Private Health Insurance Act 2007

CHAPTER 3 - COMPLYING HEALTH INSURANCE PRODUCTS  

PART 3-3 - REQUIREMENTS FOR COMPLYING HEALTH INSURANCE PRODUCTS  

Division 72 - Benefit requirements for policies that cover hospital treatment  

SECTION 72-10   MINIMUM BENEFITS FOR MEDICAL DEVICES AND HUMAN TISSUE PRODUCTS  

72-10(1)    
Private Health Insurance (Medical Devices and Human Tissue Products) Rules made for the purposes of item 4 of the table in subsection 72-1(2) must only list a kind of *medical device or *human tissue product if:

(a)    an application has been made under subsection (2) in relation to that kind of medical device or human tissue product; and

(b)    the Minister has granted the application.

72-10(2)    
A person may apply to the Minister to have the Private Health Insurance (Medical Devices and Human Tissue Products) Rules list a *medical device or *human tissue product of the kind to which the application relates.

72-10(3)    
The application must be:

(a)    in the ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

approved form; and

(b)    accompanied by any *cost-recovery fee that the applicant is liable to pay at the time the application is made.

72-10(4)    
The Minister must inform the applicant in writing of the Minister ' s decision whether or not to grant the application. If the Minister decides not to grant the application, the Minister must also inform the applicant of the reason for that decision.

72-10(5)    
If:

(a)    the Minister grants the application; and

(b)    the applicant pays to the Commonwealth any *cost-recovery fee that the applicant is liable to pay in connection with the initial listing of the kind of *medical device or *human tissue product to which the application relates;

the Minister must, on the next occasion when the Minister makes or varies the Private Health Insurance (Medical Devices and Human Tissue Products) Rules:

(c)    list the kind of *medical device or *human tissue product to which the application relates in those Rules; and

(d)    set out in those Rules a minimum benefit for the medical device or human tissue product; and

(e)    if the Minister considers it appropriate - set out in those Rules a maximum benefit for the medical device or human tissue product.

Note:

Despite this subsection, the Minister may, under section 72-25 , refuse to perform a function under this subsection if the applicant fails to pay a cost-recovery fee or medical devices and human tissue products levy that is due and payable.

72-10(6)    
The Private Health Insurance (Medical Devices and Human Tissue Products) Rules may set out criteria ( listing criteria ) to be satisfied in order for an application (a listing application ) made under subsection (2) to be granted. The Rules may provide for different listing criteria to apply in different circumstances.

72-10(7)    
The Minister must not grant a listing application if any applicable listing criteria are not satisfied in relation to the application.

Note:

The Minister may refuse to grant a listing application even if the applicable listing criteria are satisfied.