The Private Health Insurance Legislation Amendment Rules (No. 4) 2023 (the Amendment Rules) amend the Private Health Insurance (Benefit Requirements) Rules 2011 (the Benefit Requirements Rules) and the Private Health Insurance (Complying Product) Rules 2015 (the Complying Product Rules) and the Private Health Insurance (Health Insurance Business) Rules 2018 (Business Rules).
The Amendment Rules were registered on the Federal Register of Legislation on 29 June 2023 and commence on 1 July 2023.
Nursing‑Home Type Patient (NHTP) accommodation indexation, 1 July 2023.
NHTP contributions and minimum insurer benefits are indexed by the Commonwealth twice annually, on 20 March and 20 September. Jurisdictions are consulted on changes to rates in public hospitals. Some jurisdictions apply changes from 1 July, annually.
The Private Health Insurance (Complying Product) Rules 2015 (Part 2 – 8A(3) Benefit requirement – nursing-home type patients) establish the statutory minimum daily patient contribution rate payable by a NHTP in hospitals. The amendment rules are changed the Daily patient contribution rates for the ACT from 1 July 2023. All other states and territories made changes on 20 March 2023.
Minimum benefit payable by private health insurers for NHTP
The Private Health Insurance (Benefit Requirements) Rules 2011 (Schedule 4 – Nursing-home type patient accommodation: hospitals in all States/Territories, Part 6) establish the minimum benefit payable per night by private health insurers for NHTP in hospitals. The ACT and SA applied adjustments to rates from 1 July 2023. All other states and territories reviewed rates in March 2023.
Overnight and Same Day Accommodation Benefit Indexation
The Amendment Rules amend the Benefit Requirements Rules to increase the minimum benefit payable by private health insurers for private patients' overnight and same-day accommodation in both private and public hospitals. The increase is in line with the annual increase to March 2023 in the Consumer Price Index (CPI) of 7.0 per cent.
Second-tier Default Benefits Application Fee Increase
The activities and tasks that make up the assessment for second tier default benefits eligibility have been reviewed and updated. Government policy to index charges annually has resulted in an increase in the application fee of $45, from $900 to $945.
Further details on the amendments are included in the Explanatory Statement accompanying the Amendment Rules available on the Federal Register of Legislation at www.legislation.gov.au by searching ‘Private Health Insurance Legislation Amendment Rules (No. 4) 2023’.
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