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
2. Commencement
3. Amendment of the Private Health Insurance (Benefit Requirements) Rules 2011 3
SCHEDULE A – AMENDMENTS
SCHEDULE B – AMENDMENTS 8
SCHEDULE C – AMENDMENTS 9
SCHEDULE D – AMENDMENTS 16
Part 1 Preliminary
1 Name of Rules
These Rules are the Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (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 Aust ralia $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:
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, which commenced on 1 November 2011.
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