Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 2) (Cth)

Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 2)

I, RICHARD BARTLETT, 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.

Dated

21 June 2013

____________________________________

Richard Bartlett

First Assistant Secretary

Medical Benefits Division

Department of Health and Ageing

Contents

PART 1PRELIMINARY3

1 Name of Rules 3

2. Commencement 3

3. Authority 3

4. Schedule3

Schedule A – Amendments4

Schedule B – Amendments9

Schedule C – Amendments10

Schedule D – Amendments11

Part 1Preliminary

1.

Name of Rules

These Rules are the Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 2).

2.Commencement

These Rules commence on 1 July 2013, or if registered after 1 July 2013, the day after registration.

3.Authority

These rules are made under item 3A of the table in section 333-20 of the Private Health Insurance Act 2007.

4.Schedule

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 Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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

Private Health Insurance (Benefit Requirements) Rules 2011

1Schedule 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	$394
- over 14 days	$273
Surgical patient or obstetric patient
- first 14 days	$365
- over 14 days	$273
Psychiatric patient
- first 42 days	$365
- 43 – 65 days	$317
- over 65 days	$273
Rehabilitation patient
- first 49 days	$365
- 50 - 65 days	$317
- over 65 days	$273
Other patients
- first 14 days	$317
- over 14 days	$273

2Schedule 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:

1. Table 2― Victoria:

   shared ward accommodation at a public hospital

Class of patient	Minimum benefit payable per night
Advanced surgical patient
- first 14 days	$394
- over 14 days	$273
Surgical patient or obstetric patient
- first 14 days	$365
- over 14 days	$273
Psychiatric patient
- first 42 days	$365
- 43 – 65 days	$317
- over 65 days	$273
Rehabilitation patient
- first 49 days	$365
- 50 - 65 days	$317
- over 65 days	$273
Other patients
- first 14 days	$317
- over 14 days	$273

3Schedule 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	$394
- over 14 days	$273
Surgical patient or obstetric patient
- first 14 days	$365
- over 14 days	$273
Psychiatric patient
- first 42 days	$365
- 43 – 65 days	$317
- over 65 days	$273
Rehabilitation patient
- first 49 days	$365
- 50 - 65 days	$317
- over 65 days	$273
Other patients
- first 14 days	$317
- over 14 days	$273

4Schedule 2, Clause 2 Minimum benefit, Table

Delete:

Schedule 2, Clause 2 Minimum benefit, Table

Insert:

Table

State/Territory	Minimum benefit payable per night
ACT	$326
NSW	$326
Northern Territory	$318
Queensland	$331
South Australia	$326
Western Australia	$326

5Schedule 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	$236	$263	$290	$326
ACT	$236	$263	$290	$326
Northern Territory	$230	$262	$305	$318
Queensland	$241	$270	$297	$331
South Australia	$236	$269	$297	$326
Tasmania	$229	$272	$316	$365
Victoria	$231	$273	$318	$365
Western Australia	$267	$267	$267	$267

6Schedule 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	$204	$257	$313	$365

Schedule B ― Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

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

Delete:

South Australia $108.00

Insert:

South Australia $111.00

Delete:

ACT $107.40

Insert:

ACT $111.20

Delete:

Western Australia $116.05

Insert:

Western Australia $125.45

Schedule C ― Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

1Schedule 1, Part 2 Type A procedures, Clause 4 Advanced surgical patient, subclause (3)

After “30509” delete “30512”

2Schedule 1, Part 2 Type A procedures, Clause 6 Surgical patient, subclause (3)

After “30505” delete “30511”

3Schedule 3, Part 3 Type C procedures, Clause 8 Interpretation, Category 3 Therapeutic Procedures, T8

After “32522” insert “32523 32526”

Schedule D ― Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

1 Schedule 5, Clause 4 Facilities, subclause (1)

Substitute

A hospital is a facility for the purposes of this Schedule if it is included in the list of second-tier eligible facilities approved by the Second Tier Advisory Committee existing at the time that the Private Health Insurance (Benefit Requirements) Amendment Rules 2013 (No. 2)