87Limited charges for pharmaceutical benefits

#### 87 Limited charges for pharmaceutical benefits (1) Subject to this section, an approved pharmacist, an approved medical practitioner or an approved hospital authority shall not demand or receive a payment (other than a payment from the Commonwealth) or other valuable consideration in respect of the supply of a pharmaceutical benefit. (2) Subject to subsection (2A), an approved pharmacist or an approved medical practitioner acting in accordance with his or her approval may, in respect of each supply (including each repeated supply) by the approved pharmacist or approved medical practitioner, as the case may be, of a pharmaceutical benefit: (a) upon: (i) a concessional benefit prescription; or (ii) an entitlement card prescription where the supply is an early supply of a specified pharmaceutical benefit; or (iii) a concession card prescription (other than where the supply is an early supply of a specified pharmaceutical benefit); charge the person to whom the pharmaceutical benefit is supplied $4.60 (less any allowable discount); or (b) upon a general benefit prescription if, during the relevant entitlement period in which the supply is made, the person supplied is eligible to be issued with a concession card—charge the person $4.60 (less any allowable discount); or (e) upon a general benefit prescription (other than one relating to a supply to which paragraph (b) applies), or a concession card prescription (where the supply is an early supply of a specified pharmaceutical benefit)—charge the person to whom the pharmaceutical benefit is supplied either: (i) in any case—the general patient charge amount; or (ii) if the supply is eligible for increased discounting—an amount that is less than the general patient charge amount, but greater than nil. > Note 1: The figures expressed in this subsection in dollars, and the general patient charge amount, are periodically adjusted under section 99G. > Note 2: For when a person is eligible to be issued with a concession card, see subsection 84C(1AA). (2AAAA) For a supply other than an early supply, the allowable discount is an amount of not more than $1. > Note: The allowable discount is periodically reduced under Subdivision C of Division 4A. (2AAA) Paragraph (2)(b) does not apply to an early supply of a specified pharmaceutical benefit. (2A) In addition to any amount that may be charged in accordance with subsection (2), an approved pharmacist or an approved medical practitioner acting in accordance with his or her approval may, in respect of each supply (including each repeated supply) of a pharmaceutical benefit that is a listed brand of a pharmaceutical item and in relation to which a determination under subsection 85B(3) is in force, charge the person to whom it is supplied an amount equal to the special patient contribution for the brand of the pharmaceutical item, unless the approved pharmacist or approved medical practitioner is entitled to be paid by the Commonwealth that special patient contribution under subsection 99(2AA). (3) Where an approved pharmacist or an approved medical practitioner supplies a pharmaceutical benefit in accordance with a direction included in a prescription in pursuance of subsection 88(6) or (6A), the amount chargeable in accordance with subsection (2), of this section is, in lieu of whichever of the amounts referred to in subsection (2), of this section is applicable, an amount equal to the product of that applicable amount and the minimum number of occasions of supply that would have had to be directed if the medical practitioner, authorised midwife or authorised nurse practitioner had prescribed the same total quantity or number of units of the pharmaceutical benefit by way of repeated supplies. (3A) An approved pharmacist, approved medical practitioner or approved hospital authority shall not supply a pharmaceutical benefit to a person on terms that are appropriate for the supply of the benefit to: (ba) a holder of a concession card; or (c) a holder of an entitlement card; or (d) a concessional beneficiary; or (e) a person who is a dependant of a concessional beneficiary within the meaning of subsection 84(4) or (7); or (f) a general patient; unless the pharmacist, medical practitioner or authority is satisfied that the person is entitled to receive the benefit on those terms. (3B) Without limiting the generality of subsection (3A), an approved pharmacist, approved medical practitioner or approved hospital authority may refuse to supply a pharmaceutical benefit to a person on terms that are appropriate for the supply of the benefit to: (ba) a holder of a concession card; or (c) a holder of an entitlement card; or (d) a concessional beneficiary; or (e) a person who is a dependant of a concessional beneficiary within the meaning of subsection 84(4) or (7); or (f) a general patient; unless the person produces evidence (whether by way of the production of a card or evidence of identity or otherwise) to the pharmacist, medical practitioner or authority that the person is entitled to receive the benefit on those terms. (4) The regulations may provide for the making of a charge, not exceeding an amount ascertained in accordance with the regulations: (b) by an approved pharmacist or an approved medical practitioner in respect of the supply of a pharmaceutical benefit by delivery at or to a place other than premises in respect of which the approved pharmacist is approved, or premises at which the approved medical practitioner carries on practice, as the case may be. (5) Subsection (1) does not prevent an approved hospital authority from charging, in respect of the supply of pharmaceutical benefits to a patient receiving treatment in or at a hospital, amounts not exceeding the sum of the charges that the patient could have been required to pay in accordance with subsections (2) and (2A), if the patient had obtained the pharmaceutical benefits from an approved pharmacist upon a prescription or prescriptions directing the supply of the maximum quantity or number of units applicable under a determination of the Minister under subsection 85A(2). (5A) Subsection (5) does not apply to a supply if: (a) the patient is the holder of an entitlement card; and (b) the supply is not an early supply of a specified pharmaceutical benefit. (6) The reference in subsection (1) to a payment or other valuable consideration in respect of the supply of a pharmaceutical benefit does not include a reference to a charge demanded or received by reason only that the supply is made at a time outside normal trading hours.