Private Health Insurance (Complying Product) Amendment Rules 2014 (No. 2)

Administered by Department of Health, Disability and Ageing

Legislation au F2014L00311 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 2014 (No. 2)

 

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 2014 (No. 2) (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 (NHTP) at public hospitals in some states 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 Schedule to the Amendment Rules makes minor changes to Paragraph 8A(3)(a) of the Principal Rules by amending the NHTP contribution rate at public hospitals in
New South Wales, South Australia, Queensland, Northern Territory, Tasmania, and
Western Australia.  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 and the Maximum Daily Rate of Rental Assistance (Pension and Rental Assistance Rates), which take effect on 20 March 2014.

 

Details

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

 

Consultation

On 7 March 2014, 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, South Australia, Tasmania, Queensland, Northern Territory and Western Australia advised that they will increase the NHTP contribution rates in their public hospitals from 20 March 2014.  The
Australian Capital Territory advised that it is not increasing its NHTP contribution and accommodation rates at this time. No advice has been received from Victoria at this stage.

 

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 and Rental Assistance Rates increase.  The change does not substantially alter existing arrangements.

 

The Amendment Rules commence on 20 March 2014 or, if registered after 20 March 2014, 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

 

MEDICAL BENEFITS DIVISION

DEPARTMENT OF HEALTH

MARCH 2014


ATTACHMENT

 

DETAILS OF THE PRIVATE HEALTH INSURANCE (COMPLYING PRODUCT) AMENDMENT RULES 2014 (No. 2)

 

Section 1 Name of Rules

Section 1 provides that the title of the Rules is the Private Health Insurance (Complying Product) Amendment Rules 2014 (No. 2) (the Amendment Rules).

Section 2 Commencement

Section 2 provides that the Amendment Rules are to commence on 20 March 2014, or if registered on a later date, 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)

 

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:

 

  •                    Queensland $54.75 to $55.80;
  •                    New South Wales $54.75 to $55.80;
  •                    Northern Territory $52.05 to $55.80;
  •                    South Australia $54.75 to $55.80;
  •                    Tasmania $54.75 to $55.80; and
  •                    Western Australia $54.75 to $55.80.

 

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, Paragraph 8A(3)(b) of the Principal Rules by increasing the NHTP contribution at private hospitals from $54.75 to $55.80.

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Overview

The Private Health Insurance (Complying Product) Amendment Rules 2014 (No. 2) were enacted to update the patient contribution rates for nursing-home type patients (NHTP) under the Private Health Insurance Act 2007. These amendments were made in response to the increases in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance (Pension and Rental Assistance Rates) effective from 20 March 2014. The Minister for Health, pursuant to Section 333-20 of the Act, issued these rules to adjust the patient contribution rates at both public and private hospitals, ensuring alignment with the updated pension and rental assistance rates. This legislative action aimed to maintain the financial sustainability of private health insurance contributions and the equitable distribution of costs between insurers and patients. The rules came into effect on 20 March 2014 or the day after registration if enacted later, reflecting the timely and necessary adjustments in line with the changes in social security rates.

Scope and Application

The Private Health Insurance (Complying Product) Amendment Rules 2014 (No. 2) amend the Private Health Insurance (Complying Product) Rules 2010 (No. 2) and apply to private health insurers providing health insurance in Australia. These rules are made under section 333-20 of the Private Health Insurance Act 2007 and are designed to ensure that private health insurance products comply with the requirements of the Act. Specifically, the amendment rules address the patient contribution payable per night for nursing-home type patients (NHTP) at both public and private hospitals. The amendment reflects increases in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance (Pension and Rental Assistance Rates), which took effect on 20 March 2014. The changes to the NHTP contribution rate were made in consultation with the states and territories, with New South Wales, South Australia, Tasmania, Queensland, Northern Territory, and Western Australia advising that they would increase the NHTP contribution rates in their public hospitals from 20 March 2014. The amendment rules commenced on 20 March 2014 or, if registered on a later date, the day after registration.

Key Provisions

The main operative sections of the Private Health Insurance (Complying Product) Amendment Rules 2014 (No. 2) (Amendment Rules) involve the modification of Rule 8A in the Private Health Insurance (Complying Product) Rules 2010 (No. 2) (Principal Rules). Specifically, Rule 8A(3)(a) is amended to adjust the patient contribution for nursing-home type patients (NHTP) at public hospitals in certain states, while Rule 8A(3)(b) is amended to adjust the patient contribution for NHTPs at private hospitals nationwide. These amendments reflect changes in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance (Pension and Rental Assistance Rates), effective from 20 March 2014. The Amendment Rules impose specific obligations on private health insurers by setting the maximum patient contribution that can be charged to privately insured NHTPs for hospital treatment. The revised contribution rates are tied to the increases in the Pension and Rental Assistance Rates, ensuring that the patient contribution aligns with changes in these rates. The obligation for insurers is to adhere to these new contribution rates when calculating benefits for NHTPs. Breach of the provisions outlined in the Amendment Rules may not explicitly outline specific penalties or consequences, but non-compliance with the Private Health Insurance Act 2007 (the Act) generally may result in administrative, civil, or criminal penalties. The Act allows for the enforcement of penalties by the Australian Health Insurance Commission and may include fines or other corrective measures as deemed necessary by the Minister. The maximum penalties for non-compliance with the Act can be substantial, reflecting the importance of adherence to the stipulated rules and regulations governing private health insurance products.

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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.