APRA consults on private health insurance reporting changes

The Australia Prudential Regulation Authority (APRA) is seeking industry feedback on proposed changes to private health insurance (PHI) reporting standards following amendments to PHI legislation.

APRA has proposed amendments to three PHI reporting standards:

• Reporting Standard HRS 601.0 Statistical Data by State (HRS 601.0);
• Reporting Standard HRS 603.0 Statistical Data on Prosthetic Benefits (HRS 603.0); and
• Reporting Standard HRS 605.0 Private Health Insurance Reform Data Collection (HRS 605.0).

The regulator proposed to replace the terms “prosthesis,” “prostheses,” and “prosthetic” with medical devices or human tissue products to ensure consistency between the terminology used in the updated PHI legislation and APRA reporting standards. It also made minor amendments, including removing references to the Health Insurance Act in the definition of nursing home type patient in HRS 601.0.

Updated PHI legislation

On December 01, 2022, three bills were introduced to the Parliament to change four PHI legislations:

• Private Health Insurance Legislation Amendment (Medical Device and Human Tissue Product List and Cost Recovery) Bill 2022;
• Private Health Insurance (Prostheses Application and Listing Fees) Amendment (Cost Recovery) Bill 2022; and
• Private Health Insurance (National Joint Replacement Register Levy) Amendment (Consequential Amendments) Bill 2022.

The bills passed in March 2023 and came into effect on July 01, 2023.

The amended reporting standards are expected to apply to reporting periods ending on, or after, December 31, 2023. The consultation is open for submissions until August 31, 2023.

“In the meantime, APRA expects entities to continue reporting in line with the current reporting standards,” APRA chief data officer Surabhi Jain said in a letter to private health insurers.