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Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (No. 2)

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Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (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
19 June 2014
 
 

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 2014 (No. 2).
 
2.               Commencement
 
These Rules commence on 1 July 2014, or if registered after 1 July 2014, the day after registration.
 
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Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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, 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
$405

- over 14 days
$281

Surgical patient or obstetric patient
 

- first 14 days
$376

- over 14 days
$281

Psychiatric patient
 

- first 42 days
$376

- 43 – 65 days
$326

- over 65 days
$281

Rehabilitation patient
 

- first 49 days
$376

- 50 - 65 days
$326

- over 65 days
$281

Other patients
 

- first 14 days
$326

- over 14 days
$281

 
 
2         Schedule 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
$405

- over 14 days
$281

Surgical patient or obstetric patient
 

- first 14 days
$376

- over 14 days
$281

Psychiatric patient
 

- first 42 days
$376

- 43 – 65 days
$326

- over 65 days
$281

Rehabilitation patient
 

- first 49 days
$376

- 50 - 65 days
$326

- over 65 days
$281

Other patients
 

- first 14 days
$326

- over 14 days
$281

 
3         Schedule 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
$405

- over 14 days
$281

Surgical patient or obstetric patient
 

- first 14 days
$376

- over 14 days
$281

Psychiatric patient
 

- first 42 days
$376

- 43 – 65 days
$326

- over 65 days
$281

Rehabilitation patient
 

- first 49 days
$376

- 50 - 65 days
$326

- over 65 days
$281

Other patients
 

- first 14 days
$326

- over 14 days
$281

 
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
$335

NSW
$335

Northern Territory
$335

Queensland
$341

South Australia
$335

Western Australia
$335

 
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
$243
$271
$298
$335

ACT
$243
$271
$298
$335

Northern Territory
$243
$277
$322
$335

Queensland
$248
$278
$306
$341

South Australia
$243
$277
$306
$335

Tasmania
$236
$280
$325
$376

Victoria
$238
$281
$327
$376

Western Australia
$275
$275
$275
$275

 
 
 
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
$210
$264
$322
$376

 
Schedule B ― Amendments
Private Health Insurance (Benefit Requirements) Rules 2011
1      Schedule 4, Clause 6 Minimum benefit, Table 1:
 
 
Delete:
             South Australia                            $111.00
 
Insert:
             South Australia                            $114.00
 
Delete:
             Western Australia                        $125.45
 
Insert:
             Western Australia                        $133.20
Schedule C ― Amendments
Private Health Insurance (Benefit Requirements) Rules 2011
1         Schedule 1, Part 2 Type A procedures, Clause 4 Advanced surgical patient, subclause (3)
 
After “38272” insert “38273  38274”
 
             After “42656” delete “42659”
 
             After “42734” delete “42737”
 
2         Schedule 1, Part 2 Type A procedures, Clause 6 Surgical patient, subclause (3)
 
After “31515” delete “31518  31521  31527”
 
After “31515” insert “31519  31525”
 
3         Schedule 3, Part 3 Type C procedures, Clause 8 Interpretation, Category 3 Therapeutic Procedures, T8
 
After “42794” delete “42797”
 
4         Schedule 3, Part 3 Type C procedures, Clause 8 Interpretation, Category 5 Diagnostic Imaging Services, I1
 
             After “55039” delete “55044  55045”
 
             After “55054” insert “55065  55067  55068  55069”
 
             After “55729” delete “55731  55733”
 
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 2014 (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