Commonwealth Coat of Arms of Australia

 

Private Health Insurance Legislation Amendment Rules (No. 4) 2023

I, Andrew Rintoul, delegate of the Minister for Health and Aged Care, make the following Rules.

Dated    29 June 2023

Andrew Rintoul

A/g Assistant Secretary

Private Health Strategy Branch

Benefits Integrity Division

Health Resourcing Group

Department of Health and Aged Care

 

Contents

1  Name

2  Commencement

3  Authority

4  Schedules

Schedule 1—Amendments—Minimum accommodation benefits

Private Health Insurance (Benefit Requirements) Rules 2011

Schedule 2—Amendments—Nursing-home type patient contribution

Private Health Insurance (Complying Product) Rules 2015

Schedule 3—Amendments—Second-tier application fee

Private Health Insurance (Health Insurance Business) Rules 2018

1  Name

  This instrument is the Private Health Insurance Legislation Amendment Rules (No. 4) 2023.

2  Commencement

(1)    Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  The whole of this instrument

1 July 2023

1 July 2023

Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

(2)    Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3  Authority

  This instrument is made under subsection 333-20(1) of the Private Health Insurance Act 2007.

4  Schedules

  Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1Amendments—Minimum accommodation benefits

Private Health Insurance (Benefit Requirements) Rules 2011

1  Clause 2 of Schedule 1 (Table 1)

Repeal the table (including the heading), substitute:

 

Table 1Overnight accommodation for private patients at private hospitals in all States/Territories

Column 1

Column 2

Class of patient

Minimum benefit payable per night

Advanced surgical patient

 

first 14 days

$509

over 14 days

$354

Surgical patient or obstetric patient

 

first 14 days

$472

over 14 days

$354

Psychiatric patient

 

first 42 days

$472

43 – 65 days

$410

over 65 days

$354

Rehabilitation patient

 

first 49 days

$472

50 65 days

$410

over 65 days

$354

Other patients

 

first 14 days

$410

over 14 days

$354

2  Clause 2 of Schedule 1 (Table 2)

Repeal the table (including the heading), substitute:

 

Table 2Victoriaovernight shared ward accommodation for private patients at public hospitals

Column 1

Column 2

Class of patient

Minimum benefit payable per night

Advanced surgical patient

 

first 14 days

$509

over 14 days

$354

Surgical patient or obstetric patient

 

first 14 days

$472

over 14 days

$354

Psychiatric patient

 

first 42 days

$472

43 – 65 days

$410

over 65 days

$354

Rehabilitation patient

 

first 49 days

$472

50 65 days

$410

over 65 days

$354

Other patients

 

first 14 days

$410

over 14 days

$354

 

3  Clause 2 of Schedule 1 (Table 3)

Repeal the table (including the heading), substitute:

 

Table 3Tasmaniaovernight shared ward accommodation for private patients at public hospitals

Column 1

Column 2

Class of patient

Minimum benefit payable per night

Advanced surgical patient

 

first 14 days

$509

over 14 days

$354

Surgical patient or obstetric patient

 

first 14 days

$472

over 14 days

$354

Psychiatric patient

 

first 42 days

$472

43 – 65 days

$410

over 65 days

$354

Rehabilitation patient

 

first 49 days

$472

50 65 days

$410

over 65 days

$354

Other patients

 

first 14 days

$410

over 14 days

$354

 

4  Subclause 4(3) of Schedule 1

Omit “$901.70”, substitute “$934.15”.

5  Subclause 6(3) of Schedule 1

Omit “$268.50 to $901.70”, substitute “$278.15 to $934.15”.

6  Clause 2 of Schedule 2 (Table 1)

Repeal the table (including the heading), substitute:

 

Table 1Overnight shared ward accommodation for private patients at public hospitals in the Australian Capital Territory, New South Wales, Northern Territory, Queensland, South Australia and Western Australia

Column 1

Column 2

State/Territory

Minimum benefit payable per night

Australian Capital Territory

$421

New South Wales

$421

Northern Territory

$421

Queensland

$431

South Australia

$421

Western Australia

$421

 

7  Clause 2 of Schedule 3 (Table 1)

Repeal the table (including the heading), substitute:

 

Table 1Same day accommodation for private patients at public hospitals in all States/Territories

Column 1

Column 2

Column 3

Column 4

Column 5

Public hospitals

Band 1

Band 2

Band 3

Band 4

New South Wales

$305

$340

$375

$421

Australian Capital Territory

$305

$340

$375

$421

Northern Territory

$305

$350

$403

$421

Queensland

$311

$352

$385

$431

South Australia

$305

$350

$384

$421

Tasmania

$296

$353

$407

$472

Victoria

$300

$354

$411

$472

Western Australia

$347

$347

$347

$347

 

8  Clause 2 of Schedule 3 (Table 2)

Repeal the table (including the heading), substitute:

 

Table 2 Same day accommodation for private patients at private hospitals in all States/Territories

Column 1

Column 2

Column 3

Column 4

Column 5

Private hospitals

Band 1

Band 2

Band 3

Band 4

All States and Territories

$264

$332

$441

$472

 

9  Clause 6 of Schedule 4 (Table 1, table item dealing with Australian Capital Territory, column headed “Minimum benefit per night”)

Omit “$137.30”, substitute “$142.45”.

10  Clause 6 of Schedule 4 (Table 1, table item dealing with South Australia, column headed “Minimum benefit per night”)

Omit “$132.00”, substitute “$141.00”.

Schedule 2—Amendments—Nursing-home type patient contribution

Private Health Insurance (Complying Product) Rules 2015

1  Subrule 8A(3) (paragraph (a) of the definition of patient contribution)

Repeal the paragraph, substitute:

(a) in relation to a nursinghome type patient at a public hospital, the following amount for the State or Territory in which the hospital is located:

 (i) Australian Capital Territory - $70.55;

 (ii) New South Wales - $70.55;

 (iii) Northern Territory - $70.55;

 (iv) Queensland - $70.55;

 (v) South Australia - $70.55;

 (vi) Tasmania - $70.54;

 (vii) Victoria - $70.55; and

 (viii) Western Australia - $70.55.

Schedule 3—Amendments—Second-tier application fee

Private Health Insurance (Health Insurance Business) Rules 2018

1  Rule 7B

Repeal the subrule (not including the heading), substitute:

  For the purposes of paragraph 121-8(2)(b) of the Act, the application fee is $945 for each hospital that the application seeks to have included in the secondtier eligible hospitals class.