PB 94 of 2024
National Health (Additional Community Supply Support Payment) Determination 2024
The Pharmaceutical Benefits Remuneration Tribunal, makes the following determination.
Dated 8 October 2024
Judith Wright
Chairperson
for and on behalf of the
Pharmaceutical Benefits Remuneration Tribunal
Contents
1 Name
2 Commencement
3 Authority
4 Definitions
5 ACSS eligible supplies
6 Amount of ACSS payment
(1) This instrument is the National Health (Additional Community Supply Support Payment) Determination 2024.
(2) This instrument may also be cited as PB 94 of 2024.
(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.
Commencement information | ||
Column 1 | Column 2 | Column 3 |
Provisions | Commencement | Date/Details |
1. The whole of this instrument | The day after this instrument is registered. |
|
Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.
(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.
This instrument is made under paragraph 98B(1)(b) of the National Health Act 1953.
(1) In this instrument:
Act means the National Health Act 1953.
increased maximum quantity of a pharmaceutical benefit means the maximum quantity or number of units of the benefit or the pharmaceutical item in the benefit that may, in one prescription, be directed to be supplied on any one occasion, for a relevant purpose, under a determination of the Minister under paragraph 85A(2)(a) of the Act.
increased maximum quantity prescription means a prescription directing, for a relevant purpose, the supply on any one occasion of the increased maximum quantity of a pharmaceutical benefit.
relevant purpose, for a pharmaceutical benefit, means a purpose, mentioned in Schedule 4 to the National Health (Listing of Pharmaceutical Benefits) Instrument 2024 for a purposes code (within the meaning of that instrument) specified in Schedule 1 to that instrument for the benefit, that includes the phrase “The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient”.
(2) An expression that is used in this instrument and in Part VII of the Act has the same meaning in this instrument as it has in that Part.
Note: Examples of such expressions include the following:
(a) ACSS eligible supply;
(b) ACSS payment;
(c) approved pharmacist;
(d) pharmaceutical benefit;
(e) pharmaceutical item;
(f) Schedule equivalent.
For the purposes of subparagraph 98B(1)(b)(i) of the Act, a supply by an approved pharmacist of a pharmaceutical benefit is an ACSS eligible supply unless the supply is made in accordance with any of the following special arrangements under section 100 of the Act:
(a) the National Health (Botulinum Toxin Program) Special Arrangement 2015;
(b) the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024;
(c) the National Health (Growth Hormone Program) Special Arrangement 2015;
(d) the National Health (Highly Specialised Drugs Program) Special Arrangement 2021;
(e) the National Health (IVF Program) Special Arrangement 2015;
(f) the National Health (Take Home Naloxone) Special Arrangement 2019.
(1) For the purposes of subparagraph 98B(1)(b)(ii) of the Act, the amount of the ACSS payment for each ACSS eligible supply is:
(a) if paragraph (b) of this subsection does not apply—$0.78; or
(b) if subsection (2) or (3) of this section applies to the supply—the sum of:
(i) the amount mentioned in paragraph (a) of this subsection; and
(ii) $4.79.
Note: An approved pharmacist who wants to receive an ACSS payment must make a claim for the payment under section 99AAA of the Act. Entitlement to the payment is also subject to any applicable conditions determined under section 98C of the Act and the conditions set out in section 99AAAB of the Act.
(2) This subsection applies to an ACSS eligible supply of a pharmaceutical benefit if:
(a) the ACSS eligible supply is made upon an increased maximum quantity prescription directing the supply of:
(i) the benefit; or
(ii) another pharmaceutical benefit that is Schedule equivalent to the benefit; and
(b) the ACSS eligible supply is of the increased maximum quantity of the benefit.
(3) This subsection applies to an ACSS eligible supply of a pharmaceutical benefit if:
(a) the ACSS eligible supply is made to a person in accordance with section 89A of the Act (which deals with supplies of pharmaceutical benefits without a prescription); and
(i) the benefit; or
(ii) another pharmaceutical benefit that is Schedule equivalent to the benefit; and
(c) both the ACSS eligible supply, and the immediately preceding supply referred to in paragraph (b) of this subsection, are of the increased maximum quantity of the relevant pharmaceutical benefit.