EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health
Private Health Insurance Act 2007
Private Health Insurance (Registration) Amendment Rules 2013
Authority
Section 333-20 of the Private Health Insurance Act 2007 (the Act) provides that the Minister may make Private Health Insurance (Registration) Rules providing for matters required or permitted by Part 4-3 of the Act, or necessary or convenient in order to carry out or give effect to Part 4-3 of the Act.
The Private Health Insurance (Registration) Amendment Rules 2013 (the Amendment Rules) amend the Private Health Insurance (Registration) Rules 2009 (No.2) (the Principal Rules), which commenced on 22 July 2009.
Purpose
The purpose of the Amendment Rules is to expand The Doctors’ Health Fund Limited (DHF) restricted access group as described in the Schedule to the Principal Rules.
DHF has requested that its restricted access group be extended to also include people who are employees of associations of health practitioners. For example, this amendment will allow employees of optometrist, dental and physiotherapist associations to join DHF.
The impact of this amendment is not significant as it is estimated that this class of employees is no more than 300 people.
Background
DHF, as a restricted access insurer and in accordance with subsection 126-20(6) of the Act, may only make available complying health insurance products to people who belong to a particular group as defined in subsection 126-20(7) of the Act. Restricted access insurers and groups are listed in the Schedule to the Principal Rules. The current restricted access group for DHF includes the following:
- a person who is, or was, a medical practitioner;
- a person who is, or was at any time, a health practitioner;
- a person studying to be a health practitioner;
- A health practitioner includes the following categories:
- medical;
- medical radiation;
- optometry;
- dental;
- occupational therapy;
- physiotherapy; and
- psychology,
- an employee of the Medical Practitioner or a Health Practitioner or an officer or employee of an incorporated practice of a Medical Practitioner or a Health Practitioner;
- an overseas trained doctor enrolled through the Australian Medical Council to sit for the examinations of that Council or of one of the specialist colleges affiliated with the Council;
- an officer or employee of the federal, or a state, Australian Medical Association;
- an officer or employee of an associated or subsidiary organisation of the federal, or a state, Australian Medical Association;
- an officer or employee of any federal or state association of registered medical practitioners; or
- an officer or employee (including contractors) of Avant Insurance Limited (ABN 82 003 707 471) or Avant Law Pty Limited (ACN 136 429 153).
Consultation
The Department of Health and Ageing consulted DHF in November and December 2012 regarding the Amendments and are comfortable they will not significantly affect existing arrangements. The Private Health Insurance Administration Council was consulted regarding this Amendment. The PHIAC advised they are comfortable with the Amendment.
The Office of Best Practice Regulation (OBPR) was also consulted. OBPR advised that a Regulation Impact Statement was not required because the amendment is minor.
The Amendment Rules commence on the day after registration on the Federal Register of Legislative Instruments.
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
PRIVATE HEALTH INSURANCE BRANCH
DEPARTMENT OF HEALTH AND AGEING
JANUARY 2013
Overview
The Private Health Insurance (Registration) Amendment Rules 2013 were introduced to address a gap in the restricted access group for The Doctors’ Health Fund Limited (DHF). Enacted under the authority of the Minister for Health, these rules amend the Private Health Insurance (Registration) Rules 2009 to expand DHF’s restricted access group to include employees of associations of health practitioners, such as optometrist, dental, and physiotherapist associations. This amendment ensures that these employees can also join DHF, thereby aligning the fund’s membership with broader health sector employees. The impact of this amendment is deemed minor, affecting an estimated 300 individuals. The changes were introduced following consultations with DHF, the Private Health Insurance Administration Council, and the Office of Best Practice Regulation, all of whom indicated their support for the amendment due to its minimal effect on existing arrangements.
Scope and Application
The Private Health Insurance (Registration) Amendment Rules 2013 pertains to the regulation of private health insurance in Australia, specifically amending the existing rules under the Private Health Insurance Act 2007. These rules apply to The Doctors' Health Fund Limited (DHF), a restricted access insurer, and its restricted access group. The amendment extends DHF's restricted access group to include employees of associations of health practitioners, such as optometrists, dentists, and physiotherapists, thereby expanding the eligibility criteria for membership. The rules are intended to have a minimal impact, affecting no more than 300 people. The jurisdictional reach of these rules is national, operating under the authority granted by Section 333-20 of the Private Health Insurance Act 2007. There are no stated exclusions, exemptions, or thresholds specified in the Amendment Rules themselves, though they operate within the broader framework of the Act. The Amendment Rules, upon registration on the Federal Register of Legislative Instruments, will amend the Private Health Insurance (Registration) Rules 2009, thereby extending the scope of DHF's operations as authorised by the Act.
Key Provisions
The Private Health Insurance (Registration) Amendment Rules 2013 (Amendment Rules) amend the Private Health Insurance (Registration) Rules 2009 (No.2) (Principal Rules) to expand the restricted access group of The Doctors’ Health Fund Limited (DHF) as outlined in the Schedule to the Principal Rules (Section 333-20). The primary purpose of these amendments is to include employees of associations of health practitioners in the DHF restricted access group, allowing them to join DHF. This change specifically targets employees of optometrist, dental, and physiotherapist associations. The impact of this amendment is deemed minor as it is estimated to affect no more than 300 people.
DHF, a restricted access insurer, can only offer complying health insurance products to people belonging to a particular group as defined in subsection 126-20(7) of the Act. The current restricted access group for DHF includes various categories such as medical practitioners, health practitioners, students studying to be health practitioners, and employees of medical or health practitioner practices. Additionally, the group encompasses employees of various medical associations and other specified entities. The Amendment Rules seek to expand this group by including employees of associations of health practitioners.
The obligations imposed by the Amendment Rules on DHF and its members involve ensuring that the expanded group of eligible members is correctly identified and managed. DHF must verify that individuals joining the fund meet the criteria set out in the amended rules. This includes verifying employment status and association membership. Additionally, DHF must update its membership records and ensure compliance with the amended rules when offering health insurance products.
The Amendment Rules do not explicitly outline specific offences or penalties for breaches. However, failure to comply with the Private Health Insurance Act 2007 or the amended rules could result in enforcement actions by the relevant authorities. Such actions might include administrative penalties, corrective orders, or other regulatory measures to ensure compliance. The specific consequences for non-compliance would depend on the nature and severity of the breach.