PHI 69/11

This circular issued by the Private Health Insurance Branch contains information on Private Health Insurance (Complying Product) Amendment Rules 2011 (No. 4A) and Private Health Insurance (Benefit Requirements) Amendment Rules 2011 (No. 8)

Page last updated: 02 November 2012

Printable version of 69/11 (PDF 22 KB)

22 September 2011

Private Health Insurance (Complying Product) Amendment Rules 2011 (No. 4A) and Private Health Insurance (Benefit Requirements) Amendment Rules 2011 (No. 8)

The Private Health Insurance (Complying Product) Amendment Rules 2011 (No. 4A) (Complying Product Amendment Rules) and the Private Health Insurance Benefit Requirements) Amendment Rules 2011 (No. 8) (Benefit Requirements Amendment Rules) were registered with the Federal Register of Legislative Instruments (FRLI) on 19 September 2011(FRLI No: F2011L01919 and FRLI No: F2011L01924 respectively) and commenced on 20 September 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

The amendment updates the patient contribution rates for nursing-home type patients in New South Wales (NSW), Queensland, South Australia (SA), Tasmania and at private hospitals nationally from $49.20 to $50.55.

The existing rates for Victoria, Western Australia (WA), Northern Territory and the Australian Capital Territory (ACT) remain in force.

The Complying Product Amendment Rules can be viewed on the ComLaw website.

The Benefit Requirements Amendment Rules

Hospital Accommodation Default Benefits – Schedule 2

The amendment updates the minimum benefits for shared ward overnight accommodation at public hospitals for the Northern Territory from $303.00 to $313.00.

This change is consistent with previous amendments made for other States and Territories.

Hospital Accommodation Default Benefits – Schedule 3

The amendment also increases the minimum benefit for same-day accommodation in public hospitals in the Northern Territory in Schedule 3 as follows:
Band 1
Band 2
Band 3
Band
From $219 to $226From $250 to $258From $290 to $300From $303 to $313

Nursing-Home Type Patients – Schedule 4

Nursing-home type patient minimum benefits have been updated to reflect the indexation applied to the Adult Pension Basic Rate and maximum daily rate of rental assistance.

The amendment increases the minimum benefits payable for privately insured nursing-home type patients at public hospitals in Queensland, SA and Tasmania, and decreases the minimum benefits payable at private hospitals nationally. The changes are as follows:
Public hospital: State/TerritoryMinimum benefit per night
Queenslandfrom $ 98.50 to $102.00
SAfrom $103.00 to $106.00
Tasmaniafrom $118.05 to $121.30
Private Hospitalsfrom $ 61.90 to $ 60.55
The existing rates for NSW, Victoria, WA, the Northern Territory and the ACT remain in force.

MBS Item Number Updates

Two MBS item numbers (36650 and 39133) previously in Schedule 1 – Overnight accommodation, have been identified as same day accommodation procedures and moved to Schedule 3, Rule 5 – Non-band specific Type B procedures.

Second Tier Default Benefits – Schedule 5

New Hospitals

Three hospitals have been added to Schedule 5 and will be eligible for Second Tier Default Benefits from 20 March 2011 until 30 June 2012. These hospitals are:
Provider No
Name
Suburb
State
0999771LAdelaide SurgicentreKent TownSA
0036790KLa Trobe Private HospitalBundooraVIC
0056030XToowoomba HospiceToowoombaQLD

Hospital Name Change

One hospital name has been changed to align with their current State hospital license:
Provider ID
Previous Name
New Name
0097010WThe CAPS ClinicSole Vita Surgery
The Benefit Requirements Amendment Rules can be viewed on the ComLaw website.

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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