1National Health (Multiple Hospitals Paperless Claiming Trial) Special Arrangement 2017 (PB 14 of 2017)

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PB 14 of 2017

National Health (Multiple Hospitals Paperless Claiming Trial) Special Arrangement 2017

National Health Act 1953

I, JULIANNE QUAINE, Assistant Secretary, Pharmaceutical Access Branch, Pharmaceutical Benefits Division, Department of Health, delegate of the Minister for Health, make this special arrangement under subsections 100(1) and (2) of the National Health Act 1953.

Dated 17 February 2017

Julianne Quaine

Assistant Secretary

Pharmaceutical Access Branch

Pharmaceutical Benefits Division

Department of Health

1 Name of Instrument

(1) This instrument is the National Health (Multiple Hospitals Paperless Claiming Trial) Special Arrangement 2017.

(2) This instrument may also be cited as PB 14 of 2017.

2 Commencement

This Special Arrangement commences on 1 March 2017.

3 Revocation

The National Health (Multiple Hospitals Paperless Claiming Trial) Special Arrangement 2016 (PB 59 of 2016) is revoked.

4 Definitions

In these arrangements:

Act means the National Health Act 1953.

approved supplier means the approved supplier whose name, address and approval number are specified in Column 2 of the Schedule to this Special Arrangement opposite the name of the hospital in Column 1 of the Schedule.

authority prescription means an authority prescription as defined in the Regulations.

hospital means each hospital whose name and address is specified in Column 1 of the Schedule to this Special Arrangement.

in-patient of the hospital means a person who occupies a bed in the hospital for the purpose of hospital treatment, but does not include a member of the staff of the hospital who is receiving treatment in his or her own quarters.

medication chart means a paper based medication chart.

medication chart prescription has the meaning given by subregulation 19AA(1) of the Regulations.

other Special Arrangement means another Special Arrangement under section 100 of the Act.

Regulations means the National Health (Pharmaceutical Benefits) Regulations 1960.

Rules means the rules under subsection 99AAA (8) and subsection 98AC (4) of the Act.

Note: Terms used in this Special Arrangement have the same meaning as in the Act – see section 13 of the Legislative Instruments Act 2003. These terms include:

• Chief Executive Medicare

• PBS prescriber

• pharmaceutical benefit

• Secretary

5 Application of Part VII of the Act

(1) Each pharmaceutical benefit supplied in accordance with this Special Arrangement is supplied under Part VII of the Act.

(2) A provision of Part VII of the Act, or of regulations or other instruments made for Part VII of the Act, applies subject to this Special Arrangement.

Note: See subsection 100(3) of the Act.

6 Pharmaceutical benefits covered by this Special Arrangement

(1) This Special Arrangement applies to a pharmaceutical benefit which is generally available for supply under Part VII of the Act.

(2) This Special Arrangement does not apply to a pharmaceutical benefit that can only be supplied under Part VII of the Act in accordance with any other Special Arrangement under section 100 of the Act.

(3) This Special Arrangement does not apply to a pharmaceutical benefit prescribed using a medication chart prescription.

Note: Section 85AA of the Act provides that a pharmaceutical benefit that can only be supplied under Part VII of the Act in accordance with section 100 of the Act will be the subject of a subsection 85(2A) declaration (section 100 only drug), or a determination under paragraph 85(8) (a) (section 100 only pharmaceutical benefit) or paragraph 85(8) (b) (section 100 only circumstances).

7 Prescribing of Pharmaceutical Benefits

(1) A medication chart prepared and signed by a PBS prescriber on which is prescribed a pharmaceutical benefit for the treatment of the in-patient of the hospital who is named on the medication chart, will be taken to be a prescription, written in accordance with regulation 19 of the Regulations, provided that:

(a) the location within the hospital of the in-patient for whose treatment the medication chart was prepared will be taken to be the address of that in-patient for the purpose of paragraph 19(1)(d) of the Regulations; and

(b) the medication chart bears the number of the Medicare card, including the sub-numerate, which applies to the in-patient for whose treatment the medication chart was prepared; and

(c) in the case of a medication chart prepared in respect of an in-patient of the hospital who is not a general patient within the meaning of subsection 84(1) of the Act, the medication chart bears the matters prescribed by regulation 19A of the Regulations; and

(d) the medication chart bears the identification number issued by the Chief Executive Medicare to the PBS prescriber, according to regulation 8A of the Regulations, who prescribed the pharmaceutical benefit; and

(e) if the medication chart directs, pursuant to paragraph 85A(2)(b) of the Act and subparagraph 19(1)(f)(ii) of the Regulations, that the supply of the pharmaceutical benefit is to be repeated, that direction will be invalid; and

(f) if the medication chart directs the supply of an increased quantity of the pharmaceutical benefit pursuant to subsection 88(6) of the Act and regulation 24 of the Regulations, that direction will be taken to be a direction to supply the maximum quantity for that pharmaceutical benefit determined under paragraph 85A(2)(a) of the Act; and

(g) the medication chart does not prescribe a pharmaceutical benefit that requires an authority prescription.

8 Supply and Claiming of Pharmaceutical Benefits

(1) This Special Arrangement applies to the supply of pharmaceutical benefits by approved suppliers to the in-patients of the hospitals specified in Column 1 of the Schedule.

(2) The approved supplier will supply pharmaceutical benefits to in-patients of the hospital as if medication charts were original prescriptions, provided that:

(a) where a medication chart contains a direction to supply more than one pharmaceutical benefit, the approved supplier must not, pursuant to regulation 26A of the Regulations, defer the supply of one or more of the benefits; and

(b) in lieu of the requirements of regulation 31 of the Regulations, the approved supplier or a person authorised for the purpose by the approved supplier, certifies on the medication chart that the pharmaceutical benefit has been supplied and the date on which it was supplied, and signs his or her name.

(2) The approved supplier must prepare an electronic pharmacy record in respect of each medication chart where a pharmaceutical benefit has been supplied to an in-patient of the hospital for which a claim is made under section 99AAA of the Act, and must retain that electronic pharmacy record for not less than two years after the day on which the pharmaceutical benefit was supplied.

(3) The electronic pharmacy record referred to in subsection (3) must contain all information required to be included in a prescription record by the Schedule to the Rules under section 99AAA of the Act for an online claim.

(4) Subject to subsection (6), a claim by the approved supplier in respect of pharmaceutical benefits supplied to in-patients of the hospital may be furnished unaccompanied by the medication charts in respect of which pharmaceutical benefits have been supplied to in-patients of the hospital.

(5) If the Secretary notifies the hospital that a copy of all or any of the electronic pharmacy records in respect of pharmaceutical benefits supplied to in-patients of the hospital is required to be submitted, the approved supplier shall submit a copy of each such electronic pharmacy record to the Chief Executive Medicare (on behalf of the Secretary).

(6) If the Secretary notifies the hospital that a copy of all or any of the medication charts in respect of pharmaceutical benefits supplied to in-patients of the hospital is required to be submitted, the hospital shall submit a copy of each such medication chart to the Department of Health.

(7) Information provided by electronic means to the Chief Executive Medicare by the approved supplier in respect of a claim in respect of pharmaceutical benefits supplied to in-patients of the hospital must conform to the requirements of the Rules made under section 99AAA of the Act for an online claim and the associated provision of under co-payment data under section 98AC of the Act.

9 Transitionals

(1) If a pharmaceutical benefit was prescribed for an in-patient of a hospital under the previous Special Arrangement, and the supply was not made prior to the commencement of this Special Arrangement, the supply of the pharmaceutical benefit is taken to have been validly prescribed under this Special Arrangement, and may be supplied to the in-patient of the hospital under this Special Arrangement.

(2) In this section the previous Special Arrangement means the National Health (Multiple Hospitals Paperless Claiming Trial) Special Arrangement 2016 (PB 59 of 2016), as in force immediately before 1 March 2017.

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