Private Health Insurance (Complying Product) Amendment Rules 2014 (No. 6)

Administered by Department of Health, Disability and Ageing

Legislation au F2014L01234 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. 6)

 

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. 6) (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, Victoria 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 September 2014.

 

Details

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

 

Consultation

On 25 August 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, Victoria and Western Australia advised that they will increase the NHTP contribution rates in their public hospitals from 20 September 2014.  The
Australian Capital Territory advised that it is not increasing its NHTP contribution and accommodation rates at this time.

 

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 September 2014 or, if registered after 20 September 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

SEPTEMBER 2014


ATTACHMENT

 

DETAILS OF THE PRIVATE HEALTH INSURANCE (COMPLYING PRODUCT) AMENDMENT RULES 2014 (No. 6)

 

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. 6) (the Amendment Rules).

Section 2 Commencement

Section 2 provides that the Amendment Rules are to commence on 20 September 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 $55.80 to $56.50;
  •                    New South Wales $55.80 to $56.50;
  •                    Northern Territory $55.80 to $56.50;
  •                    South Australia $55.80 to $56.50;
  •                    Tasmania $55.80 to $56.50
  •                    Victoria $55.80 to $56.50; and
  •                    Western Australia $55.80 to $56.50.

 

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 $55.80 to $56.50.

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Overview

The Private Health Insurance (Complying Product) Amendment Rules 2014 (No. 6) were enacted to amend Rule 8A of the Private Health Insurance (Complying Product) Rules 2010 (No. 2), which had commenced on 14 January 2011, under the authority of Section 333-20 of the Private Health Insurance Act 2007. The purpose of these amendments is to alter the patient contribution payable per night for nursing-home type patients (NHTP) at public hospitals in certain states and at private hospitals across the nation, reflecting the 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 September 2014. This was achieved through minor changes to the NHTP contribution rates as set out in the Schedule of the Amendment Rules. The changes were informed by consultations with states and territories, except for the amendment to private hospitals which was deemed machinery in nature and linked to the twice annual Pension and Rental Assistance Rates increase. The Amendment Rules came into effect on 20 September 2014 or, if registered after this date, the day after registration.

Scope and Application

The Private Health Insurance (Complying Product) Amendment Rules 2014 (No. 6) applies to private health insurers who must adhere to the regulations outlined to ensure their products remain compliant under the Private Health Insurance Act 2007. These rules specifically concern the patient contributions payable per night for nursing-home type patients (NHTP) in both public and private hospitals. The amendment to Rule 8A of the Private Health Insurance (Complying Product) Rules 2010 (No. 2) adjusts the patient contribution rates to align with increases in the Adult Pension Basic Rate and the Maximum Daily Rate of Rental Assistance (Pension and Rental Assistance Rates), effective from 20 September 2014. The changes include raising the NHTP contribution at public hospitals in New South Wales, South Australia, Queensland, Northern Territory, Tasmania, Victoria, and Western Australia, and at private hospitals nationally. The amendment does not apply to the Australian Capital Territory, which has decided not to increase its NHTP contribution and accommodation rates at this time. The Amendment Rules are a legislative instrument for the purposes of the Legislative Instruments Act 2003 and are authorised by Section 333-20 of the Private Health Insurance Act 2007.

Key Provisions

The Private Health Insurance (Complying Product) Amendment Rules 2014 (No. 6) (Amendment Rules) primarily focus on amending Rule 8A of the Private Health Insurance (Complying Product) Rules 2010 (Principal Rules) to adjust the patient contribution for nursing-home type patients (NHTP) at both public and private hospitals (Rule 3). Specifically, Rule 8A(3)(a) deals with the contribution for NHTPs at public hospitals in various states, while Rule 8A(3)(b) pertains to NHTPs at private hospitals nationwide (Schedule, Item 1 and Item 2). The purpose of these amendments is to align the patient contribution rates with the updated Adult Pension Basic Rate and Maximum Daily Rate of Rental Assistance, which took effect on 20 September 2014 (Explanatory Statement, Purpose). The Amendment Rules impose obligations on private health insurers to adhere to the new patient contribution rates specified in the amended Rule 8A (Rule 3). This includes ensuring that the amount of benefit paid for each day of NHTP hospital treatment at a hospital is restricted to the hospital’s charge minus the patient contribution amount (Principal Rules, Rule 8A). Insurers must implement these changes from 20 September 2014, or from the day after registration if the Amendment Rules are registered after that date (Amendment Rules, Rule 2). Breaches of the obligations set out in the Amendment Rules may result in civil or criminal consequences. The Act itself does not explicitly outline the penalties for non-compliance, but penalties can include fines and other sanctions under the legislative framework governing private health insurance. The severity of the penalties may depend on the nature and extent of the breach, but specific maximum penalties are not detailed within the Amendment Rules themselves (Explanatory Statement, Offences, Penalties, Consequences).

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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.