 

 

Dated 26 June 2018

 

 

 

 

 

Susan Azmi

Acting Assistant Secretary

Private Health Insurance Branch

Department of Health

 


Contents

 

 

1.                                  Name of Rules                                                                                   3

2.                                  Commencement                                                                                 3

3.                                  Authority                                                                                           3

4.                                  Schedule                                                                                            3

5.                                  Schedule A – Amendments                                                              4

6.                                  Schedule B – Amendments                                                               9

7.                                  Schedule C – Amendments                                                               10

8.                                  Schedule D – Amendments                                                              11

 


 

 

1.               Name of Rules

 

This instrument is the Private Health Insurance (Benefit Requirements) Amendment Rules 2018 (No. 3).

 

2.               Commencement

This instrument commences on 1 July 2018.

 

3.               Authority

This instrument is made under item 3A of the table under subsection
333-20(1) 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 – General, 2. Subclause 2. Minimum benefit, Table 1

 

Omit:

 

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

 

Substitute:


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

 

Class of patient

Minimum benefit payable per night

Advanced surgical patient

 

- first 14 days

$432

- over 14 days

$301

Surgical patient or obstetric patient

 

- first 14 days

$401

- over 14 days

$301

Psychiatric patient

 

- first 42 days

$401

- 43 – 65 days

$347

- over 65 days

$301

Rehabilitation patient

 

- first 49 days

$401

- 50 - 65 days

$347

- over 65 days

$301

Other patients

 

- first 14 days

$347

- over 14 days

$301

 

 

 

 

 

 

[2]     Schedule 1, Part 1 – General, 2. Subclause 2. Minimum Benefit, Table 2

 

Omit:

 

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

 

Substitute:

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

Class of patient

Minimum benefit payable per night

Advanced surgical patient

 

- first 14 days

$432

- over 14 days

$301

Surgical patient or obstetric patient

 

- first 14 days

$401

- over 14 days

$301

Psychiatric patient

 

- first 42 days

$401

- 43 – 65 days

$347

- over 65 days

$301

Rehabilitation patient

 

- first 49 days

$401

- 50 - 65 days

$347

- over 65 days

$301

Other patients

 

- first 14 days

$347

- over 14 days

$301

 

 

 

 

 

 

 

 

 

 

 

[3]     Schedule 1, Part 1 – General, 2. Subclause 2. Minimum Benefit, Table 3

 

Omit:

 

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

 

Substitute:

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

Class of patient

Minimum benefit payable per night

Advanced surgical patient

 

- first 14 days

$432

- over 14 days

$301

Surgical patient or obstetric patient

 

- first 14 days

$401

- over 14 days

$301

Psychiatric patient

 

- first 42 days

$401

- 43 – 65 days

$347

- over 65 days

$301

Rehabilitation patient

 

- first 49 days

$401

- 50 - 65 days

$347

- over 65 days

$301

Other patients

 

- first 14 days

$347

- over 14 days

$301

 

 

 

 

 

 

 

 

 

 

 

[4]     Schedule 2, Clause 2 Minimum benefit, Table

 

Omit:

 

Schedule 2, Clause 2 Minimum benefit, Table         

 

Substitute:

 

Table

 

State/Territory

Minimum benefit payable per night

ACT

$357

NSW

$357

Northern Territory

$357

Queensland

$366

South Australia

$357

Western Australia

$357

 

 

 

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

 

Omit:

 

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

   

Substitute:            

Table 1

Public hospitals

Band 1

Band 2

Band 3

Band 4

 

 

 

 

 

NSW

$259

$290

$318

$357

ACT

$259

$290

$318

$357

Northern Territory

$259

$297

$343

$357

Queensland

$265

$299

$328

$366

South Australia

$259

$297

$327

$357

Tasmania

$252

$300

$346

$401

Victoria

$254

$301

$348

$401

Western Australia

$294

$294

$294

$294

 

 

 

 

 

 

 

 

 

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

 

Omit:

 

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

   

Substitute:            

Table 2

 

Band 1

Band 2

Band 3

Band 4

Private Hospitals

$224

$282

$343

$401



Schedule B - Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

 

[1]         Schedule 1, Part 2 – Type A Procedures, Clause 4 Advanced Surgical Patient (3):

 

After ‘35562’ insert ‘35585’

 

 

[2]         Schedule 1, Part 2 – Type A Procedures, Clause 6 Surgical Patient (3):

 

After ‘35578’ insert ‘35581’

After ‘35581’ insert ‘35582’

 

 

[3]         Schedule 3, Part 3 – Type C Procedures, Clause 8 Interpretation, Category 5 – Diagnostic Imaging Services, I5:

 

After ‘63530’ insert ‘63541’

After ‘63541’ insert ‘63542’

After ‘63542’ insert ‘63543’

After ‘63543’ insert ‘63544’

 

 

[4]         Schedule 3, Part 3 – Type C Procedures, Clause 8 Interpretation, Category 6 – Pathology services, P7:

 

After ‘73343’ insert ‘73345’

After ‘73345’ insert ‘73346’

After ‘73346’ insert ‘73347’

After ‘73347’ insert ‘73348’

After ‘73348’ insert ‘73349’

After ‘73349’ insert ‘73350’

 

 

 

 

 

Schedule C – Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

 

[1]         Schedule 4, Clause 6 Minimum benefit, Table 1

 

Omit:

                         Australian Capital Territory                      $121.95

Substitute:

                         Australian Capital Territory                      $125.00

Omit:

                         South Australia                                          $118.00

Substitute:

                         South Australia                                          $120.00

 

 

Schedule D - Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

 

[1]     Schedule 5 – Second-tier default benefits, Clause 4. Facilities, subclause (1)

 

Substitute

(1)          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 2018 (No.3) commence.