Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 4) (Cth)

Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 4)

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

____________________________________

Richard Magor

Assistant Secretary

Private Health Insurance Branch

Medical Benefits Division

Department of Health and Ageing

15 June 2012

Contents

PART 1 PRELIMINARY

1. Name of Rules 3

2. Commencement 3

3. Amendment of the Private Health Insurance (Benefit Requirements) Rules 2011 3

SCHEDULE A – AMENDMENTS 4

SCHEDULE B – AMENDMENTS 8

SCHEDULE C – Amendments9

SCHEDULE D – AMENDMENTS16

Part 1Preliminary

1Name of Rules

These Rules are the Private Health Insurance (Benefit Requirements) Amendment Rules 20 12 (No. 4).

2.Commencement

These Rules commence on:

(a) 1 July 2012; or

(b) if registered after 1 July 2012, the day after registration.

3.Amendment of the Private Health Insurance (Benefit Requirements) Rules 2011

Schedules A, B, C and D amend the Private Health Insurance (Benefit Requirements) Rules 2011 as amended.

Schedule A - Amendments

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

Delete:

Schedule 1, Subclause 2(2) Minimum benefits, 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	$384
- over 14 days	$266
Surgical patient or obstetric patient
- first 14 days	$356
- over 14 days	$266
Psychiatric patient
- first 42 days	$356
- 43 – 65 days	$309
- over 65 days	$266
Rehabilitation patient
- first 49 days	$356
- 50 - 65 days	$309
- over 65 days	$266
Other patients
- first 14 days	$309
- over 14 days	$266

[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	$384
- over 14 days	$266
Surgical patient or obstetric patient
- first 14 days	$356
- over 14 days	$266
Psychiatric patient
- first 42 days	$356
- 43 – 65 days	$309
- over 65 days	$266
Rehabilitation patient
- first 49 days	$356
- 50 - 65 days	$309
- over 65 days	$266
Other patients
- first 14 days	$309
- over 14 days	$266

[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	$384
- over 14 days	$266
Surgical patient or obstetric patient
- first 14 days	$356
- over 14 days	$266
Psychiatric patient
- first 42 days	$356
- 43 – 65 days	$309
- over 65 days	$266
Rehabilitation patient
- first 49 days	$356
- 50 - 65 days	$309
- over 65 days	$266
Other patients
- first 14 days	$309
- over 14 days	$266

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

Delete:

Schedule 2, Clause 2 Minimum benefit, Table

Insert:

Table

State/Territory	Minimum benefit payable per night
ACT	$318
NSW	$318
Northern Territory	$318
Queensland	$324
South Australia	$318
Western Australia	$318

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

Delete:

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

Insert:

Table 1

Public hospitals	Band 1	Band 2	Band 3	Band 4
NSW	$230	$257	$283	$318
ACT	$230	$257	$283	$318
Northern Territory	$230	$262	$305	$318
Queensland	$236.50	$264	$291	$324
South Australia	$230	$262	$290	$318
Tasmania	$223	$265	$308	$356
Victoria	$225	$266	$310	$356
Western Australia	$260	$260	$260	$260

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

Delete:

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

Insert:

Table 2

Band 1	Band 2	Band 3	Band 4
Private Hospitals	$199	$251	$305	$356

Schedule B - Amendments

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

Delete:

South Australia $106.00

Insert:

South Australia $108.00

Delete:

ACT $103.80

Insert:

ACT $107.40

Delete:

Western Australia $106.80

Insert:

Western Australia $116.05

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 2011 is amended as set out below:

After:

Aesthetic Day Surgery 14 Kensington Street, KOGARAH NSW 2217

Insert:

Albury Day Surgery 4 Baker Court, ALBURY NSW 2640

After:

Cabrini Hopetoun Rehabilitation Hospital 2-6 Hopetoun Road, ELSTERNWICK VIC 3185

Insert:

Cabrini Hospital - Malvern 181-183 Wattletree Road, MALVERN VIC 3144

Insert:

Cabrini Hospital - Prahran 646 High Street, PRAHRAN EAST VIC 3181

Delete:

Calvary Health Care Tasmania - St Luke’s Campus 24 Lyttleton Street, LAUNCESTON TAS 7250

Substitute:

Calvary Health Care Tasmania – (Launceston) 24 Lyttleton Street, LAUNCESTON TAS 7250

Delete:

Calvary Health Care Tasmania - St Vincent’s Campus 5 Frederick Street, LAUNCESTON TAS 7250

Delete:

Cambridge Day Surgery 178 Cambridge Street, WEMBLEY WA 6014

After:

Campbelltown Private Hospital 42 Parkside Crescent, CAMPBELLTOWN NSW 2560

Insert:

Canberra Specialist Surgical Centre Level 3, Building 2, Equinox Business Park, 70 Kent Street, DEAKIN ACT 2600

After:

Chesterville Day Hospital 28 Chesterville Road, CHELTENHAM VIC 3192

Insert:

Churchill Day Surgery 136 Churchill Avenue, SUBIACO WA 6008

Delete:

Colin Street Day Surgery 51 Colin Street, WEST PERTH WA 6005

After:

Diaverum Diamond Valley Dialysis Clinic 15 Grimshaw Street, GREENSBOROUGH VIC 3088

Insert:

Diaverum North Melbourne Dialysis Clinic Level 1, 185-187 Boundary Road, NORTH MELBOURNE VIC 3051

After:

Geelong Private Hospital cnr Ryrie & Bellarine Streets, GEELONG VIC 3220

Insert:

Genea Day Surgery Level 4, 321 Kent Street, SYDNEY NSW 2000

Insert:

Genea IVF Liverpool 173-175 Bigge Street, LIVERPOOL NSW 2170

Insert:

Genea IVF Northwest Level 1, Suite 101, 10 Norbrik Drive, BELLA VISTA NSW 2153

After:

Hawkesbury District Health Service cnr Macquarie and Day Streets, WINDSOR NSW 2756

Insert:

Healthbridge Hawthorn Private Hospital 50 Burwood Road, HAWTHORN VIC 3122

Delete:

Kawana Private Hospital Suite 14, Level 1, Innovation Parkway, BIRTINYA QLD 4575

Substitute:

Kawana Private Hospital Suite 14, Level 1, 5 Innovation Parkway, BIRTINYA QLD 4575

Delete:

Lambton Road Day Surgery 163 Lambton Road, BROADMEADOW NSW 2292

Delete:

Macquarie University Hospital Talavera Road, MACQUARIE PARK NSW 2113

Substitute:

Macquarie University Hospital 3 Technology Place, MACQUARIE PARK NSW 2109

Delete:

Maitland Private Hospital 173 Chisholm Road, EAST MAITLAND NSW 2323

After:

Marie Stopes International Bowen Hills 8 Campbell Street, BOWEN HILLS QLD 4006

Insert:

Marie Stopes International Broadmeadow 163 Lambton Road, BROADMEADOW NSW 2292

After:

Marie Stopes International East St Kilda 338 Dandenong Road, EAST ST KILDA VIC 3182

Insert:

Marie Stopes International Maroondah Centre 411-415 Dorset Road, CROYDON VIC 3142

Delete:

Mercy Hospital Mount Lawley Thirlmere Road, MOUNT LAWLEY WA 6050

Delete:

Murdoch Surgicentre 100 Murdoch Drive, MURDOCH WA 6150

Delete:

Nephrocare Bondi Dialysis Clinic Suite G2, 19-23 Hollywood Avenue, BONDI JUNCTION NSW 2022

Delete:

Nephrocare Newcastle Dialysis Clinic Suite 402, Level 4, 670 Hunter Street, NEWCASTLE NSW 2308

After:

North Eastern Rehabilitation Centre 134-144 Ford Street, IVANHOE VIC 3079

Insert:

North Lakes Day Hospital 7 Endeavour Boulevard, NORTH LAKES QLD 4509

Delete:

North Melbourne Dialysis Clinic Level 1, 185-187 Boundary Road, NORTH MELBOURNE VIC 3051

After:

North Shore Specialist Day Surgery 176 Pacific Highway, GREENWICH NSW 2065

Insert:

North Tas Urology 25-27 Canning Street, LAUNCESTON TAS 7250

After:

Northside West Clinic 23-27 Lytton Street, WENTWORTHVILLE NSW 2145

Insert:

Northwest Day Hospital 221 Maribyrnong Road, ASCOT VALE VIC 3032

Delete:

Oromax Day Surgery Level 3, 1 Hutt Street, ADELAIDE SA 5000

Substitute:

Oromax Day Surgery Pty Ltd Level 3, 1 Hutt Street, ADELAIDE SA 5000

Delete:

Reservoir Private Hospital 73 – 75 Pine Street, RESERVOIR VIC 3071

Delete:

Robina Procedure Centre Robina Town Centre, ROBINA QLD 4230

Substitute:

Robina Procedure Centre Tenancy 4110, Level 3, Robina Town Centre Drive, ROBINA TOWN CENTRE QLD 4230

After:

Roderick Street Day Surgery 23 Roderick Street, IPSWICH QLD 4305

Insert:

Rosebery Day Surgery 308 Gardeners Road, ROSEBERY NSW 2018

Delete:

Skin Cancer Day Surgery 19 Cleveland Road, ASHWOOD VIC 3147

After:

Spring Hill Specialist Day Hospital 1st and 4th Floor St Andrew's Place, 33 North Street, SPRING HILL QLD 4000

Insert:

Springvale Endoscopy Centre and Day Hospital 20 Balmoral Avenue, Springvale VIC 3171

Delete:

St Frances Xavier Cabrini Hospital – Malvern 181-183 Wattletree Road, MALVERN VIC 3144

Delete:

St Francis Xavier Cabrini Hospital – Prahran 646 High Street, PRAHRAN EAST VIC 3181

Delete:

Subiaco Private Hospital Ground Floor, Suite F and Level 1, 1 Salvado Road, SUBIACO WA 6008

Delete:

Sydney IVF Canberra 2 King Street - Suite 17B, DEAKIN ACT 2600

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:

Sydney IVF Northwest Level 1, Suite 101, 10 Norbrik Drive, BELLA VISTA NSW 2153

Delete:

The Hornsby Sleep Disorder and Diagnostic Centre 104 Balmoral Street, WAITARA NSW 2077

Delete:

The Marian Centre 187 Cambridge Street, WEMBLEY WA 6014

Delete:

Victor Harbor Private Hospital Bay Road, VICTOR HARBOR SA 5211

Delete:

Vision Eye Institute Levels 3 & 4, 270 Victoria Street, CHATSWOOD NSW 2067

Substitute:

Vision Eye Institute, Chatswood Levels 3 & 4, 270 Victoria Street, CHATSWOOD NSW 2067

After:

Westmed Centre 27 Railway Parade, WESTMEAD NSW 2145

Insert:

Westpoint Endoscopy Day Hospital 243 Heaths Road, HOPPERS CROSSING VIC 3029

Schedule D - Amendments

[1]Schedule 1, Part 2, Type A procedures, Subclause 6(3) Surgical patient

Delete:

37219

[2]Schedule 3, Part 2, Type B procedures, Subclause 5(1) Non-band specific Type B day procedures

After:

13292

Insert:

13318

After:

13757

Insert:

13815

[3]Schedule 3, Part 3, Type C procedures, Clause 8, Category 6 – Pathology services

After:

73324

Insert:

1. 73328

   73330 73332

Notes

1. All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003.See These Rules amend the Private Health Insurance (Benefit Requirements) Rules 2011