EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health
Private Health Insurance Act 2007
Private Health Insurance (Accreditation) Amendment Rules 2012 (No. 2)
Authority
Section 333-20 of the Private Health Insurance Act 2007 (the Act) provides that the Minister may make Private Health Insurance (Accreditation) Rules providing for matters required or permitted by section 81-1 of the Act, or necessary or convenient to be provided in order to carry out or give effect to section 81-1 of the Act.
The Private Health Insurance (Accreditation) Amendment Rules 2012 (No. 2) (the Amendment Rules) amend the Private Health Insurance (Accreditation) Rules 2011 (Principal Rules) which commenced on 5 November 2011.
Purpose
The purpose of the Amendment Rules is to make consequential amendments to the Principal Rules in light of the new National Safety and Quality Health Service Standards developed by the Australian Commission on Safety and Quality in Healthcare (the Commission) which are scheduled to commence from 1 January 2013.
The Amendment Rules amend the definition of ‘appropriate accrediting body’ in Part 1, Rule 4 to clarify that an appropriate accreditation body is a body approved by the Commission. The Amendment Rules also add a new paragraph 6(2)(d) in Part 2 to also clarify that the standard for accreditation is the National Standards as enforced under state and territory law.
Background
Section 81-1 of the Act provides that an insurance policy meets the quality assurance requirements in Division 81-1 of the Act if the policy prohibits the payment of private health insurance benefits for a treatment that does not meet the standards in the Principal Rules.
Details
Details of the Amendment Rules are set out in the Attachment.
Consultation
In accordance with Section 17 of the Legislative Instruments Act 2003, the Department of Health and Ageing has consulted with the Australian Commission on Safety and Quality in Health Care, the Australian Private Hospitals Association and Private Healthcare Australia regarding this amendment.
The Amendment Rules commence on 1 January 2013, or if registered after 1 January 2013, the day after registration.
The Amendment Rules are a legislative instrument for the purposes of the Legislative Instruments Act 2003.
Authority: Section 333-20 of the
Private Health Insurance Act 2007
ATTACHMENT
DETAILS OF THE PRIVATE HEALTH INSURANCE (ACCREDITATION) AMENDMENT RULES 2012 (No. 2)
Section 1 Name of Rules
Section 1 provides that the title of the Rules is the Private Health Insurance (Accreditation) Amendment Rules 2012 (No. 2) (the Amendment Rules).
Section 2 Commencement
Section 2 provides that the Amendment Rules are to commence on 1 January 2013 or, if registered on a later date, the day after registration.
Section 3 Amendment of Private Health Insurance (Accreditation) Rules 2011
Section 3 provides that the Schedule to the Amendment Rules amend the Private Health Insurance (Accreditation) Rules 2011 which commenced on 5 November 2011.
Schedule – Amendments
Item 1 – Part 1, Rule 4 Definitions, definition of appropriate accrediting body
Item 1 amends the definition for appropriate accrediting body to mean a body approved by the Australian Commission on Safety and Quality in Healthcare to accredit or certify health care organisations or health care providers against the National Safety and Quality Health Service Standards as at 1 January 2013.
Item 2 – Part 1, Rule 4 Definitions, after definition of National Law
Item 2 inserts the definition of National Safety and Quality Health Service Standards to mean the standards developed by the Australian Commission on Safety and Quality in Healthcare as at 1 January 2013.
Item 3 – Part 2, Rule 6 Treatments provided by hospitals and health care organisations, subrule (2)
Item 3 inserts a new paragraph 6(2)(d) which states that the State and Territory law requirements referred to in subrule 6 may include the National Safety and Quality Health Service Standards. It is noted that currently under the Private Health Insurance (Accreditation) Rules 2011 (the Accreditation Rules), hospitals must meet state and territory licensing requirements for all private health insurance benefits to be paid. The Accreditation Amendment Rules clarify that hospitals and health care organisations will be required to meet the National Standards when required under their relevant state or territory regulatory regime. Hospitals and health care organisations will continue to be required to meet state and territory regulatory regimes under the Principal Rules. This will not change.
PRIVATE HEALTH INSURANCE BRANCH
DEPARTMENT OF HEALTH AND AGEING
DECEMBER 2012