Document ID: chunk:federal_register_of_legislation:C2025C00097:section:5:p23
Version: federal_register_of_legislation:C2025C00097
Segment Type: section
Provision Reference: s 5 (pt 23/56)
Character Range: 140521–143523

is *health insurance business; or
 (b) any other business, or business included in a class of businesses, specified in the Private Health Insurance (Health Benefits Fund Policy) Rules for the purposes of this paragraph.

131‑20  Risk equalisation jurisdictions
 (1) An area is a risk equalisation jurisdiction if the Private Health Insurance (Health Benefits Fund Policy) Rules so provide.
 (2) The Private Health Insurance (Health Benefits Fund Policy) Rules may specify circumstances in which a private health insurer may (despite subsection 23(2) of the Private Health Insurance (Prudential Supervision) Act 2015) have more than one *health benefits fund in respect of a particular *risk equalisation jurisdiction.

131‑25  Operation of health‑related businesses through health benefits funds
  If a private health insurer has a *health benefits fund in respect of its *health insurance business and some or all of its *health‑related businesses, the insurer must comply with any requirements specified in the Private Health Insurance (Health Benefits Fund Policy) Rules relating to how the health‑related businesses are to be conducted.

Part 4‑5—Miscellaneous obligations of private health insurers

Division 157—Introduction

157‑1  What this Part is about
      This Part imposes miscellaneous notification and other obligations on private health insurers.

157‑5  Private Health Insurance (Data Provision) Rules
  Obligations of private health insurers are also dealt with in the Private Health Insurance (Data Provision) Rules. The provisions of this Part indicate when a particular matter is or may be dealt with in these Rules.
Note: The Private Health Insurance (Data Provision) Rules are made by the Minister under section 333‑20.

Division 169—Notification obligations

169‑10  Private health insurers to notify any changes to rules
 (1) A private health insurer that proposes to change its *rules (other than a change to which section 66‑10 applies) must notify the Secretary of the Department of the proposed change:
 (a) in the *approved form; and
 (b) before the day on which the insurer proposes the change to take effect.
Note: See section 93‑25 for a private health insurer's obligation to notify insured persons of changes to its rules.
 (2) The Minister may, in writing, direct the insurer not to make the change if the Minister is satisfied that the change might or would result in a breach of the Act.
Note: Directions are reviewable under Part 6‑9.
 (3) The Minister must give the Secretary and *APRA a copy of a direction under subsection (2).

Division 172—Other obligations

172‑5  Agreements with medical practitioners

Medical purchaser‑provider agreements
 (1) If a private health insurer enters into an agreement with a *medical practitioner for the provision of treatment to persons insured by the insurer, the agreement must not limit the medical practitioner's professional freedom, within the scope of accepted clinical practice, to identify and provide appropriate