Better health and ageing for all Australians

Private health insurance circulars

PHI 67/07

This circular issued by the Private Health Insurance Branch contains information for the Private Health Industry regarding changes to the Private Health Insurance (Benefit Requirements) Rules 2007

In this section:

Printable version of PHI 67/07 (PDF 24 KB)

1 November 2007

Private Health Insurance (Benefit Requirements) Rules 2007 (No.4)

With the release of the 1 November 2007 Medicare Benefits Schedule (MBS), the Private Health Insurance (Benefit Requirements) Rules 2007 (No.3) have been revoked and remade with the Private Health Insurance (Benefit Requirements) Rules 2007 (No.4) (the Rules). Adjustments have been made to Schedules 1, 2 and 3 of the Rules.

The Rules have been registered on the Federal Register of Legislative Instruments (FRLI) and take effect 1 November 2007. The Rules are available on the internet at:

http://www.comlaw.gov.au/ComLaw/Legislation/LegislativeInstrument1.nsf/all/whatsnew/DDFBE2C0357DC60BCA2573830083661A?OpenDocument

A hard copy of the Rules made under item 3A of the table in section 333-20 of the Private Health Insurance Act 2007 is attached. Please refer to the 1 November 2007 MBS for the full description details.

Changes to Schedule 1 – Overnight accommodation: private hospitals in all States/Territories and shared ward accommodation at public hospitals in Victoria and Tasmania


For the purposes of Schedule 1, an advanced surgical patient is specified in sub-section 4(3) of Part 2, and the item numbers are derived from the MBS and apply to those MBS items specified with a MBS fee that is greater than $770.29.
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A surgical patient is specified in sub-section 6(3) of Schedule 1 and the item numbers are derived from the MBS and apply to MBS item numbers specified that have a MBS fee within the range of $229.37 to $753.71.

Amendments to the Advanced Surgical List

Please refer to the 1 November 2007 MBS for full description details.

New Items

45897

Amendments to the Surgical List

Please refer to the 1 November 2007 MBS for full description details.

New Items

458854588845891459034590645912
459154591845921459244593945984
459874599045993

Changes to Schedule 2 – Overnight Accommodation: shared ward accommodation at public hospitals in the ACT, NSW, Northern Territory, Queensland, South Australia and Western Australia

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As in previous years the Australian Government has set the minimum benefits for hospital treatment in hospitals. These accommodation components are subject to annual review and are amended with reference to the Consumer Price Index (CPI) movements from March to March each year. In the year March 2006 to March 2007 there was an increase of 2.4% in the CPI. These Rules reflect the increase in the Northern Territory minimum benefit payable per night. Increases to the other States and Territories occurred on 1 July 2007.

State/Territory

Minimum benefit payable per night

Northern Territory
$275

Changes to Schedule 3 – Same-day accommodation: hospitals in all States/Territories

Public hospitals

Band 1

Band 2

Band 3

Band 4

Northern Territory
$200
$227
$264
$275

Amendments to Type C (Exclusion) List:

Please refer to the 1 November 2007 MBS for full description details.

New Items

132133141143145147
35936145882650796508265109
651106515765158651666518065181
665176660666609666396664266651
666526666366666666966669766714
667156672366724667566675766780
667836678966790667926680466805
668166681766820668216682666827
668306931669317693196932569328
693316937969383694006940169419
694516948269483694894949269497
694986950071076710907109271096
711487115471156711697117071180
711837118671189711927119571198
712007120372838733097331273315
733187332173323739237392573927
739297393173933739357393773939
850118501285013850228502585031
850378503985047850518507185111
851138511485115851178512185123
851318514185161851658517185213
852218522285225852318523285233
852348523885241852458531185314
853168532285323853248532685331
853378533885341853778537885381
853848538685387853918539285411
854128541485415854168541785418
854198543185432854338543485436
854378543885445854518545285453
854558545785458855118551285513
855148551585521855228552385524
855258553185532855338553485535
855418554285543855448554585551
855528555385554855558557285574
855758557685577855788559585596
855978561385615856188562585627
856298563185632856428564385644
856458564985651856528565385655
856568565885659856618566985671
856728567385711857128571685719
857218572285727857288573185732
857338573585736857378573885739
857418574385744857458574685751
857528575385761857628576385764
857658576785768857698577185772
857738577685777858118582185823
858298583185911859268592785949
859638596485965859668596885971
859728598185986860128601386014
860158602286025860318603586036
860378603886039860478605186071
860828611186113861148611586117
861218612386131861418616186165
861718621386221862228622586231
862328623386234862358623686237
862388624186245863118631486316
863228632386324863268633186332
863378633886341863438634486345
863718637386375863768637786378
863798638186382863848638586386
863878638886389863918639286393
863948639586411864128641486415
864168641786418864198643186432
864338643486436864378643886445
864518645286453864558645786458
865118651286513865148651586521
865228652386524865258653186532
865338653486535865418654286543
865448654586551865528655386554
865558657286574865758657686577
865788659586596865978661386615
866188662586627866298663186632
866428664386644866458664986651
866528665386655866568665886659
866618666386664866668666986671
866728667386679866848668886691
867118671286716867198672186722
867278672886731867328673386735
867368673786738867398674186743
867448674586746867518675286753
867618676286763867648676586767
867688676986771867728677386776
867778681186821868238682986831
868628691186926869278694986963
869648696586966869688697186972
869818698687011870148707187711
877128771687719877218772287727
877288773187732877338773687737
877388773987741877438774487745
877468775187752877538776187762
877638776487765877678776887769
877718777687777

Item Number Changes

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Old
New
Old
New
Old
New
651326517565133651766513465177
651356517865136651796666966819
666706682266672668256667366828
694866941869442694886944369491
693646949469365694956936769496
694446949971109711657111371166
711157116771117711687390173922
739037392473905739267390773928
739097393073910739327391273934
739137393673915739387392173940

Deleted Item Numbers

257425752577257827042705
2707270842875428784288142884
428874299042991429934299642999
430004300243005430084301143014
430175654956551667136673766809
6681869402
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If you require further information please telephone: (02) 6289 9853/24 hr answering machine or email the enquiry to PrivateHealth@health.gov.au
Internet: http://www.health.gov.au/internet/main/publishing.nsf/Content/health-privatehealth-providers-circulars.htm
Changing your e-mail address? No longer want circulars? Please notify Private Health Insurance Branch at PrivateHealth@health.gov.au

Private Health Insurance Branch

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