Document ID: chunk:federal_register_of_legislation:F2025C00117:body:0:p2
Version: federal_register_of_legislation:F2025C00117
Segment Type: other
Provision Reference: 
Character Range: 2742–5825

2 ‑ Overnight shared ward accommodation for private patients at public hospitals in the Australian Capital Territory, New South Wales, Northern Territory, Queensland, South Australia and Western Australia
1. Circumstances
2. Minimum benefit
Schedule 3―Same‑day accommodation:  hospitals in all States/Territories
Part 1 General
1. Circumstances
2. Minimum benefit
Part 2 Type B procedures
3. Interpretation
4. Band 1
5. Non‑band specific Type B day procedures
6. Other bands
7. Certified Type C procedure
Part 3 Type C procedures
8. Interpretation
Schedule 4―Nursing‑home type patient accommodation:  hospitals in all States/Territories
1. Circumstances
2. Interpretation
3. Application
4. Provision of acute care
5. Ceasing and resuming hospital treatment
6. Minimum benefit
Table 1
Table 2
Schedule 5―Second‑tier default benefits
1. Interpretation
1A. Categorisation of private hospitals
1B. Internal review of a categorisation determination
2. Circumstances
3. Minimum benefit
4. Transitional
Endnotes
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history

Part 1 Preliminary

1. Name of Rules

     These Rules are the Private Health Insurance (Benefit Requirements) Rules 2011.

3. Definitions

     In these Rules:

     Act means the Private Health Insurance Act 2007.

     ACT means the Australian Capital Territory.

     certified Type B procedure means a Type B procedure certified in accordance with clause 10 of Schedule 1.

     certified overnight Type C procedure means a Type C procedure certified in accordance with clause 11 of Schedule 1.

     certified Type C procedure means a Type C procedure certified in accordance with clause 7 of Schedule 3.

     continuous period of hospitalisation, for the purpose of counting days of hospital treatment, includes any two periods during which a patient was, or is, receiving hospital treatment as a patient at a hospital, whether or not the same hospital, where the periods are separated from each other by a period of not more than 7 days during which the patient was not receiving hospital treatment as a patient at any hospital.

     diagnostic imaging services table means the table prescribed under subsection 4AA(1) of the Health Insurance Act 1973.

     fee in the MBS means the Schedule fee as defined in subsection 8(1A) of the Health Insurance Act 1973.

     general medical services table means the table prescribed under subsection 4(1) of the Health Insurance Act 1973.

     insurer means a private health insurer.

     item has the same meaning as in subsection 3(1) of the Health Insurance Act 1973.

     MBS comprises the:
           (a) general medical services table;
           (b) diagnostic imaging services table; and
           (c) pathology services table.
     negotiated agreement means an agreement entered into between a hospital and an insurer, that includes provisions to the effect that, except to the extent (if any) provided in the agreement, the hospital agrees to accept payment by the insurer in satisfaction of any