PB 65 of 2010

 

 

National Health (Remote Aboriginal Health Services Program) Special Arrangements Instrument 2010

 

National Health Act 1953                            

 

I, LINDA JACKSON, Assistant Secretary, Access and Systems Branch, Department of Health and Ageing, delegate of the Minister for Health and Ageing:

  1.        make the special arrangements set out in this instrument under subsection 100(1) of the National Health Act 1953; and
  2.       revoke under subsection 100(2) of the National Health Act 1953, the special arrangements made under paragraph 100(1)(a) of the National Health Act 1953 for patients of remote Aboriginal Health Services on 5 June 2009 (PB 57 of 2009).

 

 

Dated 9 June 2010

 

 

 

 

 

 

 

 

L Jackson

 

Assistant Secretary, Access and Systems Branch, Department of Health and Ageing

                                                            


Contents

 

1. Name of Instrument

2. Commencement

3. Definitions

4. Eligibility

5. Scope

6. Obtaining pharmaceutical benefit items

7. Dispensing

8. Claims system

9. Remuneration


1. Name of Instrument

 

This Instrument is the National Health (Remote Aboriginal Health Services Program) Special Arrangements Instrument 2010.

 

This Instrument may also be cited as PB 65 of 2010.

 

 

This instrument commences on 1 July 2010.

 

In this Instrument:

 

 

The eligibility criteria for the purposes of this arrangement are:

 

  1.       The Aboriginal Health Service (AHS) must have a primary function of meeting the health care needs of Aboriginal and Torres Strait Islander peoples.

 

  1.      The clinic or other health care facility operated by the AHS from which pharmaceutical benefits are supplied to patients must be in a remote zone as defined in the Rural, Remote and Metropolitan Areas Classification, 1991 Census Edition.

 

  1.       The AHS must not be a party to an arrangement, such as a coordinated care trial, for which funds from the Pharmaceutical Benefits Scheme (PBS) have already been provided.

 

  1.      The AHS must employ, or be in a contractual relationship with, health professionals who are suitably qualified under the legislation of the relevant State or Territory to supply all pharmaceutical benefits covered by these arrangements, and must undertake that all supply of pharmaceutical benefits will be made under the direction of such qualified persons.

 

  1.       The clinic or other health care facility operated by the AHS from which pharmaceutical benefits are supplied must have storage facilities that will:
    1.                  prevent access by unauthorised persons;
    2.                 maintain the quality (eg chemical and biological stability and sterility) of the pharmaceutical benefit; and
    3.                comply with any special conditions specified by the manufacturer of the pharmaceutical benefit.

 

 

PBS medicines available through this arrangement include items contained in Section 2 of the Schedule of Pharmaceutical Benefits, in force at the time of supply, excluding:

  1.       pharmaceutical benefit items supplied to medical practitioners as emergency drug (Doctor’s Bag) supplies, pursuant to section 93 of the Act; and
  2.      pharmaceutical benefit items in respect of which special arrangements are in force under paragraph 100(1)(b) of the Act; and
  3.       pharmaceutical benefit items that are Schedule 8 drugs, as defined by the relevant State or Territory drugs and poisons legislation.

 

 

Each participating remote area AHS will maintain a stock of pharmaceutical benefit items, ordered using an approval form on a bulk supply basis from an approved pharmacist or an approved hospital authority, and dispensed through the AHS as appropriate.  Pharmaceutical benefit items must be supplied directly by the approved pharmacist or the approved hospital authority to the participating AHS.  Approved pharmacists and approved hospital authorities will be reimbursed directly by Medicare Australia (MA).

 

 

Pharmaceutical benefit items will be dispensed to patients by an appropriate health professional (either a medical practitioner, or an Aboriginal Health Worker or nurse working under the supervision of a medical practitioner, where consistent with the law of the relevant State or Territory).  A patient who is supplied with a pharmaceutical benefit under this arrangement is not to be charged a patient copayment.

 

 

Each AHS will be registered with MA and, if there are several remote area clinics operating under the auspices of a large AHS or a State or Territory Government Agency, a unique approval number will be allocated to each clinic.  The approved pharmacist or approved hospital authority will maintain a record of pharmaceutical benefit items supplied to each approved AHS, and will provide this information to MA as the basis for reimbursement.

 

 

Reimbursement by the Commonwealth of approved pharmacists and approved hospital authorities for each pharmaceutical benefit item supplied to an approved AHS under this arrangement will be the sum of the following:

  1.        the approved price to pharmacists within the meaning of subsection 98B(3) of the Act; and
  2.      a mark-up at the rate specified in the determination under paragraph 98B(1)(a) of the Act that is in force at the time of supply of the benefit; and
  3.      a handling fee of $2.74.

 

Costs of transportation and cold chain maintenance are included in the above reimbursement formula.