PHI 71/12

This circular issued by the Private Health Insurance Branch contains information about Private Health Insurance (Benefit Requirements) Amendment Riles 2012 (NO. 8) and corrections to PHI Circular 67/12.

Page last updated: 12 June 2013

Printable version of PHI 71/12 (PDF 156 KB)

9 November 2012

Private Health Insurance (Benefit Requirements) Amendment Riles 2012 (NO. 8) and corrections to PHI Circular 67/12.

The Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 8) (the Amendment Rules) were registered with the Federal Register of Legislative Instruments (FRLI) on 7 November 2012 (F2012L02151) and took effect on 8 November 2012. The Amendment Rules can be found on the ComLaw website.

The Amendment Rules amend Schedule 1 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 1, Part 2 Type A procedures, Clause 4 Advanced surgical patient, subclause (3) of the Principal Rules to include Medicare Benefit Schedule (MBS) item 42731. MBS item 42731 was inadvertently removed from the Principal Rules by the Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No.7). It is noted that the inadvertent removal of this item did not prevent insurers from continuing to cover this item under their insurance policies and paying benefits for patient treatment with respect to this item.

MBS item 42731 relates to Limal or Pars Plana Lensectomy combined with vitrectomy, not being a service associated with items 42698, 42702, 42719 or 42725.

In addition, PHI circular 67/12 stated that the Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 7) added 13 new Magnetic Resonance Imaging (MRI) items to the Principal Rules. However, only 12 of these were listed in the circular. MBS item 63482 was also inserted into the Principal Rules.

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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