Private Health Insurance (Transition) Rules 2007
I, ANTHONY JOHN ABBOTT, Minister for Health and Ageing, make these Rules under section 55 of the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007.
Dated 30 March 2007
 
TONY ABBOTT
____________________________________
 
Minister for Health and Ageing
 
 
 
 
 
 
 
 
Contents
 
 
1.           Name of Rules                                                                                        3
2.           Commencement                                                                                      3
3.           Definitions                                                                                               3
4.           Continued application of section 82ZVC of the National Health Act               3
5.           Interpretation of the Incentives Act from the commencement time to repeal   4
6.           Persons who are taken to be registered as participants under new Act         4
7.           Applications for a determination that a prosthesis is a gap prosthesis or a no gap prosthesis 4
8.           Continuing agreements and quality standards                                            5
9.           Continuing operation of contracts resulting in discounts                              5
 
 
 

1.                      Name of Rules
These Rules are the Private Health Insurance (Transition) Rules 2007.
2.                      Commencement
These Rules commence:
(a)                    if the Rules are registered before the Private Health Insurance Act 2007 commences―at the same time as that Act commences; or
(b)                   if the Rules are registered on or after the day on which the Private Health Insurance Act 2007 commences―on the date on which the Rules are registered,
whichever occurs first.
3.                      Definitions
Note:         Terms used in these Rules have the same meaning as in section 4 of the Transitional Provisions Act─see section 13 of the Legislative Instruments Act 2003.  These terms include:
             commencement time
new Act
complying health insurance policy
In these Rules:
complaints levy has the same meaning as in the Private Health Insurance Act 2007.
health care provider has the same meaning as in the Private Health Insurance Act 2007.
Incentives Act means the Private Health Insurance Incentives Act 1998.
insured person has the same meaning as in the Private Health Insurance Act 2007.
National Health Act means the National Health Act 1953.
private health insurer has the same meaning as in the Private Health Insurance Act 2007.
Transitional Provisions Act means the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007.
4.                      Continued application of section 82ZVC of the National Health Act
Despite the repeal of section 82ZVC of the National Health Act by the Transitional Provisions Act, the section continues to apply after the commencement time, to the exclusion of Part 6-6 of the new Act, in relation to an amount of complaints levy to which section 82ZVC applied immediately before the commencement time.
5.                      Interpretation of the Incentives Act from the commencement time to repeal
(1)        Despite the operation of item 2 of the table in subsection 6 (1) of the Transitional Provisions Act, for the Incentives Act to apply after 1 April 2007 to an insurance policy, whether the policy is issued before, on or after that date, and whether the policy is designated an appropriate private health insurance policy or a complying health insurance policy, the policy must satisfy the condition set out in the definition of 'appropriate private health insurance policy' in section 20-5 of the Incentives Act that the person, or each of the persons, covered by the policy is:
(a)                    an eligible person within the meaning of subsection 3 (1) of the Health Insurance Act 1973; or
(b)                   treated as an eligible person because of the operation of sections 6, 6A or 7 of that Act.
(2)        This rule ceases to operate on the day on which the Incentives Act is repealed.
6.                      Persons who are taken to be registered as participants under new Act
(1)        A person who is a 'participant in the premiums reduction scheme', within the meaning of that term in the Incentives Act, immediately before 1 July 2007, is taken to be, on and after 1 July 2007, a person who is registered as a participant in the premium reductions scheme under subsection 23-15 (3) of the new Act.
(2)        This rule ceases to apply to the person if the Medicare Australia CEO revokes the person's registration under section 23-35 of the new Act.
7.                      Applications for a determination that a prosthesis is a gap prosthesis or a no gap prosthesis
If:
(a)                    before the commencement time, an application was made to the Minister for a determination under subsections 73AAG (6) or (7) of the National Health Act that a prosthesis is a gap prosthesis or no gap prosthesis for the purposes of that Act; and
(b)                   as at the commencement time, the Minister had not decided the application,
the application is taken to be an application to the Minister under subsection 72-10 (2) of the new Act, but subsection 72‑10 (3) does not apply to the application.
Note:         Subsection 72-10 (3) of the new Act requires applications to be in the approved form and to be accompanied by the application fee imposed under the Private Health Insurance (Prostheses Application and Listing Fees) Act 2007.
8.                      Continuing agreements and quality standards
The repeal of provisions of the National Health Act that refer to hospital purchaser-provider agreements or any other arrangements between private health insurers and health care providers does not affect the operation of any such arrangements to the extent that they are not inconsistent with the new Act, and in particular does not affect the operation of provisions in such arrangements that require the health care provider to meet particular quality assurance standards, accreditation standards or professional standards in respect of the provision of treatment to insured persons.
9.                      Continuing operation of contracts resulting in discounts
If, immediately before the commencement of the new Act, a private health insurer is a party to a written contract, the effect of which results in a discount being available under an insurance policy of the insurer for a period, and the discount, or the total of that discount and any other discounts for the policy, would result in the policy not meeting the premium requirement specified in paragraph 66-1 (1) (c) of the new Act, the discount may continue to be provided as long as:
(a)                    the contract remains in force; and
(b)                   the discount resulting from the contract continues to meet requirements in and under the National Health Act, including the determination under section 73AAG (4) of the National Health Act, as in force immediately before the commencement of the new Act.
Note
1.       All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See www.frli.gov.au