EXPLANATORY STATEMENT
Private Health Insurance (National Joint Replacement Register Levy) Act 2009
Private Health Insurance (National Joint Replacement Register Levy) Rules 2026
Purpose and operation
The Private Health Insurance (National Joint Replacement Register Levy) Rules 2026 (the NJRR Rules 2026) revokes and replaces the Private Health Insurance (National Joint Replacement Register Levy) Rule 2015 (the NJRR Rule 2015), which is due to sunset on 1 April 2026
The Rules give effect to matters in the Private Health Insurance (National Joint Replacement Register Levy) Act 2009 (the Act), including specifying days on which the National Joint Replacement Register Levy (NJRR) levy will be imposed (levy day) and the rate of the NJRR levy.
The NJRR Rules 2026 provide updated NJRR funding amounts for the next three levy days and removes the exception for hand and foot articulation devices contained in the NJRR Rule 2015. While the Australian Orthopaedic Association (AOA) have been collecting data on hand and foot articulation devices they were previously excluded from the levy. Removing the exception means that all orthopaedic devices used in joint replacement surgeries will now be subject to the NJRR levy.
Background
Section 7 of the Act provides for the Private Health Insurance (National Joint Replacement Register Levy) Rules to specify the rate at which the NJRR levy is to be imposed on persons liable to pay the levy. Section 8 of the NJRR Rule states the persons liable to pay the national joint replacement register levy as the persons mentioned in Schedule 1 to the Private Health Insurance (Medical Devices and Human Tissue Products) Rules in force on the national joint replacement levy day for that financial year.
The NJRR levy supports the work of the NJRR. The NJRR, administered by the AOA, collects data on the implantation of prosthetic joint replacement devices and reports on revision rates, complications and other outcomes for those devices for inclusion on the NJRR. Its aim is to improve the quality of care for patients undergoing joint replacement surgery.
The funding provided to AOA for administering the NJRR is effectively cost recovered through the NJRR levy from the medical device industry who have relevant orthopaedic devices listed on the Prescribed List of Medical Devices and Human Tissue Products (the PL). In the 2025-26 Budget, the Government announced an increased funding to $13.381m to be provided to the AOA over 4 years to increase core operating funding.
Authority
The NJRR Rules 2026 are made under section 8 of the Act which provides that the Minister may, by legislative instrument, make Private Health Insurance (National Joint Replacement Register Levy) Rules providing for matters required or permitted by the Act to be provided, or necessary or convenient to be provided, in order to carry out or give effect to the Act.
Reliance on subsection 33(3) of the Acts Interpretation Act 1901
Subsection 33(3) of the Acts Interpretation Act 1901 provides that where an Act confers a power to make, grant or issue any instrument of a legislative or administrative character (including rules, regulations or by-laws), the power shall be construed as including a power exercisable in the like manner and subject to the like conditions (if any) to repeal, rescind, revoke, amend, or vary any such instrument.
Commencement
The NJRR Rules 2026 commence on 1 April 2026.
Consultation
Persons who are liable to pay the NJRR levy are aware that the levy is calculated annually, based on the funding requirements to administer the NJRR.
In January 2026, a draft of the National Joint Replacement Registry: Cost Recovery Implementation Statement (CRIS) for the period 1 July 2025 to 30 June 2029 was published on the Department of Health, Disability and Ageing (the Department) website to consult on proposed changes to the cost recovery arrangements for funding provided to administer the NJRR. One response was received, while feedback strongly supported the value of the AOANJRR, orthopaedic device sponsors maintain the view that a proportion of the costs should be recovered from private health insurers. No concerns were raised about the removal of the exception for hand and foot articulation devices.
A summary of consultation feedback and the departmental responses will be included in the final CRIS to be published on the Department’s website. The CRIS reflects the NJRR funding amount that is cost recovered through the levy, as detailed in the NJRR Rules 2026.
General
The NJRR Rules 2026 are a legislative instrument for the purposes of the Legislation Act 2003.
Details of the NJRR Rules 2026 are set out in Attachment A.
The NJRR Rules 2026 are compatible with the human rights and freedoms recognised or declared under section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011. A full statement of compatibility is set out in Attachment B.
ATTACHMENT A
Details of the Private Health Insurance (National Joint Replacement Register Levy) Rules 2026
Section 1 – Name
This section provides that the name of the instrument is the Private Health Insurance (National Joint Replacement Register Levy) Rules 2026.
Section 2 – Commencement
This section provides that the NJRR Rules 2026 commence on 1 April 2026.
Section 3 – Authority
This section provides that the NJRR Rules 2026 are made under the Private Health Insurance (National Joint Replacement Register Levy) Act 2009.
Section 4 – Schedules
This section provides that each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
Section 5 – Definitions
This section provides definitions for terms in the NJRR Rules 2026.
Section 6 – Levy day
The section specifies the levy day to be 30 November in each financial year for the purposes of the NJRR Rules 2026.
Section 7 – Rate of levy
This section provides the steps for calculating the NJRR levy, which no longer includes an exception for hand articulation medical device or a foot articulation medical device. It also provides the NJRR funding amounts for the next three financial years’ levy days.
Section 8 – Liability for payment of levy
This section details who is responsible for paying the NJRR levy.
Schedule 1 – Repeals
Schedule 1 repeals the whole of the Private Health Insurance (National Joint Replacement Register Levy) Rule 2015, as it is due to sunset on 1 April 2026.
ATTACHMENT B
Statement of Compatibility with Human Rights
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011
Private Health Insurance (National Joint Replacement Register Levy) Rules 2026
This Disallowable Legislative Instrument is 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.
Overview of the Disallowable Legislative Instrument
The Private Health Insurance (National Joint Replacement Register Levy) Rule 2026 (the NJRR Rules 2026) give effect to matters in the Private Health Insurance (National Joint Replacement Register Levy) Act 2009 (the Act), including those relating to the national joint replacement register levy (NJRR levy) day and the rate of the NJRR levy.
The purpose of the NJRR Rules 2026 is to revoke and replace the Private Health Insurance (National Joint Replacement Register Levy) Rules 2015, which is due to sunset on 1 April 2026.
Human rights implications
The NJRR Rules 2026 engage the following rights:
- the right to the enjoyment of the highest attainable standard of physical and mental health in Article 12(1) of the International Covenant on Economic Social and Cultural Rights (ICESCR).
NJRR levy
The ongoing collection of the NJRR levy facilitates the administration of the National Joint Replacement Registry (NJRR). The purpose of the NJRR is to define, improve and maintain health outcomes for individuals receiving joint replacement surgery. For the 2025-26 financial year, the costs of the data management of the NJRR are fully recovered and align with advice provided to industry through consultation and the relevant CRIS. By removing the exclusion of hand and foot articulation devices the levy now captures all orthopaedic devices used in joint replacement surgery.
Right to Health
This supports the right to the enjoyment of the highest attainable standard of physical and mental health contained in article 12(1) of the ICESCR. Whilst the UN Committee on Economic Social and Cultural Rights has stated that the right to health is not to be understood as a right to be healthy, it does entail a right to a system of health protection which provides equality of opportunity for people to enjoy the highest attainable level of health. In addition, the right to health must meet certain key requirements, including that health care must be scientifically and medically appropriate and of good quality.
Conclusion
The NJRR Rules 2026 are compatible with human rights as they further promote the realisation of relevant rights under Article 12 of the ICESCR, in particular the right to health.
The Hon Mark Butler MP
The Minister for Health and Ageing