Private Health Insurance (Prostheses) Amendment Rules 2014 (No. 1) (Cth)

Private Health Insurance (Prostheses) Amendment Rules 2014 (No. 1)

I, Shane Porter, delegate of the Minister for Health, make these Rules under item 4 of the table in section 333-20 of the Private Health Insurance Act 2007.

Dated 17 February 2014

Shane Porter

Shane Porter

Assistant Secretary

Private Health Insurance Branch

Medical Benefits Division

Department of Health

Contents

PART 1PRELIMINARY

3. Authority 3

SCHEDULE – AMENDMENTS4

Part 1Preliminary

1.Name of Rules

These Rules are the Private Health Insurance (Prostheses) Amendment Rules 2014

(No. 1).

2.Commencement

These Rules commence on 28 February 2014.

3.Authority

These Rules are made under the Private Health Insurance Act 2007.

4.Schedules

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 Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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

Private Health Insurance (Prostheses) Rules 2014 (No. 1)

1Schedule, Part A, billing codes, BX296, BX297, BX298, BX299, BX300, BX301, BX302, BX303, BX304, BX305, BX306 and BX307

delete the contents of items 1 to 12 of the table from the columns indicated:

Item	Billing Code	Product	Description	Size	Minimum benefit
1	BX296	ACTIFUSE SHAPE 1.6mL–BONE MATRIX IMPLANT ARTIFICIAL	A silicate substituted synthetic bone graft	1.6mL	$760.00
2	BX297	ACTIFUSE SHAPE 2.6mL–BONE MATRIX IMPLANT ARTIFICIAL	A silicate substituted synthetic bone graft	2.6mL	$760.00
3	BX305	ACTIFUSE MICROGRANULES2.5mL–BONE MATRIX IMPLANT ARTIFICIAL	A silicate substituted synthetic bone graft	2.5mL	$760.00
4	BX306	ACTIFUSE MICROGRANULES 5mL–BONE MATRIX IMPLANT ARTIFICIAL	A silicate substituted synthetic bone graft	5mL	$760.00
5	BX299	ACTIFUSE SHAPE 8.0mL –BONE MATRIX IMPLANT ARTIFICIAL	A silicate substituted synthetic bone graft	8.0mL	$1,200.00
6	BX301	ACTIFUSE GRANULES 10mL–BONE MATRIX IMPLANT ARTIFICIAL	A silicate substituted synthetic bone graft	10mL	$1,200.00
7	BX304	ACTIFUSE EASY PREP –BONE MATRIX IMPLANT ARTIFICIAL	A silicate substituted synthetic bone graft	10ml	$1,200.00
8	BX307	ACTIFUSE MICROGRANULES –BONE MATRIX IMPLANT ARTIFICIAL	A silicate substituted synthetic bone graft	10mL	$1,200.00
9	BX298	ACTIFUSE GRANULES –BONE MATRIX IMPLANT ARTIFICIAL	A silicate substituted synthetic bone graft	20mL	$1,500.00
10	BX300	ACTIFUSE SHAPE15.8mL –BONE MATRIX IMPLANT ARTIFICIAL	A silicate substituted synthetic bone graft	15.8mL	$1,500.00
11	BX302	ACTIFUSE GRANULES –BONE MATRIX IMPLANT ARTIFICIAL	A silicate substituted synthetic bone graft	5mL	$1,500.00
12	BX303	ACTIFUSE GRANULES 40mL–BONE MATRIX IMPLANT ARTIFICIAL	A silicate substituted synthetic bone graft	40mL	$1,560.00

2Schedule, Part A, Group 8.14.01 – Implantable Cardiac Event Recorders, Billing Codes BT153 and MI141, after entry for billing code WC295

delete the subheadings:

8.14.01 – Implantable Cardiac Event Recorders

Biotronik Australia Pty Ltd

i

Medtronic Australasia Pty Ltd

delete the contents of item 1 of the table from the columns indicated:

Item	Billing Code	Product	Description	Size	Minimum benefit
1	BT153	BioMonitor	Implantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope	53.3mm x 42.7mm x 7.1mm, 26 grams	$3,900.00
2	MI141	Reveal LINQ	Insertable Cardiac Monitor	45 x 7 x 3.5mm, 1.18cc	$3,900.00

3Schedule, Part C, Group 8.14.01 – Implantable Cardiac Event Recorders, Billing Codes BT153, After subheading 8.14.01 – Implantable Cardiac Event Recorders,

insert the subheading “Biotronik Australia Pty Ltd”

under that subheading insert the contents of item 1 of the table in the columns indicated:

Item	Billing Code	Product	Description	Size		Minimum benefit
1	BT153	BioMonitor	Implantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope		53.3mm x 42.7mm x 7.1mm, 26 grams	$3,900.00

4Schedule, Part C, Group 8.14.01 – Implantable Cardiac Event Recorders, Billing Codes BT153, After entry for billing code BT153,

insert the subheading “i”

insert the subheading “Medtronic Australasia Pty Ltd”

under that subheading insert the contents of item 1 of the table in the columns indicated:

Item	Billing Code	Product	Description	Size		Minimum benefit
1	MI141	Reveal LINQ	Insertable Cardiac Monitor		45 x 7 x 3.5mm, 1.18cc	$3,900.00

5Schedule, Part A, Subgroup 6.02.02.01 – Thumb, carpometacarpal, After entry for billing code LM028,

delete the subheading “Orthopaedic Solutions Pty Ltd”

delete the contents of item 1 of the table from the columns indicated:

Item	Billing Code	Product	Description	Size	Minimum benefit
1	OE029	BIOProfile Pyrocarbon Carpometacarpal Implants	Low Temperature Isotropic Pyrolytic Carbon Implants for carpometacarpal resurfacing (arthroplasty)	Small, Medium, Large & Extra Large	$884.00

5Schedule, Part A, Subgroup 6.02.02.01 – Thumb, carpometacarpal, After entry for billing code LM028,

insert the subheading “Tornier Pty Ltd”

under that subheading insert the contents of item 1 of the table in the columns indicated:

Item	Billing Code	Product	Description	Size		Minimum benefit
1	TO149	BIOProfile Pyrocarbon Carpometacarpal Implants	Low Temperature Isotropic Pyrolytic Carbon Implants for carpometacarpal resurfacing (arthroplasty)		Small, Medium, Large & Extra Large	$884.00

6Schedule, Part A, Group 07.01.01 – Intracanalicular, After entry for billing code SO044,

insert the contents of item 1 of the table in the columns indicated:

Item	Billing Code	Product	Description	Size		Minimum benefit
1	SO049	FCI Masterka	Self-retaining monocanalicular nasal intubation WITHOUT nasal retrieval		30mm to 40mm	$180.00

7Schedule, Part A, Group 07.01.01 – Intracanalicular, After entry for billing code SO043,

insert the contents of item 1 of the table in the columns indicated:

Item	Billing Code	Product	Description	Size		Minimum benefit
1	SO050	FCI Nunchaku	Self-retaining bicanalicular nasal intubation WITHOUT nasal retrieval		90mm to 105mm	$135.00