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. 8)
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 Chapter 3 and/or section 188-1 of the Act.
The Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 8) (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 the Northern Territory.
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 Schedule to the Amendment Rules makes a minor change to Paragraph 8A(3)(a) of the Principal Rules by amending the NHTP contribution rate at public hospitals in the Northern Territory. Changes to the NHTP contribution rate reflect increases in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance (Pension and Rental Assistance Rates), which take effect on the day after registration.
Details
Details of the Amendment Rules are set out in the Attachment.
Consultation
On 23 August 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 and Rental Assistance Rates. New South Wales, Queensland, South Australia, Tasmania and Victoria requested an increase the NHTP contribution rates in their public hospitals from 20 September 2012. The Australian Capital Territory advised that it would not increase its NHTP contribution rate at this time. On 25 September 2012, the Northern Territory advised the Department of Health and Ageing to increase the NHTP contribution rate.
The Amendment Rules commence on 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 (COMPLYING PRODUCT) AMENDMENT RULES 2012 (No. 8)
Section 1 Name of Rules
Section 1 provides that the title of the Rules is the Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 8) (the Amendment Rules).
Section 2 Commencement
Section 2 provides that the Amendment Rules are to commence on the day after registration.
Section 3 Amendment of Private Health Insurance (Complying Product) Rules 2010 (No. 2)
Section 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)(iii)
Paragraph 8A(3)(a)(iii) 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)(iii) of the Principal Rules by increasing the NHTP contribution at public hospitals in the Northern Territory from $50.95 to $52.05.
PRIVATE HEALTH INSURANCE BRANCH
DEPARTMENT OF HEALTH AND AGEING
OCTOBER 2012
Overview
The Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 8) are a legislative instrument designed to amend the existing Private Health Insurance (Complying Product) Rules 2010 (No. 2), which commenced on 14 January 2011. These amendments were made under the authority of Section 333-20 of the Private Health Insurance Act 2007. The purpose of these changes is to adjust the patient contribution payable per night for nursing-home type patients (NHTPs) at public hospitals in the Northern Territory, reflecting the increases in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance (Pension and Rental Assistance Rates). This adjustment was necessary following consultations with the Northern Territory, which requested an increase in the NHTP contribution rate from $50.95 to $52.05 per night, aligning with the increases in the relevant pension and rental assistance rates. The Amendment Rules will take effect on the day after their registration, ensuring timely compliance with the updated contribution rates.
Scope and Application
The Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 8) amends the Private Health Insurance (Complying Product) Rules 2010 (No. 2) under the authority of Section 333-20 of the Private Health Insurance Act 2007. These rules apply to the patient contribution payable per night for nursing-home type patients (NHTPs) at public hospitals in the Northern Territory, modifying Rule 8A to reflect changes in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance (Pension and Rental Assistance Rates). These amendments were made in response to consultations with states and territories, particularly the Northern Territory, which requested an increase in the NHTP contribution rates. The rules specify the increased patient contribution rate from $50.95 to $52.05, effective from the day after registration. This adjustment aims to align the private health insurance contributions with updated pension and rental assistance rates, ensuring that the financial obligations for NHTPs at public hospitals remain consistent with broader social welfare changes.
Key Provisions
The Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 8) amends Rule 8A of the Private Health Insurance (Complying Product) Rules 2010 (No. 2) by increasing the patient contribution for nursing-home type patients (NHTPs) in public hospitals in the Northern Territory. Specifically, Rule 8A(3)(a)(iii) of the Principal Rules, which set out the patient contribution for privately insured NHTPs, is amended to increase the contribution from $50.95 to $52.05. This change reflects the increases in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance (Pension and Rental Assistance Rates). This amendment was made under the authority provided by Section 333-20 of the Private Health Insurance Act 2007, which allows the Minister to make rules necessary to implement the Act.
The Amendment Rules impose obligations on private health insurers to adjust their patient contribution rates for NHTPs at public hospitals in the Northern Territory in line with the new rates specified in the Amendment Rules. Insurers must ensure that their policies reflect the increased contribution rate of $52.05, and they must inform their policyholders of these changes. The obligation extends to all insurers who offer private health insurance policies that cover NHTPs at public hospitals in the Northern Territory.
Failure to comply with the provisions of the Amendment Rules could result in civil or criminal penalties. Although the exact penalties are not specified in the Amendment Rules, the Private Health Insurance Act 2007 provides for potential civil penalties for non-compliance. Additionally, any insurer found to be in breach of these rules could face enforcement actions by the Australian Prudential Regulation Authority (APRA), which regulates the private health insurance industry in Australia. While specific penalties are not outlined in the Amendment Rules, non-compliance could lead to significant repercussions for the insurers involved.