EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health and Ageing
Private Health Insurance Act 2007
Private Health Insurance (Complying Product) Amendment Rules 2011 (No.7)
Authority
Section 333-20 of the Private Health Insurance Act 2007 (the Act) provides that the Minister may make Private Health Insurance (Complying Product) Rules providing for matters required or permitted by Chapter 3 of the Act, or necessary or convenient in order to carry out or give effect to Chapter 3 of the Act.
Purpose
The Private Health Insurance (Complying Product) Amendment Rules 2011 (No.7) (the Amendment Rules) amend rules 4 and 8A of the Private Health Insurance (Complying Product) Rules 2010 (No.2) (the Rules) which commenced on 14 January 2011.
The purpose of the amendment to rule 8A is to increase the patient contribution rate for nursing-home type patients (NHTPs) at public hospitals in the Northern Territory and Western Australia. Consequential amendments to insert three new definitions in rule 4 are also required.
Background
Rule 8A of the Rules sets out the amount of patient contribution, payable per night, for privately insured NHTPs in public and private hospitals in all States and Territories. The NHTP contribution amount is subject to review and change twice annually (in March and September) to reflect increases in the Adult Pension Basic Rate and the maximum daily rate of rental assistance.
The Private Health Insurance (Accreditation) Rules 2011 were made in October 2011 and changed the standard for treatment of a kind practised by a podiatric surgeon to require it to be provided by a podiatric surgeon who holds specialist registration in the specialty of podiatric surgery under the National Law. As a result of this change, the definition of an ‘accredited podiatrist’ in the Private Health Insurance (Prostheses) Rules 2011 (No.2) was recently amended to align it with the new Private Health Insurance (Accreditation) Rules 2011. As the Rules also refer to an ‘accredited podiatrist’, the Amendment Rules make a consequential amendment to rule 4 to include a definition for ‘accredited podiatrist’, which is the same as already provided in the Private Health Insurance (Prostheses) Rules 2011 (No.2).
In September 2011, the Private Health Insurance (Complying Product) Amendment Rules 2011 (No.5) inserted rules 17 and18 in the Rules which set out the kinds of pilot projects allowed and the requirements for conducting a pilot project. One of the requirements is that private health insurers provide information about a pilot project to the Department. As the term ‘Department’ is currently undefined in the Rules, the Amendment Rules insert a definition for ‘Department’.
Details
The Amendment Rules increase the NHTP contribution rate at public hospitals in the Northern Territory and Western Australia to $50.55. This reflects an increase in the Adult Pension Basic Rate and the maximum daily rate of rental assistance, which took effect on 20 September 2011.
The Amendment Rules also insert in rule 4 definitions for the terms ‘Department’ and ‘accredited podiatrist’. As the definition for an ‘accredited podiatrist’ refers to the ‘National Law’, a definition for the term ‘National Law’ has also been added. The definitions for ‘accredited podiatrist’ and ‘National Law’ are the same definitions as those used in the Private Health Insurance (Prostheses) Rules 2011 (No.2).
Details of the Amendment Rules are set out in the Attachment.
Consultation
In accordance with section 18 of the Legislative Instruments Act 2003, the Department of Health and Ageing (the Department) undertook consultation with respect to the changes to the NHTP contribution rates.
On 30 August 2011, the Department advised the States and Territories of increases to the Adult Pension Basic Rate and maximum daily rate of rental assistance and asked the jurisdictions to advise if they would be increasing their NHTP contribution and accommodation rates as a result. New South Wales, Queensland, South Australia and Tasmania responded to the Department confirming their new NHTP contribution rates, which were incorporated in the Private Health Insurance (Complying Product) Amendment Rules 2011 (No. 4A) and took effect on 20 September 2011. The Northern Territory and Western Australia provided late notice of their new NHTP contribution rates on 20 September 2011 and 24 October 2011, respectively.
The Australian Private Hospitals Association, Private Healthcare Australia, Consumers’ Health Forum of Australia and Health Insurance Restricted Membership Association of Australia were also advised of the new NHTP contribution rates to be applied in public hospitals in the Northern Territory and Western Australia.
In accordance with section 18 of the Legislative Instruments Act 2003, consultation was unnecessary for the amendments to rule 4 to add three new definitions as it is minor and does not substantially alter existing arrangements.
The Amendment Rules commence on the day after registration on the Federal Register of Legislative Instruments.
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
PRIVATE HEALTH INSURANCE BRANCH
DEPARTMENT OF HEALTH AND AGEING
NOVEMBER 2011
ATTACHMENT
DETAILS OF THE PRIVATE HEALTH INSURANCE (COMPLYING PRODUCT) AMENDMENT RULES 2011 (No.7)
- Name of Rules
Rule 1 provides that the title of the Rules is the Private Health Insurance (Complying Product) Amendment Rules 2011 (No.7) (the Amendment Rules).
2. Commencement
Rule 2 provides that the Amendment Rules are to commence on the day after registration.
3. Amendment of Private Health Insurance (Complying Product) Rules 2010 (No.2)
Rule 3 provides that the Schedule to the Amendment Rules amends the Private Health Insurance (Complying Product) Rules 2010 (No.2), which commenced on 14 January 2011.
Schedule – Amendments
Item 1 Part 1 Preliminary, Rule 4 Definitions
Item 1 of the Schedule to the Amendment Rules inserts definitions for the terms ‘accredited podiatrist’ and ‘National Law’ in rule 4 of the Rules. An ‘accredited podiatrist’ means a podiatric surgeon who holds specialist registration in the specialty of podiatric surgery under the National Law. The definitions are the same as those used in the Private Health Insurance (Prostheses) Rules 2011 (No.2).
Item 1 also inserts a definition for the term ‘Department’ in rule 4 of the Rules for the purposes of rule 18 which refers to the Department. The ‘Department’ means the Private Health Insurance Branch of the Department of Health and Ageing.
Item 2 Part 2 General, Rule 8A Benefit requirement—nursing-home type patients
Subrule 8A(3)(a) of the Rules sets out the amount of patient contribution for privately insured nursing-home type patients (NHTPs) at public hospitals in all States and Territories.
Item 2 of the Schedule to the Amendment Rules amends subrule 8A(3)(a) by increasing the amount of NHTP contribution at public hospitals in the Northern Territory from $48.35 to $50.55, and in Western Australia from $49.20 to $50.55.