Federal Register of Legislation - Australian Government

Primary content

Rules/Other as made
This instrument amends provisions in the Private Health Insurance (Benefit Requirements) Rules 2011 and the Private Health Insurance (Complying Product) Rules 2015 to omit or insert Medicare Benefit Schedule (MBS) item numbers as a consequence of changes to the MBS effective from 1 November 2019, correct the classification of an MBS item, omit redundant MBS items and refine the expression of time in a Rule.
Administered by: Health
Registered 30 Oct 2019
Tabling HistoryDate
Tabled Senate11-Nov-2019
Table of contents.

Commonwealth Coat of Arms of Australia

 

Private Health Insurance Legislation Amendment Rules (No. 4) 2019

I, Brian Kelleher delegate of the Minister for Health, make the following rules.

Dated   29 October 2019                                            

Brian Kelleher

Assistant Secretary

Private Health Insurance Branch

Medical Benefits Division

Department of Health

 


Contents

1  Name........................................................................................................................................ 1

2  Commencement........................................................................................................................ 1

3  Authority.................................................................................................................................. 1

4  Schedules................................................................................................................................. 1

Schedule 1—Amendments                                                                                           2

Private Health Insurance (Benefit Requirements) Rules 2011                                                     2

Schedule 2—Amendments                                                                                           3

Private Health Insurance (Complying Product) Rules 2015                                                        3

 

 


1  Name

                   This instrument is the Private Health Insurance Legislation Amendment Rules (No. 4) 2019.

2  Commencement

             (1)  Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  The whole of this instrument

1 November 2019

1 November 2019

Note:          This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

             (2)  Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3  Authority

                   This instrument is made under section 333-20 of the Private Health Insurance Act 2007.

4  Schedules

                   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 1Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

1  Subclause 4(3) of Schedule 1

After “30606”, insert “30608”.

2  Subclause 6(3) of Schedule 1

Omit “30608”, “32090” and “32093”.

3  Subclause 6(3) of Schedule 1

After “45626”, insert “45627”.

4  Paragraph 4(1)(a) of Schedule 3 (Items under the heading,  “T8: Surgical Operations”)

Omit “32088” and “32090”.

5  Subclause 5(1) of Schedule 3

Omit “32089” and “32093”.

6  Subclause 5(1) of Schedule 3

After “32217”, insert: “32222”, “32223”, “32224”, “32225”, “32226”, 32227”, “32228” and “32229”.

7  Clause 8 of Schedule 3 (Category 3 – Therapeutic procedures, under the heading “T8”:)

Omit “41846”.

8  Clause 8 of Schedule 3 (Category 3 – Therapeutic procedures, under the heading “T8:”)

After “41500”, insert “41501”.

9 Clause 8 of Schedule 3 (Category 5 – Diagnostic Imaging Services, under the heading “I4:”)

After “61505”, insert “61524”.

10 Clause 8 of Schedule 3 (Category 5- Diagnostic Imaging Services, under the heading “I5:”)

After “63522”, insert: “63531”, “63532”, “63533” and “63534”.

Schedule 2Amendments

Private Health Insurance (Complying Product) Rules 2015

1  Paragraph 14(4)(a)

Omit “14 days”, substitute “10 business days”

2  Clause 2 of Schedule 5 (cell at table item dealing with clinical category “Hospital psychiatric services”, column headed “Treatments that must be covered (MBS Items) (see Notes 1, 2 and 3)”)

After “80170”, insert: “90250”, “90251”, 90252”, “90253”, 90254”, “90255”, “90256”, “90257”, 90264”, “90265”, “90272”, 90274”, “90276” and “90278”.

3  Clause 2 of Schedule 5 (cell at table item dealing with clinical category “Ear, nose and throat”, column headed “Treatments that must be covered (MBS Items) (see Notes 1, 2 and 3)”)

Omit “41846”.

4  Clause 2 of Schedule 5 (cell at table item dealing with clinical category “Ear, nose and throat”, column headed “Treatments that must be covered (MBS Items) (see Notes 1, 2 and 3)”)

After “41500”, insert “41501”.

5  Clause 2 of Schedule 5 (cell at table item dealing with clinical category  “Gastrointestinal endoscopy”, column headed “Treatments that must be covered (MBS Items) (see Notes 1, 2 and 3)”)

Omit “32088”, “32089”, “32090” and “32093”,

6  Clause 2 of Schedule 5 (cell at table item dealing with clinical category  “Gastrointestinal endoscopy”, column headed “Treatments that must be covered (MBS Items) (see Notes 1, 2 and 3)”)

After “32095”, insert: “32222”, “32223”, “32224”, “32225”, “32226”, “32227”, “32228” and “32229”.

7  Clause 2 of Schedule 5 (cell at table item dealing with clinical category “Joint replacement”, column headed “Treatments that must be covered (MBS Items) (see Notes 1, 2 and 3)”)

Omit “46324”, “46325” and “50127”.

8  Clause 2 of Schedule 5 (cell at table item dealing with clinical category “Plastic and reconstructive surgery (medically necessary)”, column headed “Treatments that must be covered (MBS Items) (see Notes 1, 2 and 3)”)

After “45626”, insert “45627”.


 

9  Clause 1 of Schedule 6 (table titled “Common treatments list”)

Repeal the table, substitute:

 

Common treatments list

3              4              23           24           36           37           44           47           52           53           54           57           58           59           60           65                104         105         106         107         108         109         110         111         115         116         117         119         120         122                128         131         132         133         135         137         141         143         145         147         160         161         162         163                164         173         188         193         195         197         199         214         215         218         219         220         221         222                223         224         225         226         227         228         229         230         231         232         233         235         236         237                238         239         240         243         244         253         255         257         260         262         264         266         269         271                272         276         277         279         281         282         285         287         291         293         296         299         300         302                304         306         308         310         312         314         316         318         319         330         332         334         336         338                353         355         356         357         358         359         361         385         386         387         388         410         411         412                413         414         415         416         417         501         503         507         511         515         519         520         530         532                534         536         585         588         591         594         599         600         701         703         705         707         715         721                723         729         731         732         733         735         737         739         743         747         750         758         820         822                823         825         826         828         830         832         834         835         837         838         871         872         880         900                903         2100       2497       2501       2503       2504       2506       2507       2509       2517       2518       2521       2522       2525                2526       2546       2547       2552       2553       2558       2559       2598       2600       2603       2606       2610       2613       2616                2620       2622       2624       2631       2633       2635       2664       2666       2668       2673       2675       2677       2801       2806                2814       2824       2832       2840       2946       2949       2954       2958       2972       2974       2978       2984       2988       2992                2996       3000       4001       5000       5003       5010       5020       5023       5028       5040       5043       5049       5060       5063                5067       5200       5203       5207       5208       5220       5223       5227       5228       5260       5263       5265       5267       6051                6052       6057       6058       6059       6060       6062       6063       6064       6065       6067       6068       6071       6072       6074                6075       10905    10907    10910    10911    10912    10913    10914    10915    10916    10918    10921    10922    10923                10924    10925    10926    10927    10928    10929    10930    10945    10946    10947    10948    11830    11833    12000                12001    12002    12003    12004    12005    13015    13020    13025    13030    13757    13870    13873    14200    14201                14202    14209    17615    17620    17625    17640    17645    17650    17655    18216    18219    18282    18284    18286                18288    18290    18292    18294    18296    18298    30058    30061    30068    30072    30075    30078    30081    30084                30087    30093    30094    30096    30097    30224    30225    30323    30329    30330    30332    30335    30336    30388                30390    30391    30394    30403    30405    30611    31350    31355    34538    36502    37607    37610    38456    39000                43915    44130    46324    46325    46519    46525    50127    51700    51703    52012    52015    52018    52144    75001                75004    75150    75153    82130    82135    82140    82205    82210    82215


 

10  Clause 1 of Schedule 7 (table titled “Table of MBS items”)

Repeal the table, substitute:

 

Table of MBS items

6080       6081       10801    10802    10803    10804    10805    10806    10807    10808    10809    10816    10931    10932    10933                10940    10941    10942    10943    10944    10950    10951    10952    10953    10954    10956    10958    10960    10962                10964    10966    10968    10970    11000    11003    11004    11005    11006    11009    11012    11015    11018    11021                11024    11027    11200    11204    11205    11210    11211    11215    11218    11219    11220    11221    11224    11235                11237    11240    11241    11242    11243    11244    11303    11304    11306    11309    11312    11315    11318    11324                11327    11330    11332    11333    11336    11339    11503    11505    11506    11507    11508    11512    11600    11602                11604    11605    11610    11611    11612    11614    11615    11627    11700    11701    11702    11708    11709    11710                11711    11712    11713    11715    11718    11719    11720    11721    11722    11724    11725    11726    11727    11728                12200    12201    12306    12312    12315    12320    12321    12322    12325    12326    12500    12503    12506    12509                12512    12515    12518    12521    12530    12533    13300    13303    13306    13309    13312    13318    13319    13703                13706    13709    13750    13755    13815    13818    13830    13839    13842    13847    13848    13851    13854    13857                13876    13881    13882    13885    13888    17610    17680    17690    18213    18222    18225    18226    18227    18228                18230    18232    18233    18234    18236    18238    18240    18242    18244    18248    18250    18252    18254    18256                18258    18260    18262    18264    18266    18268    18270    18272    18274    18276    18278    18280    18297    20100                20102    20104    20120    20124    20140    20142    20143    20144    20145    20146    20147    20148    20160    20162                20164    20170    20172    20174    20176    20190    20192    20210    20212    20214    20216    20220    20222    20225                20230    20300    20305    20320    20321    20330    20350    20352    20355    20400    20401    20402    20403    20404                20405    20406    20410    20420    20440    20450    20452    20470    20472    20474    20475    20500    20520    20522                20524    20526    20528    20540    20542    20546    20548    20560    20600    20604    20620    20622    20630    20632                20634    20670    20680    20690    20700    20702    20703    20704    20706    20730    20740    20745    20750    20752                20754    20756    20770    20790    20791    20792    20793    20794    20798    20799    20800    20802    20803    20804                20806    20810    20815    20820    20830    20832    20840    20841    20842    20844    20845    20846    20847    20848                20850    20855    20860    20862    20863    20864    20866    20867    20868    20880    20882    20884    20886    20900                20902    20904    20905    20906    20910    20911    20912    20914    20916    20920    20924    20926    20928    20930                20932    20934    20936    20938    20940    20942    20943    20944    20946    20948    20950    20952    20954    20956                20958    20960    21100    21110    21112    21114    21116    21120    21130    21140    21150    21155    21160    21170                21195    21199    21200    21202    21210    21212    21214    21216    21220    21230    21232    21234    21260    21270                21272    21274    21275    21280    21300    21321    21340    21360    21380    21382    21390    21392    21400    21402                21403    21404    21420    21430    21432    21440    21445    21460    21461    21462    21464    21472    21474    21480                21482    21484    21486    21490    21500    21502    21520    21522    21530    21532    21535    21600    21610    21620                21622    21630    21632    21634    21636    21638    21650    21652    21654    21656    21670    21680    21682    21685                21700    21710    21712    21714    21716    21730    21732    21740    21756    21760    21770    21772    21780    21785                21790    21800    21810    21820    21830    21832    21834    21840    21842    21850    21860    21865    21870    21872                21878    21879    21880    21881    21882    21883    21884    21885    21886    21887    21900    21906    21908    21910                21912    21914    21915    21916    21918    21922    21925    21926    21930    21935    21936    21939    21941    21942                21943    21945    21949    21952    21955    21959    21962    21965    21969    21970    21973    21976    21980    21990                21992    21997    22002    22007    22008    22012    22014    22015    22020    22025    22031    22036    22041    22042                22051    22055    22060    22065    22075    22900    22905    23010    23025    23035    23045    23055                    23065                23075    23085    23091    23101    23111    23112    23113    23114    23115    23116    23117    23118    23119    23121                23170    23180    23190    23200    23210    23220    23230    23240    23250    23260    23270    23280    23290    23300                23310    23320    23330    23340    23350    23360    23370    23380    23390    23400    23410    23420    23430    23440                23450    23460    23470    23480    23490    23500    23510    23520    23530    23540    23550    23560    23570    23580                23590    23600    23610    23620    23630    23640    23650    23660    23670    23680    23690    23700    23710    23720                23730    23740    23750    23760    23770    23780    23790    23800    23810    23820    23830    23840    23850    23860                23870    23880    23890    23900    23910    23920    23930    23940    23950    23960    23970    23980    23990    24100                24101    24102    24103    24104    24105    24106    24107    24108    24109    24110    24111    24112    24113    24114                24115    24116    24117    24118    24119    24120    24121    24122    24123    24124    24125    24126    24127    24128                24129    24130    24131    24132    24133    24134    24135    24136    25000    25005    25010    25015    25020    25025                25030    25050    25200    25205    30001    51300    51303    51306    51309    51312    51315    51318    51800    51803                53700    53702    53704    53706    75009    75012    75015    75018    75021    75023    10950    10951    10952    10953                10954    10956    10958    10960    10962    10964    10966    10968    10970    10984    10987    10988    10989    10990                10991    10992    10997    81000    81005    81010