26Modified requirements for claims or giving information

26 Modified requirements for claims or giving information

Under co‑payment data (1) A reference in the rules made by the Minister under subsections 98AC(4) and 99AAA(8) of the Act to under co‑payment data is taken to include a reference to information relating to the special arrangement supply of a dose of a chemotherapy drug or of a related pharmaceutical benefit where the amount payable to the supplier under Division 2 of this Part is nil. Supplies of doses of chemotherapy drugs (2) For a claim or giving of information in relation to a special arrangement supply of a dose of a chemotherapy drug, the requirements in the rules made by the Minister under subsections 98AC(4) and 99AAA(8) of the Act are modified as follows: (a) a reference to a pharmaceutical benefit includes a reference to a dose of a chemotherapy drug; (b) a reference to an authority prescription in the rules includes a reference to an authority prescription within the meaning of this instrument; (c) the claim or information must include the following: (i) an identifying code for the chemotherapy drug; (ii) the dose of the drug supplied; (iii) the compounder ID of the site at which the compounder compounded the dose of the drug; (iv) if the claim is made using the manual system referred to in section 99AAA of the Act, the eligible patient is a CTG registered patient and the supplier is a CTG supplier—an indicator that the eligible patient is a CTG registered patient; (d) the supplier is not required to include the following in the claim or information: (i) the PBS/RPBS Item Code for the supplied pharmaceutical benefit; (ii) the brand of the supplied pharmaceutical item; (iii) whether or not section 49 of the Regulations applies; (iv) whether or not immediate supply was necessary.

Note: A special arrangement supply of a dose of a chemotherapy drug is taken to be a supply of a pharmaceutical benefit (see subsection 9(2) of this instrument).

Supplies of related pharmaceutical benefits—CTG registered patients and suppliers (3) For a claim in relation to a special arrangement supply of a related pharmaceutical benefit, the requirements in the rules made by the Minister under subsections 98AC(4) and 99AAA(8) of the Act are modified as set out in subsection (4) of this section. (4) If: (a) a claim is made using the manual system referred to in section 99AAA of the Act; and (b) the supplier is a CTG supplier; and (c) the eligible patient is a CTG registered patient; the claim must include an indicator that the eligible patient is a CTG registered patient.