Recent Amendments to Private Health Insurance Legislation

The Private Health Insurance (Benefit Requirements) Amendment Rules 2017 (No. 8) (the Rules) amends the Private Health Insurance (Benefit Requirements) Rules 2011 (the Principal Rules) and was registered with the Federal Register of Legislation (FRL) and commence on 1 November 2017.

Page last updated: 30 October 2017

PDF version: Recent amendments to Private Health Insurance Legislation (PDF 53 KB)

Medicare Benefit Schedule (MBS) Item Changes

Schedule 1

The Rules amends Schedule 1 of the Principal Rules to add 11 new MBS items and remove 15 MBS items.

Schedule 3

The Rules amends Schedule 3 of the Principal Rules to add 13 new MBS items and remove 18 MBS items.

Details of the amendments are set out in the Rules, which are available on the FRL website.

Second Tier

The Department was recently made aware of a publication error in PHI Circular 46/17 regarding a Second-Tier Advisory Committee approved list of second-tier eligible facilities provided by the Australian Private Hospitals Association. Six private hospital facilities were mistakenly omitted from the facility additions list published in the Circular. The private hospitals omitted were:

  • Sight Foundation Theatre (0027240F);
  • South Perth Hospital (0075260B);
  • Southern Respiratory and Sleep Disorders Centre(0017260W);
  • St Andrew's Hospital Inc (0065310B);
  • The Victorian Cosmetic Institute (0036920W); and
  • West Leederville Private Hospital (0075710T).

The Department promptly corrected this error and updated PHI Circular 46/17 with the correct facility addition list; however industry may not have noticed this rectification. As stated in PHI Circular 46/17 the effective date is 20 September 2017.

If you have any questions regarding PHI Circular 46/17 please contact the Department of Health at