Private Health Insurance (Prostheses Application and Listing Fee) Rules 2007 (No. 2)

Administered by Department of Health, Disability and Ageing

Legislation au F2007L02347 Rules Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

 

 

Issued by the Authority of the Minister for Health and Ageing

 

Private Health Insurance (Prostheses Application and Listing Fees) Act 2007

 

Private Health Insurance (Prostheses Application and Listing Fee) Rules 2007 (No.2)

 

Section 8 of the Private Health Insurance (Prostheses Application and Listing Fees) Act 2007 (the Act) provides that the Minister may make Private Health Insurance (Prostheses Application and Listing Fee) 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.

 

Sections 3 and 4 of the Act provide that the Private Health Insurance (Prostheses Application and Listing Fee) Rules may specify:

  • an application fee for applications made under section 72-10 of the Private Health Insurance Act 2007 (the PHI Act);
  • an initial listing fee for the purposes of subsection 72-10(5) of the PHI Act;
  • an ongoing listing fee for the purposes of section 72-15 of the PHI Act; and
  • ongoing listing fee imposition days.

 

These specified fees are imposed as taxes (see subsections 3(2), 4(2) and 4(4) of the Act).

 

The purpose of these taxes is to recover the cost from industry for the administration of the prostheses list arrangements and for the clinical assessment of products using expert advisory groups established to advise on products placed on the list.

 

The Act does not specify any conditions that need to be met before the power to make the Private Health Insurance (Prostheses Application and Listing Fee) Rules may be exercised.

 

The Private Health Insurance (Prostheses Application and Listing Fee) Rules 2007 (the Previous Rules) commenced on 1 April 2007.

 

The Private Health Insurance (Prostheses Application and Listing Fee) Rules 2007 (No. 2) (the Rules) revoke and replace the Previous Rules.

 

The Rules differ from the Previous Rules in that they specify an additional initial listing fee and an additional ongoing listing fee for specific circumstances.  These additional fees are fees of nil amount.  

 

These two new rules are minor and machinery in nature and as such, it was not considered necessary to engage in further consultation with the private health insurance industry in relation to the making of these Rules.

 

Draft versions of the Previous Rules were published on the Departmental website for comment, and information sessions were held to provide industry stakeholders with the opportunity to be consulted on the making of the Previous Rules.

 

Details of the Rules are set out in the Attachment.

 

These Rules are a legislative instrument for the purposes of the Legislative Instruments Act 2003. 

 

The Rules commenced on 14 July 2007.

 

 

Authority: Section 8 of the Private Health Insurance (Prostheses Application and Listing Fees) Act 2007

 

 

 

 


ATTACHMENT

 

DETAILS OF THE PRIVATE HEALTH INSURANCE (PROSTHESES APPLICATION AND LISTING FEE) RULES 2007 (No.2)
 

 

1. Name of Rules

 

Rule 1 provides that the title of the Rules is the Private Health Insurance (Prostheses Application and Listing Fee) Rules 2007 (No. 2).

 

2. Commencement

 

Rule 2 provides that the Rules commence on 14 July 2007.

 

This means that the Rules will have retrospective effect.

 

The Rules differ from the Previous Rules (the Private Health Insurance (Prostheses Application and Listing Fee) Rules 2007) in that they specify an additional initial listing fee (see rule 8) and an additional ongoing listing fee (see rule 9) for specific circumstances.  These additional fees are fees of nil amount. 

 

The paragraphs set out below concerning rules 8 and 9 explain why the retrospective operation of rules 8 and 9 will not infringe subsection 12(2) of the Legislative Instruments Act 2003.

 

3.  Revocation

 

Rule 3 provides that the Rules revoke the Private Health Insurance (Application and Listing Fee) Rules 2007.

 

4.  Definitions

 

Rule 4 provides a definition of human tissue prosthesis and clarifies that the Act means the Private Health Insurance (Prostheses Application and Listing Fee) Act 2007.

 

5. Application fees

 

Rule 5 specifies the application fee for an application made to the Minister under subsection 72-10(2) of the Private Health Insurance Act 2007.  The application fee for a human tissue prosthesis is nil, and for any other prosthesis is $400.

 

6. Initial listing fee

 

Rule 6 specifies the initial listing fee imposed if the Minister grants an application made under subsection 72-10(2) of the Private Health Insurance Act 2007.  The initial listing fee for a human tissue prosthesis is nil, and for any other prosthesis is $110.

 

7. Ongoing listing fee

 

Rule 7 specifies the ongoing listing fee for the purposes of section 72-15 of the Private Health Insurance Act 2007.  The ongoing listing fee for a human tissue prosthesis is nil, and for any other prosthesis is $110.

 

8. Transitioned applications

 

Rule 8 specifies an additional initial listing fee of nil amount.  This rule operates as an exception to rule 6.

 

Rule 8 provides that despite rule 6, if rule 7 of the Private Health Insurance (Transition) Rules 2007 applies to an application, the initial listing fee is, and is taken always to have been, nil.

 

Rule 7 of the Private Health Insurance (Transition) Rules 2007 (the Transition Rules) concerns the transitional arrangements for applications that were made prior to the commencement of the Private Health Insurance Act 2007 (1 April 2007) for a determination under subsections 73AAG(6) or (7) of the National Health Act 1953 that a prosthesis if a gap prosthesis or no gap prosthesis.

 

Rule 7 of the Transition Rules provides that if, as at 1 April 2007, such an application has not been decided, the application is taken to be an application to the Minister under subsection 72-10(2) of the Private Health Insurance Act 2007.

 

A fee of nil is permitted by subsection 5(4) of the Private Health Insurance (Prostheses Application and Listing Fees) Act 2007.

 

The fee of nil is being specified with retrospective effect.  However, this retrospectivity will not infringe subsection 12(2) of the Legislative Instruments Act 2003 because rule 8 is beneficial in nature, and will not affect the rights of a person (other than the Commonwealth) as at the date of registration of the Rules so as to disadvantage that person.  In addition, rule 8 does not impose any liabilities on any person (other than the Commonwealth) in respect of anything done or omitted to be done before the date of registration of the Rules.  The effect of rule 8 is to retrospectively reduce to nil the amount of the initial listing fee that might otherwise have been imposed on applicants to whom rule 7 of the Transition Rules applies.

 

9. First ongoing listing fee following grant of application

 

Rule 9 specifies an additional ongoing listing fee of nil amount.  This rule operates as an exception to rule 7.

 

Rule 9 provides that despite rule 7, the ongoing listing fee imposed on the “ongoing listing fee imposition day” immediately following the granting of an application made under subsection 72-10(2) is nil.

 

The fee of nil is being specified with retrospective effect.  However, this retrospectivity will not infringe subsection 12(2) of the Legislative Instruments Act 2003 because rule 9 is beneficial in nature, and will not affect the rights of a person (other than the Commonwealth) as at the date of registration of the Rules so as to disadvantage that person.  In addition, rule 9 does not impose any liabilities on any person (other than the Commonwealth) in respect of anything done or omitted to be done before the date of registration of the Rules.  The effect of rule 9 is to retrospectively reduce to nil the amount of the first ongoing listing fee that might otherwise have been imposed on applicants to whom section 72-15 of the Private Health Insurance Act 2007 applies, following the grant of their application.

 

10. Ongoing listing fee imposition day

 

Rule 10 specifies 15 January and 15 July as “ongoing listing fee imposition days”.

 

The ongoing listing fee is imposed as a tax on each day specified in the Rules as an ongoing listing fee day.  Accordingly, ongoing listing fees are imposed on 15 January and 15 July each year.  Subsection 72-15(2) of the Private Health Insurance Act 2007 provides that the ongoing listing fee must be paid within 28 days of each ongoing listing fee imposition day.

 

Overview

The Private Health Insurance (Prostheses Application and Listing Fees) Act 2007, enacted by the Parliament of Australia, was introduced to address the need for a regulatory framework governing fees associated with the application and listing of prostheses in private health insurance. This legislation was necessary to establish a formal process for the imposition of fees related to the assessment and listing of prosthetic devices, thereby ensuring the efficient administration of these processes within the private health insurance sector. The policy objective of the Act is to provide a mechanism for recovering costs from industry for the administration of prostheses list arrangements and the clinical assessment of products, utilising expert advisory groups. The Act empowers the Minister for Health and Ageing to make rules specifying application fees, initial listing fees, ongoing listing fees, and the days on which ongoing listing fees are imposed. These fees serve as taxes, designed to fund the administrative and assessment activities related to prostheses in private health insurance.

Scope and Application

The Private Health Insurance (Prostheses Application and Listing Fees) Act 2007, along with the subsequent Private Health Insurance (Prostheses Application and Listing Fee) Rules 2007 (No. 2), applies to entities and individuals involved in the private health insurance sector in Australia, particularly those submitting applications for the listing of prostheses under the Private Health Insurance Act 2007. The Act and its associated rules are designed to establish a framework for setting and imposing fees related to the application and listing of prostheses for private health insurance purposes. These fees serve to recover costs associated with the administration of the prostheses list arrangements and the clinical assessment of prostheses products. The geographic scope of the Act is national, as it is a Commonwealth Act, thereby applying across all states and territories within Australia. The Act includes provisions that allow the Minister for Health and Ageing to specify application and listing fees through subordinate legislation, which the 2007 Rules do by detailing the fees for various types of prostheses and the days on which ongoing listing fees are imposed. The Rules also include transitional provisions to manage the retrospective application of certain fees, ensuring that these changes do not disadvantage individuals who submitted applications prior to the Act's commencement. The Act and Rules do not specify exclusions or exemptions beyond what is outlined in the Rules, and any additional minor and machinery changes are made through the Rules without further consultation, as deemed necessary by the Department.

Key Provisions

The Private Health Insurance (Prostheses Application and Listing Fee) Rules 2007 (No. 2) (the "Rules") establish the fees for applications and ongoing listings for prostheses under the Private Health Insurance (Prostheses Application and Listing Fees) Act 2007 (the "Act"). These fees are imposed as taxes to recover costs associated with the administration of prostheses lists and the clinical assessment of prostheses products. The Rules, which came into effect on 14 July 2007, revoke and replace the previous rules and introduce additional fees for specific circumstances, albeit these fees are set at nil amount. Under section 3 of the Act, the Rules specify application fees for submissions made under section 72-10 of the Private Health Insurance Act 2007. Rule 5 sets the application fee for a human tissue prosthesis at nil and for any other prosthesis at $400. Similarly, the Rules, as per section 4, specify initial and ongoing listing fees under subsections 72-10(5) and section 72-15 of the PHI Act, respectively. Rule 6 specifies the initial listing fee at nil for a human tissue prosthesis and $110 for any other prosthesis, while rule 7 specifies the ongoing listing fee at nil for a human tissue prosthesis and $110 for any other prosthesis. Furthermore, rule 10 designates 15 January and 15 July each year as the "ongoing listing fee imposition days," on which the ongoing listing fees must be paid within 28 days. The Rules impose obligations on private health insurers and other relevant parties to pay the specified fees for applications and ongoing listings of prostheses. The fees must be paid within the stipulated timeframes, and failure to do so may result in non-compliance with the Act. Additionally, the Rules provide for exceptions to the fees under specific circumstances, such as transitioned applications, as outlined in rules 8 and 9. Breach of the Rules may lead to civil or criminal consequences, depending on the nature and severity of the offence. However, the Explanatory Statement does not specify any particular offences, penalties, or consequences for breach of the Rules. It is essential for the parties and entities governed by the Act to adhere to the obligations and requirements set out in the Rules to avoid any potential repercussions.

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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.