Financial Sector (Collection of Data) (reporting standard) determination No. 34 of 2015
Reporting Standard HRS 604.0 Medical Specialty Block Grouping Information
Financial Sector (Collection of Data) Act 2001
 
I, Ian Laughlin, delegate of APRA, under paragraph 13(1)(a) of the Financial Sector (Collection of Data) Act 2001 (the Act) DETERMINE Reporting Standard HRS 604.0 Medical Specialty Block Grouping Information, in the form set out in the Schedule, which applies to the financial sector entities to the extent provided in paragraph 3 of the reporting standard.
 
Under section 15 of the Act, I DECLARE that the reporting standard shall begin to apply to those financial sector entities on the day that the Private Health Insurance (Prudential Supervision) Act 2015 commences.
 
This instrument commences on the day that the Private Health Insurance (Prudential Supervision) Act 2015 commences.
 
Dated: 26 June 2015
 
[Signed]
Ian Laughlin
Deputy Chairman
Interpretation
In this Determination:
APRA means the Australian Prudential Regulation Authority.
financial sector entity has the meaning given by section 5 of the Act.
Schedule
 
Reporting Standard HRS 604.0 Medical Specialty Block Grouping Information comprises the 5 pages commencing on the following page.

 
Reporting Standard HRS 604.0
Medical Specialty Block Grouping Information
Objective of this Reporting Standard
This Reporting Standard sets out the requirements for the provision of information to APRA allowing for the publication of aggregate statistics on medical services by State and Territory.  
It includes Form HRF 604.0 Medical Specialty Block Grouping Information and associated specific instructions.
 
Authority
1.             This Reporting Standard is made under section 13 of the Financial Sector (Collection of Data) Act 2001.
Purpose
2.             Information collected under this Reporting Standard, as set out in Form HRF 604.0 Medical Specialty Block Grouping Information (HRF 604.0), is used for the purposes of assisting the Department of Health in performing its functions and for publication by APRA.
Application and commencement
3.             This Reporting Standard applies to all private health insurers.
4.             This Reporting Standard applies for reporting periods ending on or after 1 July 2015.
Information required
5.             A private health insurer must provide APRA with the information required by HRF 604.0in respect of each reporting period.
6.             The information required by this Reporting Standard, as set out in HRF 604.0, must be provided for each health benefits fund of the private health insurer.
Forms and method of submission
7.             The information required by this Reporting Standard must be lodged as electronic data via the PHIAC Extranet, or an alternate method notified by APRA and a method notified by APRA, in writing, prior to submission.
Reporting periods and due dates
8.             A private health insurer to which this Reporting Standard applies must provide the information required by this Reporting Standard in respect of each calendar quarter (i.e. the periods ending 30 September, 31 December, 31 March and 30 June).
9.             The information required by this Reporting Standard must be provided to APRA within 28 calendar days after the end of the reporting period to which the information relates.[1]
10.         APRA may, in writing, grant a private health insurer an extension of a due date, in which case the new due date for the provision of the information will be the date on the notice of extension.
Quality control
11.         All information provided by a private health insurer under this Reporting Standard must be subject to systems, processes and controls developed by the private health insurer for the internal review and authorisation of that information. It is the responsibility of the Board and senior management of the private health insurer to ensure that an appropriate set of policies and procedures for the authorisation of information submitted to APRA is in place.
Authorisation
12.         A person who submits the information required under this Reporting Standard must be suitably authorised by an officer of the private health insurer.
Variations
13.         APRA may, in writing, vary the reporting requirements of this Reporting Standard in relation to a private health insurer.
Transitional
14.         Any approval, determination or other exercise of discretion, made prior to the commencement of this reporting standard by PHIAC in relation to the PHIAC 4 return, will continue to have effect after the commencement of this reporting standard, as if made under this reporting standard, until revoked by APRA. 
15.         Information that would have been required to be submitted to PHIAC on the PHIAC 4 return in respect of the quarter ending 30 June 2015 must instead be submitted to APRA as though it was required under this Reporting Standard. 
16.         Information that had previously been required to be submitted to PHIAC on the PHIAC 4 return relating to a period ending before 30 June 2015, but which had not been submitted to PHIAC by the end of 30 June 2015, must be submitted to APRA.
17.         If, at the end of 30 June 2015, a private health insurer was under an obligation to submit an amended quarterly return to replace a quarterly return that the private health insurer submitted to PHIAC prior to 1 July 2015, the private health insurer must submit the amended quarterly return to APRA as soon as practicable.
18.         If APRA, acting reasonably, is satisfied that information submitted by a private health insurer to PHIAC on the PHIAC 4 return prior to 1 July 2015 is inaccurate, APRA may, by notifying the private health insurer in writing of the basis of APRA’s concern, require resubmission of that information in a way that corrects the inaccuracy.
Interpretation
19.         In this Reporting Standard:
(a)           unless the contrary intention appears, words and expressions have the meanings given to them in Prudential Standard HPS 001 Definitions (HPS 001); and
(b)          APRA means the Australian Prudential Regulation Authority established under the Australian Prudential Regulation Authority Act 1998;
officer has the meaning in the Private Health Insurance (Prudential Supervision) Act 2015;
PHIAC means the Private Health Insurance Administration Council continued in existence under subsection 264-1(1) of the Private Health Insurance Act 2007, as it existed immediately prior to the commencement of the Private Health Insurance (Prudential Supervision) Act 2015; and
PHIAC 4 return means the form titled PHIAC 4 return issued under sections 264-10(2), 264-20 and 172-1 of the Private Health Insurance Act 2007, as it existed immediately prior to the commencement of the Private Health Insurance (Prudential Supervision) Act 2015;
PHIAC Extranet is an environment (based on SharePoint) for secure (user ID and password required) sharing of documents, accessible via the internet;
private health insurer has the meaning in the Private Health Insurance (Prudential Supervision) Act 2015; and
 
reporting period means a period mentioned in paragraph 8.
 

 
 

[1]           For the avoidance of doubt, if the due date for a particular reporting period falls on a day other than a usual business day, a private health insurer is nonetheless required to submit the information required no later than the due date.