8Definition of eligible patient

8 Definition of eligible patient

Persons receiving treatment by medical practitioners at or from public hospitals other than as admitted patients (1) A person is an eligible patient for an HSD pharmaceutical benefit if the person: (a) is, or is to be treated as, an eligible person; and (b) is receiving medical treatment by a medical practitioner at or from a public hospital; and (c) is receiving that treatment as: (i) a non‑admitted patient of the hospital; or (ii) a day admitted patient of the hospital; or (iii) a patient on discharge from the hospital; and (d) is not an EFC patient (see subsection (7)) for the benefit. Persons receiving treatment by authorised nurse practitioners at or from public hospitals other than as admitted patients—medication for the treatment of hepatitis C (2) A person is an eligible patient for an HSD pharmaceutical benefit that has a drug that is a medication for the treatment of hepatitis C if the person: (a) is, or is to be treated as, an eligible person; and (b) is receiving medical treatment by an authorised nurse practitioner at or from a public hospital; and (c) is receiving that treatment as: (i) a non‑admitted patient of the hospital; or (ii) a day admitted patient of the hospital; or (iii) a patient on discharge from the hospital. Persons receiving treatment by medical practitioners in public hospitals as admitted patients—HSD pharmaceutical benefits that contain eculizumab for the treatment of atypical haemolytic uraemic syndrome (3) A person is an eligible patient for an HSD pharmaceutical benefit that has the drug eculizumab for the treatment of atypical haemolytic uraemic syndrome if the person: (a) is, or is to be treated as, an eligible person; and (b) is receiving medical treatment by a medical practitioner in a public hospital; and (c) is receiving that treatment as an admitted patient (other than a day admitted patient) of the hospital. Persons receiving treatment by medical practitioners in, at or from private hospitals (4) A person is an eligible patient for an HSD pharmaceutical benefit if the person: (a) is, or is to be treated as, an eligible person; and (b) is receiving medical treatment by a medical practitioner in, at or from a private hospital; and (c) is not an EFC patient (see subsection (7)) for the benefit. Persons receiving treatment by authorised nurse practitioners in, at or from private hospitals—medication for the treatment of hepatitis C (5) A person is an eligible patient for an HSD pharmaceutical benefit that has a drug that is a medication for the treatment of hepatitis C if the person: (a) is, or is to be treated as, an eligible person; and (b) is receiving medical treatment by an authorised nurse practitioner in, at or from a private hospital. Persons receiving HSD pharmaceutical benefits that have drugs that are community access medications (6) A person is an eligible patient for an HSD pharmaceutical benefit if: (a) the benefit has a drug that is a community access medication; and (b) the person is, or is to be treated as, an eligible person. EFC patient (7) A person is an EFC patient for an HSD pharmaceutical benefit that has a UNAR drug if the benefit is or will be prescribed to the person: (a) in accordance with the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024; or (b) for the purposes of chemotherapy treatment for cancer.