PHI circular type:
The Private Health Insurance Legislation Amendment Rules (No. 7) 2020 (the Amendment Rules) were registered on the Federal Register of Legislation on 30 October 2020 and commence on 1 November 2020.
The Amendment Rules amend the:
- Private Health Insurance (Benefit Requirement) Rules 2011 to:
- amend Schedules 1 to 3, to classify new and amended MBS items for blood products, computed tomography angiography, chemotherapy, neurology and neurosurgery and urology MBS items, and remove deleted items where appropriate.
- Private Health Insurance (Complying Product) Rules 2015 to:
- amend Schedules 5 to 7, to classify new and amended MBS items for blood products, computed tomography angiography, chemotherapy, neurology and neurosurgery and urology MBS items, and remove deleted items where appropriate.
- Private Health Insurance (Health Insurance) Rules 2018 to:
- The effect of this amendment, is that if a hospital is assessed as eligible for second-tier default benefits, the second-tier expiry date will be set to 60 days after the maintained accreditation was expected to expire (usually 3 years).
- Following the resumption of assessments, once a hospital is assessed and accredited and the certificate is issued, the hospital must immediately submit it to the department at firstname.lastname@example.org
- If the accreditation expiry date is later than the date the department had calculated (due to delays in accreditation assessments), a new second-tier expiry date will be set to 60 days after that date. No application or fee is required for this process.
- If the hospital is not accredited following the resumption of assessments, it must immediately inform the department.
- amend Part 2A to align second-tier expiry dates with hospital accreditation expiry under the arrangements adopted by the Australian Commission for Safety and Quality in Health Care during the COVID-19 pandemic.
Further details on the amendments are included in the Explanatory Statement accompanying the Amendment Rules which is available from www.legislation.gov.au and searching F2020L01378 or ‘Private Health Insurance Legislation Amendment Rules (No.7) 2020’.