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PHI 43/10

This circular issued by the Private Health Insurance Branch contains information regarding Private Health Insurance (Benefits Requirements) amendment rules 2010 (No.4)

Printable version of PHI 43/10 (PDF 72 KB)

Private Health Insurance (Benefit Requirements) Amendment Rules 2010 (No.4) – Changes to Second Tier Eligible Hospitals

Please note that the Private Health Insurance (Benefit Requirements) Amendment Rules 2010 (No.4) (the Rules) have been registered with the Federal Register of Legislative Instruments (FRLI) and take effect on 8 July 2010 (FRLI No: F2010L01949). The changes to the Rules relate to Schedule 5 – Second Tier Default Benefits and are outlined below:

New Hospitals Added to Schedule 5

The following hospitals have been added to Schedule 5 of the Rules. These hospitals will be eligible for Second Tier Default Benefits from 8 July 2010 until 30 June 2012.

Hospital Name	Suburb	State
Chermside Dialysis Unit	Chermside	QLD
Diaverum Cannington Dialysis Clinic	Cannington	WA
Diaverum Diamond Valley Dialysis Clinic	Greensborough	VIC
Diaverum Stirling Dialysis Clinic	Stirling	WA
Forest Hill Dialysis Clinic	Forest Hill	VIC
Gosford Private Hospital	Gosford	NSW
Hartley Dialysis Clinic	Brighton	SA
Lindfield Dialysis Clinic	Lindfield	NSW
Maitland Private Hospital	Maitland	NSW
Malvern Dialysis Clinic	Malvern	VIC
Modbury Dialysis Clinic	Modbury	SA
Peninsula Endoscopy Centre	Frankston	VIC
Reservoir Private Hospital	Reservoir	VIC
Southern Eye Centre, Day Surgery & Laser Clinic	Frankston	VIC
Subiaco Private Hospital	Subiaco	WA
The Glen Endoscopy Centre	Glen Waverley	VIC
Woodvale Private Hospital for Women	Woodvale	WA

40 other hospitals, which are already listed in Schedule 5 of the Rules, were confirmed by the Second Tier Advisory Committee as continuing to be eligible for Second Tier Default Benefits until 30 June 2012. These hospitals are:

Hospital Name	Suburb	State
Bega Valley Private Hospital	Bega	NSW
Buderim Gastroenterology Centre (Maroochydore)	Maroochydore	QLD
Cabrini Brighton	Brighton	VIC
Colin Street Day Surgery	West Perth	WA
Dalcross Private Hospital	Killara	NSW
Eye-Tech Day Surgeries	Spring Hill	QLD
Eye-Tech Day Surgeries Southside	Upper Mount Gravatt	QLD
Forster Private Hospital	Forster	NSW
Gympie Private Hospital	Gympie	QLD
Hervey Bay Surgical Hospital	Pialba	QLD
Holroyd Private Hospital	Guildford	NSW
Kawana Private Hospital	Birthinya	QLD
Kingaroy Private Hospital	Kingaroy	QLD
Malvern Private Hospital	Malvern East	VIC
Mater Misericordiae Day Unit	Mackay	QLD
Mater Misericordiae Hospital Bundaberg	Bundaberg	QLD
Mater Misericordiae Hospital Gladstone	Gladstone	QLD
Mater Misericordiae Hospital Mackay	Mackay	QLD
Mater Misericordiae Hospital Rockhampton	Rockhampton	QLD
Mater Misericordiae Hospital Yeppoon	Yeppoon	QLD
Mater Sydney	North Sydney	NSW
Murdoch Surgicentre	Murdoch	WA
Niola Private Hospital	West Leederville	WA
Pendlebury Clinic Private Hospital	Cardiff	NSW
Rosebud SurgiCentre	Rosebud West	VIC
Sentiens Clinic	West Perth	WA
South Terrace Urology Day Surgery	Adelaide	SA
St Frances Xavier Cabrini Hospital - Malvern	Malvern	VIC
St Frances Xavier Cabrini Hospital - Prahran	Prahran	VIC
St John of God Hospital, Ballarat	Ballarat	VIC
St John of God Hospital Geelong	Geelong	VIC
St Vincent's Private Hospital (Darlinghurst)	Darlinghurst	NSW
Stirling District Hospital	Stirling	WA
Sydney Haematology & Oncology Clinics	Hornsby	NSW
Terrace West Endoscopy Centre	Ipswich	QLD
The Hornsby Sleep Disorder and Diagnostic Centre	Waitara	NSW
The Marian Centre	Wembley	WA
The Melbourne Eastern Private Hospital	Boronia	VIC
The Sydney Private Hospital	Ashfield	NSW
Westmead Rehabilitation Hospital	Merrylands	NSW

Hospital Name Changes on Schedule 5

Please note that the following hospital names have been changed on Schedule 5 to reflect their current State/Territory hospital licences:

Previous Name	New Name	Suburb	State
Hervey Bay Surgical Centre	Hervey Bay Surgical Hospital	Pialba	QLD
Saint Frances Xavier Cabrini Hospital (Malvern)	St Frances Xavier Cabrini Hospital – Malvern	Malvern	VIC
Saint Frances Xavier Cabrini Hospital (Prahran)	St Frances Xavier Cabrini Hospital – Prahran	Prahran	VIC
St John of God Health Care (Ballarat)	St John of God Hospital, Ballarat	Ballarat	VIC

The provider numbers have not changed and there has been no loss in eligibility for Second Tier Default Benefits for these hospitals.
The facilities listed below have closed and have been removed from Schedule 5.

Name	Suburb	State
Logan Surgery Centre	Logan Central	QLD
Marie Stopes International – Caboolture	Morayfield	QLD
Pioneer Valley Private Hospital	North Mackay	QLD

Further to Private Health Insurance Circular PHI 11/10, the following hospitals did not reapply to the Second Tier Advisory Committee for consideration on 28 May 2010. They have been deleted from Schedule 5 as they are not eligible for Second Tier Default Benefits from 30 June 2010.

Name	Suburb	State
Bentleigh Surgicentre	Bentleigh	VIC
Calvary College Grove Rehabilitation Hospital	Walkerville	SA
Calvary Health Care ACT	Bruce	ACT
Calvary John James Hospital	Deakin	ACT
Calvary Wakefield Hospital	Adelaide	SA
Delmar Private Hospital	Dee Why	NSW
Diagnostic Endoscopy Centre	Darlinghurst	NSW
Healthwoods Specialist Centre	Granville	NSW
HOCA @ Mater	South Brisbane	QLD
HOCA Chermside	Chermside	QLD
HOCA Gold Coast	Southport	QLD
Inner West Endoscopy Centre	Marrickville	NSW
Melbourne Oral & Facial Surgery	Melbourne	VIC
Oral Surgery Day Centre	Chatswood	NSW
South Western Day Surgical Centre	Liverpool	NSW
Sydney IVF Canberra	Deakin	ACT
The Eye Institute	Chatswood	NSW
The Wesley Clinic for Haematology & Oncology	Auchenflower	QLD

The Rules are available on the ComLaw website.
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Next Second Tier Advisory Committee Meeting

The next Second Tier Advisory Committee meeting will be held on Friday 27 August 2010.

The closing date for applications is Friday 6 August 2010.

Please note that applicants are required to submit nine stapled copies of their application to

Second Tier Advisory Committee Secretariat
c/o Department of Health and Ageing
MDP 401
GPO Box 9848
Canberra ACT 2601

Information which must be included in applications is outlined in the Second Tier Default Benefit – Sample Application Guide 2010 located on the Australian Private Hospitals Association website. Select Advocacy; Resources; Second Tier Default Benefits - Sample Application Guide 2010.

Health Insurers' Second Tier Default Benefit Rates Annual Audit

Health insurers are reminded that annual lists of un-audited Second Tier Default Benefit rates, from 1 September 2010 to 30 August 2011, are due to the Department of Health and Ageing by 31 August 2010.

The audited rates, along with a statement from the auditor stating that the rates have been calculated in accordance with Schedule 5. are due to the Department and the Private Health Insurance Administration Council (PHIAC) by 30 September 2010.
In order to reduce the amount of paper used to meet this requirement, it is preferred that both the un-audited and the audited rates (along with the statement from the auditor), be emailed to Stephen Lewis.

If an electronic version is not available, a hardcopy of the second tier listing should be printed, double-sided if possible, and posted to:

Mr Stephen Lewis
Director, Legal Policy Section
Department of Health and Ageing
MDP 401
GPO Box 9848
Canberra ACT 2601

Please email only audited second tier listings to PHIAC or, if unable to email, post to:

PHIAC
Suite 16, 1^st Floor
71 Leichhardt Street
Kingston ACT 2601

If you require further information please telephone: (02) 6289 9853/24 hr answering machine or email the enquiry to Private Health Insurance Branch

For more information visit 2010 Private Health Insurance (PHI) Circulars.

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