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22 July 2010
Prostheses List Guide and Application Forms
The updated Prostheses List guide to listing and setting benefits for prostheses
(the Guide) is now available from the Department of Health and Ageing's Private Health Insurance - Prostheses List webpage
The Guide is in two parts:
Part 1 – Understanding the Prostheses Arrangements; and
Part 2 – Making an application for inclusion in the Prostheses List.
All sponsors are encouraged to use the Guide. Note that the Guide does not address the requirements for human tissue items. The Guide will be frequently updated to reflect the implementation of the recommendations from the Review of Health Technology Assessment in Australia
, in particular recommendations 10, 11 and 12.Top of Page
Sponsors should note the following changes that have been included in the Guide:
- continuous applications – applications will be accepted on a continuous basis from 2 August 2010. Applicants are advised to submit their applications as soon as possible after 2 August to maximise the likelihood of the application being considered in time for the February 2011 Prostheses List.
- applications will be accepted for products without an ARTG listing or associated MBS item number however the product will not be listed on the Prostheses List until valid ARTG and/or MBS item numbers have been provided. As a guide these numbers should be provided no later than 4 weeks before a list is due to be published.
- a section has been provided advising sponsors of when they can expect communication from the Prostheses Section during processing of their application.
Prostheses Application Forms
The forms to apply to list prostheses and human tissue prostheses on the Prostheses List are available from the Department of Health and Ageing's Private Health Insurance - Prostheses List webpage
Application forms for new products on Part A of the Prostheses List include:
- Part A1 - Prostheses List application to list a product;
- Part A2 - Prostheses List application to list a product, Statement in support;
- Part B - Prostheses List application to list a product. There are 9 Part B forms for the relevant CAG body these are: Cardiac; Cardiothoracic; Vascular; Ophthalmic; Urogenital; Hip; Knee; Spinal; and Specialist Orthopaedic.
Note, while there are no Part B forms for the following PoCE products, the Grouping Schemes have been updated, and are available for download from the Department of Health and Ageing’s website (as above):Top of Page
- Ear, Nose and Throat;
- Neurosurgical; and
- Plastic and Reconstruction.
Key Dates Leading up to the Publication of the February 2011 Prostheses List
|2 August 2010||Commencement of continuous applications for the Prostheses List|
|23 August 2010||Applications received by this date will have best prospects of being considered in time for the February 2011 Prostheses List|
|7 September 2010||Advisory Committee Meeting 1 (to be confirmed)|
|15 September 2010||Ongoing listing fees invoices to be sent |
|5 October 2010||Advisory Committee Meeting 2 (to be confirmed)|
|26 October 2010||Advisory Committee Meeting 3 (to be confirmed)|
|31 October 2010||NJRR levy invoices to be sent|
|16 November 2010||Advisory Committee Meeting 4 (to be confirmed)|
|30 November 2010||Advisory Committee Meeting 5 (to be confirmed)|
|16 December 2010||Advisory Committee Meeting 6 (to be confirmed)|
|10 January 2010||ARTG and MBS item numbers required for recommended new applications for the February 2011 Prostheses List|
|Mid Jan 2011||Letter to sponsors re: payment of initial listing fees/gap letters|
|Late Jan 2011||Deadline for payment of initial listing fees|
|7 February 2011||February 2011 Prostheses List scheduled to be released|
|21 February 2011||February 2011 Prostheses List scheduled to commence|
Application workshops are being organised for the last week of July and the first week of August.
Brisbane: Friday 30 July 2010
Melbourne: Wednesday 4 August 2010
Sydney:Thursday 5 August 2010
Confirmed dates, times and venues will be provided as soon as possible.
If you have any enquiries about the application forms or the applications process, please contact the Prostheses Section, Department of Health and Ageing, on (02) 6289 9463 or via email the Prostheses inbox
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 2012 Private Health Insurance (PHI) Circulars.
Changing your e-mail address? No longer want circulars? Please email Private Health Insurance Branch