PHI 89/16 Private Health Insurance (Benefit Requirements) Amendment Rules 2016 (No. 8)

Page last updated: 30 November 2016

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The Private Health Insurance (Benefit Requirements) Amended Rules 2016 (No.8) (the Amendment Rules) were registered with the Federal Register of Legislation (FRL) and commences on 1 December 2016.

These Amendment Rules amend the Private Health Insurance (Benefit Requirements) Rules 2011.

Item 1 - Schedule 1, Part 2 – Type A Procedures, Clause 4 Advanced surgical patient, Subclause (3)

Item 1 amends Schedule 1, Part 2 – Type A Procedures, Clause 4 Advanced surgical Patient, Subclause (3) of the Principal Rules by removing two MBS items numbers (45201 and 45202) due to a clerical error.

Item 2 - Schedule 1, Part 2 – Type A Procedures, Clause 6 Surgical patient, Subclause (3)

Item 2 amends Schedule 1, Part 2 – Type A Procedures, Clause 6 Surgical Patient, Subclause (3) of the Principal Rules by inserting two MBS items numbers (45201 and 45202). The items are for the provision of services for surgical excision in the removal of malignant or non-malignant skin lesions.

Item 3 - Schedule 3, Part 3 – Type C Procedures, Clause 8 Interpretation, Category 2, Diagnostic procedures and investigations, D1

Item 3 amends Schedule 3, Part 3 – Type C Procedures, Clause 8 Interpretation, Category 2, Diagnostic procedures and investigations, D1 of the Principal Rules by inserting two new MBS item numbers (11219 and 11220). MBS item 11219 for optical coherence tomography was amended to reflect the listing on the Pharmaceutical Benefits Scheme (PBS) of aflibercept to treat branch retinal vein occlusion and ocriplasmin to treat vitreomacular traction. Item 11220 has been listed for optical coherence tomography for the assessment of the need for further treatment following PBS-subsidised ocriplasmin.