16 Supply of Pharmaceutical Benefits — Procedure by Community Pharmacists
Subject to paragraph 16AAA (special arrangements) and paragraph 16A (continued dispensing), a Community Pharmacist is required to supply a Pharmaceutical benefit only upon the surrender of:
(a) a valid Standard Prescription Form; or
(b) a valid Authority Prescription Form; or
(c) a valid repeat authorisation form presented with a duplicate prescription in accordance with the requirements under the PBS; or
(d) a valid medication chart prescription;
provided that such documents are in accordance with State or Territory law and this Scheme and the Explanatory Notes, and with any requirements which the Department or the Commission, from time to time, notifies.
16AAA Pharmaceutical benefits supplied under a special arrangement
(1) A Community Pharmacist will be required to supply a Pharmaceutical
benefit to an Eligible Person under a special arrangement if:
(a) the supply is made in accordance with the conditions specified in the National Health (COVID‑19 Supply of Pharmaceutical Benefits) Special Arrangement 2020 as in force from time to time:
(i) as if the supply under the Scheme is a supply covered by the instrument; and
(ii) the instrument has effect under subsections (2), (3), (4), (5), (6),
(7), (8), (9), (10) and (11) of this section; and
(iii) to the extent that those conditions are applicable to the supply;
and
(iv) the supply of the Pharmaceutical benefit occurs before the repeal of the National Health (COVID‑19 Supply of Pharmaceutical Benefits) Special Arrangement 2020;
(b) the supply otherwise conforms to this section.
(2) For the purposes of paragraph (1)(a) of this section, the National Health (COVID‑19 Supply of Pharmaceutical Benefits) Special Arrangement 2020 has effect in accordance with the following table.
Modified effect of the National Health (COVID‑19 Supply of Pharmaceutical Benefits) Special Arrangement 2020 instrument
Item Column 1The instrument has effect as if a reference to … Column 2were a reference to …
1 a paper‑based repeat authorisation a repeat authorisation form
2 a PBS prescriber a person who prescribes a Pharmaceutical benefit under the Scheme
3 a pharmaceutical benefit a Pharmaceutical benefit
4 an approved hospital authority an Approved Hospital Authority
5 an approved pharmacist a Community Pharmacist
6 a CTS claim a claim under the claims rules
7 Part VII of the Act the Scheme
8 section 44 of the Regulations section 16 of the Scheme
9 subsections 40(1), (2) and (2A) of the Regulations subsections 11A(1) and (1A) of the Scheme
10 subsection 40(2) of the Regulations subsection 11A(1) of the Scheme
Further modifications of the instrument
(3) The special arrangement referred to in paragraph (1)(a) has effect as if the definition of “approved hospital authority” in subsection 6(1) of the instrument is omitted.
(4) The special arrangement referred to in paragraph (1)(a) has effect as if the definition of “approved hospital authority dispenser” in subsection 6(1) of the instrument is replaced with the following:
approved hospital authority dispenser means the Community Pharmacist or approved medical practitioner by whom, or under whose supervision, a Pharmaceutical benefit supplied by an Approved Hospital Authority will be dispensed.
(5) The special arrangement referred to in paragraph (1)(a) has effect as if the definition of “CTS claim” in subsection 6(1) of the instrument is omitted.
(6) The special arrangement referred to in paragraph (1)(a) has effect as if the definition of “medication chart prescription” in subsection 6(1) of the instrument is replaced with the following:
medication chart prescription has the same meaning as in the Scheme.
(7) The special arrangement referred to in paragraph (1)(a) has effect as if the definition of “paper‑based prescription” in subsection 6(1) of the instrument is replaced with the following:
paper‑based prescription has the same meaning as in the Scheme.
(8) The special arrangement referred to in paragraph (1)(a) has effect as if section 8 of the instrument is replaced with the following:
8 Application of the Scheme
A provision of the Scheme applies subject to this Special Arrangement.
(9) The special arrangement referred to in paragraph (1)(a) has effect as if subsection 9(1) was omitted and replaced with the following:
(1) Division 2 of Part 2 of this Special Arrangement applies to the supply of a pharmaceutical benefit by an approved supplier based on a paper‑based prescription (excluding a medication chart prescription) written as the result of a telehealth attendance or phone attendance provided on or after 20 March 2020 to which an item in a Fee Schedule (a document incorporated as in force from time to time for the purposes of the Treatment Principles) applies.
(10) The special arrangement referred to in paragraph (1)(a) has effect as if subsection 9(4) of the instrument is omitted.
(11) The special arrangement referred to in paragraph (1)(a) has effect as if subsection 10(4) of the instrument is replaced with the following:
(4) If the prescription is or would be an authority prescription, the supplier may supply the Pharmaceutical benefit under this section only if prior approval has been obtained.
16AA Supply of pharmaceutical benefit on basis of medication chart prescription
(1) A Pharmaceutical benefit may only be supplied on the basis of a medication chart prescription by:
(a) if the person in respect of whom the Pharmaceutical benefit is to be supplied is receiving treatment in or at a residential care service – a Community Pharmacist; or
(b) if the person in respect of whom the Pharmaceutical benefit is to be supplied is receiving treatment in or at an approved hospital—a Community Pharmacist or the Approved Hospital Authority.
(2) A Community Pharmacist may supply a Pharmaceutical benefit on the basis of a medication chart prescription only if:
(a) the Community Pharmacist has seen:
(i) the medication chart by which the prescription was written; or
(ii) a copy of so much of the chart as would indicate that subsections 11B(3) and (4) (if applicable) have been complied with; and
(b) the date on which the Pharmaceutical benefit is supplied is:
(i) during the period of validity of the medication chart; and
(ii) no later than the stop date (if any) indicated in the prescription; and
(c) the Community Pharmacist writes on the medication chart or the copy of the chart, the following for the supply:
(i) the Community Pharmacist’s name and any approval number under section 16 of the National Health (Pharmaceutical Benefits) Regulations 2017;
(ii) an identification number for the supply;
(iii) the date on which the Pharmaceutical benefit is supplied.
(3) For paragraph (2)(b), the period of validity of a medication chart for a person receiving treatment in or at a residential care service:
(a) starts on the day in a calendar month (the first calendar month) when the first prescription for a Pharmaceutical benefit is written in the medication chart; and
(b) ends on the last day of the third calendar month that starts after the first calendar month.
Example: The first prescription is written in a medication chart on 11 June. The period of validity of the medication chart starts on 11 June and ends on 30 September.
Note: calendar month is defined in section 2B of the Acts Interpretation Act 1901.
(3A) For paragraph (2)(b), the period of validity of a medication chart for a person receiving treatment in or at a hospital:
(a) starts on the day when the first prescription for a Pharmaceutical benefit is written in the chart; and
(b) ends at the end of the day specified in the chart as the day on which the chart’s period of validity ends (see paragraph 11B(3)(f)).
(4) A Community Pharmacist may supply up to a maximum quantity of a Pharmaceutical item or Pharmaceutical benefit more than once on the basis of a particular medication chart prescription for the Pharmaceutical benefit only if:
(a) the prescription indicates that an ongoing supply of the Pharmaceutical benefit is authorised for the period of validity of the chart; or
(b) the prescription indicates a stop date for the supply of the Pharmaceutical benefit and, based on the dose and frequency of administration of the Pharmaceutical benefit indicated in the prescription, more than one supply of a maximum quantity of the Pharmaceutical item or Pharmaceutical benefit is needed before the stop date is reached.
Note: See paragraph 85A(2)(a) of the National Health Act 1953, the PBS Schedule, and the RPBS Schedule, in relation to maximum quantities of pharmaceutical items or pharmaceutical benefits.
(5) If paragraphs (4)(a) and (b) do not apply, a Community Pharmacist may only supply the quantity of the Pharmaceutical benefit needed to give effect to the prescription, up to a maximum quantity of the pharmaceutical item or Pharmaceutical benefit.
Note: The following information entered in the prescription may also indicate the quantity of the Pharmaceutical benefit that is needed:
(a) the dose and frequency of administration of the Pharmaceutical benefit;
(b) the date of prescribing, or the start date (if any) for administration of the Pharmaceutical benefit;
(c) the stop date (if any) for administration of the Pharmaceutical benefit.
(6) However, for a supply:
(a) on the basis of a prescription mentioned in paragraph (4)(a); or
(b) mentioned in paragraph (5);
a Community Pharmacist may supply up to a maximum quantity of the pharmaceutical item or Pharmaceutical benefit even if the period of validity of the medication chart will end before administration of that quantity in accordance with the prescription would finish.
Continued Dispensing
16A When Pharmaceutical benefits may be supplied by Community Pharmacists without prescription
Pharmaceutical benefits covered by PBS and National Health Act section 89A instruments
(1) A Community Pharmacist may, at or from premises in respect of which the pharmacist is for the time being approved under the National Health Act 1953, supply a Pharmaceutical benefit to an Eligible Person without a prescription for that supply if:
(a) the Pharmaceutical benefit is covered by the Scheme and an instrument in force under subsection 89A(3) of the National Health Act 1953; and
(b) the supply is made in accordance with the conditions specified in the instrument:
(i) as if the supply under the Scheme is a supply covered by the instrument; and
(ii) as the instrument has effect under subsection (1B) of this section; and
(c) the supply otherwise conforms to this section.
Certain Pharmaceutical benefits not covered by PBS
(1A) A Community Pharmacist may, at or from premises in respect of which the pharmacist is for the time being approved under the National Health Act 1953, supply a Pharmaceutical benefit to an Eligible Person without a prescription for that supply if:
(a) the Pharmaceutical benefit is specified in the table in Schedule 2; and
(b) the supply is made in accordance with the conditions specified in the National Health (Continued Dispensing – Emergency Measure) Determination 2025 (No.3):
(i) as if the supply under the Scheme is a supply covered by that instrument; and
(ii) as that instrument has effect under subsection (1B) of this section; and
(iii) to the extent that those conditions are applicable to the supply; and
(c) the supply otherwise conforms to this section.
Modified effect of National Health Act section 89A instruments
(1B) For the purposes of subparagraphs (1)(b)(ii) and (1A)(b)(ii) of this section, an instrument in force under subsection 89A(3) of the National Health Act 1953 has effect in accordance with the following table.
Modified effect of National Health Act section 89A instruments
Item Column 1The instrument has effect as if a reference to … Column 2were a reference to …
1 a PBS prescriber a person who prescribes a Pharmaceutical benefit under the Scheme
2 a pharmaceutical benefit a Pharmaceutical benefit
3 a pharmaceutical item a Pharmaceutical benefit
4 an approved pharmacist a Community Pharmacist
5 paragraph 85A(2)(a) of the Act the Scheme
6 paragraph 89A(3)(a) of the Act the Scheme
7 Part VII of the Act the Scheme
8 subsection 89A(1) of the Act the Scheme
9 a statement that particular conditions are satisfied a statement that particular conditions, as they have effect under this subsection, are satisfied
Other matters
(2) If a Community Pharmacist makes a supply in accordance with subsection (1) or (1A), then this Scheme applies in relation to the supply as if the Eligible Person had presented the pharmacist with a prescription that had been written in accordance with this Scheme.
(3) The supply of a Pharmaceutical benefit in accordance with this section is a continued dispensing supply.
(4) A Community Pharmacist must not supply a Pharmaceutical benefit under this section unless the pharmacist writes on the repeat authorisation form for the supply:
(a) the pharmacist’s name and approval number under section 16 of the National Health (Pharmaceutical Benefits) Regulations 2017; and
(b) an identification number for the supply; and
(c) the date on which the Pharmaceutical benefit is supplied by the pharmacist.
Note: a failure to observe these requirements means the supply is not a continued dispensing supply.
(5) For a continued dispensing supply a Community Pharmacist or Approved Medical Practitioner must collect the following information at the time of supply:
(a) information about whether the patient is, at the time of the supply:
(i) a concessional beneficiary or a dependant of a concessional beneficiary; or
(ii) the holder of a concession card or entitlement card;
(b) for a person mentioned in subparagraph (a)(i)—the number specified on a card, issued by the Commonwealth, as an entitlement number (however described) in relation to the person;
(c) for a person mentioned in subparagraph (a)(ii)—the number of the concession card or entitlement card.
(6) The Community Pharmacist or Approved Medical Practitioner must include the information collected under subsection (5) in the claim for a payment from the Commonwealth in relation to the supply using the Claims Transmission System, within the meaning given by subsection 99AAA(1) of the National Health Act 1953.
Note: a failure to observe these requirements means the supply is not a continued dispensing supply.
(7) For the supply of a Pharmaceutical benefit by a Community Pharmacist on the basis of a previous prescription from a PBS prescriber or RPBS prescriber, if the PBS prescriber or RPBS prescriber directed in the prescription the supply on one occasion of a quantity or number of units of the Pharmaceutical benefit allowable under subsection 88(6) of the National Health Act 1953, instead of directing a repeated supply, the direction does not apply for the purposes of the continued dispensing supply.
(8) If, for a continued dispensing supply, a Pharmaceutical benefit is supplied a number of times greater than the number specified in the prescription, then subject to subsection 51(2) of the National Health (Pharmaceutical Benefits) Regulations 2017 (the regulations), subregulation (3) or (4) of those regulations applies as if:
(a) the person had presented the supplier with a prescription that:
(i) had been written by a PBS prescriber or RPBS prescriber in accordance with the National Health Act 1953, the regulations and the Scheme; and
(ii) did not include a medicare number; and
(iii) did not direct a repeated supply of a Pharmaceutical benefit; and
(b) subparagraphs (3)(b)(ii) and (c)(ii) or (4)(b)(ii) and (c)(ii), of the regulations, were omitted, and the words ‘immediate supply necessary’ were required to be written on the repeat authorisation form for the supply; and
(c) subparagraphs (3)(b)(iii) and (c)(iii) or (4)(b)(iii) and (c)(iii), of the regulations, were omitted, and the supplier were required to sign the repeat authorisation form mentioned in paragraph (b).
(9) A Community Pharmacist must use a repeat authorisation form for the purposes of making a claim for a payment from the Commonwealth under section 99AAA of the Act in relation to a continued dispensing supply, however, the pharmacist must not use the form for authorising a repeated supply of the pharmaceutical benefit under this section.
(10) For a continued dispensing supply a Community Pharmacist is to obtain, from the person receiving the Pharmaceutical benefit (whether or not for the person’s own use), a written acknowledgement that the person has received the benefits but if it is not practicable for the pharmacist to obtain, from the person a written acknowledgement, the pharmacist must write on the repeat authorisation form for the supply:
(a) the date on which the Pharmaceutical benefit were supplied by the pharmacist; and
(b) the reason why it was not practicable for the pharmacist to obtain the written acknowledgement.
16AB Information about status of person—continued dispensing and medication chart prescriptions
(1) This section applies in relation to:
(a) the supply of a Pharmaceutical benefit to a person (the patient) by a Community Pharmacist (the supplier) under subsection 16A (continued dispensing); and
(b) the supply of a Pharmaceutical benefit by a Community Pharmacist, on the basis of a medication chart prescription written for a person (the patient);
(2) The supplier must collect the following information at the time of supply:
(a) information about whether the patient is, at the time of the supply:
(i) a concessional beneficiary or a dependant of a concessional beneficiary; or
(ii) the holder of a concession card or entitlement card;
(b) for a person mentioned in subparagraph (a)(i)—the number specified on a card, issued by the Commonwealth, as an entitlement number (however described) in relation to the person;
(c) for a person mentioned in subparagraph (a)(ii)—the number of the concession card or entitlement card.
(3) The supplier must include the information collected under subsection (2) in the claim for a payment from the Commonwealth in relation to the supply using the Claims Transmission System, within the meaning given by subsection 99AAA(1) of the National Health Act 1953.