PHI 87/12

This circular issued by the Private Health Insurance Branch contains information on Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 9)

Page last updated: 22 October 2013

Printable version of 87/12 (PDF 91 KB)

19 December 2012

Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 9)

The Private Health Insurance (Benefit Requirements) Amendment Rules 2012 (No. 9) (the Amendment Rules) were registered on the Federal Register of Legislative Instruments and commence on 18 December 2012 (F2012L02502). The Amendment Rules can be found on Australian Government ComLaw website.

The Amendment Rules amend Schedules 1, 3 and 5 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 classify four Medicare Benefit Schedule (MBS) item numbers (50100, 52144, 52300 and 52303) that were incorrectly listed as both Type A and Type B procedures, and to include seven new facilities that are eligible for second-tier default benefits.

The Amendment Rules remove MBS item 50100 as a Type A procedure because this procedure does not normally require an overnight stay. This item continues to be listed under Schedule 3, Part 2 Type B procedures, Clause 5 Non Band specific Type B procedures, subclause (1). It is noted this item can be certified as a Type A procedure.

The Amendment Rules also remove MBS items 52144, 52300 and 52303 as Type B procedures because these procedures normally require an overnight stay. These items continue to be listed under Schedule 1, Part 2 Type A procedures, Clause 6 Surgical patient, subclause (3).

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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