Document ID: chunk:federal_register_of_legislation:C2025C00097:section:5:p1
Version: federal_register_of_legislation:C2025C00097
Segment Type: section
Provision Reference: s 5 (pt 1/56)
Character Range: 84025–87067

5                                                                      any treatment for which the Private Health Insurance (Benefit Requirements) Rules specify there must be a benefit.                                                                                                                                                                                                     at least the amount set out, or worked out using the method set out, in the Private Health Insurance (Benefit Requirements) Rules as the minimum benefit, or method for working out the minimum benefit, for that treatment.

Note: If a private health insurer provides an insured person with, or arranges for an insured person to be provided with, treatment, it is treated as a benefit for the purposes of this Division (see subsection 69‑5(3)).
 (3) For the purposes of this section, disregard section 19AD of the Health Insurance Act 1973 when determining whether medicare benefit is payable.

72‑5  Rules requirement in relation to provision of benefits
 (1) For the purposes of paragraph 72‑1(1)(d), the *rules of the private health insurer that issues the policy meet the rules requirement in this section if the rules have the effect required by subsection (2).
 (2) The effect required is that if, under an agreement or arrangement with a private health insurer, a particular *health care provider (other than a *medical practitioner) provides particular *hospital treatment or *hospital‑substitute treatment to people insured under the same *complying health insurance product of the insurer, any charge for the treatment:
 (a) that is payable by an insured person; and
 (b) which is not recoverable by a benefit under the product;
must be the same for all of the people insured under the product, irrespective of:
 (c) the frequency with which that provider provides that particular treatment to people insured under that product; or
 (d) any other matter.
 (3) The Private Health Insurance (Complying Product) Rules may modify the effect required by subsection (2) in relation to all or particular kinds of *complying health insurance products, benefits, treatments or *health care providers. To the extent the Rules do so, the rules requirement is taken to be met if the conditions in the Rules are met.

72‑10  Minimum benefits for medical devices and human tissue products
 (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.
 (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.
 (3) The application must be:
 (a) in the *approved form; and
 (b)