Private Health Insurance (Prostheses) Amendment Rules 2009 (No.1) (Cth)
Private Health Insurance (Prostheses) Amendment Rules 2009 (No.1)
I, PENNY SHAKESPEARE, delegate of the Minister for Health and Ageing, make these Rules under item 4 of the table in section 333-20 of the Private Health Insurance Act 2007.
Dated 2 March 2009
________________________
Penny Shakespeare
Assistant Secretary
Private Health Insurance Branch
Acute Care Division
Department of Health and Ageing
Name of Rules
These Rules are the Private Health Insurance (Prostheses) Amendment Rules 2009 (No.1).
Commencement
These Rules commence on 3 March 2009.
Amendment of the Schedule to the Private Health Insurance (Prostheses) Rules 2009 (No.1)
These Rules amend the Schedule to the Private Health Insurance (Prostheses) Rules 2009 (No.1) dated 2 February 2009 and effective on 23 February 2009, as set out below:
3.1Part A – Prostheses, at page 7 of 857, after Billing Code BS139, delete the heading “Generation 4”; delete the subheading “Medtronic Australasia Pty Ltd”; and delete the Billing Code MC814 and the contents of all fields associated with it.
3.2Part A – Prostheses, at page 11 of 857, for the Billing Code AB002, under the heading “Maximum Benefit” delete “$6,200.00”.
3.3Part A – Prostheses, at page 11 of 857, for the Billing Code AB064, under the heading “Maximum Benefit” delete “$6,200.00”.
3.4Part A – Prostheses, at page 14 of 857, for the Billing Code AB001, under the heading “Maximum Benefit”, delete “$7,100.00”.
3.5Part A – Prostheses, at page 30 of 857, after Billing Code BS136, insert the subheading “Medtronic Australasia Pty Ltd”; and after the subheading insert the Billing Code MC813; under the heading “Product Name” insert “Secura VR”; under the heading “Description” insert “Fully Automatic, Wireless Implantable cardioverter defibrillator with high energy capability and therapies for ventricular tachyarrhythmia”; under the heading “Size” insert “37cc”; and under the heading “Minimum Benefit” insert “$42,640.00”.
3.6Part A – Prostheses, at page 30 of 857, after Billing Code MC813, insert the Billing Code MC814; under the heading “Product Name” insert “Secura DR”; under the heading “Description” insert “Fully Automatic, Wireless Implantable cardioverter defibrillator with high energy capability and therapies for ventricular and atrial tachyarrhythmia”; under the heading “Size” insert “37cc”; and under the heading “Minimum Benefit” insert “$45,760.00”.
3.7Part A – Prostheses, at page 38 of 857, after Billing Code DW002, delete the subheading “Medtronic Australasia Pty Ltd”; and delete the billing code MC813 and the contents of all fields associated with it.
3.8Part A – Prostheses, at page 123 of 857, for the Billing Code AB010, under the heading “Maximum Benefit” delete “$31.00”.
3.9Part A – Prostheses, at page 123 of 857, for the Billing Code AB012, under the heading “Maximum Benefit” delete “$372.00”.
3.10Part A – Prostheses, at page 123 of 857, for the Billing Code AB013, under the heading “Maximum Benefit” delete “$372.00”.
3.11Part A – Prostheses, at page 123 of 857, for the Billing Code AB018, under the heading “Maximum Benefit” delete “$372.00”.
3.12Part A – Prostheses, at page 123 of 857, for the Billing Code AB020, under the heading “Maximum Benefit” delete “$372.00”.
3.13Part A – Prostheses, at page 156 of 857, for the Billing Code MC764, under the heading “Minimum Benefit” delete “$140.00” and insert “$150.00”.
3.14Part A – Prostheses, at page 157 of 857, for the Billing Code MC766, under the heading “Minimum Benefit” delete “$900.00” and insert “$950.00”.
3.15Part A – Prostheses, at page 214 of 857, after Billing Code ZI699, insert the billing code ZI706; under the heading “Product Name” insert “Nex-Link”; under the heading “Description” insert “Spinal Fixation System, Open Screw”; under the heading “Size” insert “4.00mm”; under the heading “Minimum Benefit” insert “$170.00” and under the heading “Maximum Benefit” insert “$900.00”.
3.16Part A – Prostheses, at page 236 of 857, after Billing Code ZI677, insert the billing code ZI707; under the heading “Product Name” insert “AcuFix”; under the heading “Description” insert “2 segment SlimLine plate – Anterior cervical plate system - Titanium”; under the heading “Size” insert “34 - 54mm”; under the heading “Minimum Benefit” insert “$1,400.00” and under the heading “Maximum Benefit” insert “$1,450.00”.
3.17Part A – Prostheses, at page 262 of 857, after Billing Code DE177, delete the heading “Group14c: Lacrimal duct drainage prostheses: Punctal occlusion”; delete the subheading “Device Technologies Australia Pty Ltd”; and delete the Billing Code DE276 and the contents of all fields associated with it.
3.18Part A – Prostheses, at page 500 of 857, for the Billing Code DY514, under the heading “Minimum Benefit” delete “$5,750.00” and insert “$4,300.00”.
3.19Part A – Prostheses, at page 502 of 857, for the Billing Code DY516, under the heading “Minimum Benefit” delete “$5,750.00” and insert “$4,350.00”.
3.20Part A – Prostheses, at page 503 of 857, after the heading “Group 05e – Uncemented, mesh, not HA, short and standard lengths, no modularity”, delete the subheading “ESKA Australia”; and delete the Billing Code EK087 and the contents of all fields associated with it.
3.21Part A – Prostheses, at page 503 of 857, after the heading “Group 05f – Uncemented, mesh, HA, short and standard lengths, no modularity”, delete the subheading “ESKA Australia”; and delete the Billing Code EK086 and the contents of all fields associated with it.
3.22Part A – Prostheses, at page 503 of 857, after the heading “Group 05e – Uncemented, mesh, not HA, short and standard lengths, no modularity”, insert the subheading “ESKA Australia”; and after the subheading insert the Billing Code EK086; under the heading “Product Name” insert “Adapter Uncemented Femoral Stem”; under the heading “Description” insert “Co Cr, Titanium Spray, 3 Dimensional Metal, Non HA”; under the heading “Size” insert “Femoral Stem 1 - 7”; and under the heading “Minimum Benefit” insert “$4,450.00”.
3.23Part A – Prostheses, at page 503 of 857, after the heading “Group 05f – Uncemented, mesh, HA, short and standard lengths, no modularity”, insert the subheading “ESKA Australia”; and after the subheading insert the Billing Code EK087; under the heading “Product Name” insert “Adapter Uncemented Femoral Stem”; under the heading “Description” insert “Co Cr, Titanium Spray, 3 Dimensional Metal, HA”; under the heading “Size” insert “Femoral Stem 1 - 7”; and under the heading “Minimum Benefit” insert “$4,950.00”.
3.24Part A – Prostheses, at page 509 of 857, for the Billing Code MA500, under the heading “Product Name” delete “Lima Revision Total Hip System” and insert “Modular Revision Stem System”.
3.25Part A – Prostheses, at page 513 of 857, for the Billing Code JJ749, under the heading “Minimum Benefit” delete “$5,220.00” and insert “$4,720.00”.
3.26Part A – Prostheses, at page 513 of 857, for the Billing Code JJ750, under the heading “Minimum Benefit” delete “$4,720.00” and insert “$5,220.00”.
3.27Part A – Prostheses, at page 514 of 857, for the Billing Code DY515, under the heading “Minimum Benefit” delete “$4,300.00” and insert “$5,750.00”.
3.28Part A – Prostheses, at page 515 of 857, for the Billing Code DY517, under the heading “Minimum Benefit” delete “$4,350.00” and insert “$5,750.00”.
3.29Part A – Prostheses, at page 516 of 857, for the Billing Code MA499, under the heading “Product Name” delete “Lima Revision Total Hip System” and insert “Modular Revision Stem System”.
3.30Part A – Prostheses, at page 517 of 857, for the Billing Code MA501, under the heading “Product Name” delete “Lima Revision Total Hip System” and insert “Modular Revision Stem System”.
3.31Part A – Prostheses, at page 526 of 857, delete the Billing Code GM145 and the contents of all fields associated with it.
3.32Part A – Prostheses, at page 527 of 857, for the Billing Code GM146, under the heading “Minimum Benefit” delete “$950.00” and insert “$800.00”.
3.33Part A – Prostheses, at page 529 of 857, after the Billing Code GM136, insert the Billing Code GM140; under the heading “Product Name” insert “Bio Ball Femoral Head Biolox Forte”; under the heading “Description” insert “Bio Ball Femoral Head Biolox Forte”; under the heading “Size” insert “28mm, 32mm”; and under the heading “Minimum Benefit” insert “$2,000.00”.
3.34Part A – Prostheses, at page 529 of 857, for the Billing Code GO188, under the heading “Minimum Benefit” delete “$2,055.00” and insert “$2,000.00”.
3.35Part A – Prostheses, at page 529 of 857, for the Billing Code JJ751, under the heading “Minimum Benefit” delete “$2,100.00” and insert “$2,000.00”.
3.36Part A – Prostheses, at page 530 of 857, for the Billing Code JJ752, under the heading “Minimum Benefit” delete “$2,000.00” and insert “$2,100.00”.
3.37Part A – Prostheses, at page 532 of 857, after the Billing Code GM138, insert the Billing Code GM145; under the heading “Product Name” insert “Bio Ball Femoral Head”; under the heading “Description” insert “Femoral Head CoCr”; under the heading “Size” insert “36mm”; under the heading “Minimum Benefit” insert “$950.00” and under the heading “Maximum Benefit” insert “$1,144.00”.
3.38Part A – Prostheses, at page 532 of 857, for the Billing Code GM137, under the heading “Minimum Benefit” delete “$800.00” and insert “$950.00”; under the heading “Maximum Benefit” delete “$936.00”.
3.39Part A – Prostheses, at page 532 of 857, for the Billing Code GM138, under the heading “Minimum Benefit” delete “$950.00” and insert “$800.00”; under the heading “Maximum Benefit” insert “$936.00”.
3.40Part A – Prostheses, at page 534 of 857, delete Billing Code GM140 and the contents of all fields associated with it.
3.41Part A – Prostheses, at page 534 of 857, for the Billing Code GO187, under the heading “Minimum Benefit” delete “$2,000.00” and insert “$2,055.00”.
3.42Part A – Prostheses, at page 547 of 857, for the Billing Code MA496, under the heading “Minimum Benefit” delete “$2,300.00” and insert “$2,508.00”.
3.43Part A – Prostheses, at page 548 of 857, delete the Billing Code EK089 and the contents of all fields associated with it.
3.44Part A – Prostheses, at page 548 of 857, after the Billing Code EK041, insert the Billing Code EK088; under the heading “Product Name” insert “2000 Plus Acetabular Metal Shell”; under the heading “Description” insert “Co Cr, Titanium Spray, 3 Dimensional Metal, Variable Screw Holes”; under the heading “Size” insert “44 – 68 mm”; and under the heading “Minimum Benefit” insert “$2,500.00”.
3.45Part A – Prostheses, at page 549 of 857, delete the Billing Code EK088 and the contents of all fields associated with it.
3.46Part A – Prostheses, at page 549 of 857, after the Billing Code EK040, insert the Billing Code EK089; under the heading “Product Name” insert “2000 Plus Acetabular Metal Shell”; under the heading “Description” insert “Co Cr, Titanium Spray, 3 Dimensional Metal, Variable Screw Holes, HA”; under the heading “Size” insert “44 – 68 mm”; and under the heading “Minimum Benefit” insert “$2,900.00”.
3.47Part A – Prostheses, at page 549 of 857, for the Billing Code MA497, under the heading “Minimum Benefit” delete “$2,508.00” and insert “$2,300.00”.
3.48Part A – Prostheses, at page 560 of 857, for the Billing Code DY512, under the heading “Minimum Benefit” delete “$2,100.00” and insert “$2,560.00”.
3.49Part A – Prostheses, at page 562 of 857, for the Billing Code DY513, under the heading “Minimum Benefit” delete “$2,560.00” and insert “$2,100.00”.
3.50Part A – Prostheses, at page 670 of 857, after Billing Code SY052, delete the heading “Prostheses, Joint”; delete the subheading “Medimen Australia Pty Ltd”; and delete the Billing Code MM001 and the contents of all fields associated with it.
3.51Part A – Prostheses, at page 857 of 857, after Billing Code MG030, insert the Billing Code MG031; under the heading “Product Name” insert “Haemostatic Ligating Clips”; under the heading “Description” insert “Titanium Ligating Clips”; under the heading “Size” insert “small, medium (24 clips per pouch)”; and under the heading “Minimum Benefit” insert “$32.00”.
Note
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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