Dental Benefits Amendment Rule 2017 (No. 2) (Cth)

Dental Benefits Amendment Rule 2017 (No. 2)

Dental Benefits Act 2008

I, GREG HUNT, Minister for Health, make this Rule under subsection 60(1) of the Dental Benefits Act 2008.

Dated 2010

Dated 15:11:17

GREG HUNT

Minister for Health

Contents

PART 1PRELIMINARY

Part 1Preliminary

1Name of Rule

This Rule is the Dental Benefits Amendment Rule 2017 (No. 2).

2Commencement

This Rule commences on 1 January 2018.

3Authority

This Rule is made under subsection 60(1) of the Dental Benefits Act 2008.

4Schedules

Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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

Dental Benefits Rules 2014

1Rule 17

Repeal the rule, substitute:

17Limitation on number of certain services

For any particular eligible dental patient:

1. (a)

   an item of the Dental Benefits Schedule mentioned in column 2 of the following table is applicable to a service not more than the number of times mentioned in column 3 of the table in the period mentioned in column 4 of the table;

Item	Item of service	Number of times	Period
1	88311, 88314, 88322, 88323, 88324	1	1 day
2	88111, 88114, 88121	1	5 months
3	88942	1	12 months
4	88221, 88721, 88722	1	24 months
5	88115, 88213	2	12 months
6	88013, 88572	3	3 months
7	88458	3	12 months
8	88022, 88161, 88575	4	1 day
9	88768	8	24 months

1. (b)

   items 88111, 88114 and 88121 must not be provided more than two times per calendar year.

2Rule 18

Repeal the rule, substitute:

18Limitation on provision of certain services

For any particular eligible dental patient:

1. (a)

   an item of the Dental Benefits Schedule mentioned in column 2 of the following table is applicable to a service provided by a particular eligible dental provider, not more than once in the period mentioned in column 3 of the table:

Item	Item of service	Period
1	88012	5 months
2	88011	24 months

1. (b)

   item 88012 must not be provided more than two times by a particular eligible dental provider per calendar year.

3Paragraph 19(b)

Omit “6”, substitute “5”.

4After rule 24

Insert:

24ALimitation on Denture Bases

For any particular eligible dental patient:

1. (a)

   item 88721 does not apply to a service provided within a 6 month period of a service described in item 88723;

2. (b)

   item 88722 does not apply to a service provided within a 6 month period of a service described in item 88724;

3. (c)

   item 88723 must not be provided more than once;

4. (d)

   item 88724 must not be provided more than once.

5Paragraphs 25(a), (b) and (c)

Omit “88721 or 88722”, substitute “88721, 88722, 88723 or 88724”.

6Paragraph 25(d)

Omit “either item 88721 or 88722”, substitute “item 88721, 88722, 88723 or 88724”.

7After rule 27

Insert:

27ALimitation on items 88586 and 88587

For any particular eligible dental patient, only one of either item 88586 or 88587 is applicable for a service provided in respect of a particular tooth on a day.

8Schedule 1 (item 88111, column headed “Service”)

After “teeth”, insert “and/or implants”.

9Schedule 1 (item 88576)

Repeal the item.

10Schedule 1 (after item 88579)

Insert:

88586	Crown - metallic - with tooth preparation – preformed Placing a preformed metallic crown as a coronal restoration for a tooth. (Item is subject to Rule 27A)	257.05
88587	Crown - metallic - minimal tooth preparation – preformed Placing a preformed metallic crown as a coronal restoration for a tooth and where minimal or no restoration of the tooth is required. Commonly referred to as a ‘Hall’ crown. (Item is subject to Rule 27A)	152.50

11Schedule 1 (item 88721, column headed “Service”)

Omit “Rule 17”, substitute “Rules 17 and 24A”.

12Schedule 1 (item 88721, column headed “Benefit ($)”)

Omit “322.95”, substitute “436.60”.

13Schedule 1 (item 88722, column headed “Service”)

Omit “Rule 17”, substitute “Rules 17 and 24A”.

14Schedule 1 (item 88722, column headed “Benefit ($)”)

Omit “322.95”, substitute “436.60”.

15Schedule 1 (after item 88722)

Insert:

88723	Provisional partial maxillary denture Provision of a patient removable partial dental prosthesis replacing the natural teeth and adjacent tissues in the maxilla which is designed to last until the definitive prosthesis can be constructed. This item should only be used where a provisional denture is not an intrinsic part of item 88721. (Item is subject to Rules 24A and 25)	327.45
88724	Provisional partial mandibular denture Provision of a patient removable partial dental prosthesis replacing the natural teeth and adjacent tissues in the mandible which is designed to last until the definitive prosthesis can be constructed. This item should only be used where a provisional denture is not an intrinsic part of item 88722. (Item is subject to Rules 24A and 25)	327.45

16Schedule 1 (item 88733, column headed “Benefit ($)”)

Omit “67.00”, substitute “36.15”.