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. 9)
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. 9) (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 amendment to Rule 8A is to change the patient contribution payable per night for nursing-home type patients (NHTPs) at public hospitals in Western Australia from $50.95 to $52.05 per day.
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 Subparagraph 8A(3)(a)(viii) of the Principal Rules by amending the NHTP contribution rate at public hospitals in Western Australia. 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.
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 to 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. The Northern Territory subsequently requested an increase to its NHTP contribution rate which became effective from 2 November 2012. On 2 November 2012, Western Australia advised the Department of Health and Ageing to increase the NHTP contribution rate for public hospitals in their state.
The Amendment Rules commence 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
Overview
The Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 9) were enacted to amend the Private Health Insurance (Complying Product) Rules 2010, specifically Rule 8A, to adjust the patient contribution payable per day for nursing-home type patients (NHTPs) at public hospitals in Western Australia. This change was necessitated by increases in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance (Pension and Rental Assistance Rates). The amendment reflects the need to align the patient contributions with these updated rates, ensuring that the private health insurance scheme remains consistent with broader changes in pension and rental assistance rates. These rules were made under the authority of Section 333-20 of the Private Health Insurance Act 2007, providing the Minister with the power to create rules necessary for the implementation and enforcement of the Act. The purpose of the amendment is to maintain the integrity and relevance of the private health insurance contributions in line with evolving social security benchmarks.
Scope and Application
The Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 9) are subordinate legislation made under the authority of Section 333-20 of the Private Health Insurance Act 2007. These Amendment Rules specifically modify Rule 8A of the Private Health Insurance (Complying Product) Rules 2010 (No. 2), which commenced on 14 January 2011, to adjust the patient contribution payable per night for nursing-home type patients (NHTPs) at public hospitals in Western Australia from $50.95 to $52.05 per day. This change aligns with recent increases in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance (Pension and Rental Assistance Rates). The purpose of these amendments is to ensure that private health insurers' payments for NHTP hospital treatment are adjusted to reflect the updated rates. These Amendment Rules apply to private health insurers operating within Australia, particularly those providing coverage for NHTPs, and are effective from the day after their registration, thereby impacting the financial obligations and benefits available to patients in Western Australia.
Key Provisions
The Private Health Insurance (Complying Product) Amendment Rules 2012 (No. 9) (Amendment Rules) amend Rule 8A of the Private Health Insurance (Complying Product) Rules 2010 (No. 2) (Principal Rules), which came into effect on 14 January 2011. The primary change introduced by the Amendment Rules is to the patient contribution payable per night for nursing-home type patients (NHTPs) at public hospitals in Western Australia. Specifically, Rule 8A(3)(a)(viii) has been modified to adjust the patient contribution from $50.95 to $52.05 per day. This adjustment is in response to increases in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance (Pension and Rental Assistance Rates) which became effective on the day after the registration of these rules.
The Amendment Rules impose specific obligations on private health insurers who offer policies that qualify as complying products under the Private Health Insurance Act 2007. These insurers must adhere to the updated patient contribution rates as stipulated in Rule 8A. For NHTPs in public hospitals, this means they will now be required to contribute $52.05 per day towards their treatment costs, which is a direct result of the changes implemented by the Amendment Rules. Insurers need to ensure their policies reflect this new rate to remain compliant with the legislative requirements.
Failure to comply with the requirements set out in the Amendment Rules may result in civil or administrative penalties. Although the Amendment Rules themselves do not explicitly detail the penalties for non-compliance, the overarching Private Health Insurance Act 2007 does outline potential consequences. Insurers found to be in breach of the rules could face actions such as fines, corrective orders, or other enforcement measures intended to ensure adherence to the legislative framework. The penalties can vary, but they are designed to maintain the integrity and intended operation of the private health insurance system in Australia.