{"id":"F2020L01038","name":"National Health (Chemotherapy Prescribing) Special Arrangement 2020","slug":"national-health-chemotherapy-prescribing-special-arrangement-2020","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":100433,"registerId":"commonwealth-F2020L01038-current","compilationNumber":null,"startDate":"2026-04-02","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Name of Special Arrangement","content":"#### 1 Name of Special Arrangement\n\n  (1) This Special Arrangement is the National Health (Chemotherapy Prescribing) Special Arrangement 2020.\n  (2) This Special Arrangement may also be cited as PB 52 of 2020.","sortOrder":0},{"sectionNumber":"3","sectionType":"section","heading":"Authority","content":"#### 3 Authority\n\nThis instrument is made under subsection 100(1) of the National Health Act 1953.","sortOrder":1},{"sectionNumber":"4","sectionType":"section","heading":"Simplified outline of this instrument","content":"#### 4 Simplified outline of this instrument\n\nThis instrument makes a special arrangement to make the supply of certain pharmaceutical benefits to patients who have been prescribed certain pharmaceutical benefits for the purposes of chemotherapy more efficient and convenient.\n\nThe instrument modifies arrangements for prescribing the supply of pharmaceutical benefits available for general supply, to enable them to be prescribed using a medication chart also used to prescribe the person a dose of a chemotherapy drug or related pharmaceutical benefit under the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024.\n\n> Note: Part VII of the Act, and regulations or other instruments made for the purposes of that Part, have effect subject to this instrument (see subsection 100(3) of the Act).","sortOrder":2},{"sectionNumber":"5","sectionType":"section","heading":"Definitions","content":"#### 5 Definitions\n\n  In this Special Arrangement:\n\n> Act means the National Health Act 1953.\n\n> authorised prescriber, for a pharmaceutical benefit, means a PBS prescriber (within the meaning of Part VII of the Act) authorised under section 12 of the National Health (Listing of Pharmaceutical Benefits) Instrument 2024 to write a prescription for the supply of the benefit.\n\n> authority prescription has the meaning given by section 5 of the Regulations.\n\n> electronic medication chart prescription means a medication chart prescription prepared, in electronic form, in a software system that is used for prescribing and recording the administration of medicines to persons receiving treatment in, at or from a hospital.\n\n> eligible private hospital patient means a person who:\n\n> (a) is, or is to be treated as, an eligible person; and\n\n> (b) is receiving treatment at or from a private hospital.\n\n> Note: Under subsection 4(1A) of the Act, the phrase eligible person has the same meaning as in the Health Insurance Act 1973.\n\n> eligible public hospital patient means a person who:\n\n> (a) is, or is to be treated as, an eligible person; and\n\n> (b) is receiving treatment at or from a public hospital as a non‑admitted patient, day admitted patient or patient on discharge.\n\n> Note: Under subsection 4(1A) of the Act, the phrase eligible person has the same meaning as in the Health Insurance Act 1973.\n\n> medication chart has a meaning affected by subsection 8(2).\n\n> participating hospital authority has the meaning given by the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024.\n\n> related pharmaceutical benefit has the meaning given by the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024.\n\n> Regulations means the National Health (Pharmaceutical Benefits) Regulations 2017.\n\n> Note: Terms used in this Special Arrangement have the same meaning as in the Act—see section 13 of the Legislation Act 2003. These terms include:\n\n     approved hospital authority\n\n     approved pharmacist\n\n     approved supplier\n\n     Chief Executive Medicare\n\n     pharmaceutical benefit.","sortOrder":3},{"sectionNumber":"6","sectionType":"section","heading":"Pharmaceutical benefits covered by this Special Arrangement","content":"#### 6 Pharmaceutical benefits covered by this Special Arrangement\n\n(1) This Special Arrangement applies to a pharmaceutical benefit that is generally available for supply under Part VII of the Act.\n\n(2) A pharmaceutical benefit is generally available for supply under Part VII if:\n\n(a) it does not contain a drug that is subject to a declaration under subsection 85(2A) of the Act; and\n\n(b) it is not subject to a determination under paragraph 85(8)(a) of the Act; and\n\n(c) for a pharmaceutical benefit in relation to which a determination under paragraph 85(8)(b) has been made about the circumstances in which the benefit can only be supplied under a special arrangement under section 100 ‑ the supply is not in those circumstances.\n\n(3) This Special Arrangement does not apply to a pharmaceutical benefit that can only be supplied under Part VII of the Act in accordance with any other Special Arrangement under section 100 of the Act.","sortOrder":4},{"sectionNumber":"7","sectionType":"section","heading":"Application of Part VII of the Act","content":"#### 7 Application of Part VII of the Act\n\n(1) Each pharmaceutical benefit supplied in accordance with this Special Arrangement is supplied under Part VII of the Act.\n\n(2) A provision of Part VII of the Act, or of regulations or other instruments made for Part VII of the Act, applies subject to this Special Arrangement.\n\nNote: See subsection 100(3) of the Act.","sortOrder":5},{"sectionNumber":"8","sectionType":"section","heading":"Method of prescribing pharmaceutical benefits","content":"#### 8 Method of prescribing pharmaceutical benefits\n\n(1) An authorised prescriber for a pharmaceutical benefit may write a prescription for supply of the pharmaceutical benefit to an eligible private hospital patient or eligible public hospital patient under this Special Arrangement by completing a section of a medication chart, in accordance with section 41 of the Regulations as modified by this section, that also directs the special arrangement supply of a dose of a chemotherapy drug or of a related pharmaceutical benefit to the patient under the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024.\n\n(2) A medication chart referred to in subsection (1):\n\n(a) is not required to be in a form approved under paragraph 41(5)(a) of the Regulations or meet the information requirements approved under paragraph 41(5)(b) of the Regulations; and\n\n(b) is taken to be a medication chart for the purposes of the Regulations despite paragraphs 41(4)(a) and (b) of the Regulations.\n\n(3) For an electronic medication chart prescription:\n\n(a) paragraph 41(2)(c) of the Regulations does not apply; and\n\n(b) the authorised prescriber must approve the prescription in the electronic system used to write the prescription; and\n\n(c) paragraph 104(3)(b) of the Regulations does not apply.","sortOrder":6},{"sectionNumber":"9","sectionType":"section","heading":"Variation of application of determination of maximum number of repeats or maximum number or quantity of units","content":"#### 9 Variation of application of determination of maximum number of repeats or maximum number or quantity of units\n\nSection 30 of the Regulations applies in relation to a prescription written under this Special Arrangement as if a reference to a person receiving treatment in or at an approved hospital included a reference to a person receiving treatment from an approved hospital.","sortOrder":7},{"sectionNumber":"10","sectionType":"section","heading":"Supply of pharmaceuticals under this Special Arrangement","content":"#### 10 Supply of pharmaceuticals under this Special Arrangement\n\n(1) A pharmaceutical benefit may be supplied under this Special Arrangement by:\n\n(a) a participating hospital authority to an eligible public hospital patient; or\n\n(b) an approved hospital authority for a private hospital to an eligible private hospital patient; or\n\n(c) an approved pharmacist to an eligible public hospital patient or eligible private hospital patient.\n\n(2) However, a participating hospital authority may not supply a related pharmaceutical benefit under this Special Arrangement.\n\n(3) Subsections 45(2) to (7) of the Regulations apply to a supply made under this Special Arrangement as if a reference to a person receiving treatment in or at a hospital includes a reference to a person receiving treatment from a hospital.\n\n(4) For a supply made on the basis of an electronic medication chart prescription:\n\n(a) paragraph 45(2)(c) of the Regulations does not apply; and\n\n(b) the participating hospital authority, approved hospital authority for a private hospital or approved pharmacist must verify the supply and the date of supply in the electronic system used to write the prescription; and\n\n(c) section 61 of the Regulations applies as if the reference to the details referred to in paragraph 45(2)(c) of the Regulations included a reference to the verification required by paragraph (b) of this subsection.","sortOrder":8},{"sectionNumber":"11","sectionType":"section","heading":"Modified application of rules","content":"#### 11 Modified application of rules\n\nFor the purposes of item 32 of the table in clause 1 of Schedule 1 to the National Health (Supply of Pharmaceutical Benefits—Under Co‑payment Data and Claims for Payment) Rules 2022, an electronic medication chart prescription is taken to be a paper‑based prescription.","sortOrder":9}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"The legislation remains tightly focused on its original purpose of enabling efficient prescribing of pharmaceutical benefits for chemotherapy patients through medication chart prescribing. It does not appear to have expanded beyond this specific administrative efficiency measure for cancer treatment settings."},"complexity_factors":["11 defined terms in section 5, with several terms inheriting meanings from external instruments (National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024, National Health (Listing of Pharmaceutical Benefits) Instrument 2024, National Health (Pharmaceutical Benefits) Regulations 2017)","Multiple cross-references to external legislation: National Health Act 1953, Health Insurance Act 1973, National Health (Pharmaceutical Benefits) Regulations 2017, and the parallel Chemotherapy Special Arrangement 2024","Conditional exclusions in section 6(2) and (3) that limit which pharmaceutical benefits are covered based on declarations and determinations under the Act","Modification of existing regulatory provisions through \"as if\" clauses (sections 9 and 10(3)) that extend geographical/application scope (\"in or at\" expanded to include \"from\")","Nested exceptions: section 10(2) creates a specific exclusion preventing participating hospital authorities from supplying \"related pharmaceutical benefits\" under this arrangement","Technical modifications to prescription requirements (section 8) that override specific paragraphs of the Regulations"],"plain_english_summary":"This legislation creates a streamlined way for cancer patients to get their medications while undergoing chemotherapy treatment in hospitals.\n\n**What it does:**\nNormally, when a doctor prescribes medication under Australia's Pharmaceutical Benefits Scheme (PBS), there are strict rules about how prescriptions must be written and what forms must be used. This Special Arrangement allows doctors to prescribe certain supportive medications (like anti-nausea drugs or pain relief) on the **same medication chart** they use to prescribe chemotherapy drugs, rather than writing separate prescriptions.\n\n**Who it affects:**\n- **Cancer patients** receiving treatment at public or private hospitals\n- **Hospital doctors** prescribing chemotherapy and related medications\n- **Hospital pharmacies** and approved pharmacists who supply these medications\n\n**Why it matters:**\nChemotherapy treatment is complex and involves multiple medications. Without this arrangement, doctors would need to fill out separate paperwork for each drug, creating administrative burden and potential delays for patients. By allowing \"chart prescribing\" (writing prescriptions on a shared medication chart), the system becomes more efficient and convenient for both medical staff and patients receiving cancer treatment.\n\n**Key features:**\n- Applies to pharmaceutical benefits (subsidised medications) that are generally available under the PBS\n- Works alongside the separate \"Efficient Funding of Chemotherapy\" arrangement\n- Allows electronic medication charts to be used, not just paper\n- Modifies standard PBS rules about prescription forms and supply verification to accommodate hospital workflows"},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This Special Arrangement changes the operational scope of Part VII pharmaceutical supply by allowing certain pharmaceutical benefits to be prescribed and supplied via a chemotherapy medication chart (section 8(1)), removing some formal prescription form requirements (section 8(2)), and treating an electronic medication chart prescription as a paper‑based prescription for specified purposes (section 11). It limits coverage to benefits \"generally available\" under Part VII and excludes benefits subject to certain statutory declarations or separate special arrangements (section 6). These changes adjust who may lawfully prescribe and supply covered items and the form and verification processes those actors must follow (sections 8 and 10)."},"complexity_factors":["Extensive cross‑references to other instruments and Regulations (e.g. National Health Act Part VII, National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024, National Health (Listing of Pharmaceutical Benefits) Instrument 2024, and the National Health (Pharmaceutical Benefits) Regulations 2017) (see sections 3, 5, 7, and multiple later sections).","Conditional exclusions and narrowly defined scope — multiple statutory exceptions to which pharmaceutical benefits are covered (section 6).","Different operational rules depending on whether prescriptions are paper or electronic, with some regulatory requirements disapplied and new verification duties imposed (sections 8(2)–(3) and 10(4)).","Multiple supplier categories with an explicit negative exception (participating hospital authorities may not supply a related pharmaceutical benefit) requiring careful allocation of supply rights (section 10(1)–(2)).","Modifications to existing regulatory provisions and to the application of rules on repeats and unit limits, creating layered application of rules (section 9 and section 11).","Dependence on software/electronic system capabilities for lawful prescribing and verification increases practical implementation complexity (sections 8(3) and 10(4))."],"plain_english_summary":"# What this instrument does, who it affects, and how it works\n\nThis Special Arrangement changes how certain Pharmaceutical Benefits are prescribed and supplied to hospital patients who are being given chemotherapy. Mechanically, it lets authorised prescribers use the medication chart that documents chemotherapy dosing to also prescribe certain other pharmaceutical benefits, and it adjusts some regulatory requirements that would otherwise apply to those prescriptions and supplies.\n\nKey mechanical changes\n\n- Prescribing via chemotherapy medication chart: An authorised prescriber can write a prescription for a pharmaceutical benefit by completing a section of a medication chart that also directs supply of a chemotherapy dose or related benefit under the linked chemotherapy funding arrangement (see section 8(1)).\n- Medication charts treated as prescriptions despite form differences: Medication charts used this way are not required to be in the formal, approved form otherwise required by the Regulations, and are taken to be medication charts for the purposes of the Regulations despite some standard form requirements (see section 8(2)).\n- Electronic prescribing and verification rules: For electronic medication chart prescriptions, some specific regulatory form and information requirements do not apply, but the authorised prescriber must approve the prescription in the electronic system (section 8(3)(b)). Suppliers (hospital authorities or approved pharmacists) must verify the supply and date of supply in the same electronic system and the Regulations are applied as if that verification were the required detail (section 10(4)(b)–(c)).\n- Who may supply the medicines: Supplies under this arrangement may be made by a participating hospital authority to eligible public hospital patients, by an approved hospital authority for a private hospital to eligible private hospital patients, or by an approved pharmacist to eligible patients (section 10(1)). One limitation: a participating hospital authority may not supply a \"related pharmaceutical benefit\" under this arrangement (section 10(2)).\n- Interaction with general Part VII rules: Each pharmaceutical benefit supplied under this arrangement is supplied under Part VII of the National Health Act 1953, but Part VII and associated regulations apply subject to this Special Arrangement (section 7(1)–(2)).\n\nWhat the instrument says is its purpose\n\n- The instrument states its purpose is to make supply of certain pharmaceutical benefits for chemotherapy more efficient and convenient by enabling them to be prescribed on the same medication chart used for chemotherapy dosing (section 4). That is the stated rationale; the text then implements that change by altering prescription and supply rules as described above.\n\nPractical effects, incentives and trade-offs (source‑grounded)\n\n- Administrative substitution and reduced formality: The arrangement reduces the need for a separate, approved paper prescription form for the covered supplies by treating an (approved or non‑approved) medication chart section as the prescription (section 8(2); section 11). This lowers one formality imposed under the Regulations but shifts reliance onto the medication chart and the systems that record it.\n\n- Reliance on electronic systems and verification duties: If an electronic medication chart is used, the prescriber must approve the prescription in the electronic prescribing system (section 8(3)(b)) and the supplier must verify the supply and date of supply in that system (section 10(4)(b)). The instrument therefore imposes operational duties on hospitals and pharmacists to record and verify supplies electronically, creating an implementation and compliance requirement tied to software capability and workflow.\n\n- Limits on who can supply certain items: The arrangement lists three supply routes (participating hospital authority, approved hospital authority for a private hospital, approved pharmacist) (section 10(1)), and expressly prevents participating hospital authorities from supplying a defined class of items (\"related pharmaceutical benefit\") under this arrangement (section 10(2)). That changes which organisational actors can supply which items in certain cases.\n\n- Scope boundaries and exclusions: The arrangement only applies to pharmaceutical benefits that are \"generally available for supply under Part VII\" (section 6(1)). It expressly excludes drugs subject to certain statutory declarations or determinations (section 6(2)) and excludes benefits that are allowed only under another Special Arrangement (section 6(3)). Those provisions narrow the arrangement’s coverage to items not already restricted by other legal mechanisms.\n\nCosts, compliance burden and implementation risk\n\n- Who bears compliance tasks: Authorised prescribers must complete and approve the medication chart prescriptions (see sections 5 definition of authorised prescriber and 8(3)(b)). Participating hospital authorities, approved hospital authorities for private hospitals, and approved pharmacists must verify supply and dates in electronic systems when used (section 10(4)(b)). These are concrete operational tasks allocated in the instrument.\n\n- System dependency and operational risk: Because the instrument removes some traditional form requirements but substitutes electronic approval and verification duties, hospitals and pharmacies must have electronic systems able to capture the required approvals and verifications. If such systems are not available or interoperable, there is an implementation risk and potential for disrupted workflows (see sections 8(3) and 10(4)).\n\n- Potential substitution effects: By enabling the chemotherapy medication chart to serve as the prescription, the arrangement changes the point and method of prescribing and supply. That can reduce duplicate paperwork for prescribers and pharmacists but may shift recordkeeping and audit burdens to hospital electronic systems and pharmacy procedures (sections 8 and 10).\n\nBureaucratic discretion and cross‑references\n\n- The instrument operates by modifying the operation of existing regulatory provisions and other instruments (for example, the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024 and Pharmaceutical Benefits Regulations). It therefore depends on how those other instruments define terms like \"participating hospital authority\" and \"related pharmaceutical benefit\" (see section 5 definitions and the cross‑references throughout the instrument). The interaction with other instruments and Regulations creates points where administrative interpretation and system implementation will determine practical outcomes.\n\nWho is directly affected\n\n- Patients: Eligible public hospital patients and eligible private hospital patients receiving chemotherapy or related care (see section 5 definitions and section 8(1)).\n- Prescribers: Authorised prescribers who are permitted to write PBS prescriptions under the relevant listing instrument (see definition of authorised prescriber in section 5 and prescribing rules in section 8).\n- Suppliers: Participating hospital authorities, approved hospital authorities for private hospitals, and approved pharmacists who supply the pharmaceutical benefits under the arrangement (section 10(1)).\n\nSource citations: primary operative provisions are sections 4, 5, 6, 7, 8, 9, 10 and 11 of the National Health (Chemotherapy Prescribing) Special Arrangement 2020."},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/national-health-chemotherapy-prescribing-special-arrangement-2020","history":"/api/acts/national-health-chemotherapy-prescribing-special-arrangement-2020/history","analysis":"/api/acts/national-health-chemotherapy-prescribing-special-arrangement-2020/analysis","conflicts":"/api/acts/national-health-chemotherapy-prescribing-special-arrangement-2020/conflicts","importantCases":"/api/acts/national-health-chemotherapy-prescribing-special-arrangement-2020/important-cases","documents":"/api/acts/national-health-chemotherapy-prescribing-special-arrangement-2020/documents"}}