Private Health Insurance (Data Provision) Rules 2018
Part 1Preliminary
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Part 1—Preliminary
1 Name of Rules
These Rules are the Private Health Insurance (Data Provision) Rules 2018.
4 Definitions
In these Rules:
Act means the Private Health Insurance Act 2007.
GT‑Dental Data from Insurers to the Department means the protocol set out in the document approved by the Assistant Secretary of the Private Hospitals Branch of the Department of Health and Aged Care on 14 April 2025 which consists of “Data Specifications (GT‑Dental)” and “Explanatory Notes (GT‑Dental)”.
HCP1 Data from Insurers to the Department means the protocol set out in the document Supplementary – HCP Data Specifications HCP1 Insurer to Department 2025‑26 approved by the Assistant Secretary of the Private Hospitals Branch of the Department of Health, Disability and Ageing on 17 October 2025 and which consists of:
(a) Explanatory Notes;
(b) Data Specifications – Episode;
(c) Data Specifications – Medical;
(d) Data Specifications – MDHT; and
(e) Data Specification – AN‑SNAP.
HCP1 Data from Insurers to the Department 2024‑25 means the protocol set out in the document Supplementary – HCP Data Specifications HCP1 Insurer to Department 2024‑25 approved by the Assistant Secretary of the Data and Analytics Branch of the Department of Health, Disability and Ageing on 17 October 2025 and which consists of:
(a) Explanatory Notes;
(b) Data Specifications – Episode;
(c) Data Specifications – Medical;
(d) Data Specifications – MDHT; and
(e) Data Specification – AN‑SNAP.
HCP2 Data from Insurers to the Department means the protocol set out in the document approved by the Assistant Secretary of the Private Hospitals Branch of the Department of Health and Aged Care on 14 April 2025 which consists of “Data Specifications (HCP2)” and “Explanatory Notes (HCP2)”.
Note: Terms used in these Rules have the same meaning as in the Act―see section 13 of the Legislation Act 2003. These terms include:
health benefits fund
private health insurer
complying health insurance products
5 Information to be provided
(1) For the purpose of section 172‑10(1) of the Act, in relation to the treatment of insured persons under complying health insurance products that are referable to health benefits funds, private health insurers must give to the Secretary of the Department the information specified in: (a) GT‑Dental Data from Insurers to the Department; and (b) HCP1 Data from Insurers to the Department; and (ba) HCP1 Data from Insurers to the Department 2024‑25; and (c) HCP2 Data from Insurers to the Department.