Private health insurance resources
Stakeholder Feedback Report – Consultation Paper 6(a) Proposed Listing Criteria
This report provides an analysis of stakeholder feedback received in response to the Prostheses List Reform Consultation Paper 6a - Listing Criteria.
Private Health Insurance classification of MBS items 1 July 2023
This spreadsheet classifies MBS items by private health insurance clinical category or procedure type and includes MBS items effective 1 July 2023.
Private health insurance clinical category definitions 1 July 2023
Standard clinical category definitions for private health insurance hospital policies, released on 21 June 2023 and effective at 1 July 2023.
CIRG outcome note – 17 March 2023
The outcomes of the Clinical Implementation Reference Group (CIRG) Meeting 9.
NTREAP meeting outcomes – 19 May 2023
The Natural Therapies Review Expert Advisory Panel (NTREAP) met on 19 May 2023 for its 7th meeting. This document provides a record of the meeting.
Natural Therapies Review 2024 – Shiatsu evidence evaluation
This report outlines the evaluation of evidence on the clinical effectiveness of shiatsu as part of the Natural Therapies Review 2024.
Prescribed List Compliance Strategy – Safeguarding the Prescribed List
The below document outlines Prescribed List compliance obligations for relevant stakeholders and the Australian Government.
Submissions analysis on the Prostheses List Compliance Strategy
The below report provides analysis of stakeholder feedback to the proposed Prostheses List Compliance Strategy. The submission period for responses was between 14 September and 21 October 2022.
Prostheses List cardiac implantable electronic devices (CIEDs) benefit reductions from 1 July 2023
The below data documents detail cardiac implantable electronic devices (CIEDs) that will have their Prostheses List (PL) benefits reduced by 40% of the gap on 1 July 2023.
Supplementary advice on bundling arrangements for General Use Items on the Prostheses List
This report details supplementary advice on bundling arrangements for General Use Items on the Prostheses List.
Natural Therapies Review 2024 – Iridology evidence evaluation
This report outlines the evaluation of evidence on the clinical effectiveness of iridology as part of the Natural Therapies Review 2024.
CIRG outcome note – 28 October 2022
The outcomes of the Clinical Implementation Reference Group (CIRG) Meeting 8.
Private health insurance clinical category definitions 1 March 2023
Standard clinical category definitions for private health insurance hospital policies, as of 23 February 2023 and effective 1 March 2023.
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Changes to the Prostheses List timeframes (2023/24)
This webinar recording provides an overview of the timing and impact of bypassing the March 2024 update and information on the Prostheses List reforms planned for 2023.
Review of the Prostheses List advisory committee and associated subcommittees
This review provides options and recommendations for the future governance of the Prostheses List. It was developed by Ernst & Young under the Department’s Prostheses List Reform program.
Options for a reformed Prostheses List pre-listing assessment framework and governance structure
This report provides a framework and proposes options for governance that would align the Prostheses List processes with those of other health technology assessment processes within the Government. It was developed by Adelaide Health Technology Assessment, under the Prostheses List Reform program.
Prostheses List Reforms – Pre-listing Assessment framework and Governance structure
This report outlines the pre-listing assessment framework and governance structure for the Prostheses List. It also addresses Ernst & Young, and Adelaide Health Technology Assessment options and recommendations.
Private Health Insurance classification of MBS items 1 March 2023
This spreadsheet classifies MBS items by private health insurance clinical category and procedure type and includes MBS items commencing 1 March 2023.
Outcomes of the hospital treatment certification and dual listed MBS items meeting – September 2022
This fact sheet provides our position on the hospital treatment certification.
CIRG outcome note – 26 August 2022
The outcomes of the Clinical Implementation Reference Group (CIRG) Meeting 7.
Advice on Bundling Arrangements for General Use Items on the Prostheses List
A report from the Independent Health and Aged Care Pricing Authority (IHACPA) detailing advice on the bundling arrangements for General Use Items currently listed on the Prostheses List (PL).
Independent Health and Aged Care Pricing Authority – General Use item bundles – December 2022
This document contains a breakdown of each General Use Item Bundle. They are shown by Product Branch Code, Product Branch Descriptor, Product Class Code, Product Class Description, Variant Branch Code, Variant Branch Description, Bundle Variant Code, Bundle Variant Description and Bundle Benefit.
Monitoring Framework for Private Health Insurers’
Monitoring Framework for Private Health Insurers’ COVID related permanent claim savings and givebacks.
Lifetime Health Cover Calculators
Use these calculators to help you work out the lifetime health cover (LHC) loading payable on your private hospital cover.
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Private health insurance reforms campaign online video
This 30 second video outlines the Government’s reform to private health insurance.
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