PHI 04/17 Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No. 1)

Page last updated: 01 February 2017

PDF version: PHI04/17 Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No. 1) (PDF 47 KB)

The Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No.1) (the Amendment Rules) were registered with the Federal Register of Legislation (FRL) and commences on 1 February 2017.

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

Item 1 - Schedule 3, Part 3 – Type C Procedures, Clause 8 Interpretation, Category 6, Pathology services, P7

Item 1 amends Schedule 3, Part 3 – Type C Procedures, Clause 8 Interpretation, Category 6, Pathology services, P7 of the Principal Rules by inserting two new Medicare Benefits Schedule (MBS) item numbers (73295 and 73341).

MBS item 73295 is a new Medicare pathology service that provides a rebate to patients for the detection of germline BRCA1 and BRCA2 mutation in selected patients with relapsed ovarian cancer with continued sensitivity to platinum-based chemotherapy, to inform eligibility for olaparib under the Pharmaceutical Benefits Schedule (PBS).  This item is a predictive test that will identify a sub-group of patients likely to benefit from olaparib treatment.

MBS item 73341 reflects the listing on the PBS of ceritinib to treat locally advanced or metastatic non-small cell lung cancer (NSCLC). Item 73341 funds a fluorescence in situ hybridisation test for patients with NSCLC.