PHI 47/20 Indexation, second-tier and information provision changes – 1 July 2020

Private health insurance announcement.

Date published:
PHI circular
PHI circular type:
PHI announcement
Health sector

The Private Health Insurance Legislation Amendment Rules (No. 4) 2020 (the Amendment Rules) were registered on the Federal Register of Legislation on 30 June 2020 and commenced on 1 July 2020.

The Amendment Rules amend the:

  • Private Health Insurance (Benefit Requirement) Rules 2011 to:
    • increase the minimum benefit for private patients’ overnight and same-day accommodation fees in both private and public hospitals, in line with the increase of 2.2% in the Consumer Price Index (CPI) over the 12 months to the March 2020 quarter
    • index the monetary thresholds which provide a qualifier on the Medicare Benefits Schedule (MBS) items included in the definitions of ‘advanced surgical patient’ and ‘surgical patient’ by 1.5%, in line with the 1 July 2020 indexation of the MBS
    • increase the minimum benefits payable for private nursing home type patient accommodation in public hospitals in South Australia and the Australian Capital Territory
  • Private Health Insurance (Complying Product) Rules 2015 to:
    • update the daily patient contribution payable by nursing home type patients for hospital accommodation in public hospitals in the ACT
    • adjust the timing of information provision by insurers to the Private Health Insurance Ombudsman
  • Private Health Insurance (Health Insurance Business) Rules 2018 to adjust the second tier application fee.

Further details on the amendments are included in the Explanatory Statement accompanying the Amendment Rules which is available from and searching for F2020L00862 or ‘Private Health Insurance Legislation Amendment Rules (No. 4) 2020’.