PHI 79/16 Prostheses List Benefits Reduction - Private Health Insurance (Prostheses) Amendment Rules 2016 (No.4)

Page last updated: 19 October 2016

PHI 79/16 Prostheses List Benefits Reduction - Private Health Insurance (Prostheses) Amendment Rules 2016 (No.4) (PDF 76 KB)

Private Health Insurance (Prostheses) Amendment Rules 2016 (No. 4)

The delegate of the Minister for Health has made the Private Health Insurance (Prostheses) Amendment Rules 2016 (No. 4) (the Amendment Rules) to revise the benefits of 2,440 prostheses on Part A of the Private Health Insurance (Prostheses) Rules 2016 (No. 4) (the Prostheses List).

The Amendment Rules will commence on 20 February 2017.

The Amendment Rules will change the Prostheses List by reducing the minimum benefits payable for devices in the following categories or assessment bodies:
    • 01.01 - Anterior Chamber Intraocular Lenses, benefits reduced by 10%
    • 01.02 - Posterior Chamber Intraocular Lenses, benefits reduced by 10%
    • 08 - Cardiac, benefits reduced by 10%
    • 11 - Hip, benefits reduced by 7.5%
    • 12 - Knee, benefits reduced by 7.5%
The reductions are an important first step of broader reforms to the private health system.

Details of the changes can be found on the Departments Prostheses List webpage.

    NB: Please note that information contained within this circular is provided as a courtesy notification only. It is the responsibility of industry members to ensure they are operating in compliance with the Private Health Insurance Act 2007 and all other relevant Commonwealth legislation.