Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (No. 2) (Cth)

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Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (No. 2) 1

I, SHANE PORTER, 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.

____________________________________

Shane Porter

Assistant Secretary

Private Health Insurance Branch

Medical Benefits Division

Department of Health

19 June 2014

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 2014 (No. 2).

2.Commencement

These Rules commence on 1 July 2014, or if registered after 1 July 2014, 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 Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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 Minimum benefit, Table 1

Delete:

Schedule 1, Subclause 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

$405

- over 14 days

$281

Surgical patient or obstetric patient

- first 14 days

$376

- over 14 days

$281

Psychiatric patient

- first 42 days

$376

- 43 – 65 days

$326

- over 65 days

$281

Rehabilitation patient

- first 49 days

$376

- 50 - 65 days

$326

- over 65 days

$281

Other patients

- first 14 days

$326

- over 14 days

$281

2Schedule 1, Subclause 2 Minimum benefit, Table 2

Delete:

Schedule 1, Subclause 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

$405

- over 14 days

$281

Surgical patient or obstetric patient

- first 14 days

$376

- over 14 days

$281

Psychiatric patient

- first 42 days

$376

- 43 – 65 days

$326

- over 65 days

$281

Rehabilitation patient

- first 49 days

$376

- 50 - 65 days

$326

- over 65 days

$281

Other patients

- first 14 days

$326

- over 14 days

$281

3Schedule 1, Subclause 2 Minimum benefit, Table 3

Delete:

Schedule 1, Subclause 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

$405

- over 14 days

$281

Surgical patient or obstetric patient

- first 14 days

$376

- over 14 days

$281

Psychiatric patient

- first 42 days

$376

- 43 – 65 days

$326

- over 65 days

$281

Rehabilitation patient

- first 49 days

$376

- 50 - 65 days

$326

- over 65 days

$281

Other patients

- first 14 days

$326

- over 14 days

$281

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

$335

NSW

$335

Northern Territory

$335

Queensland

$341

South Australia

$335

Western Australia

$335

5Schedule 3, Part 1, Subclause 2 Minimum benefit, Table 1:

Delete:

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

Insert:

Table 1

Public hospitals

Band 1

Band 2

Band 3

Band 4

NSW

$243

$271

$298

$335

ACT

$243

$271

$298

$335

Northern Territory

$243

$277

$322

$335

Queensland

$248

$278

$306

$341

South Australia

$243

$277

$306

$335

Tasmania

$236

$280

$325

$376

Victoria

$238

$281

$327

$376

Western Australia

$275

$275

$275

$275

6Schedule 3, Part 1, Subclause 2 Minimum benefit, Table 2:

Delete:

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

Insert:

Table 2

Band 1

Band 2

Band 3

Band 4

Private Hospitals

$210

$264

$322

$376

Schedule B ― Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

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

Delete:

South Australia $111.00

Insert:

South Australia $114.00

Delete:

Western Australia $125.45

Insert:

Western Australia $133.20

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 “38272” insert “38273 38274”

After “42656” delete “42659”

After “42734” delete “42737”

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

After “31515” delete “31518 31521 31527”

After “31515” insert “31519 31525”

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

After “42794” delete “42797”

4Schedule 3, Part 3 Type C procedures, Clause 8 Interpretation, Category 5 Diagnostic Imaging Services, I1

After “55039” delete “55044 55045”

After “55054” insert “55065 55067 55068 55069”

After “55729” delete “55731 55733”

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 2014 (No. 2) commence.

Notes

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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