Note: Where available, the PDF/Word icon below is provided to view the complete and fully formatted document
Private Health Insurance Legislation Amendment (Fairer Rules for General Treatments) Bill 2019

Bill home page  


Download WordDownload Word


Download PDFDownload PDF

2019

 

 

 

THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA

 

 

 

HOUSE OF REPRESENTATIVES

 

 

 

 

 

 

 

 

Private Health Insurance Legislation Amendment (Fairer Rules for General Treatments) Bill 2019

 

 

EXPLANATORY MEMORANDUM

and

STATEMENT OF COMPATIBILITY WITH HUMAN RIGHTS

 

 

 

 

 

 

 

Circulated by authority of

Andrew Wilkie MP

 



Private Health Insurance Legislation Amendment (Fairer Rules for General Treatments) Bill 2019

 

 

OUTLINE

 

This bill amends relevant legislation to prevent private health insurers awarding differential rebates for the same treatments provided under the same product in the same jurisdiction. It also gives the Australian Prudential Regulation Authority (APRA) the ability to intervene if private health insurers are inappropriately using information obtained from Health Industry Claims and Payments Service (HICAPS) to manipulate the market. Both of these amendments enshrine recommendation 12 of the 2017 Report into the Value and Affordability of Private Health Insurance and Out-of-Pocket Medical Costs conducted by the Senate Standing Committee on Community Affairs. This bill also prevents private health funds from being both insurers and service providers of general health treatments.

 

FINANCIAL IMPACT

 

The bill will have no financial impact.

 

NOTES ON CLAUSES

 

Clause 1: Short Title

 

1.       This clause is a formal provision and specifies the short title of the bill as the Private Health Insurance Legislation Amendment (Fairer Rules for General Treatments) Act 2019 .

 

Clause 2: Commencement

 

2.       This clause provides for the commencement of the Act on the day after it receives Royal Assent.

 

Clause 3: Schedules

 

3.       This clause establishes that, as the intent of the bill is to be realised through amendments to other Acts, the Schedules of this bill will amend those Acts accordingly.

 

Schedule 1

 

Private Health Insurance Act 2007

 

Item 1: After paragraph 55-5(2)(g)

 

1.       Item 1 expands the definition of ‘improper discrimination’ in the Private Health Insurance Act 2007 . It states that discrimination by a private health insurer, as to the health care provider a person chooses for their general treatment, may constitute improper discrimination on the part of the private health insurer.

 

 

 

 

Private Health Insurance (Prudential Supervision) Act 2015

 

Item 2: Section 4

 

2.       Item 2 inserts a definition of “general treatment” into the Private Health Insurance (Prudential Supervision) Act 2015.

 

Item 3: Section 14

 

3.       Item 3 is a procedural provision, allowing for the implementation of Item 4.

 

Item 4: At the end of section 14

 

4.       Item 4 inserts a provision that prevents a body registering as a private health insurer if they assume the dual role of also conducting health-related business, such as providing general treatments. For example, a private health insurer will not be able to conduct dental treatments or optometry services. However, this section will not apply to general treatments provided within an aged care facility.

 

Item 5: At the end of subsection 21(1)

 

5.       Item 5 inserts a provision relating to the cancellation of a private health insurer’s registration, being that registration may be cancelled by APRA if the insurer conducts a health-related business, including by providing general treatments. However, this section will not apply to general treatments provided within an aged care facility.

 

Item 6: At the end of section 96

 

6.       Item 6 gives APRA the authority to give direction to private health insurers to change their conduct if it believes the private health insurer is inappropriately using information gained from HICAPS to gain a competitive advantage in the private health insurance market. This will prevent private health insurance companies from knowing sensitive information about their competition, and thereby minimise the growing monopolisation that the private health insurance companies have in the market.

 

Item 7: Application provision

 

7.       Item 7 specifies that the amendments made in this Act will apply to conduct after this Act commences, meaning that the Act will not be applied retrospectively.



 

STATEMENT OF COMPATIBILITY WITH HUMAN RIGHTS

 

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011



Private Health Insurance Legislation Amendment (Fairer Rules for General Treatments) Bill 2019



This bill is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

 

Overview of the bill

 

This bill amends relevant legislation to prevent private health insurers awarding differential rebates for the same treatments provided under the same product in the same jurisdiction. It also gives the Australian Prudential Regulation Authority (APRA) the ability to intervene if private health insurers are inappropriately using information obtained from HICAPS to manipulate the market. Both of these amendments enshrine recommendation 12 of the 2017 Report into the Value and Affordability of Private Health Insurance and Out-of-Pocket Medical Costs conducted by the Senate Standing Committee on Community Affairs. This bill also prevents private health funds from being both insurers and service providers of general health treatments.

 

Human rights implications

 

This bill is necessary to ensure the right to healthcare, as enshrined in international agreements such as the International Covenant on Economic, Social and Cultural Rights, the United Nations Convention on the Rights of the Child, the Convention on the Rights of Persons with Disabilities , the Convention on the Elimination of All Forms of Discrimination Against Women , and the Convention on the Elimination of All Forms of Racial Discrimination . It prevents private health insurers from discriminating again patients seeking general treatments on the basis of the patient’s choice of private health care provider. In doing so, this bill promotes the right of everyone to enjoy the highest attainable standard of physical and mental health.

 

Conclusion

 

This bill is compatible with human rights because it strengthens human rights, particularly the right to healthcare.

 

 

 

Andrew Wilkie MP