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(1) This instrument is the National Health (Additional Community Supply Support Payment) Determination 2024. (2) This instrument may also be cited as PB 94 of 2024.
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Commonwealth legislation
This Determination sets which community pharmacy supplies qualify for an "Additional Community Supply Support" payment and fixes the amount: a $1.21 base per eligible supply and a $4.91 premium (total $6.12) when the supply meets "increased maximum quantity" conditions. It applies to approved pharmacists, excludes specified special arrangements, is paid under the National Health Act, and creates a modest financial incentive to dispense larger permitted quantities while adding prescription‑checking and claims‑processing requirements.
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Direct links to the current provisions in National Health (Additional Community Supply Support Payment) Determination 2024.
(1) This instrument is the National Health (Additional Community Supply Support Payment) Determination 2024. (2) This instrument may also be cited as PB 94 of 2024.
This instrument is made under paragraph 98B(1)(b) of the National Health Act 1953.
(1) In this instrument:
Act means the National Health Act 1953.
increased maximum quantity of a pharmaceutical benefit means the maximum quantity or number of units of the benefit or the pharmaceutical item in the benefit that may, in one prescription, be directed to be supplied on any one occasion, for a relevant purpose, under a determination of the Minister under paragraph 85A(2)(a) of the Act.
increased maximum quantity prescription means a prescription directing, for a relevant purpose, the supply on any one occasion of the increased maximum quantity of a pharmaceutical benefit.
relevant purpose, for a pharmaceutical benefit, means a purpose, mentioned in Schedule 4 to the National Health (Listing of Pharmaceutical Benefits) Instrument 2024 for a purposes code (within the meaning of that instrument) specified in Schedule 1 to that instrument for the benefit, that includes the phrase “The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient”.
(2) An expression that is used in this instrument and in Part VII of the Act has the same meaning in this instrument as it has in that Part.
Note: Examples of such expressions include the following:
(a) ACSS eligible supply;
(b) ACSS payment;
(c) approved pharmacist;
(d) pharmaceutical benefit;
(e) pharmaceutical item;
(f) Schedule equivalent.
For the purposes of subparagraph 98B(1)(b)(i) of the Act, a supply by an approved pharmacist of a pharmaceutical benefit is an ACSS eligible supply unless the supply is made in accordance with any of the following special arrangements under section 100 of the Act: (a) the National Health (Botulinum Toxin Program) Special Arrangement 2025; (b) the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024; (c) the National Health (Growth Hormone Program) Special Arrangement 2025; (d) the National Health (Highly Specialised Drugs Program) Special Arrangement 2021; (e) the National Health (IVF Program) Special Arrangement 2025; (f) the National Health (Take Home Naloxone) Special Arrangement 2019.
(1) For the purposes of subparagraph 98B(1)(b)(ii) of the Act, the amount of the ACSS payment for each ACSS eligible supply is: (a) if paragraph (b) of this subsection does not apply—$1.21; or (b) if subsection (2) or (3) of this section applies to the supply—the sum of: (i) the amount mentioned in paragraph (a) of this subsection; and (ii) $4.91.
Note: An approved pharmacist who wants to receive an ACSS payment must make a claim for the payment under section 99AAA of the Act. Entitlement to the payment is also subject to any applicable conditions determined under section 98C of the Act and the conditions set out in section 99AAAB of the Act.
(2) This subsection applies to an ACSS eligible supply of a pharmaceutical benefit if: (a) the ACSS eligible supply is made upon an increased maximum quantity prescription directing the supply of: (i) the benefit; or (ii) another pharmaceutical benefit that is Schedule equivalent to the benefit; and (b) the ACSS eligible supply is of the increased maximum quantity of the benefit. (3) This subsection applies to an ACSS eligible supply of a pharmaceutical benefit if: (a) the ACSS eligible supply is made to a person in accordance with section 89A of the Act (which deals with supplies of pharmaceutical benefits without a prescription); and (b) the immediately preceding supply to the person of the benefit, or of another pharmaceutical benefit that is Schedule equivalent to the benefit, was made upon an increased maximum quantity prescription directing the supply of: (i) the benefit; or (ii) another pharmaceutical benefit that is Schedule equivalent to the benefit; and (c) both the ACSS eligible supply, and the immediately preceding supply referred to in paragraph (b) of this subsection, are of the increased maximum quantity of the relevant pharmaceutical benefit.
Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.
(1) This instrument is the National Health (Additional Community Supply Support Payment) Determination 2024. (2) This instrument may also be cited as PB 94 of 2024.
This instrument is made under paragraph 98B(1)(b) of the National Health Act 1953.
(1) In this instrument:
Act means the National Health Act 1953.
increased maximum quantity of a pharmaceutical benefit means the maximum quantity or number of units of the benefit or the pharmaceutical item in the benefit that may, in one prescription, be directed to be supplied on any one occasion, for a relevant purpose, under a determination of the Minister under paragraph 85A(2)(a) of the Act.
increased maximum quantity prescription means a prescription directing, for a relevant purpose, the supply on any one occasion of the increased maximum quantity of a pharmaceutical benefit.
relevant purpose, for a pharmaceutical benefit, means a purpose, mentioned in Schedule 4 to the National Health (Listing of Pharmaceutical Benefits) Instrument 2024 for a purposes code (within the meaning of that instrument) specified in Schedule 1 to that instrument for the benefit, that includes the phrase “The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient”.
(2) An expression that is used in this instrument and in Part VII of the Act has the same meaning in this instrument as it has in that Part.
Note: Examples of such expressions include the following:
(a) ACSS eligible supply;
(b) ACSS payment;
(c) approved pharmacist;
(d) pharmaceutical benefit;
(e) pharmaceutical item;
(f) Schedule equivalent.
For the purposes of subparagraph 98B(1)(b)(i) of the Act, a supply by an approved pharmacist of a pharmaceutical benefit is an ACSS eligible supply unless the supply is made in accordance with any of the following special arrangements under section 100 of the Act: (a) the National Health (Botulinum Toxin Program) Special Arrangement 2025; (b) the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024; (c) the National Health (Growth Hormone Program) Special Arrangement 2025; (d) the National Health (Highly Specialised Drugs Program) Special Arrangement 2021; (e) the National Health (IVF Program) Special Arrangement 2025; (f) the National Health (Take Home Naloxone) Special Arrangement 2019.
(1) For the purposes of subparagraph 98B(1)(b)(ii) of the Act, the amount of the ACSS payment for each ACSS eligible supply is: (a) if paragraph (b) of this subsection does not apply—$1.21; or (b) if subsection (2) or (3) of this section applies to the supply—the sum of: (i) the amount mentioned in paragraph (a) of this subsection; and (ii) $4.91.
Note: An approved pharmacist who wants to receive an ACSS payment must make a claim for the payment under section 99AAA of the Act. Entitlement to the payment is also subject to any applicable conditions determined under section 98C of the Act and the conditions set out in section 99AAAB of the Act.
(2) This subsection applies to an ACSS eligible supply of a pharmaceutical benefit if: (a) the ACSS eligible supply is made upon an increased maximum quantity prescription directing the supply of: (i) the benefit; or (ii) another pharmaceutical benefit that is Schedule equivalent to the benefit; and (b) the ACSS eligible supply is of the increased maximum quantity of the benefit. (3) This subsection applies to an ACSS eligible supply of a pharmaceutical benefit if: (a) the ACSS eligible supply is made to a person in accordance with section 89A of the Act (which deals with supplies of pharmaceutical benefits without a prescription); and (b) the immediately preceding supply to the person of the benefit, or of another pharmaceutical benefit that is Schedule equivalent to the benefit, was made upon an increased maximum quantity prescription directing the supply of: (i) the benefit; or (ii) another pharmaceutical benefit that is Schedule equivalent to the benefit; and (c) both the ACSS eligible supply, and the immediately preceding supply referred to in paragraph (b) of this subsection, are of the increased maximum quantity of the relevant pharmaceutical benefit.