Private health insurance circulars
This circular issued by the Private Health Insurance Branch contains information on August 2011 Prostheses List
Printable version of 57/11 (PDF 28 KB)
8 August 2011
August 2011 Prostheses List
PurposeThe purpose of this Circular is to inform the health industry that:
- the delegate of the Minister for Health and Ageing has made rules giving effect to a new version of the Prostheses List (August 2011); and
- the August 2011 Prostheses List commences on 22 August 2011.
Variations from the previous Prostheses List – Part A (Prostheses)The August 2011 Prostheses List (Part A) contains the following changes:
- 566 new billing codes (239 for new products, 138 resulting from expansions, 156 resulting from transfers, 19 resulting from compressions and 14 duplications).
- 3,078 billing codes have had amendments to one or more of the following: benefit/s, product information text, product groups/subgroups; and
- 605 billing codes have been removed (354 at the request of the sponsor, 42 as a result of compressions, 54 as a result of expansions and155 as a result of transfers).
Part B - Human Tissue ListNo applications were received for new listings for Part B Human Tissue of the Prostheses List.
Applications were received for benefit variations to 35 items on Part B Human Tissue List of the Prostheses List.
Gap permitted productsThere are 1,542 (16.5%) products with potential gaps in part A of the August 2011 Prostheses List.
This is a decrease of 7.9 percentage points from the February 2011 Prostheses List, primarily a result of implementation of the HTA review. Human tissue prostheses in Part B of the Prostheses List do not have gap permitted products.
The August 2011 Prostheses List and associated reports are available on the Department’s website.
Part CCircular 25/10 advised that the Private Health Insurance Act 2007 had been amended to facilitate the implementation of Part C of the Prostheses List. It was anticipated that Part C would be implemented for the August 2011 Prostheses List.
PHI Circular 47/11 indicated that implementation had been delayed. However, products that have been identified for listing on Part C (insulin infusion pumps and cardiac event recorders) will be so listed for the August 2011 Prostheses List. 16 products on Part A of the Prostheses List that meet the Part C listing criteria have been transferred from Part A to Part C.
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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