Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No. 5) (Cth)

Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No. 5)

I, TRACEY DUFFY, 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.

____________________________________

Tracey Duffy

Assistant Secretary

Private Health Insurance Branch

Department of Health

28 June 2017

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 2017 (No. 5).

2.Commencement

These Rules commence on 1 July 2017.

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 Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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

1. 1

   Schedule 1, Part 1 – General, 2. Subclause 2. Minimum benefit, Table 1

   Delete:

   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	$424
- over 14 days	$295
Surgical patient or obstetric patient
- first 14 days	$394
- over 14 days	$295
Psychiatric patient
- first 42 days	$394
- 43 – 65 days	$341
- over 65 days	$295
Rehabilitation patient
- first 49 days	$394
- 50 - 65 days	$341
- over 65 days	$295
Other patients
- first 14 days	$341
- over 14 days	$295

1. 2

   Schedule 1, Part 1 – General, 2. 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	$424
- over 14 days	$295
Surgical patient or obstetric patient
- first 14 days	$394
- over 14 days	$295
Psychiatric patient
- first 42 days	$394
- 43 – 65 days	$341
- over 65 days	$295
Rehabilitation patient
- first 49 days	$394
- 50 - 65 days	$341
- over 65 days	$295
Other patients
- first 14 days	$341
- over 14 days	$295

1. 3

   Schedule 1, Part 1 – General, 2. 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	$424
- over 14 days	$295
Surgical patient or obstetric patient
- first 14 days	$394
- over 14 days	$295
Psychiatric patient
- first 42 days	$394
- 43 – 65 days	$341
- over 65 days	$295
Rehabilitation patient
- first 49 days	$394
- 50 - 65 days	$341
- over 65 days	$295
Other patients
- first 14 days	$341
- over 14 days	$295

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	$350
NSW	$350
Northern Territory	$350
Queensland	$359
South Australia	$350
Western Australia	$350

1. 5

   Schedule 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	$254	$285	$312	$350
ACT	$254	$285	$312	$350
Northern Territory	$254	$291	$337	$350
Queensland	$260	$293	$322	$359
South Australia	$254	$291	$321	$350
Tasmania	$247	$294	$340	$394
Victoria	$249	$295	$342	$394
Western Australia	$289	$289	$289	$289

1. 6

   Schedule 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	$220	$277	$337	$394

Schedule B - Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

1. 1

   Schedule 1, Part 2 – Type A Procedures, Clause 6 Surgical patient, (3):

   After ‘35726’ delete ‘35730’

2. 2

   Schedule 3, Part 2 – Type B Procedures, Clause 5 Non-band specific Type B day procedures, (1):

   After ‘35688’ insert ‘35730’

   After ‘44338’ insert ‘44376’

Schedule C – Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

1

Schedule 4, Clause 6 Minimum benefit, Table 1

Delete:

Australian Capital Territory $119.55

Insert:

Australian Capital Territory $121.95

Schedule D - Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

1. 1

   Schedule 5 – Second-tier default benefits, Clause 4. Facilities, subclause (1)

Substitute

(1) 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 2017 (No.5)