EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health
Private Health Insurance Act 2007
Private Health Insurance (Prostheses) Amendment Rules 2012 (No.2)
Authority
Section 333-20 of the Private Health Insurance Act 2007 (the Act) provides that the Minister may make Private Health Insurance (Prostheses) Rules, providing for matters required or permitted by Part 3-3 of the Act, or necessary or convenient in order to carry out or give effect to Part 3-3 of the Act.
Purpose
The purpose of this legislative instrument is to amend Part A of the Schedule to the Private Health Insurance (Prostheses) Rules 2012 (No. 1) (Principal Rules) by changing the Minimum Benefit for the billing code DE370 which refers to Cannulated titanium Low Profile Screws sponsored by Device Technologies Australia Pty Ltd. This change was inadvertently not made when the Principal Rules were drafted. DE370 should have had a minimum benefit specified of $231.00 in the Principal Rules rather than the previous benefit of $91.00
Background
Item 4 of the table in subsection 72-1(2) of Part 3-3 of the Act provides for requirements that a complying health insurance policy that covers hospital treatment must meet. There must be a benefit for the provision of a prosthesis, of a kind listed in the Private Health Insurance (Prostheses) Rules (i.e. a listed prosthesis), in specified circumstances and under any specified conditions. The specified circumstances are that the listed prosthesis is provided in circumstances in which a Medicare benefit is payable or those other circumstances which are set out in the Private Health Insurance (Prostheses) Rules.
If the complying health insurance policy also covers hospital-substitute treatment, the same requirements apply.
The Principal Rules commenced on 3 March 2012.
The Schedule to the Principal Rules has three parts:
- Part A – Prostheses; and
- Part B – Human Tissue List;
- Part C – Other Prostheses.
Consultation
In accordance with section 17 of the Legislative Instruments Act 2003, the amendment rules have been made having regard to recommendations made by the Prostheses List Advisory Committee (PLAC), which is a ministerially appointed committee comprised of nominees from health insurers, hospitals, clinicians, prostheses sponsors and consumer representatives. In making its recommendations, the PLAC was advised by Clinical Advisory Groups, other clinical experts, and the Health Technology Assessment Review Consultative Committee.
Details
This legislative instrument commences on 7 May 2012.
These 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
Statement of Compatibility with Human Rights
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011
Private Health Insurance (Prostheses) Amendment Rules 2012 (No. 2)
This Bill/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 Bill/Legislative Instrument
The Private Health Insurance (Prostheses) Amendment Rules 2012 (No. 2) amend Part A of the Schedule to the Private Health Insurance (Prostheses) Rules 2012 (No. 1) to correct an error in the listing of the Minimum Benefit for billing code DE370. DE370 should have had a minimum benefit specified of $231.00 in the Principal Rules rather than the previous benefit of $91.00.
Human rights implications
This Legislative Instrument does not engage any of the applicable rights or freedoms.
Conclusion
This Legislative Instrument is compatible with human rights as it does not raise any human rights issues.
Richard Magor
Assistant Secretary