Health Legislation Amendment Act 2007

Administered by Department of Health, Disability and Ageing

Legislation au C2007A00180 In force Act

Legislation content

 

 

 

 

 

 

Health Legislation Amendment Act 2007

 

No. 180, 2007

 

 

 

 

 

An Act to amend the law in relation to health and private health insurance, and for related purposes

 

 

Contents

1 Short title

2 Commencement

3 Schedule(s)

Schedule 1—Private health insurance

Part 1—Amendments

Private Health Insurance Act 2007

Part 2—Transitional provisions

Schedule 2—Pharmaceutical benefits

National Health Act 1953

 

 

 

 

Health Legislation Amendment Act 2007

No. 180, 2007

 

 

 

An Act to amend the law in relation to health and private health insurance, and for related purposes

[Assented to 28 September 2007]

The Parliament of Australia enacts:

1  Short title

  This Act may be cited as the Health Legislation Amendment Act 2007.

2  Commencement

 (1) Each provision of this Act specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

 

Commencement information

Column 1

Column 2

Column 3

Provision(s)

Commencement

Date/Details

1.  Sections 1 to 3 and anything in this Act not elsewhere covered by this table

The day on which this Act receives the Royal Assent.

28 September 2007

2.  Schedule 1, items 1 to 3

1 April 2007.

1 April 2007

3.  Schedule 1, items 4 to 4B

The day after this Act receives the Royal Assent.

29 September 2007

4.  Schedule 1, item 5

1 April 2007.

1 April 2007

5.  Schedule 1, item 6

The day after this Act receives the Royal Assent.

29 September 2007

6.  Schedule 2, items 1 to 6

1 August 2007.

1 August 2007

7.  Schedule 2, item 7

Immediately after the commencement of item 15 of Schedule 1 to the National Health Amendment (Pharmaceutical Benefits) Act 2007.

28 September 2007

8.  Schedule 2, items 8 to 11

1 August 2007.

1 August 2007

Note: This table relates only to the provisions of this Act as originally passed by both Houses of the Parliament and assented to. It will not be expanded to deal with provisions inserted in this Act after assent.

 (2) Column 3 of the table contains additional information that is not part of this Act. Information in this column may be added to or edited in any published version of this Act.

3  Schedule(s)

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


Schedule 1—Private health insurance

Part 1—Amendments

Private Health Insurance Act 2007

1  Paragraph 841(1)(b)

Repeal the paragraph, substitute:

 (b) the insurance under the policy, or under a policy in the product, is *health insurance business; and

2  Paragraph 841(1)(c)

Omit “policy.”, substitute “policy; and”.

3  After paragraph 841(1)(c)

Insert:

 (d) the *health insurance business is not business of a kind specified in the Private Health Insurance (Complying Product) Rules as excluded from subsection 631(1).

4  Subsection 12620(4)

After “discrimination”, insert “in relation to the applicant’s *complying health insurance policies”.

4A  Subsection 27045(4)

Omit “The *member”, substitute “Unless the Minister or the Council otherwise determines, the *member”.

4B  At the end of section 27045

Add:

 (5) For the purposes of the Council making a determination under subsection (4) in relation to a *member who has made a disclosure under subsection (1), a member who has a direct or indirect pecuniary interest in the matter to which the disclosure relates must not:

 (a) be present during any deliberations of Council for the purposes of making the determination; or

 (b) take part in the making by the Council of the determination.


Part 2—Transitional provisions

5  Transitional provision in relation to health cover for overseas visitors

(1) This item applies in relation to business that, at any time in the period starting on 1 April 2007 and ending on 30 June 2008 (the transition period), is covered by subrule 17(2) of the Private Health Insurance (Health Insurance Business) Rules made under the Private Health Insurance Act 2007.

(2) During the transition period, sections 631 and 841 of the Private Health Insurance Act 2007 do not apply in relation to insurance that is that kind of business.

6  Certain business taken to be health insurance business for certain purposes during transition period

For the purposes of:

 (a) paragraphs 12BAA(7)(d) and (8)(b) of the Australian Securities and Investments Commission Act 2001; and

 (b) paragraph 765A(1)(c) of the Corporations Act 2001; and

 (c) paragraph (k) of the definition of insurance business in subsection 3(1) of the Insurance Act 1973; and

 (d) paragraph 9(1)(b) of the Insurance Contracts Act 1984;

business that, at any time during the period starting on the day this item commences and ending on 30 June 2008, is covered by rule 18 of the Private Health Insurance (Health Insurance Business) Rules made under the Private Health Insurance Act 2007 is, during that period, taken to be health insurance business.


Schedule 2—Pharmaceutical benefits

 

National Health Act 1953

1  Subsection 84(1)

Insert:

Schedule equivalent has the meaning given by section 84AJ.

2  Subsection 84(1B)

Repeal the subsection, substitute:

 (1B) If:

 (a) a prescription directs a repeated supply of a pharmaceutical benefit (the specified benefit); and

 (b) another pharmaceutical benefit (the supplied benefit) is supplied, on the repeated supply, in accordance with subsection 103(2A);

then, for the purposes of determining whether a repeated supply of the specified benefit has occurred, the supplied benefit is taken to be the repeated supply, upon the prescription, of the specified benefit.

3  Paragraph 84AAA(1)(a)

Repeal the paragraph, substitute:

 (a) the supply of the pharmaceutical benefit is made within 20 days after the day of a previous supply to the person of:

 (i) the pharmaceutical benefit; or

 (ii) another pharmaceutical benefit that has the same pharmaceutical item as the pharmaceutical benefit; or

 (iii) another pharmaceutical benefit that is Schedule equivalent to the pharmaceutical benefit;

  whether or not the previous supply was a supply of a kind described in paragraph 84C(4A)(a); and

4  At the end of Division 1 of Part VII

Add:

84AJ  When pharmaceutical benefits are Schedule equivalent

  A pharmaceutical benefit (the first benefit) is Schedule equivalent to another pharmaceutical benefit (the second benefit) if the Schedule of Pharmaceutical Benefits referred to in paragraph 103(2A)(b) states that the first benefit and the second benefit are equivalent.

5  Paragraph 84C(3)(b)

Omit “the pharmaceutical benefit”, substitute “a pharmaceutical benefit”.

6  Subsections 88(1AA) and (1B)

After “the pharmaceutical benefit” (first occurring), insert “that he or she is directing”.

7  Subsection 88(1D)

After “the pharmaceutical benefit” (first occurring), insert “that he or she is directing”.

8  Paragraphs 88(8)(a) and (b)

Repeal the paragraphs, substitute:

 (a) the supply of a pharmaceutical benefit (the first benefit) and another pharmaceutical benefit (the second benefit) is directed; and

 (b) the second benefit is:

 (i) Schedule equivalent to the first benefit; or

 (ii) if the first benefit is a listed brand of a pharmaceutical item—another listed brand of the pharmaceutical item;

9  Paragraph 103(2)(a)

Omit “as specified”, substitute “that is directed to be supplied”.

10  Subsection 103(2A)

Omit “in lieu of a listed brand of a pharmaceutical item specified in a prescription (the specified benefit), another listed brand of the pharmaceutical item”, substitute “instead of the pharmaceutical benefit that is directed to be supplied in a prescription (the specified benefit), another pharmaceutical benefit”.

11  After paragraph 103(2A)(b)

Insert:

 (c) the substitute benefit is a listed brand of a pharmaceutical item; and

 

 

 

 

[Minister’s second reading speech made in—

House of Representatives on 13 September 2007

Senate on 20 September 2007]

(179/07)

 

Overview

The Health Legislation Amendment Act 2007, enacted by the Parliament of Australia and assented to on 28 September 2007, is designed to amend the laws pertaining to health and private health insurance in Australia. The legislation seeks to address specific gaps and issues within the existing health framework by introducing amendments to both the Private Health Insurance Act 2007 and the National Health Act 1953. Through these amendments, the Act aims to ensure clarity and precision in the definitions and operations of health insurance businesses, particularly in relation to the supply of pharmaceutical benefits and the oversight by the Private Health Insurance Ombudsman. The policy objective is to enhance the administration and regulation of health and private health insurance, thereby improving the overall healthcare experience for Australians.

Scope and Application

The Health Legislation Amendment Act 2007 No. 180, 2007 is an Act of the Parliament of Australia that amends laws relating to health and private health insurance. This Act applies to the provisions of the Private Health Insurance Act 2007 and the National Health Act 1953, affecting entities, conduct, and transactions within the health and private health insurance sectors. Geographically, its jurisdiction extends across the Commonwealth of Australia, impacting the health insurance industry nationwide. The Act includes specific transitional provisions to facilitate the implementation of changes, particularly affecting businesses during the transition period starting on 1 April 2007 and ending on 30 June 2008. The amendments aim to refine the definitions and operational parameters of health insurance business and pharmaceutical benefits, ensuring compliance with updated regulatory standards. Notably, certain exclusions and exemptions are defined within the Act, while further application and interpretation may be extended or restricted through subordinate instruments as specified in the Schedules.

Key Provisions

The Health Legislation Amendment Act 2007, No. 180, is designed to amend the law related to health and private health insurance, and it comes into effect on various dates specified in the Act. Sections 1 to 3, and any other provisions not specifically covered in the table, commence on the day the Act receives Royal Assent, which is 28 September 2007. Other provisions in Schedule 1, such as items 1 to 3 and 4 to 4B, commence on 1 April 2007 and the day after Royal Assent, respectively. Schedule 2 items 1 to 6 and 8 to 11 commence on 1 August 2007, while item 7 commences immediately after the commencement of item 15 of Schedule 1 to the National Health Amendment (Pharmaceutical Benefits) Act 2007. The Act imposes several obligations on entities and parties involved in private health insurance. For example, under Schedule 1, Part 1, Amendments to the Private Health Insurance Act 2007, it requires that certain health insurance policies be considered as health insurance business, subject to specific criteria (Section 84-1(1)(b)). Additionally, it mandates that health insurance policies must not be excluded from the definition of complying health insurance policies as per the Private Health Insurance (Complying Product) Rules (Section 84-1(1)(d)). Furthermore, it outlines specific conditions under which members of the Private Health Insurance Ombudsman can be excluded from deliberations related to determinations concerning their disclosures (Section 270-45(4) and (5)). Furthermore, the Act imposes certain transitional provisions to ease the implementation of these changes. For instance, during a specified transition period starting on 1 April 2007 and ending on 30 June 2008, certain sections of the Private Health Insurance Act 2007 do not apply to particular types of business (Schedule 1, item 5). Additionally, certain business activities covered by specific rules are taken to be health insurance business for certain purposes during this transition period (Schedule 1, item 6). In terms of penalties and consequences, the Act does not explicitly detail criminal or civil penalties for breaches of its provisions. However, non-compliance with the stipulated obligations and requirements could potentially lead to enforcement actions by relevant authorities, such as the Australian Prudential Regulation Authority or the Private Health Insurance Ombudsman. These enforcement actions could include fines, corrective measures, or other administrative actions depending on the nature and severity of the breach.

Legal classification tags

Area of Law
Health Law
Insurance Law
Instrument
Act
Concepts
Commencement Provisions
Repeal & Amendment
Transitional Provisions
Reporting & Disclosure Obligations
Regulatory Standards

Interactions

Authorises

All Versions

Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.