Private Health Insurance (Benefit Requirements) Amendment Rules 2018 (No. 3) (Cth)

Private Health Insurance (Benefit Requirements) Amendment Rules 2018 (No. 3)

I, SUSAN AZMI, delegate of the Minister for Health, make these Rules under item 3A of the table in subsection 333-20(1) of the Private Health Insurance Act 2007.

Dated 26 June 2018

Susan Azmi

Acting Assistant Secretary

Private Health Insurance Branch

Department of Health

Contents

1. Name of Rules 3

2. Commencement 3

3. Authority 3

4. Schedule 3

5. Schedule A – Amendments 4

6. Schedule B – Amendments 9

7. Schedule C – Amendments 10

8. Schedule D – Amendments 11

1.

Name of Rules

This instrument is the Private Health Insurance (Benefit Requirements) Amendment Rules 2018 (No. 3).

2.Commencement

This instrument commences on 1 July 2018.

3.Authority

This instrument is made under item 3A of the table under subsection

333-20(1) of the Private Health Insurance Act 2007.

4.Schedule

Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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]Schedule 1, Part 1 – General, 2. Subclause 2. Minimum benefit, Table 1

Omit:

Table 1 – Accommodation at private hospitals in all States/Territories

Substitute:

Table 1 – Accommodation at private hospitals in all States/Territories

Class of patient	Minimum benefit payable per night
Advanced surgical patient
- first 14 days	$432
- over 14 days	$301
Surgical patient or obstetric patient
- first 14 days	$401
- over 14 days	$301
Psychiatric patient
- first 42 days	$401
- 43 – 65 days	$347
- over 65 days	$301
Rehabilitation patient
- first 49 days	$401
- 50 - 65 days	$347
- over 65 days	$301
Other patients
- first 14 days	$347
- over 14 days	$301

[2]Schedule 1, Part 1 – General, 2. Subclause 2. Minimum Benefit, Table 2

Omit:

Schedule 1, Subclause 2 Minimum benefit, Table 2 – Victoria: shared ward accommodation at a public hospital

Substitute:

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	$432
- over 14 days	$301
Surgical patient or obstetric patient
- first 14 days	$401
- over 14 days	$301
Psychiatric patient
- first 42 days	$401
- 43 – 65 days	$347
- over 65 days	$301
Rehabilitation patient
- first 49 days	$401
- 50 - 65 days	$347
- over 65 days	$301
Other patients
- first 14 days	$347
- over 14 days	$301

[3]Schedule 1, Part 1 – General, 2. Subclause 2. Minimum Benefit, Table 3

Omit:

Schedule 1, Subclause 2 Minimum benefit, Table 3 - Tasmania: shared ward accommodation at a public hospital

Substitute:

1. Table 3 - Tasmania:

   shared ward accommodation at a public hospital

Class of patient	Minimum benefit payable per night
Advanced surgical patient
- first 14 days	$432
- over 14 days	$301
Surgical patient or obstetric patient
- first 14 days	$401
- over 14 days	$301
Psychiatric patient
- first 42 days	$401
- 43 – 65 days	$347
- over 65 days	$301
Rehabilitation patient
- first 49 days	$401
- 50 - 65 days	$347
- over 65 days	$301
Other patients
- first 14 days	$347
- over 14 days	$301

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

Omit:

Schedule 2, Clause 2 Minimum benefit, Table

Substitute:

Table

State/Territory	Minimum benefit payable per night
ACT	$357
NSW	$357
Northern Territory	$357
Queensland	$366
South Australia	$357
Western Australia	$357

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

Omit:

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

Substitute:

Table 1

Public hospitals	Band 1	Band 2	Band 3	Band 4
NSW	$259	$290	$318	$357
ACT	$259	$290	$318	$357
Northern Territory	$259	$297	$343	$357
Queensland	$265	$299	$328	$366
South Australia	$259	$297	$327	$357
Tasmania	$252	$300	$346	$401
Victoria	$254	$301	$348	$401
Western Australia	$294	$294	$294	$294

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

Omit:

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

Substitute:

Table 2

Band 1	Band 2	Band 3	Band 4
Private Hospitals	$224	$282	$343	$401

Schedule B - Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

[1]Schedule 1, Part 2 – Type A Procedures, Clause 4 Advanced Surgical Patient (3):

After ‘35562’ insert ‘35585’

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

After ‘35578’ insert ‘35581’

After ‘35581’ insert ‘35582’

[3]Schedule 3, Part 3 – Type C Procedures, Clause 8 Interpretation, Category 5 – Diagnostic Imaging Services, I5:

After ‘63530’ insert ‘63541’

After ‘63541’ insert ‘63542’

After ‘63542’ insert ‘63543’

After ‘63543’ insert ‘63544’

[4]Schedule 3, Part 3 – Type C Procedures, Clause 8 Interpretation, Category 6 – Pathology services, P7:

After ‘73343’ insert ‘73345’

After ‘73345’ insert ‘73346’

After ‘73346’ insert ‘73347’

After ‘73347’ insert ‘73348’

After ‘73348’ insert ‘73349’

After ‘73349’ insert ‘73350’

Schedule C – Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

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

Omit:

Australian Capital Territory $121.95

Substitute:

Australian Capital Territory $125.00

Omit:

South Australia $118.00

Substitute:

South Australia $120.00

Schedule D - Amendments

Private Health Insurance (Benefit Requirements) Rules 2011

[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 2018 (No.3)