PHI 27/12

This circular issued by the Private Health Insurance Branch contains information about Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (NO. 3)

Page last updated: 07 May 2013

Printable version of 27/12 (PDF 20 KB)

24 April 2012

Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (NO. 3)

The Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No.3) (the Amendment Rules) were registered on the Federal Register of Legislative Instruments (FRLI) on 20 April 2012 (F2012L00905) and take effect on 21 April 2012. The Amendment Rules can be found on the ComLaw website.

The Amendment Rules amends Schedules 3 of the Private Health Insurance (Benefit Requirements) Rules 2011 (the Principal Rules) which commenced on 1 November 2011.

The purpose of the Amendment Rules is to amend Schedule 3 of the Principal Rules to reclassify Medicare Benefit Schedule (MBS) item number 42738 in Schedule 3, Part 2 Type B procedures, which is currently listed in Schedule 3, Part 3–Type C procedures.

MBS item 42738 relates to Paracentesis of Anterior Chamber or Vitreous Cavity, or both, for the injection of therapeutic substances, or the removal of aqueous or vitreous humours for diagnostic or therapeutic purposes, 1 or more of, as an independent procedure

In Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No.1) MBS item 42738 was inserted as a Type C procedure. It has subsequently been brought to the Department’s attention that this may inadvertently, and negatively, affect patients. The Department has decided to classify MBS item 42738 as a Type B procedure and will conduct further consultation on the most appropriate location for MBS item number 42738 in the Principal Rules.

The Department will consult further with medical practitioners, private health insurers and patients on the appropriate location of MBS item number 42738 as either a Type B or Type C procedure.

If you require further information please telephone: (02) 6289 9853/24 hr answering machine or email the enquiry to Private Health Insurance Branch

For more information visit 2012 Private Health Insurance (PHI) Circulars.

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