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PHI 45/10

This circular issued by the Private Health Insurance Branch contains information regarding Prostheses List Guide and Application Forms

Printable version of 45/10 (PDF 44 KB)

22 July 2010

Prostheses List Guide and Application Forms

Guide

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;
• General/Miscellaneous;
• Neurosurgical; and
• Plastic and Reconstruction.

Key Dates Leading up to the Publication of the February 2011 Prostheses List

Date	Event
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

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.

Enquiries

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.

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