National Health Act 1953 Determination under subsection 84BA(2) (08/12/2009) (Cth)
COMMONWEALTH OF AUSTRALIA
Determination made pursuant to subsection 84BA(2) of the National Health Act 1953
I, CHRIS BEDFORD, delegate of the Minister for Health and Ageing, under subsection 84BA(2) of the National Health Act 1953 (‘the Act’), make the following Determination:
1. Commencement
This Determination commences on 1 January 2010.
2. Repeal
The Determination under subsection 84BA(2) of the National Health Act 1953 (‘the Act’) made on 19 June 2009, with effect on 1 July 2009, is repealed.
3. Interpretation
In this Determination:
(a) “the Act” means the National Health Act 1953;
(b) “the amount referred to in paragraph 87(2)(a) of the Act” means the amount as periodically adjusted under section 99G of the Act;
(c) “the amount referred to in paragraph 87(2)(e) of the Act” means the amount as periodically adjusted under section 99G of the Act; and
(d) unless the contrary intention appears, a word or expression that is defined in the Act shall be taken to have the same meaning as in the Act.
4. Amount taken to have been paid to a public hospital for the supply of out-patient medication
The amount which, for the purposes of Part VII of the Act, will be taken to have been paid to a public hospital for a supply of out-patient medication shall be:
(a) the maximum value of the supply of out-patient medication; or
(b) the amount charged,
whichever is the lesser.
Maximum value of the supply of out-patient medication to a concessional beneficiary, their dependent or a holder of a concession card
The maximum value of the supply of out-patient medication to a concessional beneficiary, a dependant of a concessional beneficiary or the holder of a concession card shall be the amount referred to in paragraph 87(2)(a) of the Act.
6. Maximum value of the supply of out-patient medication to a general patient who is not a holder of a concession card
Except in the case of a public hospital situated in the State of Queensland, or a public hospital that is participating in arrangements under Pharmaceutical Reform Arrangements within the meaning of the National Healthcare Agreement, the maximum value of the supply of out-patient medication to a general patient who is not the holder of a concession card shall be $26.60.
7. Maximum value of the supply of out-patient medication by a Queensland public hospital to a general patient who is not a holder of a concession card
In the case of a public hospital situated in the State of Queensland, the maximum value of the supply of out-patient medication to a general patient who is not the holder of a concession card shall be:
(a) where the medication is a drug or medicinal preparation which is a pharmaceutical benefit and the Commonwealth price for that pharmaceutical benefit exceeds the amount referred to in paragraph 87(2)(e) of the Act — the amount referred to in paragraph 87(2)(e) of the Act; or
(b) where the medication is a drug or medicinal preparation which is a pharmaceutical benefit and the Commonwealth price for that pharmaceutical benefit does not exceed the amount referred to in paragraph 87(2)(e) of the Act — the price for that pharmaceutical benefit ascertained in accordance with the determination under subsection 84C(7) of the Act as in force from time to time; or
(c) where the medication is a drug or medicinal preparation which is not a pharmaceutical benefit — the amount ascertained by taking as a basis the cost to the hospital of that drug or medicinal preparation and applying, as if that cost were the approved price to pharmacists, the determination under subsection 84C(7) of the Act as in force from time to time.
8. Maximum value of the supply of out-patient medication by a participating public hospital to a general patient who is not a holder of a concession card
In the case of a public hospital that is participating in arrangements under Pharmaceutical Reform Arrangements within the meaning of the National Healthcare Agreement, the maximum value of the supply of out-patient medication to a general patient who is not the holder of a concession card shall be:
(a) where the medication is a drug or medicinal preparation that is a pharmaceutical benefit — the maximum value of the pharmaceutical benefit ascertained in accordance with subregulation 9A(5) of the National Health (Pharmaceutical Benefits) Regulations 1960; or
(b) where the medication is a drug or medicinal preparation that is not a pharmaceutical benefit — the amount ascertained by taking as a basis the cost to the hospital of that drug or medicinal preparation and applying, as if that cost were the approved price to pharmacists, the determination under subsection 84C(7) of the Act as in force from time to time.
Dated 8 December 2009
Signed
Chris Bedford
Acting Assistant Secretary
Access and Systems Branch
Pharmaceutical Benefits Division
Department of Health and Ageing
Note
1. All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See
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