PHI 47/18 Prostheses List Benefit Reduction Rounding Issue - August 2018

Page last updated: 27 August 2018

PHI 47/18 Prostheses List Benefit Reduction Rounding Issue - August 2018 (PDF 50 KB)

27 August 2018

This circular informs Prostheses List users that a rounding issue has been identified with the implementation of the Prostheses Benefit Reduction that was communicated on the 19 June 2018 via PHI 40/18 Private Health Insurance (Prostheses) Amendment Rules 2018 No. 2 – Prostheses Benefit Reductions.

In implementing the remaining 20% prostheses benefit reduction for 2018, as outlined in the Government Agreement with the Medical Technology Association of Australia (MTAA agreement), the two step process used has introduced a second rounding of benefits which has resulted in some prostheses benefits being rounded down an additional dollar and some rounded up an additional dollar.

A number of sponsors have been impacted by this second rounding where their benefits were rounded up or down twice by the two step process.
The Department is working to correct the rounding issue but to avoid creating undue administrative disruption, the prostheses benefit rounding issue will be corrected when the March 2019 Prostheses List is published, which is planned for mid-February 2019.

If you have any queries or concerns about the 2018 Prostheses List Benefit Rounding Issue, please email to the Prostheses Section at Prostheses@health.gov.au with "Prostheses List Benefit Rounding Issue" in the Subject field.