PHI 18/11

This circular issued by the Private Health Insurance Branch contains

Page last updated: 14 February 2013

Printable version of 18/11 (PDF 69KB)

18 March 2011

Private Health Insurance (Complying Product) Amendment Rules 2011 (NO. 2) and Private Health Insurance (Benefit Requirements) Amendment Rules 2011 (NO. 2)

The Private Health Insurance (Complying Product) Amendment Rules 2011 (No. 2) (the Complying Product Amendment Rules) and the Private Health Insurance (Benefit Requirements) Amendment Rules 2011 (No. 2) (the Benefit Requirements Amendment Rules) were registered with the Federal Register of Legislative Instruments (FRLI) on 18 March 2011(FRLI No: F2011L00449 and FRLI No: F2011L00448 respectively) and commenced on 20 March 2011.

The Rules amend the Private Health Insurance (Complying Product) Rules 2010 (No. 2) and the Private Health Insurance (Benefit Requirements) Rules 2010.

The Complying Product Amendment Rules amends the patient contribution rates for nursing-home type patients in each State except Western Australia (WA), the Northern Territory (NT) and the Australian Capital Territory (ACT) and at private hospitals nationally. The existing rates for WA, NT and the ACT remain in force. The Complying Product Amendment Rules can be viewed on the ComLaw website.

The Benefit Requirements Amendment Rules amends Schedules 4 and 5 of the Private Health Insurance (Benefit Requirements) Rules 2010. The purpose of the amendments to Schedule 4 is to change the minimum benefits payable per night for nursing-home type patients at public hospitals in New South Wales, Tasmania and Victoria, and at private hospitals nationally. The purpose of the amendments to Schedule 5 is to add eight facilities that are eligible for second tier default benefits and to update the name or address of twelve facilities. The Benefit Requirements Amendment Rules can be viewed on the ComLaw website.

Further information on the amendments is provided below.

Nursing-Home Type Patients

Nursing-home type patient contribution rates and minimum benefits are subject to review and change bi-annually, to reflect the indexation applied to the Adult Pension Basic Rate and maximum daily rate of rental assistance.

Changes to the Private Health Insurance (Benefit Requirements) Rules 2010

Amendments have been made to Schedule 4 to increase the minimum benefits payable for privately insured nursing-home type patients at public hospitals in New South Wales, Tasmania and Victoria, and to decrease the minimum benefits payable at private hospitals. The changes to the minimum benefits payable for nursing-home type patients are as follows:
New South Walesfrom $103.25to $104.90
Tasmania from $116.05to $118.05
Victoriafrom $103.65 to $105.65
Private hospitalsfrom $62.75 to $61.90

Changes to the Private Health Insurance (Complying Product) Rules (No. 2)

Amendments have been made to Rule 8A to increase the contribution rates payable by nursing-home type patients at public hospitals in New South Wales, Queensland, South Australia, Tasmania and Victoria, and at private hospitals. The changes to the nursing-home type patient contribution rates are as follows:
New South Walesfrom $48.35to $49.20
Queenslandfrom $48.35to $49.20
South Australiafrom $48.35to $49.20
Tasmaniafrom $48.35to $49.20
Victoriafrom $48.35to $49.20
Private Hospitalfrom $48.35to $49.20

Second Tier Default Benefits

New Hospitals Added to Schedule 5

Eight hospitals have been added to Schedule 5 of the Benefit Requirements Rules. These hospitals will be eligible for Second Tier Default Benefits from 20 March 2011 until 30 June 2012. These hospitals are:
NameSuburbState
Ballina Day SurgeryBallinaNSW
Macquarie St Day SurgerySydneyNSW
Nambour Day SurgeryNambourQLD
Nephrocare Newcastle Dialysis ClinicNewcastleNSW
Peninsula Eye HospitalRedcliffeQLD
Robina Procedure CentreRobinaQLD
The Surgery Centre - HurstvilleHurstvilleNSW
Victor Harbor Private HospitalVictor HarborSA

Hospitals with Continued Eligibility

The following hospitals, which are already listed in Schedule 5 of the Rules, have been approved to continue to be eligible for second tier default benefits until 30 June 2013.
NameSuburbState
Adelaide Day SurgeryAdelaideSA
Allamanda Private Hospital SouthportQLD
Ashford Private HospitalAsfordSA
Bedford Day SurgeryClovelly ParkSA
Bellbird PrivateBlackburn SouthVIC
Brindabella Endoscopy CentreGarranACT
Brisbane Private HospitalBrisbaneQLD
Brisbane Waters Private HospitalWoy WoyNSW
Campbelltown Private HospitalCampbelltownNSW
Chesterville Day HospitalCheltenhamVIC
Como Private HospitalParkdaleVIC
Cotham Private HospitalKewVIC
Darwin Private HospitalTiwiNT
Dee Why Endoscopy UnitDeeWhyNSW
Dorset Rehabilitation HospitalPascoe ValeVIC
Flinders Private HospitalBedfordSA
Geelong Private HospitalGeelongVIC
Griffith Rehabilitation HospitalHoveSA
Hawkesbury District Health ServiceWindsor NSW
Hills Private HospitalBaulkham HillsNSW
Holy Spirit Northside ChermsideQLD
Hurstville PrivateHurstvilleNSW
Ipswich Day HospitalIpswichQLD
John Fawkner Private HospitalCoburgVIC
Knox Private HospitalWantirnaVIC
Lady Davidson Private HospitalNorth TurramurraNSW
Mater Adult HospitalSouth BrisbaneQLD
Mater Children's Hospital South BrisbaneQLD
Mater Mother's HospitalSouth BrisbaneQLD
Mater Private HospitalSouth BrisbaneQLD
Mater Private Hospital RedlandClevelandQLD
Mater Women's & Children's Private Health ServicesSouth BrisbaneQLD
Melbourne Private HospitalParkvilleVIC
Memorial HospitalNorth AdelaideSA
Mosman Private HospitalMosmanNSW
Mount HospitalPerthWA
National Capital Private HospitalGarranACT
Nepean Private HospitalPenrithNSW
Newcastle Private HospitalNew Lambton HeightsNSW
North Eastern Rehabilitation CentreIvanhoeVIC
Northpark Private HospitalBundooraVIC
Norwest Private HospitalBella VistaNSW
Pacific Day Surgery CentreFortitude ValleyQLD
Pacific Private Day HospitalSouthportQLD
Parkwynd Private HospitalAdelaideSA
Peninsula Private HospitalKippa RingQLD
Pine Rivers Private HospitalStrathpineQLD
Prince of Wales Private HospitalRandwickNSW
Ringwood Private HospitalEast RingwoodVIC
Rivercity Private HospitalAuchenflowerQLD
Sight Foundation TheatreSydneyNSW
South Coast Digestive Diseases CentreBundallQLD
St Andrew's Toowoomba HospitalToowoombaQLD
St Luke's HospitalPotts PointNSW
St Vincent’s Hospital BrisbaneKangeroo PointQLD
St Vincent’s HospitalToowoombaQLD
Sunnybank Private HospitalSunnybankQLD
Sydney Day Surgery (Prince Alfred)NewtownNSW
Sydney Southwest Private HospitalLiverpoolNSW
The Geelong ClinicSt Albans ParkVIC
The Melbourne ClinicRichmondVIC
The San Day Surgery HornsbyNSW
The Sydney ClinicBronteNSW
The Victoria ClinicPrahranVIC
Toowoomba SurgicentreToowoombaQLD
Tweed Day SurgeryTweed HeadsNSW

Hospital Address Changes on Schedule 5

The addresses of 11 hospitals have been changed on Schedule 5 to reflect their current State/Territory hospital licences as follows:
NamePrevious AddressNew Address
Bellbird Private Hospital198 Canterbury Road
Blackburn VIC 3130
198 Canterbury Road
Blackburn South VIC 3130
Chesterville Day Hospital26-28 Chesterville Road
Cheltenham VIC 3192
28 Chesterville Road
Cheltenham VIC 3192
Como Private Hospital152 Como Parade West
Parkdale VIC 3194
152 Como Parade West
Parkdale VIC 3195
Lady Davidson Private HospitalBobbin Head Road
Turramurra NSW 2074
434 Bobbin Head Road
North Turramurra NSW 2074
Nepean Private HospitalBarber Avenue
Penrith NSW 2750
Barber Avenue
Kingswood NSW 2747
Newcastle Private Hospital2 Lookout Road
New Lambton NSW 2305
2 Lookout Road
New Lambton Heights NSW 2305
North Eastern Rehabilitation Centre134-142 Ford Street
Ivanhoe VIC 3079
134-144 Ford Street
Ivanhoe VIC 3079
Prince of Wales Private HospitalLevels 5-7, Ambulatory Care Services Centre Building
Prince of Wales Campus
Barker Street
Randwick NSW 2031
Levels 5-7, Ambulatory Care Services Centre Building
Prince of Wales Campus
Baker Street
Randwick NSW 2031
Ringwood Private Hospital36 Mount Dandenong Road
East Ringwood VIC 3134
36 Mount Dandenong Road
East Ringwood VIC 3135
The Sydney Clinic22-24 Murray Street
Waverley NSW 2024
22-24 Murray Street
Bronte NSW 2024
Tweed Day Surgery38-44 Boyd Street
Tweed Heads NSW 2485
Suite 4, 38-44 Boyd Street
Tweed Heads NSW 2485

Hospital Name Changes on Schedule 5

The name of one hospital has been changed on Schedule 5 to reflect its current State hospital licence as follows:
Previous NameNew NameSuburbState
Victorian Rehabilitation CentreThe Victorian Rehabilitation CentreGlen WaverleyVIC

Next Second Tier Advisory Committee Meeting

The next meeting of the Second Tier Advisory Committee will be held on Friday 27 May 2011. The closing date for applications is 6 May 2011, however applications may be submitted as soon as they are ready.

Information which must be included in applications is outlined in the Sample Application For 2nd Tier Default Benefit Eligibility guide located on the Australian Private Hospitals Association website.

When gathering the required documentation, facilities are asked to be mindful that the Committee won’t be considering their applications until late May and they should check the expiry dates on their licences and accreditation certificates in that context.

Nine stapled copies of the application should be sent to:

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

For further information, please contact Ann Mulholland on 02 6289 9833.

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 2011 Private Health Insurance (PHI) Circulars.

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