PHI Circular 77/24 – Private Health Insurance (Medical Devices and Human Tissue Products) Rules (No. 2) 2024

The Prescribed List of Medical Devices and Human Tissue Products (PL) will be updated on 1 November 2024

Date published:
PHI circular type:
Prescribed List announcement
Audience:
Health sector

The Prescribed List of Medical Devices and Human Tissue Products (PL ) will be updated on 1 November 2024. The delegate of the Minister for Health and Aged Care has made the Private Health Insurance (Medical Devices and Human Tissue Products) Rules (No. 2) 2024, to replace the Private Health Insurance (Medical Devices and Human Tissue Products) Rules (No. 1) 2024.

The Private Health Insurance (Medical Devices and Human Tissue Products) Rules (No. 2) 2024 (the MDHTP Rules) were registered on the Federal Register of Legislation on 23 October 2024 and will commence on 1 November 2024.

The changes effected in the MDHTP Rules

The MDHTP Rules give effect to all changes resulting from completion of the Prescribed List applications (new, amendment, expansion, compression, deletion, and sponsors’ transfers).

Other changes

Incorrectly listed billing codes

The department has reviewed several incorrectly listed billing codes from the specialist orthopaedic, knee, and spinal categories, following concerns regarding incorrect groupings (groups, subgroups, or suffixes), which the billing codes are listed in.

Following detailed consideration of the above, some of these billing codes have been corrected in the 1 November 2024 PL.

The department will continue to work on correcting other errors where appropriate and practicable to do so.

Changes to Part D

The MDHTP Rules also reflect the removal of billing codes for medicines and accessories to medicines previously listed in Part D. The products listed under these billing codes do not meet the Prescribed List eligibility requirements.

For further information please refer to the Explanatory Statement for the MDHTP Rules.

Other

The department continues to transition the administration of the Prescribed List from the web-based Prostheses List Management System (PLMS) to the Health Products Portal (HPP).

It is the second time the department has used HPP to prepare the Prescribed List. The information published in the 1 November 2024 PL is extracted from the HPP. The department is focusing on continuous improvement of the HPP and has now included functionality to allow for production of a draft PL prior to making the MDHTP Rules. This aims to minimise the risk of errors. 

Reports on changes to the Prescribed List (Part A, Part B, Part C, and Part D) are provided in Excel format on the Prescribed List webpage.