16ABInformation about status of person—continued dispensing and medication chart prescriptions

16AB Information about status of person—continued dispensing and medication chart prescriptions

(1) This section applies in relation to: (a) the supply of a Pharmaceutical benefit to a person (the patient) by a Community Pharmacist (the supplier) under subsection 16A (continued dispensing); and (b) the supply of a Pharmaceutical benefit by a Community Pharmacist, on the basis of a medication chart prescription written for a person (the patient); (2) The supplier must collect the following information at the time of supply: (a) information about whether the patient is, at the time of the supply: (i) a concessional beneficiary or a dependant of a concessional beneficiary; or (ii) the holder of a concession card or entitlement card; (b) for a person mentioned in subparagraph (a)(i)—the number specified on a card, issued by the Commonwealth, as an entitlement number (however described) in relation to the person; (c) for a person mentioned in subparagraph (a)(ii)—the number of the concession card or entitlement card. (3) The supplier must include the information collected under subsection (2) in the claim for a payment from the Commonwealth in relation to the supply using the Claims Transmission System, within the meaning given by subsection 99AAA(1) of the National Health Act 1953.

10 Section 24A (including the note)

omit.

11 Section 24

at the end, insert:

Note (1): this provision incorporates into the Scheme, among other relevant “National Health Act 1953 requirements” (particularly the requirements in the claims rules made under subsections 98AC(4) and 99AAA(8) of the National Health Act 1953), the requirement for a claimant to include a “supply certification form” with a claim (manual and electronic).

Note (2): if a claim is made electronically, the supply certification form is to be given electronically (claims rules).

Note (3): for electronic claims, prescriptions need not be provided (claims rules).

12 Section 24B

omit.

13 Section 25

substitute:

25. Claims Requirements and Payment

(1) The payment of a claim under the Scheme is subject to:

(a) compliance with the Scheme, in particular section 24; and

(b) submission of a completed supply certification form under the claims rules.

13A Section 37

substitute:

37. The annual value of the pharmaceutical allowance component is calculated as follows:

(a) for a veteran in receipt of veterans supplement or MRCA supplement at different times throughout the year, the amount of $6 per fortnight, indexed according to section 198F of the Act:

(i) as if the amount of $6 is the dollar amount in subsection 198F(1);

(ii) since September 2009 (i.e. once annually since 1 January 2010), calculated at a daily rate and valued according to the number of days in the calendar year veterans supplement or MRCA supplement was payable;

(b) subject to (c), for a veteran in receipt of an income support payment or an income support payment under the Social Security Act 1991 that, respectively, attracts pension supplement, or social security pension supplement greater than the basic amount of pension supplement, the amount of $6 per fortnight, indexed according to Division 18 of Part IIIB of the Act:

(i) as if the amount of $6 is an amount of PS rate (pension supplement rate) in Item 1A of the CPI Indexation Table in section 59B;

(ii) since September 2009 (i.e. each 20 March and 20 September commencing 20 March 2010), calculated at a daily rate and valued according to the number of days in the calendar year pension supplement was payable;

Note: this provision could also apply to a veteran who is a member of a couple.

(c) for a veteran in receipt of pension supplement who is a member of a couple:

(i) if the veteran's partner does not receive an income support payment that attracts pension supplement or an income support payment under the Social Security Act 1991 that attracts social security pension supplement greater than the basic amount of pension supplement — 50% of the amount in (b); or

(ii) if the veteran and partner are an illness separated couple— the amount in (b); or

(iii) if the veteran and partner are not an illness separated couple but the veteran's partner is a veteran or a member — 50% of the amount in (b);

(d) for a veteran who is a war widow/war widower —pensioner, the amount of $6 per fortnight, indexed according to Division 18 of Part IIIB of the Act:

(i) as if the amount of $6 is an amount of PS rate (pension supplement rate) in Item 1A of the CPI Indexation Table in section 59B;

(ii) since September 2009 (i.e. each 20 March and 20 September commencing 20 March 2010), calculated at a daily rate and valued according to the number of days in the calendar year the person was a war widow/war-widower —pensioner.

Note: a pharmaceutical allowance component calculated under (d) may be in addition to a pharmaceutical allowance component calculated under (b) or (c) and the sum of all the pharmaceutical allowance components could reduce the amount of the pharmaceutical reimbursement.

Note: the following terms are defined in the Act:

“member of a couple” - 5E(2).

“partner” – 5E(1).

“war widow/war-widower —pensioner” – 5Q(1).

14 Section 45

substitute: