Prostheses List Reforms – Consultation Paper 4(b) Exposure Drafts for legislative amendments to Private Health Insurance Acts to support the PL reforms

The Prostheses List (PL) Reform measures were announced as part of the 2021-22 Budget Measure: Modernising and Improving the Private Health Insurance Prostheses List to reduce the cost of medical devices used in the private health sector, improving affordability and value of private health insurance for Australians. These measures will be implemented over a four­ year period.

In order to successfully implement many of the PL Reform measures, amendments are required to the Private Health Insurance Act 2007 (PHI Act), Private Health Insurance (Prostheses Application and Listing Fees) Act 2007 (PHI Fees Act), Private Health Insurance (National Joint Replacement Register Levy) Act 2009 (PHI NJRR Act) and the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007.

The Department of Health and Aged Care has engaged in significant and ongoing stakeholder consultation since the PL Reform work commenced on 1 July 2021. In August 2022, the Department released Consultation Paper 4(a) which outlined the proposed legislative amendments and how they will modernise and improve the PL. In September 2022, the Department conducted a series of webinars with stakeholders and invited questions and comments on the proposed legislative amendments.

Additionally, on 16 September 2022, the Department released Consultation Paper 3(b) - Pathways for applications to the Prostheses List which included details of the new proposed PL cost recovery model, including a draft schedule of indicative fees.