Document ID: chunk:federal_register_of_legislation:F2024C01114:clause:7_29:p6
Version: federal_register_of_legislation:F2024C01114
Segment Type: clause
Provision Reference: sch 7 cl 29 (pt 6/7)
Character Range: 52434–55307

policy holders, new models of service delivery or health care.  The objectives of the pilot project must be for any or all of the following:

        (a) to increase the value to consumers of their health insurance products by better meeting their needs;

        (b) to prolong health, improve quality of life and reduce expenditure on hospital benefits by preventing and reducing disease and prevent the need for hospitalisation;

        (c) to produce products that better reflect advances in medical knowledge and service delivery models.

     18. Requirements of pilot projects

       For the purposes of sub‑section 55‑15(2) of the Act, a pilot project of a kind specified in rule 17 is to be conducted in accordance with all the following requirements:

         (a) an insurer must not charge a person to participate in the project;

         (b) participation in a pilot project must be voluntary;

         (c) a pilot project may be conducted for a maximum of four years;

         (d) an insurer may only limit participation in a pilot project on the basis of where a person lives;

         (e) an insurer must develop a written plan for a pilot project, including a timeline and evaluation process;

         (f) written notice of the details of the project, including a copy of the written plan referred to in (e), must be provided to the Department at least 28 days before the pilot project commences.

Part 5 Transitional provisions

     19. Transitional provisions relating to the Private Health Insurance (Complying Product) Amendment (Psychiatric Care) Rules 2018

Definitions

      (1) In this rule:

      amending rules means the Private Health Insurance (Complying Product) Amendment (Psychiatric Care) Rules 2018.

Application of subrule 9A(4)

      (2) Subrule 9A(4), as inserted by the amending rules, applies to a waiting period that ends on or after 1 April 2018, whether the upgrade occurred before, on or after 1 April 2018.

Application of subrules 9A(6) to (8)

      (3) Subrules 9A(6) to (8), as inserted by the amending rules, apply to an upgrade that occurs on or after 1 April 2018.

      (4) If a person:

            (a) became an admitted patient of a hospital in relation to specialist psychiatric treatment before 1 April 2018; and

            (b) is still an admitted patient in relation to the treatment on 1 April 2018;

      the reference in paragraph 9A(6)(a), as inserted by the amending rules, to the day the person became an admitted patient of a hospital in relation to the treatment is taken to be a reference to 1 April 2018.

      (5) If subrule 9A(7), as inserted by the amending rules, would, apart from this subrule, require an insurance policy's coverage of specialist psychiatric treatment to start before 1 April 2018, subrule 9A(7) is taken to require the coverage to start no later than 1 April