Part 3Other

Part 3—Other

11 Timing of applications to have a prosthesis listed

As a matter of normal administrative practice, applications made under subsection 72‑10(2) of the Act will be considered after they have been received and, if the Minister decides to grant the application, the kind of prosthesis will be listed in Schedule 1 the next time the Minister makes or varies the Private Health Insurance (Prostheses) Rules.

Note 1: Under subsection 72‑10(5) of the Act the Minister must list the kind of prosthesis, set out the minimum benefit and, if the Minister considers it appropriate, the maximum benefit for the prosthesis in these Rules on the next occasion that the Minister makes or varies the Rules after he or she grants an application and the applicant has paid to the Commonwealth any initial listing fee within 14 days of being informed of the Minister's decision to grant the application.

Note 2: Under subsection 72‑15(3) of the Act, the Minister may remove a kind of prosthesis from the list in the Rules if the applicant fails to pay an ongoing listing fee.

12 Minister may have regard to recommendations and advice

In making the decision under subsection 72‑10 of the Act, the Minister may have regard to a recommendation from the Prostheses List Advisory Committee.

13 Listing criteria for prostheses to be listed in Part C of Schedule 1

For a listing application to be granted to list a kind of prosthesis in Part C of Schedule 1, the listing criterion is that the kind of prosthesis is:

(i) an insulin infusion pump;
(ii) an implantable cardiac event recorder;
(iii) a cardiac home/remote monitoring system;
(iv) a cardiac ablation catheter;
(v) a mapping catheter for catheter cardiac ablation;
(vi) a patch for cardiac ablation;
(vii) a monopolar device for surgical cardiac ablation;
(viii) a bipolar device for surgical cardiac ablation;
(ix) a system for surgical cardiac ablation; or
(x) a probe for surgical cardiac ablation.

Note 1: The power to make listing criteria is in subsection 72‑10(6) of the Act.

Note 2: Under subsection 72‑10(7) of the Act the Minister must not grant a listing application if any applicable listing criteria are not satisfied in relation to the application.

Note 3: Under the Act the Minister may refuse to grant a listing application even if the listing criteria are satisfied. See Note to subsection 72‑10(7) of the Act.