PHI 56/19 Amendments to the July 2019 Prostheses List

Private health insurance announcement about the Prostheses List.

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

The delegate for the Minister for Health has made the Private Health Insurance (Prostheses) Amendment Rules (No. 6) 2019 (the Amendment Rules) to remove the listings of 5 textured breast implants and tissue expanders from the Prostheses List, and to correct an error in the benefit for a human tissue item.

This follows:

  • advice from Emergo Asia Pacific Pty Ltd that the following products are no longer being sold in Australia

Billing code
Sponsor
Product name
Description
Size
Benefit
ARTG

ER198
Emergo Asia Pacific Pty Ltd
Aeroform Patient Controlled Tissue Expander
Aeroform Patient Controlled Tissue Expander; Multichamber, textured, CO2 filled
width (12.5, 14, 15.5 cm) x height (11, 12.5, 14 cm) x projection (8, 9.5, 10.5 cm); volume 400, 600 and 800 cc
$1,024
216704

ER199
Emergo Asia Pacific Pty Ltd
AeroForm Tissue Expander System Dosage Controller
AeroForm Tissue Expander System Dosage Controller
N/A
$1,365
216653

  • a request from Allied Scientific Products Pty Ltd (Surgiplas Medical) to remove the listings for the products below as a precaution in light of the ongoing review Therapeutic Goods Administration (TGA) review of textured breast implants.

Billing code
Sponsor
Product name
Description
Size
Benefit
ARTG

SP047
Surgiplas Medical
Gel Filled Mammary Prosthesis Models GFX-LP, GFX and GFX-EHP
Textured Round
80 to 800ml
$741.00
142863

SP049
Surgiplas Medical
Gel Filled Mammary Prosthesis Models CoGel-XR, CoGel-XRH, CoGel-XL, CoGel- XM and CoGel XF
CoGel High Cohesive
100 to 790gm
$1,170.00
142863

SP114
Surgiplas Medical
Nagor Breast Implants
Silicone Firm and Stable Gel Breast Implants
150 - 620cc
$741.00
142863

The Amendment Rules also correct the benefit for human tissue item RNB01 – Femoral Head. The Hunter New England Tissue Bank successfully applied to increase the benefit from $2,500 to $3,000 in the July 2019 Prostheses List; however, due to a technical issue the increased benefit was not reflected in the Private Health Insurance (Prostheses) Rules (No. 2) 2019.

The Amendment Rules commence the day after registration.