Federal Register of Legislation - Australian Government

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Rules/Other as made
This instrument amends the National Health (Claims and under co-payment data) Rules 2012 (PB 19 of 2012) to detail the information to be provided by approved suppliers in relation to the supply of pharmaceutical benefits upon electronic prescriptions.
Administered by: Health
Registered 30 Oct 2019
Tabling HistoryDate
Tabled Senate11-Nov-2019
Table of contents.

 

National Health (Claims and under co‑payment data) Amendment (Electronic Prescriptions) Rules 2019

I, Thea Daniel, as delegate of the Minister for Health, make the following rules.

Dated   29 October 2019

Thea Daniel

Assistant Secretary
Pricing and Pharmaceutical Benefits Scheme Policy Branch
Technology Assessment and Access Division
Department of Health

 

  

  


Contents

1............ Name............................................................................................................................. 1

2............ Commencement............................................................................................................. 1

3............ Authority....................................................................................................................... 1

4............ Schedules...................................................................................................................... 1

Schedule 1—Amendments                                                                                                                          2

Part 1—Main amendments                                                                                                                   2

National Health (Claims and under co‑payment data) Rules 2012                                             2

Part 2—Technical corrections                                                                                                              6

National Health (Claims and under co‑payment data) Rules 2012                                             6

 


1  Name

                   This instrument is the National Health (Claims and under co-payment data) Amendment (Electronic Prescriptions) Rules 2019.

2  Commencement

             (1)  Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  The whole of this instrument

31 October 2019.

31 October 2019

Note:          This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

             (2)  Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3  Authority

                   This instrument is made under subsections 98AC(4) and 99AAA(8) of the National Health Act 1953.

4  Schedules

                   Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1Amendments

Part 1Main amendments

National Health (Claims and under co‑payment data) Rules 2012

1  Subrule 4(1)

Insert:

approved supplier has the same meaning as in Part VII of the Act.

healthcare identifier has the same meaning as in the Healthcare Identifiers Act 2010.

healthcare provider organisation has the same meaning as in the Healthcare Identifiers Act 2010.

2  Subrule 4(1) (paragraphs (c) and (d) of the definition of prescription)

Repeal the paragraphs, substitute:

                     (c)  an electronic prescription.

3  Clause 1 of Schedule 1 (after note 2)

Insert:

Note 3:       Clause 2 requires the approved supplier to give extra information in relation to the supply of a pharmaceutical benefit upon an electronic prescription.

4  Clause 1 of Schedule 1 (cell at table item 23, column 2)

Repeal the cell, substitute:

 

Continued dispensing patient = D

Community patient = 0 (zero)

Medication chart public hospital patient = M

Medication chart private hospital patient = P

Paperless private hospital patient = H

Paperless public hospital patient = C

Private PBS HMC Inpatient prescription = V

Private PBS HMC discharge prescription = W

Private PBS HMC outpatient prescription = X

Public hospital patient = B

Public PBS HMC Inpatient prescription = S

Public PBS HMC discharge prescription = T

Public PBS HMC outpatient prescription = U

Residential aged care facility patient (PBS NRMC prescription) = R

Residential aged care facility patient (prescription that is not a PBS NRMC prescription) = N

 

5  Clause 1 of Schedule 1 (after table item 25)

Insert:

 

25A

PBS Prescriber Number

The number (if any) allotted to the approval of the PBS prescriber under section 16 of the Regulations.

 

6  Clause 1 of Schedule 1 (cell at table item 28A, column 2)

Repeal the cell, substitute:

 

Claim from a paper‑based prescription, including one that is a medication chart prescription = P

Claim from an electronic prescription, including one that is a medication chart prescription = E

 

7  At the end of Schedule 1

Add:

2  Extra information required when using Claims Transmission System in relation to supply of pharmaceutical benefits upon electronic prescriptions

             (1)  For the purposes of paragraph 7(e) of these Rules, an approved supplier must give, in relation to the supply of a pharmaceutical benefit upon an electronic prescription, the information referred to in an item in the following table in accordance with that item.

Note 1:       The table applies for the purposes of an approved supplier giving under co‑payment data (see subsection 98AC(1) of the Act) or information required to be given because the approved supplier is making, or proposing to make, a claim (see subsection 99AAA(3) of the Act).

Note 2:       The details in column 2 of an item in the table may have the effect that information is not required to be given under that item in relation to a particular supply.

 

Information to be given when using the Claims Transmission System in relation to supply of pharmaceutical benefits upon electronic prescriptions

Item

Column 1

Information

Column 2

Details

1

Approved Supplier Healthcare Provider Identifier—Individual (HPI‑I)

The healthcare identifier (if any) assigned to:

(a) if the supplier is an individual—the supplier; or

(b) otherwise—the individual who supplied the pharmaceutical benefit on behalf of the supplier.

2

Approved Supplier Healthcare Provider Identifier—Organisation (HPI‑O)

The healthcare identifier assigned to a healthcare provider organisation to which the supplier, or the individual who supplied the pharmaceutical benefit on behalf of the supplier, is linked (within the meaning of the Healthcare Identifiers Act 2010).

3

Dispensing Software Conformance Identifier

A valid conformance identifier provided to the Australian Digital Health Agency in relation to the software used to dispense the pharmaceutical benefit.

4

Intermediary Systems Conformance Identifiers

A valid conformance identifier provided to the Australian Digital Health Agency in relation to any software used to store or transmit the prescription until the pharmaceutical benefit is dispensed.

5

Patient Date of Birth

The date of birth of the person for whom the pharmaceutical benefit is prescribed.

Only required if included in the electronic prescription.

6

PBS Dispensing Notes

Notes of any clarification of the prescription at the time of the supply.

7

PBS Prescriber Healthcare Provider Identifier—Individual (HPI‑I)

The healthcare identifier (if any) assigned to the PBS prescriber who wrote the electronic prescription.

Only required if included in the electronic prescription.

8

PBS Prescriber Healthcare Provider Identifier—Organisation (HPI‑O)

The healthcare identifier assigned to a healthcare provider organisation to which the PBS prescriber who wrote the electronic prescription is linked (within the meaning of the Healthcare Identifiers Act 2010).

9

PBS/RPBS Item Receipt Flag

An indication that the person to whom the pharmaceutical benefit was supplied, or an agent of that person, has acknowledged receiving the benefit.

10

Prescribed Pharmaceutical Benefit

The code, in Australian Medicines Terminology, for the pharmaceutical benefit that is prescribed.

Only required if included in the electronic prescription.

11

Prescribing Software Conformance Identifier

A valid conformance identifier provided to the Australian Digital Health Agency in relation to the software used to prepare the prescription.

12

Reason for Prescription

The code, in SNOMED CT‑AU clinical terminology, for the clinical condition for which the pharmaceutical benefit is prescribed.

Only required if included in the electronic prescription.

13

Reason for Supply

The code, in SNOMED CT‑AU clinical terminology, for the clinical condition for which the pharmaceutical benefit is supplied.

Optional.

14

Supplied Pharmaceutical Benefit

The code, in Australian Medicines Terminology, for the pharmaceutical benefit that is supplied.

Optional.

15

Unique PBS Electronic Prescription Number

A unique identifier for the prescription generated by the software used to prepare the prescription.

 

             (2)  This clause has effect in addition to clause 1.

Part 2Technical corrections

National Health (Claims and under co‑payment data) Rules 2012

8  Subrule 4(1) (paragraph (a) of the definition of authority prescription)

Omit “subregulation 13(5)”, substitute “subsection 30(4)”.

9  Subrule 4(1) (definition of deferred supply authorisation)

Omit “regulation 26A”, substitute “section 53”.

10  Subrule 4(1) (note to the definition of paper‑based prescription)

Repeal the note.

11  Subrule 4(1) (paragraph (a) of the definition of prescriber bag supply form)

Omit “regulation 16”, substitute “section 33”.

12  Subrule 4(1) (paragraph (b) of the definition of prescriber bag supply form)

Omit “subregulation 18A(3)”, substitute “subsection 36(4)”.

13  Subrule 4(1) (paragraph (c) of the definition of prescriber bag supply form)

Omit “subregulation 18A(5A)”, substitute “subsection 36(7)”.

14  Subrule 4(1) (definition of Regulations)

Omit “1960 made under the Act”, substitute “2017”.

15  Subrule 4(1) (paragraph (a) of the definition of repeat authorisation)

Omit “regulation 26”, substitute “section 52”.

16  Subrule 4(1) (paragraph (a) of the definition of under co‑payment data)

After “99(2B)”, insert “of the Act”.

17  Paragraph 7(a)

Omit “regulation 8A”, substitute “section 16”.

18  Clause 1 of Schedule 1 (table item 17)

Omit “regulation 25”, substitute “section 51 of the Regulations”.

19  Clause 1 of Schedule 1 (table item 20)

Omit “regulation 24”, substitute “section 49 of the Regulations”.

20  Clause 1 of Schedule 1 (table item 21)

Omit “regulation 8A”, substitute “section 16 of the Regulations”.

21  Clause 1 of Schedule 1 (table items 31 and 32)

Omit “under regulation 24”, substitute “under section 49 of the Regulations”.