Response to submissions: Consequential amendments to private health insurance (PHI) reporting standards

To: All private health insurers

Following the August 2023 consultation on consequential updates to three PHI reporting standards, APRA is releasing its response to submissions and finalised reporting standards. Implementing these updates will ensure consistency between terminology used across the updated PHI legislation and APRA PHI reporting standards. 

Background

To align with recent and upcoming changes to the PHI legislation, APRA proposed consequential amendments to three APRA PHI reporting standards on 2 August 2023: 

• 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). 

APRA proposed the following changes that would apply to reporting periods ending on or after 31 December 2023: 

• replacing references to the terms, prosthesis, prostheses and prosthetic with medical device/s or human tissue product/s in line with updates to PHI legislation; and 
   
• other minor updates to references to relevant legislation, including removing references to the Health Insurance Act in the definition for nursing home type patient in HRS 601.0.

Consultation feedback

APRA received six responses from industry associations, service providers and private health insurers. 

Feedback was supportive of the changes, including the decision to align with updated terminology.

Submissions also suggested providing PHIs with additional lead time to implement the changes, including making the changes effective for reporting periods ending on or after 31 March 2024. In addition, responses to the consultation also requested updated reporting templates to help PHIs prepare for the changes.

Some submissions also noted minor typographical errors and provided further feedback on APRA’s PHI data collection and publications, particularly for data on benefits related to the Prescribed List of Medical Devices and Human Tissue Products.

APRA’s response and next steps

In response to industry feedback, APRA has amended the commencement of the draft reporting standards. It is now proposed that the revised standards will apply to all reporting period ending on or after 31 March 2024. The current reporting standards will continue to apply to all reporting periods prior to the commencement of the revised standards. APRA has also corrected minor typographical errors in the reporting standards, with the changes made since consultation marked up.

APRA will release updated taxonomy artefacts for HRS 601.0, HRS 603.0, and HRS 605.0 this year.

Please refer to the reporting standards released together with this letter. PHIs are invited to contact DataConsultations@apra.gov.au with any queries.

Yours sincerely,

Andy Robertson
Chief Data Officer 
Technology and Data Division