{"id":"F2024L00145","name":"Financial Sector (Collection of Data) (reporting standard) determination No. 2 of 2024","slug":"financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2024","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":105082,"registerId":"commonwealth-F2024L00145-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Financial Sector (Collection of Data) (reporting standard) determination No. 2 of 2024","content":"![Commonwealth Coat of Arms of Australia](image.001.png)\n\nFinancial Sector (Collection of Data) (reporting standard) determination No. 2 of 2024\n\nReporting Standard HRS 603.0 Statistical Data on Medical Devices or Human Tissue Products Benefits\n\nFinancial Sector (Collection of Data) Act 2001\n\nI, Andrew Robertson, delegate of APRA, under paragraph 13(1)(a) of the Financial Sector (Collection of Data) Act 2001 (the Act) and subsection 33(3) of the Acts Interpretation Act 1901:\n\n(a) revoke Financial Sector (Collection of Data) (reporting standard) determination No. 33 of 2015, including Reporting Standard HRS 603.0 Statistical Data on Prosthetic Benefits made under that Determination; and\n\n(b) determine Reporting Standard HRS 603.0 Statistical Data on Medical Devices or Human Tissue Products Benefits, in the form set out in the Schedule, which applies to the financial sector entities to the extent provided in paragraph 3 of the reporting standard.\n\nUnder section 15 of the Act, I declare that the reporting standard shall begin to apply to those financial sector entities, and the revoked reporting standard shall cease to apply, at the start of the day after the instrument is registered on the Federal Register of Legislation.\n\nThis instrument commences at the start of the day after the day that the instrument is registered on the Federal Register of Legislation.\n\nDated: 1 February 2024\n\nAndrew Robertson\n\nGeneral Manager – Chief Data Officer\n\nTechnology and Data Division\n\nInterpretation\n\nIn this Determination:\n\nAPRA means the Australian Prudential Regulation Authority.\n\nFederal Register of Legislation means the register established under section 15A of the Legislation Act 2003.\n\nfinancial sector entity has the meaning given by section 5 of the Act.\n\nSchedule\n\nReporting Standard HRS 603.0 Statistical Data on Medical Devices or Human Tissue Products Benefits comprises the document commencing on the following page.\n\n![Commonwealth Coat of Arms of Australia](image.001.png)\n\nReporting Standard HRS 603.0\n\nStatistical Data on Medical Devices or Human Tissue Products Benefits\n\nObjective of this Reporting Standard\n\nThis Reporting Standard sets out the requirements for the provision of information to APRA allowing for the publication of aggregate statistics on the use of medical devices or human tissue products by State and Territory.\n\nIt includes Form HRF 603.0 Statistical Data on Medical Devices or Human Tissue Products Benefits and associated specific instructions.\n\nAuthority\n\n1. This Reporting Standard is made under section 13 of the Financial Sector (Collection of Data) Act 2001.\n\nPurpose\n\n2. Information collected under this Reporting Standard, as set out in Form HRF 603.0 Statistical Data on Medical Devices or Human Tissue Products Benefits (HRF 603.0), is used for the purposes of assisting the Department of Health in performing its functions and for publication by APRA.\n\nApplication\n\n 3. This Reporting Standard applies to all private health insurers.\n\n4. This Reporting Standard applies for reporting periods ending on or after 31 March 2024.\n\nInformation required\n\n5. A private health insurer must provide APRA with the information required by HRF 603.0 in respect of each reporting period.\n\n6. The information required by this Reporting Standard, as set out in HRF 603.0, must be provided for each health benefits fund of the private health insurer.\n\nMethod of submission\n\n7. The information required by this Reporting Standard must be given to APRA:\n\n(a) in electronic format using an electronic method available on APRA’s website; or\n\n(b) by a method notified by APRA prior to submission.\n\nReporting periods and due dates\n\n8. A private health insurer to which this Reporting Standard applies must provide the information required by this Reporting Standard in respect of each calendar quarter (i.e. the periods ending 30 September, 31 December, 31 March and 30 June).\n\n9. The information required by this Reporting Standard must be provided to APRA within 28 calendar days after the end of the reporting period to which the information relates.[\\[1\\]](#_ftn1)\n\n10. APRA may, in writing, grant a private health insurer an extension of a due date, in which case the new due date for the provision of the information will be the date on the notice of extension.\n\nQuality control\n\n11. All information provided by a private health insurer under this Reporting Standard must be subject to systems, processes and controls developed by the private health insurer for the internal review and authorisation of that information. It is the responsibility of the Board and senior management of the private health insurer to ensure that an appropriate set of policies and procedures for the authorisation of information submitted to APRA is in place.\n\nAuthorisation\n\n12. A person who submits the information required under this Reporting Standard must be suitably authorised by an officer of the private health insurer.\n\nVariations\n\n13. APRA may, in writing, vary the reporting requirements of this Reporting Standard in relation to a private health insurer.\n\nTransitional\n\n14. An insurer must report under the old reporting standard in respect of a transitional reporting period. For these purposes:\n\nold reporting standard means the reporting standard revoked in the determination making this Reporting Standard; and\n\ntransitional reporting period means a reporting period under the old reporting standard:\n\n(a) which ended before 31 March 2024; and\n\n(b) in relation to which the insurer was required, under the old reporting standard, to report by a date on or after the date of revocation of the old reporting standard.\n\n Note: For the avoidance of doubt, if an insurer was required to report under an old reporting standard, and the reporting documents were due before the date of revocation of the old reporting standard, the insurer is still required to provide any overdue reporting documents in accordance with the old reporting standard.\n\nInterpretation\n\n15. In this Reporting Standard:\n\n(a) unless the contrary intention appears, words and expressions have the meanings given to them in Prudential Standard HPS 001 Definitions (HPS 001); and\n\n(b) APRA means the Australian Prudential Regulation Authority established under the Australian Prudential Regulation Authority Act 1998;\n\nofficer has the meaning in the Private Health Insurance (Prudential Supervision) Act 2015;\n\nprivate health insurer has the meaning in the Private Health Insurance (Prudential Supervision) Act 2015; and\n\nreporting period means a period mentioned in paragraph 8.\n\n| HRF_603_0_1: Statistical Data on Medical Devices or Human Tissue Products Benefits - NSW |\n| ---------------------------------------------------------------------------------------- |\n\n| Australian Business Number | Institution Name |\n| -------------------------- | ----------------------------------- |\n| | |\n| Reporting Period | Scale Factor |\n| Quarterly | Whole dollars to two decimal places |\n| Reporting Consolidation | |\n| Health Benefits Fund | |\n\n| Medical devices or human tissue products benefits paid by registered private health insurer |\n| ------------------------------------------------------------------------------------------- |\n\n```html\n

Private hospitals and day hospitals

Public hospitals

Medical devices or human tissue products category

Number of no gap medical devices or human tissue products

No gap benefits paid

Number of gap permitted medical devices or human tissue products

Gap permitted charge

Gap permitted benefits paid

Number of no gap medical devices or human tissue products

No gap benefits paid

Number of gap permitted medical devices or human tissue products

Gap permitted charge

Gap permitted benefits paid

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

1 - Ophthalmic

2 - Ear, Nose & Throat

3 - General Miscellaneous

4 - Neurosurgical

5 - Urogenital

6 - Specialist Orthopaedic

7 - Plastic and Reconstructive

8 - Cardiac

9 - Cardiothoracic

10 - Vascular

11 - Hip

12 - Knee

13 - Spinal

Other

\n```\n\n| Total | | | | | | | | | | |\n| ----- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n\n| | Number | Benefits |\n| ------------------------------------ | ------ | -------- |\n| | (1) | (2) |\n| 2. Total public and private hospital | | |\n\n---\n\n[\\[1\\]](#_ftnref1) For the avoidance of doubt, APRA’s expectation is that if the due date for a particular reporting period falls on a day other than a usual business day, a private health insurer will submit the information required no later than the due date.","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument replaces the 2015 reporting standard on prosthetic benefits with a broader Reporting Standard HRS 603.0 on \"Medical Devices or Human Tissue Products Benefits\" (revocation and replacement in the instrument preamble and Schedule). That change alters the subject matter covered (from prosthetic benefits to medical devices and human tissue products), introduces a detailed, category‑based form (HRF 603.0) with 13 clinical categories and separate private/public hospital breakdowns, and updates reporting mechanics (quarterly submissions, electronic method, defined 28‑day due date). The change therefore broadens and reconfigures the data collected compared with the earlier standard and may affect time‑series comparability and insurer compliance scope (instrument preamble; Schedule paras 2–6; HRF 603.0)."},"complexity_factors":["Single reporting standard document replacing an older standard (revocation plus replacement clauses)","Applies uniformly to all private health insurers (para 3) but requires per‑fund reporting (para 6)","Quarterly frequency with 28‑day statutory due date and potential APRA extensions (paras 8–10)","Cross‑reference to Prudential Standard HPS 001 for definitions (para 15(a))","Transitional provisions requiring some insurers to continue reporting under the old standard in certain cases (para 14)","Reporting form with 13 named clinical categories plus 'Other' and multiple columns (no‑gap, gap permitted numbers and amounts) for private and public hospital settings (HRF 603.0 table)","APRA discretion to vary requirements in writing for individual insurers (para 13)","Governance requirements for internal review and board/senior management responsibility (para 11) and authorised submitter requirement (para 12)"],"plain_english_summary":"**What this instrument does (mechanics)\n\n- Repeals the previous APRA reporting standard on prosthetic benefits and replaces it with a new reporting standard titled \"Reporting Standard HRS 603.0 Statistical Data on Medical Devices or Human Tissue Products Benefits\" (instrument preamble and first paragraphs).\n- Requires all private health insurers to submit a specified data form (HRF 603.0) to APRA for each calendar quarter ending on or after 31 March 2024 (Application para 3; Para 4; Information required para 5–6; Reporting periods para 8).\n- Sets the due date: data must be submitted within 28 calendar days after the end of the quarter, subject to APRA-granted extensions (Para 9–10).\n- Prescribes the submission methods (electronic via APRA’s website or another method APRA notifies) and requires internal quality-control and authorised sign-off by the insurer (Method of submission para 7; Quality control para 11; Authorisation para 12).\n- Gives APRA the power to vary reporting requirements in writing for an individual private health insurer and provides transitional rules for reports that were due under the revoked standard (Variations para 13; Transitional para 14).\n- The stated purpose is to collect information that APRA will publish in aggregate and that will assist the Department of Health (Objective/Purpose paragraphs).\n\n**Who has to do what (who pays, who decides, what changes)\n\n- Who pays / provides the data: every private health insurer (defined under the Private Health Insurance (Prudential Supervision) Act 2015) must collect and provide the data required by HRF 603.0 for each of its health benefits funds (Application para 3; Para 6).\n- Who decides / enforces: APRA sets and collects the data under the Financial Sector (Collection of Data) Act 2001; APRA can vary requirements in writing for particular insurers (Authority para 1; Variations para 13).\n- Behaviour change required of insurers: map claims/payments for medical devices or human tissue products to the specified categories and columns in HRF 603.0; submit quarterly by the due date; maintain internal systems, controls and authorised sign-off procedures for the submitted data (Information required para 5–6; Quality control para 11; Authorisation para 12).\n\n**What data is collected (form structure in plain terms)\n\n- The reporting form (HRF 603.0) collects, by State/Territory and by health benefits fund, counts and dollar amounts for categories of medical devices or human tissue products.\n- For both private hospitals/day hospitals and public hospitals the form captures: number of \"no gap\" items, total \"no gap\" benefits paid, number of \"gap-permitted\" items, gap-permitted charge, and gap-permitted benefits paid. The form lists 13 clinical categories (e.g. Ophthalmic, Cardiac, Hip, Knee, etc.) plus an \"Other\" row and totals (Form table).\n\n**Why APRA says it matters (stated rationale)\n\n- APRA states the collected information will be used to assist the Department of Health and for APRA to publish aggregate statistics on usage of medical devices and human tissue products by State and Territory (Objective; Purpose para 2).\n\n**Testing that stated purpose against costs, incentives and trade-offs\n\n- Direct compliance cost and frequency: insurers must report every calendar quarter (Para 8) and meet a 28‑day deadline (Para 9). Costs include IT changes to extract/match claims to the specified categories, staff time for validation and senior‑management/board oversight of controls (Quality control para 11). Those costs are concentrated on private health insurers and their funds (Application para 3; Para 6).\n- Data mapping and definitional risk: the standard relies on defined terms in Prudential Standard HPS 001 (Interpretation para 15(a)). Insurers will need to reconcile their internal item codes and clinical classifications to the Form's categories and to any definitions in HPS 001, which may require interpretation and system changes.\n- Administrative discretion and operational risk: APRA can vary requirements for particular insurers (Para 13). That provides flexibility but increases uncertainty about permanent reporting obligations and potential compliance planning costs.\n- Publication and competitive effects: APRA will publish aggregate statistics (Purpose para 2). Aggregate publication lowers the risk that commercially sensitive firm‑level data is exposed, but insurers bear the cost of gathering and assuring the underlying data. Aggregate public statistics may affect Department of Health policy work; any competitive impacts are indirect because reporting is by fund and State aggregated, not necessarily firm‑level public disclosure (Purpose para 2; Form structure).\n- Transitional and timing friction: transitional rules (Para 14) require insurers to finish outstanding reports under the old standard where due dates fall after revocation; this reduces immediate discontinuity but requires maintenance of two reporting logics briefly.\n- Potential for substitution or compliance avoidance: the instrument compels reporting of certain benefit categories. If insurers find the compliance cost high relative to the value of offering certain product options, they could alter product design, pricing or coding practices to reduce reporting burdens — although the form's categories mirror clinical groupings, limiting easy re‑classification.\n\n**Implementation burdens and governance implications\n\n- Insurers must have systems, processes and board/senior management oversight for internal review and authorisation of data submitted to APRA (Quality control para 11; Authorisation para 12).\n- The reporting method is electronic (Para 7), so insurers need compatible data export facilities and likely validation routines prior to submission.\n- APRA may grant extensions in writing; insurers should plan for exception handling and maintain records of any extensions (Para 10).\n\n**Key cross‑references and definitions to note\n\n- The Reporting Standard uses definitions from Prudential Standard HPS 001 (Interpretation para 15(a)) and the Private Health Insurance (Prudential Supervision) Act 2015 for \"officer\" and \"private health insurer\" (Interpretation para 15).\n- The new standard replaces the prior Reporting Standard No. 33 of 2015 and the older HRS 603.0 on prosthetic benefits (instrument preamble and revocation clause), so historical comparability of time series may be affected depending on how categories changed.\n\n**Practical takeaways for an insurer**\n\n- Expect a quarterly electronic submission per health benefits fund covering counts and dollar amounts for 13 named clinical categories plus \"Other\", split by private vs public hospital settings and by \"no‑gap\" vs \"gap‑permitted\" items (Form HRF 603.0).\n- Update IT and reporting processes to map internal coding to the form, implement internal review and authorised sign‑off, and allow at least 28 days after quarter‑end to prepare and lodge the return unless an APRA extension is obtained.\n\n(References: instrument preamble; Schedule: Objective, Purpose, Application paras 2–6, 8–15; Form HRF 603.0.)"},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":true,"description":"The original 2015 standard covered 'prosthetic benefits' only. This 2024 version expands scope to 'medical devices or human tissue products benefits' - a broader category that captures more types of implantable medical items. The change reflects updated medical terminology and regulatory scope, though the core purpose (statistical reporting to Health Department) remains unchanged."},"complexity_factors":["Short, single-purpose instrument (approximately 15 operative paragraphs plus form)","Only 4 defined terms in the interpretation section (APRA, Federal Register of Legislation, financial sector entity, plus inherited definitions from other Acts)","Simple conditional logic: quarterly reporting with fixed due dates, plus discretionary extension power","One cross-reference to Prudential Standard HPS 001 for definitions","Straightforward transitional provision handling overlap with old standard","Main complexity lies in the detailed tabular form (HRF 603.0) with 13 medical device categories and 11 data columns, but this is formatting rather than legal complexity"],"plain_english_summary":"This APRA reporting standard requires all Australian private health insurers to collect and submit quarterly electronic data (within 28 days) on payments for medical devices and human tissue products—expanding the former 2015 prosthetic-only regime. Insurers must report counts and dollars by device category, payment gap status and hospital type, with senior-officer authorisation and internal quality controls. APRA will publish aggregate statistics to inform the Department of Health and improve transparency of private insurer payouts for costly implants."}},"importantCases":[],"_links":{"self":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2024","history":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2024/history","analysis":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2024/analysis","conflicts":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2024/conflicts","importantCases":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2024/important-cases","documents":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2024/documents"}}