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Private Health Insurance (Benefit Requirements) Amendment Rules 2015 (No. 2)

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Private Health Insurance (Benefit Requirements) Amendment Rules 2015 (No. 2) 1
 
I, SHANE PORTER, delegate of the Minister for Health, make these Rules under item 3A of the table in section 333-20 of the Private Health Insurance Act 2007.
 
 
 
 
 
 
 
____________________________________
 
Shane Porter
Assistant Secretary
Private Health Insurance Branch
Medical Benefits Division
Department of Health
21 June 2015
 
 

Contents
 
 
PART 1            PRELIMINARY   3
 
1           Name of Rules  3
2.          Commencement 3
3.          Authority  3
4.          Schedule                                                                                                3
 
 
Schedule A – Amendments  4
Schedule B – Amendments  9
Schedule C – Amendments  10
Schedule D – Amendments  11
 
Part 1        Preliminary
 
1.               Name of Rules
 
These Rules are the Private Health Insurance (Benefit Requirements) Amendment Rules 2015 (No. 2).
 
2.               Commencement
 
These Rules commence on 1 July 2015.
 
3.               Authority
 
These Rules are made under item 3A of the table in section 333-20 of the Private Health Insurance Act 2007.
 
4.               Schedule
 
Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms. 
 
 
Schedule A – Amendments
 
Private Health Insurance (Benefit Requirements) Rules 2011
 
1         Schedule 1, Part 1, Subclause 2 Minimum benefit, Table 1
 
Delete:
 
             Schedule 1, Subclause 2 Minimum benefits, Table 1 –   Accommodation at private hospitals in all States/Territories
 
Insert:
Table 1―Accommodation at private hospitals in all States/Territories
Class of patient
Minimum benefit payable per night

Advanced surgical patient
 

- first 14 days
$410

- over 14 days
$285

Surgical patient or obstetric patient
 

- first 14 days
$381

- over 14 days
$285

Psychiatric patient
 

- first 42 days
$381

- 43 – 65 days
$330

- over 65 days
$285

Rehabilitation patient
 

- first 49 days
$381

- 50 - 65 days
$330

- over 65 days
$285

Other patients
 

- first 14 days
$330

- over 14 days
$285

 
 
2         Schedule 1, Part 1, Subclause 2 Minimum benefit, Table 2
 
Delete:
 
             Schedule 1, Subclause 2 Minimum benefit, Table 2 - Victoria:  shared ward accommodation at a public hospital
 
Insert:
 
Table 2― Victoria:  shared ward accommodation at a public hospital
Class of patient
Minimum benefit payable per night

Advanced surgical patient
 

- first 14 days
$410

- over 14 days
$285

Surgical patient or obstetric patient
 

- first 14 days
$381

- over 14 days
$285

Psychiatric patient
 

- first 42 days
$381

- 43 – 65 days
$330

- over 65 days
$285

Rehabilitation patient
 

- first 49 days
$381

- 50 - 65 days
$330

- over 65 days
$285

Other patients
 

- first 14 days
$330

- over 14 days
$285

 
3         Schedule 1, Part 1, Subclause 2 Minimum benefit, Table 3
 
Delete:
 
             Schedule 1, Subclause 2 Minimum benefit, Table 3 - Tasmania:  shared ward accommodation at a public hospital
 
Insert:
 
Table 3― Tasmania:  shared ward accommodation at a public hospital
Class of patient
Minimum benefit payable per night

Advanced surgical patient
 

- first 14 days
$410

- over 14 days
$285

Surgical patient or obstetric patient
 

- first 14 days
$381

- over 14 days
$285

Psychiatric patient
 

- first 42 days
$381

- 43 – 65 days
$330

- over 65 days
$285

Rehabilitation patient
 

- first 49 days
$381

- 50 - 65 days
$330

- over 65 days
$285

Other patients
 

- first 14 days
$330

- over 14 days
$285

 
4         Schedule 2, Clause 2 Minimum benefit, Table
 
Delete:
                           Schedule 2, Clause 2 Minimum benefit, Table      
 
             Insert:
 
Table
 
State/Territory
Minimum benefit payable per night

ACT
$339

NSW
$339

Northern Territory
$339

Queensland
$346

South Australia
$339

Western Australia
$339

 
5         Schedule 3, Part 1, Subclause 2 Minimum benefit, Table 1:
 
Delete:
 
Schedule 3, Part 1, Subclause 2 Minimum benefit, Table 1
            
Insert:  
Table 1
Public hospitals
Band 1
Band 2
Band 3
Band 4

 
 
 
 
 

NSW
$246
$275
$302
$339

ACT
$246
$275
$302
$339

Northern Territory
$246
$281
$326
$339

Queensland
$251
$282
$310
$346

South Australia
$246
$281
$310
$339

Tasmania
$239
$284
$329
$381

Victoria
$241
$285
$331
$381

Western Australia
$279
$279
$279
$279

 
 
 
6         Schedule 3, Part 1, Subclause 2 Minimum benefit, Table 2:
 
Delete:
Schedule 3, Part 1, Subclause 2 Minimum benefit, Table 2
            
Insert:  
Table 2
 
Band 1
Band 2
Band 3
Band 4

Private Hospitals
$213
$267
$326
$381

 
Schedule B ― Amendments
Private Health Insurance (Benefit Requirements) Rules 2011
1      Schedule 4, Clause 6 Minimum benefit, Table 1:
 
 
Delete:
             South Australia                            $114.00
 
Insert:
             South Australia                            $115.00
 
Delete:
             ACT                                             $111.20
            
Insert:
             ACT                                             $117.65
 
Delete:
             Western Australia                        $133.20
 
Insert:
             Western Australia                        $138.10
Schedule C ― Amendments
Private Health Insurance (Benefit Requirements) Rules 2011
 
1         Schedule 3, Part 3 Type C procedures, Clause 8 Interpretation, Category 3 Therapeutic Procedures, T11
 
After “18351” delete “18352” and insert “18353”
 
After “18362” delete “18364” and insert “18365”
 
After “18368” insert “18369”
 
After “18370” delete “18371”
 
After “18372” delete “18373” and insert “18374”
 
 
 
Schedule D ― Amendments
Private Health Insurance (Benefit Requirements) Rules 2011
 
1           Schedule 5, Clause 4 Facilities, subclause (1)
 
Substitute
 
A hospital is a facility for the purposes of this Schedule if it is included in the list of second-tier eligible facilities approved by the Second Tier Advisory Committee existing at the time that the Private Health Insurance (Benefit Requirements) Amendment Rules 2015 (No. 2) commence.  
Notes
1.       All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See www.comlaw.gov.au