Private Health Insurance (Benefit Requirements) Amendment Rules 2011 (No. 3) (Cth)
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 1 PRELIMINARY
1 Name of Rules
2. Commencement
3. Amendment of the Private Health Insurance (Benefit Requirements) Rules 2010
SCHEDULE A ―AMENDMENTS
SCHEDULE B ―AMENDMENTS
SCHEDULE C ―AMENDMENTS
Part 1 Preliminary
1 Name of Rules
These Rules are the Private Health Insurance (Benefit Requirements) Amendment Rules 2011 (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
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
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
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
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:
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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