Private Health Insurance (Prostheses) Amendment Rules 2017 (No. 4) (Cth)

Private Health Insurance (Prostheses) Amendment Rules 2017 (No. 4)

I, Megan Keaney, 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

6 October 2017

signed

Megan Keaney

Acting Assistant Secretary

Technology Assessment and Access Division

Department of Health

Contents

PART 1PRELIMINARY

3. Authority 3

SCHEDULE – AMENDMENTS 4

Part 1Preliminary

1.Name of Rules

These Rules are the Private Health Insurance (Prostheses) Amendment Rules 2017 (No. 4).

2.Commencement

These Rules commence on 1 November 2017.

3.Authority

These Rules are made under item 4 of the table to section 333-20 of 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 Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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 2017 (No. 2)

1. [1]

   Schedule, Part A, Opthalmic, billing code AO038 (column headed Min benefit)

   Omit 1198 and substitute 1078.

2. [2]

   Schedule, Part A, Specialist Orthopaedic, billing code LV119 (column headed Min benefit)

   Omit 465 and substitute 310.

3. [3]

   Schedule, Part A, Specialist Orthopaedic, billing code LV124 (column headed Min benefit)

   Omit 335 and substitute 310.

4. [4]

   Schedule, Part A, Specialist Orthopaedic, billing code SK527 (column headed Min benefit)

   Omit 353 and substitute 163.

5. [5]

   Schedule, Part A, Specialist Orthopaedic, after subheading

   06.03.03.07 - Mini (screw size ≤2.7mm)(including blade) ≤ 6 holes

   Insert the contents of Item 1 of the table:

Item	Billing Code	Product	Description	Size	Minimum Benefit
1	Device Technologies Australia Pty Ltd
	DE575	Straight Plate	Plate for Fracture Fixation	2-5 Holes	660

1. [6]

   Schedule, Part A, Specialist Orthopaedic, after entry for billing code SN460

   Insert the contents of Item 1 of the table:

Item	Billing Code	Product	Description	Size	Minimum Benefit
1	Surgical Specialties
	SQ141	NEO Pedicle Screw System - K-wire	Stainless steel	1.5mm	12

1. [7]

   Schedule, Part A, Cardiac, after entry for billing code WC295

   Insert subheading 08.13.03 – Left Atrial Appendage Closure

   under that subheading insert the contents of Item 1 of the table:

Item	Billing Code	Product	Description	Size	Minimum Benefit
1	Boston Scientific Australia Pty Ltd
	BS332	WATCHMAN	Left Atrial Appendage Closure Device	21mm to 33mm	11400

1. [8]

   Schedule, Part A, Cardiac, billing code SJ390

   Repeal the entry for billing code SJ390.

2. [9]

   Schedule, Part A, Cardiac, after entry for billing code LH582

   Insert subheading 08.17 – Catheter Delivery

   under that subheading insert subheading 08.17.01 – Transcatheter Aortic Valve Implantation

   under that subheading insert the contents of Items 1, 2 and 3 of the table:

Item	Billing Code	Product	Description	Size	Minimum Benefit
1	Edwards Lifesciences Pty Ltd
	EL063	Edwards SAPIEN 3 Transcatheter Heart Valve	Transcatheter, balloon expanded aortic heart valve with Commander Delivery System	23mm, 26mm and 29mm	22932
2	Medtronic Australasia Pty Ltd
	MI259	Medtronic CoreValve Evolut R transcatheter aortic valve	Transcatheter aortic valve, self-expanding, re-sheath and/or complete recapture after partial deployment and redeployment	Inflow/Valve Size (mm): 23, 26, 29 and 31	22932
3	St Jude Medical Australia Pty Ltd
	SJ394	Portico transcatheter aortic valve	Self-expanding transcatheter aortic tissue valve, nitinol stent, bovine valve	23-29	22932

1. [10]

   Schedule, Part A, Hip, after entry for billing code MA496

   Insert the contents of Item 1 of the table:

Item	Billing Code	Product	Description	Size	Minimum Benefit
1	Smith & Nephew Pty Ltd
	SL089	Reflection	Acetabular Shell, Beaded TItanium Alloy	44-68mm	2320

1. [11]

   Schedule, Part C, Cardiac, after entry for billing code SJ152

   Insert the contents of Item 1 of the table in the columns indicated:

Item	Billing Code	Product	Description	Size	Minimum Benefit
1	SJ390	Confirm RX	Insertable Cardiac Monitor	5cm X 0.95cm` X 0.33cm	3900