National Health Act 1953 - Condition of Registration pursuant to subsection 73B(1) (03/11/2005)

Administered by Department of Health, Disability and Ageing

Legislation au F2005L03613 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

Issued by Authority of the Minister for Health and Ageing

 

National Health Act 1953

Condition of Registration pursuant to Subsection 73B(1)

(HIB22/05)

 

Subsection 73B(1) of the National Health Act 1953 (the Act) provides that the Minister may impose further conditions to which the registration of a registered organization, or registered organizations generally, are subject. 

 

The Minister for Health and Ageing, by instrument dated 3 November 2005, has imposed, with effect from the date after registration on the Federal Register of Legislative Instruments, five additional conditions of registration on registered organizations generally, which prevent registered organizations from imposing, or continuing to impose, benefit limitation periods on transferred or transferring contributors or their dependants.

 

A benefit limitation period is defined in condition (d) of the instrument, as a period of time set by a registered organization, during which a contributor or dependant is eligible to receive an amount of benefit under an applicable benefits arrangement (hospital cover policy) that is less than the amount of benefit that the contributor or dependant would be eligible to receive after that period has expired. 

 

Conditions (a), (b) and (c) provide as follows.

 

a)  In relation to a registered organization’s applicable benefits arrangements, contributors or dependants transferring from another organization must not be subject, in any form, to a benefit limitation period.

 

b)     In relation to a registered organization’s applicable benefits arrangements, contributors or dependants transferring from one applicable benefits arrangement to another within the same organization must not be subject, in any form, to a benefit limitation period.

 

c)   If a contributor or dependant is currently serving a benefit limitation period with an organization following transfer from another organization, the receiving organization must cease to impose the benefit limitation period by 1 December 2005, and must notify affected contributors and dependants to this effect before 1 December 2005.

 

Condition (e) provides that a waiting period permitted by the Act, including a waiting period applied to part of the benefit of a transferring member in accordance with the portability provisions of Schedule 1 of that Act [paragraphs (la) to (ld)], is not a benefit limitation period for the purpose of conditions (a), (b) and (c) contained in the instrument signed by the Minister and dated 3 November 2005.

 


Consultation

 

The Private Health Insurance Administration Council (PHIAC) has been consulted, as required by subsection 73B(1) of the Act.

 

Consultation with the private health insurance industry was undertaken via circular, following which all registered organizations had the opportunity to make written submissions to the Minister for Health and Ageing.  

 

The Department of Health and Ageing also wrote to relevant interest groups for their comment and inclusion in the process.  This included the Australian Medical Association, the Australian Private Hospitals Association, the Australian Health Insurance Association, beyondblue, and the Mental Health Council of Australia.

 

Subsection 73B(1A) of the Act requires the Minister to cause notice in writing of his decision to impose additional conditions of registration to be served on the public officer of each registered organisation to which the condition relates. This was done by industry circular issued on 29 August 2005.  A further industry circular will be issued following registration of the conditions on the Federal Register of Legislative Instruments.

 

Subsection 73B(2) of the Act requires the Minister, within one month of imposing additional conditions of registration, to publish in the Gazette , and free of charge on the Department’s website not later than 5 working days after action is taken by the Minister, notification setting out:

 

  • the name of the registered organizations;
  • the particulars of the action taken, including the conditions imposed; and
  • the date on which the action was taken.

 

Notification on the Department’s website will take place immediately following registration of the conditions on the Federal Register of Legislative Instruments.

 

By virtue of subsection 56(1) of the Legislative Instruments Act 2003, notification on the Federal Register of Legislative Instruments is taken to satisfy the requirement for publication in the Gazette.

 

The imposition of additional conditions of registration under subsection 73B is reviewable by the Administrative Appeals Tribunal: subsection 105AB(3)(b) of the Act.

 

The conditions of registration were made on 3 November 2005 and take effect the date after registration on the Federal Register of Legislative Instruments. The conditions of registration and this explanatory statement have been lodged for registration on the Federal Register of Legislative Instruments.

 

 

PRIVATE HEALTH INSURANCE BRANCH

DEPARTMENT OF HEALTH AND AGEING

November 2005

Overview

The National Health Act 1953, enacted by the Commonwealth Parliament, serves as the legislative foundation for regulating private health insurance in Australia, aiming to ensure that health insurance practices are fair and equitable. In 2005, the Minister for Health and Ageing introduced additional conditions of registration under the Act to address the issue of benefit limitation periods imposed by registered organizations on contributors or their dependants transferring from one health insurer to another. These periods restricted the amount of benefit the contributors or dependants could receive, creating a gap in equitable treatment. The policy objective was to eliminate these periods, ensuring that transferring contributors or dependants are not disadvantaged by their prior insurance history. The Minister for Health and Ageing imposed these conditions following consultation with the Private Health Insurance Administration Council and other relevant stakeholders, as mandated by the Act.

Scope and Application

The National Health Act 1953 applies to registered organizations generally within the Australian private health insurance sector, imposing additional conditions of registration to prevent these entities from imposing or continuing to impose benefit limitation periods on transferred or transferring contributors or their dependants. These conditions are designed to ensure that contributors or dependants transferring from another organization or within the same organization are not subjected to periods where they are eligible to receive a lesser benefit amount. If a contributor or dependant is currently serving such a period, the receiving organization must cease this practice by 1 December 2005 and notify affected individuals accordingly. However, waiting periods permitted by the Act, including those applied under the portability provisions, are not considered benefit limitation periods for the purposes of these conditions. The Minister for Health and Ageing has imposed these conditions through subordinate instruments, and their imposition is subject to review by the Administrative Appeals Tribunal. The conditions came into effect following their registration on the Federal Register of Legislative Instruments and subsequent notification to relevant stakeholders.

Key Provisions

The National Health Act 1953, as amended by the Minister for Health and Ageing, introduces new conditions of registration for registered organizations. These conditions, which apply to registered organizations generally, are aimed at preventing these organizations from imposing, or continuing to impose, benefit limitation periods on transferred or transferring contributors or their dependants. Condition (a) stipulates that contributors or dependants transferring from another organization must not be subject to a benefit limitation period in any form (section 73B(1)(HIB22/05)(a)). Similarly, condition (b) mandates that contributors or dependants transferring from one applicable benefits arrangement to another within the same organization must not be subject to a benefit limitation period (section 73B(1)(HIB22/05)(b)). Condition (c) requires that if a contributor or dependant is currently serving a benefit limitation period with an organization following transfer from another organization, the receiving organization must cease to impose the benefit limitation period by 1 December 2005 and must notify affected contributors and dependants to this effect before 1 December 2005 (section 73B(1)(HIB22/05)(c)). Additionally, condition (e) clarifies that a waiting period permitted by the Act is not considered a benefit limitation period for the purposes of conditions (a), (b), and (c) (section 73B(1)(HIB22/05)(e)). The Act imposes several obligations on registered organizations. Firstly, they must ensure that contributors or dependants transferring from another organization are not subjected to any benefit limitation period. Secondly, they must also ensure that contributors or dependants transferring within the same organization are not subjected to any benefit limitation period. Furthermore, if a contributor or dependant is currently serving a benefit limitation period with an organization following transfer from another organization, the receiving organization must cease to impose the benefit limitation period by 1 December 2005 and must notify affected contributors and dependants to this effect before 1 December 2005. Failure to comply with these conditions could result in legal repercussions. The Act does not explicitly state the offences, penalties, or consequences for breaching the new conditions of registration. However, as the imposition of these conditions is reviewable by the Administrative Appeals Tribunal, non-compliance could potentially lead to legal actions being taken against the offending organization. The severity of these actions would depend on the specific circumstances of the breach and the tribunal's determination. It is important for registered organizations to adhere to these conditions to avoid any potential legal consequences.

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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.