Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 1)

Administered by Department of Health, Disability and Ageing

Legislation au F2012L00599 Rules Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

Issued by the Authority of the Minister for Health

 

Private Health Insurance Act 2007

 

Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 1)

 

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 and/or section 188-1 of the Act, or necessary or convenient in order to carry out or give effect to the Act.

 

The Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 1) (the Amendment Rules) amend Rule 8A of the Private Health Insurance (Complying Product) Rules 2010 (No. 2) (the Principal Rules) which commenced on 14 January 2011.

 

Purpose

The purpose of the amendments to Rule 8A is to change the patient contribution payable per night for nursing-home type patients (NHTPs) at public hospitals in some States and Territories and at private hospitals nationally. 

 

Background

Rule 8A of the Principal Rules sets the patient contribution for privately insured NHTPs by restricting the amount of benefit that private health insurers pay for each day of NHTP hospital treatment at a hospital.  The amount of benefit is restricted to the hospital’s charge less the patient contribution amount.

 

The Amendment Rules make minor changes to paragraph 8A(3)(a) of the Principal Rules by amending the NHTP contribution rate at public hospitals in New South Wales, the Northern Territory, Queensland, South Australia and Tasmania.  The Amendment Rules also make changes to paragraph 8A(3)(b) of the Principal Rules by amending the NHTP contribution rate at private hospitals nationally.  Changes to the NHTP contribution rate reflect increases in the Adult Pension Basic Rate (Pension Rate) and the Maximum Daily Rate of Rental Assistance (Rental Assistance Rate), which take effect on 20 March 2012.

 

Details

Details of the Amendment Rules are set out in the Attachment.

 

Statement of Compatibility

The Rules are compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

 

Consultation

On 28 February 2012, States and Territories were asked whether they would be increasing the NHTP contribution and accommodation rates in their jurisdiction in line with increases in the Pension Rate and Rental Assistance Rate.  New South Wales, the Northern Territory, Queensland, South Australia and Tasmania advised that they will increase the NHTP

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contribution rates in their public hospitals from 20 March 2012.  Australian Capital Territory advised that it is not increasing its NHTP contribution and accommodation rates at this time.  Western Australia advised of its intention to increase its NHTP contribution and accommodation rates at a later date yet to be determined.  No advice was received from Victoria.

 

No specific consultation was undertaken in relation to the amendment to paragraph 8A(3)(b) of the Principal Rules regarding private hospitals because the change was machinery in nature and linked to the twice annual pension increase.  The change does not substantially alter existing arrangements.

 

The Amendment Rules commence on 20 March 2012 or, if registered after 20 March 2012, 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

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ATTACHMENT

 

DETAILS OF THE PRIVATE HEALTH INSURANCE (COMPLYING PRODUCT) AMENDMENT RULES 2012 (No. 1)

 

  1. Name of Rules

Rule 1 provides that the title of the Rules is the Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 1) (the Amendment Rules).

2.                   Commencement

Rule 2 provides that the Amendment Rules are to commence on 20 March 2012, or if registered on a later date, 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) (the Principal Rules) which commenced on 14 January 2011.

Schedule – Amendments

Item 1 – Part 2, Paragraph 8A(3)(a)

 

Paragraph 8A(3)(a) of the Principal Rules set out the patient contribution for privately insured NHTPs at public hospitals.

 

Item 1 of the Schedule of the Amendment Rules amends Part 2 paragraph 8A(3)(a) of the Principal Rules by increasing the NHTP contribution at public hospitals:

 

  • New South Wales from $50.55 to $50.95;
  • Northern Territory from $50.55 to $50.95;
  • Queensland from $50.55 to $50.95;
  • South Australia from $50.55 to $50.95; and
  • Tasmania from $50.55 to $50.95.

 

Item 2 – Part 2, Paragraph 8A(3)(b)

 

Paragraph 8A(3)(b) of the Principal Rules set out the patient contribution for privately insured NHTPs at private hospitals.

 

Item 2 of the Schedule of the Amendment Rules amends Part 2 subparagraph 8A(3)(b) of the Principal Rules by increasing the NHTP contribution at private hospitals from $50.55 to $50.95.

 

 

 

PRIVATE HEALTH INSURANCE BRANCH

DEPARTMENT OF HEALTH AND AGEING

MARCH 2012

 

Overview

The Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 1) were introduced to amend the Private Health Insurance (Complying Product) Rules 2010 (No. 2) under the authority of Section 333-20 of the Private Health Insurance Act 2007. The primary purpose of these amendments is to adjust the patient contribution rates for nursing-home type patients (NHTPs) in both public and private hospitals across Australia, reflecting the increases in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance. The changes were made in response to the increases in these rates that took effect on 20 March 2012, ensuring that the contributions paid by patients for hospital treatment are aligned with the updated rates. The rules were developed following consultation with states and territories, with New South Wales, the Northern Territory, Queensland, South Australia, and Tasmania agreeing to increase their NHTP contribution rates in line with the federal changes. The Amendment Rules aim to maintain consistency in the contributions payable by NHTPs, thereby ensuring that private health insurance arrangements remain fair and effective. The Amendment Rules are compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Scope and Application

The Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 1) amends the Private Health Insurance (Complying Product) Rules 2010 (No. 2) to adjust the patient contribution payable per night for nursing-home type patients (NHTPs) at public hospitals in certain states and territories, and at private hospitals nationally. The amendment is made pursuant to Section 333-20 of the Private Health Insurance Act 2007, which allows the Minister to create rules for matters required or permitted by Chapter 3 and/or section 188-1 of the Act. The purpose of these changes is to reflect increases in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance, which took effect on 20 March 2012. The amended patient contribution rates were determined following consultation with relevant states and territories, with some increasing their rates in line with the pension and rental assistance increases, while others chose not to do so at that time. These amendments apply to private health insurers and privately insured NHTPs, specifically affecting the amount of benefit that private health insurers pay for each day of NHTP hospital treatment at a hospital, by adjusting the hospital’s charge to account for the patient contribution amount.

Key Provisions

The Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 1) amend Rule 8A of the Private Health Insurance (Complying Product) Rules 2010 (No. 2) to adjust the patient contribution for nursing-home type patients (NHTPs) at public hospitals in New South Wales, the Northern Territory, Queensland, South Australia, and Tasmania, as well as at private hospitals nationally. These amendments are made to reflect increases in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance, effective from 20 March 2012. Specifically, the Amendment Rules modify paragraph 8A(3)(a) to set new patient contribution rates at public hospitals, and paragraph 8A(3)(b) to adjust the rates at private hospitals (Item 1 and Item 2 of the Schedule). These changes ensure that the patient contributions align with the updated rates, thereby maintaining the financial arrangements between private health insurers and patients under the Act. The Amendment Rules impose specific obligations on private health insurers to adhere to the revised patient contribution rates for NHTPs. Insurers must now pay benefits based on the new rates for hospital treatments provided to NHTPs at both public and private hospitals. These obligations are crucial in ensuring that the benefits paid by insurers accurately reflect the patient's contribution, which is determined by the updated rates set forth in the Amendment Rules. By complying with these changes, insurers maintain their adherence to the regulatory framework established by the Private Health Insurance Act 2007. Failure to comply with the amended patient contribution rates stipulated in the Amendment Rules may result in civil or criminal consequences. While the specific penalties are not detailed in the Amendment Rules, the Act provides for potential penalties for non-compliance. Such penalties could include fines or other sanctions as prescribed by the Act. It is essential for private health insurers to comply with these requirements to avoid any legal repercussions that may arise from non-compliance with the amended rules.

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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.