Private Health Insurance (Benefit Requirements) Amendment Rules 2011 (No. 3) (Cth)

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Private Health Insurance (Benefit Requirements) Amendment Rules 2011 (No.3)

I, PETER WOODLEY, delegate of the Minister for Health and Ageing, make these Rules under item 3A of the table in section 333-20 of the Private Health Insurance Act 2007.

____________________________________

Peter Woodley

Assistant Secretary

Private Health Insurance Branch

Medical Benefits Division

Department of Health and Ageing

17 June 2011

Contents

Part 1Preliminary

1Name of Rules

These Rules are the Private Health Insurance (Benefit Requirements) Amendment Rules 20 11 (No.3).

2.Commencement

These Rules commence on:

(a) 1 July 2011; or

(b) if registered after 1 July 2011, the day after registration.

3.Amendment of the Private Health Insurance (Benefit Requirements) Rules 2010

Schedules A, B and C amend the Private Health Insurance (Benefit Requirements) Rules 2010 as amended.

Schedule A ―Amendments

[1]Schedule 1, Part 2, Subclause 4(3):

delete

38324, 38327 and 38330

[2]Schedule 1, Part 2, Subclause 6(3):

delete

15360, 15363, 15541 and 38321

[3.1]Schedule 3, Part 3, Subclause 8 Items in the general medical services table, Category 1 – Attendances - A15

delete

  1. 725

    727

substitute

732

[3.2]Schedule 3, Part 3, Subclause 8 Items in the general medical services table, Category 1 – Attendances – M4

delete

‘M4

  1. 10975

    10976 10977’

[3.3]Schedule 3, Part 3, Subclause 8 Items in the general medical services table, Category 3 - Therapeutic Procedures – T1

after

14200

insert

14201

14202

[3.4]Schedule 3, Part 3, Subclause 8 Items in the general medical services table, Category 3 - Therapeutic Procedures - T7

delete

  1. 18350

    18351 18352 18354 18356 18358 18360 18362 18364 18366 18368 18370 18371 18372 18373

[3.5]Schedule 3, Part 3, Subclause 8 Items in the general medical services table, Category 3 - Therapeutic Procedures – T8

after

37041

insert

37217

[3.6]Schedule 3, Part 3, Subclause 8 Items in the general medical services table, Category 3 - Therapeutic Procedures – T8

delete

  1. 50124

    50125

[3.7]Schedule 3, Part 3, Subclause 8 Items in the general medical services table, Category 3 - Therapeutic Procedures – T8

after

47924

insert

‘T11:

  1. 18350

    18351 18352 18354 18356 18358 18360 18361 18362 18364 18366 18368 18370 18371 18372 18373’

[4.1]Schedule 3, Part 3, Subclause 8 Items in the pathology services table, Category 6 - Pathology services – P1

delete:

65139

65140

[4.2]Schedule 3, Part 3, Subclause 8 Items in the pathology services table, Category 6 - Pathology services – P5

delete

73324

[4.3]Schedule 3, Part 3, Subclause 8 Items in the pathology services table, Category 6 - Pathology services – P7

after

73323

insert

73324

Schedule B ―Amendments

[1]Schedule 1, Subclause 2(2) Minimum benefit, Table 1:

Delete:

Schedule 1, Subclause 2(2) Minimum benefit, 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

$378

- over 14 days

$262

Surgical patient or obstetric patient

- first 14 days

$350

- over 14 days

$262

Psychiatric patient

- first 42 days

$350

- 43 – 65 days

$304

- over 65 days

$262

Rehabilitation patient

- first 49 days

$350

- 50 - 65 days

$304

- over 65 days

$262

Other patients

- first 14 days

$304

- over 14 days

$262

[2]Schedule 1, Subclause 2(2) Minimum benefit, Table 2:

Delete:

Schedule 1, Subclause 2(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

$378

- over 14 days

$262

Surgical patient or obstetric patient

- first 14 days

$350

- over 14 days

$262

Psychiatric patient

- first 42 days

$350

- 43 – 65 days

$304

- over 65 days

$262

Rehabilitation patient

- first 49 days

$350

- 50 - 65 days

$304

- over 65 days

$262

Other patients

- first 14 days

$304

- over 14 days

$262

[3]Schedule 1, Subclause 2(2) Minimum benefit, Table 3:

Delete:

Schedule 1, Subclause 2(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

$378

- over 14 days

$262

Surgical patient or obstetric patient

- first 14 days

$350

- over 14 days

$262

Psychiatric patient

- first 42 days

$350

- 43 – 65 days

$304

- over 65 days

$262

Rehabilitation patient

- first 49 days

$350

- 50 - 65 days

$304

- over 65 days

$262

Other patients

- first 14 days

$304

- over 14 days

$262

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

Delete:

ACT $303

Insert:

ACT $313

Delete:

NSW $303

Insert:

NSW $313

Delete:

South Australia $303

Insert:

South Australia $313

Delete:

Western Australia $303

Insert:

Western Australia $313

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

Delete:

Schedule 3, Subclause 2(2) Minimum benefit, Table 1

Insert:

Table 1

Public hospitals

Band 1

Band 2

Band 3

Band 4

NSW

$226

$253

$279

$313

ACT

$226

$254

$279

$313

Northern Territory

$219

$250

$290

$303

Queensland

$225.50

$252

$277

$309

South Australia

$226

$258

$285

$313

Tasmania

$219

$261

$303

$350

Victoria

$221

$262

$305

$350

Western Australia

$243

$243

$243

$243

[6]Schedule 3, Subclause 2(2) Minimum benefit, Table 2:

Delete:

Schedule 3, Subclause 2(2) Minimum benefit, Table 2

Insert:

Table 2

Private hospitals

$196

$247

$300

$350

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

Delete:

ACT $99.80

Insert:

ACT $103.80

Delete:

Western Australia $102.65

Insert:

Western Australia $106.80

Schedule C ―Amendments

[1]Schedule 5, Clause 4 Facilities, Table:

The table in Clause 4 of Schedule 5 of the Private Health Insurance (Benefit Requirements) Rules 2010 is amended as set out below:

Delete:

Adelaide Surgicentre

89 King William Street, KENT TOWN SA 5067

Delete:

Albury Day Surgery

4 Baker Court, WEST ALBURY NSW 2640

Delete:

Armidale Private Hospital

Rusden Street, ARMIDALE NSW 2350

Insert:

Armidale Private Hospital

New England Regional Hospital, Armidale Campus, Rusden St, ARMIDALE NSW 2350

Delete:

Bankstown Primary Health Care Day Surgery

67 Rickard Road, BANKSTOWN NSW 2200

Delete:

Baringa Private Hospital

Mackay Road, COFFS HARBOUR NSW 2450

Insert:

Baringa Private Hospital

Mackays Road, COFFS HARBOUR NSW 2450

After:

Belmont Private Hospital

1220 Creek Road, CARINA QLD 4152

Insert:

Bendigo Day Surgery

1-7 Chum Street, BENDIGO VIC 3550

Delete:

Bentleigh Surgicenter

157 Jasper Road, BENTLEIGH VIC 3204

Insert:

Bentleigh Surgicentre

157 Jasper Road, BENTLEIGH VIC 3204

Delete:

Cairns Day Surgery

1st Floor, cnr Florence & Grafton Streets, CAIRNS QLD 4870

Insert:

Cairns Day Surgery

156-160 Grafton Street, CAIRNS QLD 4870

Delete:

Calvary Private Hospital Wagga Wagga

Hardy Avenue, WAGGA WAGGA NSW 2650

Insert:

Calvary Private Hospital

Hardy Avenue, WAGGA WAGGA NSW 2650

Delete:

Capital Day Surgical Centre

1/9 Sydney Avenue, BARTON ACT 2600

Delete:

Castle Hill Hospital

72-74 Cecil Avenue, CASTLE HILL NSW 2154

Delete:

Dandenong Eye Clinic

1-3 Falkiner Crescent, DANDENONG VIC 3175

After:

Dee Why Endoscopy Unit

21/818 Pittwater Road, DEE WHY NSW 2099

Insert:

Delmar Private Hospital

58 Quirk Street, DEE WHY NSW 2099

After:

Delmont Private Hospital

298 Warrigal Road, GLEN IRIS VIC 3146

Insert:

Diagnostic Endoscopy Centre

601/438 Victoria Street, DARLINGHURST NSW 2010

Delete:

Epworth Hospital

89 Bridge Road, RICHMOND VIC 3121

After:

Epworth Rehabilitation Camberwell

888 Toorak Road, CAMBERWELL VIC 3184

Insert:

Epworth Richmond

89 Bridge Road, RICHMOND VIC 3121

Delete:

Frances Perry House

285 Cardigan Street, CARLTON VIC 3122

Insert:

Frances Perry House

Levels 6 and 7, cnr Grattan Street and Flemington Road, PARKVILLE VIC 3052

Delete:

Frankston Private Day Surgery

24-28 Frankston-Flinders Road, FRANKSTON VIC 3199

Insert:

Frankston Private Day Surgery

Lot T5, Levels 1 and 2, 24-28 Frankston-Flinders Road, FRANKSTON VIC 3199

Delete:

Glenferrie Private Hospital

25 Linda Crescent, HAWTHORN VIC 3122

Insert:

Glenferrie Private Hospital

29 Hilda Crescent, HAWTHORN VIC 3122

After:

Hawkesbury District Health Service

cnr Macquarie and Day Streets, WINDSOR NSW 2756

Insert:

Healthwoods Specialist Centre

53 Cowper Street, GRANVILLE NSW 2142

Delete:

Joondalup Health Campus

cnr Grand Boulevard and Shenton Avenue, JOONDALUP WA 6027

Insert:

Joondalup Health Campus

Shenton Avenue, JOONDALUP WA 6027

Delete:

La Trobe Private Hospital

cnr Plenty Road and Kingsbury Drive, BUNDOORA VIC 3083

Delete:

Lingard Private Hospital

23 Merewether Street, MEREWETHER NSW 2291

After:

Lindfield Dialysis Clinic

280 Pacific Highway, LINDFIELD NSW 2070

Insert:

Liverpool Eye Surgery

Ground Floor, 1 Moore Street, LIVERPOOL NSW 2170

Delete:

Logan Endoscopy Services

Unit 2 32 76 Beaudesert Road, BROWNS PLAINS QLD 4118

Insert:

Logan Endoscopy Services

Unit 2 3276 Beaudesert Road, BROWNS PLAINS QLD 4118

Delete:

Marie Stopes International – Canberra

Level 1, Cnr Moore & Alinga Streets, CANBERRA CITY ACT 2601

Delete:

Marie Stopes International – Salisbury

11 Hayling Street, SALISBURY QLD 4107

Delete:

Maryvale Private Hospital

McDonald Street, MORWELL VIC 3840

Insert:

Maryvale Private Hospital

286 Maryvale Road, MORWELL VIC 3840

Delete:

Mater Private Hospital

Raymond Terrace, SOUTH BRISBANE QLD 4101

Delete:

Mayo Private Hospital

Lot 1, Potoroo Drive, KOLODONG via TAREE NSW 2430

Insert:

Mayo Private Hospital

Lot 1, Potoroo Drive, TAREE NSW 2430

Delete:

Melbourne Medibrain and Medisleep Centre

631 Inkerman Road, NORTH CAULFIELD VIC 3161

Insert:

Melbourne MediBrain Centre and MediSleep

631 Inkerman Road, CAULFIELD NORTH VIC 3161

Delete:

Mercy Private Hospital

159 Grey Street, MELBOURNE EAST VIC 3002

After:

Metropolitan Rehabilitation Hospital

275 Addison Road, PETERSHAM NSW 2049

Insert:

Mildura Base Hospital

Ontario Avenue, MILDURA VIC 3500

Delete:

Montserrat Day Hospital (Gaythorne)

383-391 Samford Road, GAYTHORNE QLD 4051

Insert:

Montserrat Day Hospitals (Gaythorne)

383-391 Samford Road, GAYTHORNE QLD 4051

Delete:

Montserrat Day Hospital (Indooroopilly)

12 Riverview Terrace, INDOOROOPILLY

QLD 4068

Insert:

Montserrat Day Hospitals (Indooroopilly)

12 Riverview Terrace, INDOOROOPILLY

QLD 4068

Delete:

Montserrat Day Hospital (Spring Hill)

Level 2, 35 Astor Terrace, BRISBANE QLD 4000

Insert:

Montserrat Day Hospitals (Spring Hill)

Level 2, 35 Astor Terrace, BRISBANE QLD 4000

Delete:

North West Private Hospital

21 Brickport Road, BURNIE TAS 7320

Delete:

Northside Clinic

2 Greenwich Road, GREENWICH NSW 2065

Insert:

Northside Clinic Private Hospital

2 Greenwich Road, GREENWICH NSW 2065

Delete:

Northwest Day Hospital

221 Maribyrnong Road, ASCOT VALE VIC 3032

Delete:

Oxford Day Surgery & Dermatology

416-418 Oxford Street, MOUNT HAWTHORN WA 6016

Insert:

Oxford Day Surgery and Dermatology

Suite 4, 1st Floor, 416-418 Oxford Street, MOUNT HAWTHORN WA 6016

After:

Oxford Day Surgery and Dermatology

Suite 4, 1st Floor, 416-418 Oxford Street, MOUNT HAWTHORN WA 6016

Insert:

Oxford Day Surgery Centre

54 Oxford Terrace, UNLEY SA 5061

Delete:

Queensland Eye Hospital

55 Little Edward Street, SPRING HILL QLD 4004

Delete:

Randwick Day Surgery

2 Eurimble Avenue, RANDWICK NSW 2031

Insert:

Randwick Day Surgery

2 Eurimbla Avenue, RANDWICK NSW 2031

Delete:

Shellharbour Private Hospital

Captain Cook Drive, BARRACK HEIGHTS NSW 2528

Insert:

Shellharbour Private Hospital

27 Captain Cook Drive, BARRACK HEIGHTS NSW 2528

Delete:

Skin Cancer Day Surgery Pty Ltd

19 Cleveland Road, ASHWOOD VIC 3147

Insert:

Skin Cancer Day Surgery

19 Cleveland Road, ASHWOOD VIC 3147

After:

Southern Respiratory and Sleep Disorders Centre

Level 2, Sutherland Hospital, The Kingsway, CARINGBAH NSW 2229

Insert:

Southport Day Hospital

98a Marine Parade, SOUTHPORT QLD 4215

Delete:

Spring Hill Specialist Day Hospital

4th Floor St Andrew’s Place, 33 North Street, SPRING HILL QLD 4000

Insert:

Spring Hill Specialist Day Hospital

1ST and 4th Floor St Andrew’s Place, 33 North Street, SPRING HILL QLD 4000

Delete:

Springvale Endoscopy Centre and Day Hospital

20 Balmoral Avenue, SPRINVALE VIC 3171

Delete:

St John of God Health Care, Berwick

Gibb Street, BERWICK VIC 3806

Insert:

St John of God Hospital, Berwick

Gibb Street, BERWICK VIC 3806

Delete:

St John of God Hospital, Burwood

13 Grantham Street, BURWOOD NSW 2135

Delete:

St John of God Hospital, Geelong

80 Myers Street, GEELONG VIC 3220

Insert:

St John of God Hospital, Geelong

80 and 83 Myers Street, GEELONG VIC 3220

Delete:

St John of God Hospital, Richmond

177 Grose Vale Road, NORTH RICHMOND VIC 2754

Delete:

St John of God Hospital (Warrnambool)

136 Botanic Road, WARRNAMBOOL

VIC 3280

Insert:

St John of God Hospital Warrnambool

136 Botanic Road, WARRNAMBOOL

VIC 3280

After:

St John of God Pinelodge Clinic

1480 Heatherton Road, DANDENONG VIC 3175

Insert:

St John of God Private Hospital

13 Grantham Street, BURWOOD NSW 2135

After:

St John of God Private Hospital

13 Grantham Street, BURWOOD NSW 2135

Insert:

St John of God Private Hospital ( Richmond )

177 Grose Vale Road, NORTH RICHMOND VIC 2754

After:

St Luke’s Hospital

18 Roslyn Street, POTTS POINT NSW 2011

Insert:

St Vincent’s & Mercy Private Hospital (Mercy Campus)

159 Grey Street, MELBOURNE EAST VIC 3002

Delete:

Sydney Day Surgery

213-219 Darlinghurst Road, DARLINGHURST NSW 2010

Delete:

Sydney IVF Day Surgery

Level 4, 321 Kent Street, SYDNEY NSW 2000

Delete:

Sydney IVF Liverpool

173-175 Bigge Street, LIVERPOOL NSW 2170

Delete:

Tarietta Day Surgery

73 Kooyong Road, CAULFIELD NORTH VIC 3161

Delete:

Tennyson Centre Day Hospital

520 South Road, KURRALTA PARK SA 5037

Delete:

The Albert Road Clinic

31-33 Albert Road, SOUTH MELBOURNE VIC 3004

Insert:

The Albert Road Clinic

31 Albert Road, MELBOURNE VIC 3000

Delete:

The Burnside War Memorial Hospital

120 Kensington Road, TOORAK GARDENS SA 5065

Insert:

The Burnside War Memorial Hospital Inc.

120 Kensington Road, TOORAK GARDENS SA 5065

Delete:

The CAPS Clinic

Strickland Crescent, DEAKIN ACT 2600

Insert:

The CAPS Clinic

7 Phipps Close, DEAKIN

ACT 2600

Delete:

The Double Bay Day Surgery

20 Manning Road, DOUBLE BAY NSW 2028

After:

The Glen Endoscopy Centre

302 Springvale Road, GLEN WAVERLEY VIC 3150

Insert:

The Hills Clinic

15-17 Memorial Avenue, KELLYVILLE NSW 2155

After:

The Melbourne Eastern Private Hospital

157 Scoresby Road, BORONIA VIC 3155

Insert:

The Oculoplastics Centre Sydney

Suite 25, 20-24 Gibbs Street, MIRANDA NSW 2228

Delete:

The Surgery Centre – Hurtsville

Level 3, 31 Dora Street, HURTSVILLE NSW 2220

Insert:

The Surgery Centre – Hurstville

Level 3, 31 Dora Street, HURSTVILLE NSW 2220

Delete:

Vimy House Private Hospital

5 Studley Avenue, KEW VIC 3101

Insert:

Vimy Private Hospital

5 Studley Avenue, KEW VIC 3101

Delete:

Western Plains Day Surgery

62 Windsor Parade, DUBBO NSW 2830

Delete:

Westmed Centre

27 Railway Parade, WESTMEAD

NSW 2145

Delete:

Westpoint Endoscopy Day Hospital

243 Heaths Road, HOPPERS CROSSING VIC 3029

Note

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

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