10Claims for supply of pharmaceutical benefit

10 Claims for supply of pharmaceutical benefit

(1) An approved supplier may make a claim for payment for the supply of a pharmaceutical benefit under this Special Arrangement in accordance with the Rules, as modified by this section.

(2) Where a claim for payment for the supply of a pharmaceutical benefit of a kind mentioned in subsection (3) is made, for item 25 of the table in clause 1 of Schedule 1 to the Rules, the Patient Category details for a patient in the Residential aged care facility patient (medication chart prescription) category are 0 (zero).

(3) For the purposes of subsection (2), the kind of supply of a pharmaceutical benefit is a supply using software made available by Fred IT Group Pty Ltd (ABN 68 109 546 901) and which is:

(a) a supply where writing the prescription for the supply required authorisation by the Chief Executive Medicare under section 19 of the National Health (Listing of Pharmaceutical Benefits) Instrument 2024 (not including where writing the prescription was taken to have been authorised); or

(b) a supply of a pharmaceutical benefit having a drug (within the meaning of Part VII of the Act) that is referred to in Schedule 8 of the current Poisons Standard (within the meaning of the Therapeutic Goods Act 1989).

(4) If the Chief Executive Medicare notifies the approved supplier in writing that a copy of the electronic medication order is required to be submitted, the approved supplier must submit a copy of the electronic medication order to the Department administered by the Minister who administers the Human Services (Centrelink) Act 1997.

Electronic pharmacy records

(5) For each supply of pharmaceutical benefit based on an electronic medication order in respect of which a claim is made under section 99AAA of the Act by an approved supplier, the supplier must:

(a) prepare an electronic pharmacy record; and

(b) retain the electronic pharmacy record for not less than two years after the day on which the pharmaceutical benefit was supplied.

Note: This subsection establishes record keeping requirements that correspond to the requirements contained in section 61 of the Regulations.

(6) The electronic pharmacy record must contain all information required to be given to the Secretary by an approved supplier in relation to the supply of a pharmaceutical benefit to a person receiving residential care in a approved residential care home by Schedule 1 to the Rules for a CTS claim.

(7) If the Chief Executive Medicare notifies the approved supplier in writing that a copy of an electronic pharmacy record is required to be submitted, the approved supplier must submit a copy of the record to the Department administered by the Minister who administers the Human Services (Centrelink) Act 1997.