The National Health Service (Exemptions from Charges, Payments and Remission of Charges) (Amendment and Transitional Provisions) Regulations 2016

Amendment to the 2003 Regulations

2.—(1) The 2003 Regulations are amended in accordance with this regulation.

(2) In regulation 2(1) (interpretation)—

(a) omit the definitions of “LCW element” and “LCWRA element”; and

(b) in the definitions of “couple” and “single person”, omit the words from “except” to the end of each definition.

(3) In regulation 5(2) (entitlement to full remission and payment), for paragraph (1A), substitute—

“(1A) For the purposes of paragraph (1)(f) “relevant universal credit recipient” means a person who, in the relevant assessment period—

(a) had an award of universal credit, either as a single claimant or as one of joint claimants, where—

(i) the award did not include the child element,

(ii) the single claimant or, as the case may be, both joint claimants, did not have limited capability for work, and

(iii) the single claimant had earned income or, as the case may be, the joint claimants had combined earned income, of £435.00 or less;

(b) had an award of universal credit, either as a single claimant or as one of joint claimants, where—

(i) the award included the child element, and

(ii) the single claimant had earned income or, as the case may be, the joint claimants had combined earned income, of £935.00 or less;

(c) had an award of universal credit, either as a single claimant or as one of joint claimants, where—

(i) the single claimant or, as the case may be, one or both joint claimants, had limited capability for work, and

(ii) the single claimant had earned income or, as the case may be, the joint claimants had combined earned income, of £935.00 or less; or

(d) was a child or a qualifying young person for whom a person referred to in sub-paragraph (b) or (c) is responsible (within the meaning of Part 1 of the 2012 Act(3) (universal credit) and regulations made thereunder).

(1B) Where paragraph (1C) applies, a person is to be treated as entitled to claim repayment of a NHS charge or NHS travel expenses under regulation 11.

(1C) This paragraph applies where the conditions specified in sub-paragraphs (a), (b), (c) or (d) of paragraph (1A) are satisfied in the assessment period(4) in which the NHS charge or NHS travel expense is incurred and—

(a) there is no relevant assessment period; or

(b) none of those conditions were satisfied in the relevant assessment period.

(1D) For the purposes of paragraphs (1A) and (1C)—

“joint claimants” has the meaning given in section 40 of the 2012 Act (interpretation of Part 1);

“limited capability for work” means limited capability for work or limited capability for work and work-related activity as construed in accordance with regulations 39 and 40 respectively of the Universal Credit Regulations 2013 (limited capability for work; limited capability for work and work-related activity)(5);

“relevant assessment period” means the assessment period immediately preceding that in which the NHS charge was paid or NHS travel expenses incurred(6); and

“single claimant” has the meaning given in section 40 of the 2012 Act (interpretation of Part 1).”.

(4) In Schedule 1 (modifications of the Income Support (General) Regulations 1987)(7), in column 2 of Table A—

(a) in the modification of regulation 62(8) (calculation of grant income), in sub-paragraph (2C)(b)—

(i) for “regulations 41 to 44 of the Education (Student Support) (Wales) Regulations 2012” substitute “regulations 36 to 39 of the Education (Student Support) (Wales) Regulations 2015”(9); and

(ii) for “regulations 51 to 55” substitute “regulations 46 to 49”; and

(b) in the modification of regulation 66A(10) (treatment of student loans)—

(i) at the beginning of paragraph (1), for “A student loan” substitute “Subject to paragraph (1B), a student loan”; and

(ii) after paragraph (1A), insert—

“(1B)  Where a student is a 2016 cohort student for the purposes of the Education (Student Support) Regulations 2011(11) and a loan is available to that student under Part 6 of those Regulations (loans for living costs), the amount to be disregarded as income (if greater than zero) is A-B, where—

(a) A is the amount of that loan, as calculated in accordance with regulation 71(1)(g) (general) of those Regulations; and

(b) B is the maximum amount of such a loan that is available to an equivalent 2012 cohort student under regulation 76 (2012 cohort students with full entitlements) of those Regulations, as calculated in accordance with regulation 71(1)(c) of those Regulations.”.

(1)

Regulation 2 was amended by S.I. 2004/663, 2005/26, 2114, 2006/562, 2008/571 and 1697, 2013/475 and 2015/570, 643 and 1776.

(2)

Regulation 5 was amended by S.I. 2004/663 and 936, 2006/562, 2008/1697, 2009/411, 2013/475 and 2015/570, 643 and 1776.

(3)

2012 c.5. See regulation 4 of S.I. 2013/376 for the meaning of responsibility for a child or qualifying young person.

(4)

See regulation 2 of S.I. 2003/2382 for the meaning of “assessment period”.

(5)

Regulations 39 and 40 were amended by S.I. 2014/597.

(6)

See regulations 3(1) and 4(1) of S.I. 2003/2382 for the meaning of “NHS travel expense” and “NHS charge”.

(7)

S.I. 1987/1967 as amended.

(8)

Regulation 62 is amended by S.I. 1988/663, 1992/2155, 1996/1944, 1999/1935, 2000/1444 and 1922, 2001/2319, 2002/1589, 2003/455, 2004/1708, 2005/574 and 1807, 2006/1752, 2007/1632, 2009/ 583 and 1575 and 2016/743.

(9)

S.I. 2015/54; amended by S.I. 2015/1505 and 2016/77 and 211.

(10)

Regulation 66A is amended by S.I. 1999/1935, 2000/1922, 2001/2319, 2002/1589, 2007/1632, 2008/2767, 2009/583, 1575 and 3152 and 2016/743.

(11)

S.I. 2011/1986; amended by S.I. 2012/1653, 2013/235, 630, 1728 and 3106, 2014/1766, 2103 and 2765, 2015/1951 and 2016/211, 270 and 584.