6Procedures for giving information—form and period for giving information and certification

6 Procedures for giving information—form and period for giving information and certification

(1) For the purposes of paragraphs 98AC(4)(b) and 99AAA(8)(a) of the Act, this section defines procedures to be followed by an approved supplier in giving information to the Chief Executive Medicare, on behalf of the Secretary, in relation to the supply by the approved supplier of pharmaceutical benefits, whether the information is given: (a) under subsection 98AC(1) of the Act; or (b) in making a claim under section 99AAA of the Act. Form for giving information (2) If the Chief Executive Medicare has approved a form for giving the information, the information must be given in accordance with the approved form. Period for giving information etc. (3) The information must be given to the Chief Executive Medicare in relation to pharmaceutical benefits supplied by the approved supplier during a period not exceeding 35 days, unless the Chief Executive Medicare is satisfied that the approved supplier was unable, through circumstances outside the approved supplier’s control, to comply with that requirement. (4) The information must be given to the Chief Executive Medicare not more than 30 days after the last day of the period in respect of which previous information in relation to supplies of pharmaceutical benefits was given by the approved supplier, unless the Chief Executive Medicare is satisfied that the approved supplier was unable, through circumstances outside the approved supplier’s control, to comply with that requirement. (5) The information must not be given to the Chief Executive Medicare during the same calendar month as any previous information was given in relation to supplies of pharmaceutical benefits by the approved supplier, unless it is given in accordance with an arrangement proposed by the approved supplier and agreed to by the Chief Executive Medicare on the basis that the arrangement will not impose additional administrative expenses on the Chief Executive Medicare. Certification (6) The approved supplier must certify: (a) that each pharmaceutical benefit to which the information relates was supplied by, or on behalf of, the approved supplier in accordance with the National Health Act 1953 and the instruments made under it, or the RPBS; and (b) that the information is correct. (7) The approved supplier may make the certification in an approved form (if any) referred to in subsection (2) or in another manner.

Note: Paragraph 8(3)(d) of this instrument sets out requirements for the Claims Transmission System about warnings and notifications that apply if the certification is not included in a form referred to in subsection (2) of this section.

(8) In certifying for the purposes of paragraph (6)(a), the approved supplier must: (a) identify the range of the serial numbers for each payment category referred to in Schedule 1 allotted in respect of the pharmaceutical benefits; and (b) specify the total number of pharmaceutical benefits for each of those payment categories; and (c) identify the claim period number, and the claim reference, referred to in Schedule 1 in relation to which the information is given.