The Private Health Insurance Legislation Amendment Rules (No. 1) 2020 (the Amendment Rules) amend the Private Health Insurance (Benefit Requirements) Rules 2011 (the Benefit Requirement Rules) and the Private Health Insurance (Complying Product) Rules 2015 (the Complying Product Rules).
The Amendment Rules were registered on the Federal Register of Legislation and commence on 1 March 2020.
The Amendment Rules amend the Benefit Requirement Rules to:
- insert 4 new MBS items for GP and Medical Practitioner Focussed Psychological Strategies as part of the Bushfire Recovery Access Initiative
- insert 2 existing MBS items for GP Focussed Psychological Strategies to correct inconsistency in the classification for minimum accommodation benefits
- insert 22 new MBS items and remove the 11 existing items they replace for emergency medicine specialists and medical practitioners providing emergency medicine attendances and goals of care services
- insert 18 new emergency procedure items for emergency medicine specialists and medical practitioners
- insert 2 new items for extracorporeal life support
- remove 1 item for gastric lavage which is considered obsolete and no longer best practice
- insert 1 new item for goals of care in the specialty of intensive care.
The Amendment Rules amend the Complying Product Rules to:
- insert selected MBS in Schedule 5 (the clinical categories list) as consequential amendments to reflect changes to the MBS effective from 17 January 2020 for the Bushfire Recovery Access Initiative
- remove duplication of MBS items 10950 to 10970 and correct placement of 10984 to 10997 in Schedule 7
- implement other changes consistent with the amendments to the Benefit Requirements Rules outlined above for emergency medicine and intensive care and inserting 4 additional MBS items in Schedule 7, which do not require separate accommodation so are not reflected in amendments to the Benefit Requirement Rules.
Read details of the individual amendments and the Explanatory Statement accompanying the Amendment Rules.
A summary of the amendments is at Attachment A.
Private Health Insurance Legislation Amendment Rules (No. 1) 2020
Summary amendments
Private Health Insurance (Benefit Requirements) Rules 2011
Amended provision
Amendments
Schedule 1 (overnight accommodation), subclause 6(3)
Insert MBS items 13834 and 13837 into Type A procedures, surgical patient list.
Schedule 3 (same-day), clause 8 (Category 1 — Attendances A7:)
Insert MBS items 285 and 287 in the Type C procedures, Category 1 — Attendances A7 list.
Schedule 3 (same-day), clause 8 (Category 1 — Attendances A21:)
Insert MBS items 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017, 5019, 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035, 5036, 5039, 5041, 5042 and 5044 in the Type C procedures, Category 1 — Attendances A21 list.
Schedule 3 (same-day), clause 8 (Category 1 — Attendances A21:)
Omit MBS items 501, 503, 507, 511, 515, 519, 520, 530, 532, 534 and 536 from the Type C procedures, Category 1 — Attendances A21 list.
Schedule 3 (same-day), clause 8 (Category 1 — Attendances A39:)
Insert MBS items 91285, 91287, 91723 and 91727 in the Type C procedures, Category 1 — Attendances A39 list.
Schedule 3 (same-day), clause 8 (Category 3 — Therapeutic procedures T1:)
Insert MBS item 13899 in the Type C procedures, Category 3 — Therapeutic procedure T1 list.
Schedule 3 (same-day), clause 8 (Category 3 — Therapeutic procedures T1:)
Omit MBS item 14200 from the Type C procedures, Category 3 — Therapeutic procedure T1 list.
Schedule 3 (same-day), clause 8 (Category 3 — Therapeutic procedures T1:)
Insert MBS items 14255, 14256, 14257, 14258, 14259, 14260, 14263, 14264, 14265, 14266, 14270, 14272, 14277, 14278, 14280, 14283, 14285 and 14288 in the Type C procedures, Category 3 — Therapeutic procedure T1 list.
Private Health Insurance (Complying Product) Rules 2015
Amended provision
Amendments
Schedule 5, clinical category — Hospital psychiatric services
Insert MBS items 91285, 91287, 91723 and 91727 in the hospital psychiatric services clinical category.
Schedule 6 — Common treatments list
The Common treatments list is repealed and a new table substituted which:
- omits 11 obsolete MBS items; and
- inserts 22 MBS items.
The omitted MBS items are:
- 501, 503, 507, 511, 515, 519, 520, 530, 532, 534 and 536.
The inserted MBS items are:
- 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017, 5019, 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035, 5036, 5039, 5041, 5042, 5044.
Schedule 7 — Support treatments list
The Support treatments list is repealed and a new table substituted which:
- omits MBS items 14200; and
- inserts 25 new MBS items.
The inserted MBS items are:
- 13832, 13834, 13835, 13837, 13838, 13840, 13899, 14255, 14256, 14257, 14258, 14259, 14260, 14263, 14264, 14265, 14266, 14270, 14272, 14277, 14278, 14280, 14283, 14285 and 14288.