National Health (Pharmaceutical Benefits) Regulations (Amendment) (Cth)

Statutory Rules 1986 No. 3191

National Health (Pharmaceutical Benefits)

Regulations2 (Amendment)

I, THE GOVERNOR-GENERAL of the Commonwealth of Australia, acting with the advice of the Federal Executive Council and pursuant to section 4 of the Acts Interpretation Act 1901, hereby make the following Regulations under the National Health Act 1953.

Dated 29 October 1986.

N. M. STEPHEN

Governor-General

By His Excellency’s Command,

Neal Blewett

Minister of State for Health

 

Principal Regulations

1. In these Regulations, “Principal Regulations” means the National Health (Pharmaceutical Benefits) Regulations.

Interpretation

2. Regulation 5 of the Principal Regulations is amended—

(a) by inserting after the definition of “dependant” in sub-regulation (1) the following definitions:

“ ‘entitlement card’ has the same meaning as in Part VII of the Act;

‘entitlement card prescription’ has the same meaning as in Part VII of the Act;”;

(b) by inserting after the definition of “pharmaceutical benefit” in sub-regulation (1) the following definitions:

(S.R. 328/86)—Cat. No. 10/13.10.1986

“ ‘record form’ has the same meaning as in Part VII of the Act;

‘relevant entitlement period’ has the same meaning as in Part VII of the Act;”; and

(c) by adding at the end the following sub-regulation:

“(3) In these Regulations, unless the contrary intention appears—

(a) a reference to the holder of an entitlement card shall be read as a reference to a person who is, by virtue of section 84g of the Act, to be taken to be a holder of the card;

(b) a reference to the original holder of an entitlement card shall be read as a reference to the person to whom an entitlement card has been issued under section 84e of the Act; and

(c) a reference to a member of the family of a person shall be read as a reference to a person who is a member of that family within the meaning of section 84b of the Act.”.

3. After Part II of the Principal Regulations the following Part is inserted:

“PART IIa—PHARMACEUTICAL BENEFITS ENTITLEMENT

CARDS

Pharmaceutical benefits prescription record forms

“9a. (1) For the purposes of paragraph 84d (3) (b) of the Act, the following particulars of the person to whom a record form is issued are prescribed particulars:

(a) the Christian or given names and the surname of the person;

(b) the address of the person.

“(2) For the purposes of sub-section 84d (4) of the Act, the following particulars of a person who is a member of the family of a person to whom a record form is issued are prescribed particulars:

(a) the Christian or given names and the surname of the person;

(b) the relationship of the person to the person to whom the record form is issued.

“(3) For the purposes of paragraph 84d (7) (a) of the Act, the prescribed particulars of a prescription upon which a pharmaceutical benefit is supplied are particulars of the number allotted to the prescription in accordance with regulation 21 or 23.

“(4) For the purposes of paragraph 84d (7) (c) of the Act, the following particulars in relation to the supply of a pharmaceutical benefit are prescribed:

(a) the PBS code number of the pharmaceutical benefit, being the code number set out in relation to that pharmaceutical benefit in the document entitled ‘Schedule of Pharmaceutical Benefits for Approved Pharmacists’ and published by the Department;

(b) the number allotted under regulation 8a to the approval of the approved pharmacist, approved medical practitioner or approved hospital authority supplying the pharmaceutical benefit.

Pharmaceutical benefits entitlement card

“9b. (1) For the purposes of paragraph 84e (3) (b) of the Act, the following particulars, in relation to an application under sub-section 84e (1) or (2) of the Act, are prescribed:

(a) the Christian or given names and the surname of the applicant;

(b) the address of the applicant;

(c) the Christian or given names and the surname of each person who is a member of the applicant’s family;

(d) the relationship of each person referred to in paragraph (c) to the applicant;

(e) the date on which the application is made.

“(2) For the purposes of paragraph 84e (3) (b) of the Act, the following documents are prescribed:

(a) any record form issued to the applicant, or to a member of the applicant’s family, containing records of the number of pharmaceutical benefit supplies made to the applicant and to the members of the applicant’s family during the relevant entitlement period to which the application relates and bearing a statement, signed by the applicant, declaring that all supplies of pharmaceutical benefits recorded in the form were made to the applicant or a member of the applicant’s family;

(b) any other document that establishes the number of pharmaceutical benefit supplies made to the applicant and to the members of the applicant’s family during that period.

Additional entitlement cards

“9c. (1) A person—

(a) who is or was a holder of an entitlement card that has been lost, stolen, damaged or destroyed;

(b) who is a holder of an entitlement card but whose particulars are not included on the card; or

(c) who is a holder of an entitlement card, other than a person referred to in paragraph (a) or (b),

may apply for the issue to the person of an additional entitlement card to—

(d) the Secretary; or

(e) where the original entitlement card was issued by an approved pharmacist, approved medical practitioner or approved hospital authority—that approved pharmacist, approved medical practitioner or approved hospital authority.

“(2) An application under sub-regulation (1) shall—

(a) be in accordance with the form approved by the Secretary for the purposes of this regulation;

(b) contain particulars of—

(i) the Christian or given names and the surname of the applicant;

(ii) the address of the applicant;

(iii) the Christian or given names and surname of each person (other than the applicant) who is a member of the family of the original holder of the entitlement card and his or her relationship to the original holder;

(iv) the number (if known) of any other entitlement card held by a member of the family of the original holder of the entitlement card; and

(v) in the case of an application by a person referred to in paragraph (1) (a)—the number (if known) of the entitlement card;

(c) be signed and dated by the applicant; and

(d) except in the case of an application made to the Secretary or made by a person who is or was a holder of an entitlement card that has been lost, stolen or destroyed—be accompanied by the original entitlement card.

“(3) Where, on an application to a person for the issue of an additional entitlement card, the person is satisfied, having regard to—

(a) the matters contained in the application; and

(b) such other matters as the person considers relevant,

that an additional entitlement card should be issued to the applicant, the person shall issue an additional entitlement card to the applicant accordingly.

Replacement entitlement cards

“9d. (1) An original holder of an entitlement card may apply for the issue of a replacement card to—

(a) the Secretary; or

(b) where the original entitlement card was issued by an approved pharmacist, approved medical practitioner or approved hospital authority—that approved pharmacist, approved medical practitioner or approved hospital authority.

“(2) An application under sub-regulation (1) shall—

(a) be in accordance with the form approved by the Secretary for the purposes of this regulation;

(b) contain particulars of—

(i) the Christian or given names and surname of the applicant;

(ii) the address of the applicant; and

(iii) the Christian or given names and surname of the new family member and his or her relationship to the applicant;

(c) be signed and dated by the applicant; and

(d) except in the case of an application made to the Secretary—be accompanied by the original entitlement card.

“(3) Where a person to whom an application is made under sub-regulation (1) is satisfied that—

(a) the applicant is the original holder of the entitlement card to which the application relates; and

(b) the person identified in the application in accordance with subparagraph (2) (b) (iii) became, after the issue of that entitlement card, and during the relevant entitlement period in respect of which that card was issued, a member of the original card holder’s family,

the person shall issue a replacement card to the applicant.

Refusal to issue additional or replacement cards

“9e. (1) Where an approved pharmacist, approved medical practitioner or approved hospital authority makes a decision under regulation 9c refusing to issue an additional entitlement card or a decision under regulation 9d refusing to issue a replacement entitlement card, the applicant may apply to the Secretary under regulation 9c or 9d for the issue of the additional entitlement card or replacement entitlement card, as the case requires.

“(2) Where the Secretary makes a decision under regulation 9c refusing to issue an additional entitlement card or a decision under regulation 9d refusing to issue a replacement entitlement card, the Secretary shall, by notice in writing, inform the applicant of the making of that decision and of the reasons for the decision.

“(3) A notice referred to in sub-regulation (2) shall include a statement to the effect that, subject to the Administrative Appeals Tribunal Act 1975, application may be made to the Administrative Appeals Tribunal for review of the decision to which the notice relates by or on behalf of a person whose interests are affected by the decision.

“(4) A failure to comply with the requirements of sub-regulation (3) in relation to a decision shall not be taken to affect the validity of the decision.

Review of decisions

“9f. An application may be made to the Administrative Appeals Tribunal for review of a decision of the Secretary—

(a) refusing to issue an additional entitlement card to a person under regulation 9c; or

(b) refusing to issue a replacement entitlement card to a person under regulation 9d.”.

Information, &c., prescribed for the purposes of section 84aa of the Act

4. Regulation 19a of the Principal Regulations is amended—

(a) by omitting from sub-regulation (1) “sub-section 84aa (1) and (2)” and substituting “sub-sections 84aa (1), (1a), (2) and (3)”;

(b) by omitting sub-paragraph (1) (a) (i) and substituting the following sub-paragraph:

“(i) information that the person is a concessional beneficiary; and”;

(c) by omitting from sub-paragraph (1) (a) (ii) “the card so held by the person” and substituting “a card held by the person (being a card issued by the Commonwealth)”;

(d) by omitting sub-paragraph (1) (b) (i) and substituting the following sub-paragraph:

“(i) information that the person is a pensioner; and”;

(e) by omitting from sub-paragraph (1) (b) (ii) “the card so held by the person” and substituting “a card held by the person (being a card issued by the Commonwealth)”;

(f) by inserting after paragraph (1) (b) the following paragraph:

“(ba) in relation to a person who is a holder of an entitlement card—

(i) information that the person is the holder of an entitlement card; and

(ii) the number of the card;”;

(g) by omitting sub-paragraphs (1) (c) (i) and (ii) and substituting the following sub-paragraphs:

“(i) information that the person is a dependant of a concessional beneficiary or pensioner, as the case may be; and

(ii) the number specified on a card held by that concessional beneficiary or pensioner (being a card issued by the Commonwealth) as being an entitlement number (however described) in relation to the person.”;

(h) by omitting from sub-regulation (2) “sub-section 84aa (1)” and substituting “sub-sections 84aa (1) and (1a)”;

(j) by omitting from paragraph (2) (a) “the Form in Schedule 7” and substituting “a form approved by the Secretary for the purposes of this sub-regulation”;

(k) by omitting paragraph (2) (c) and substituting the following paragraph:

“(c) in the case of information that the person to whom the prescription relates is a concessional beneficiary or a dependant of a concessional beneficiary—a tick or a cross in the square provided on the prescription for the supply of such information in relation to the person;”;

(m) by omitting paragraph (2) (d) and substituting the following paragraphs:

“(d) in the case of information that the person to whom the prescription relates is a pensioner or a dependant of a pensioner—a tick or a cross in the square provided on the prescription for the supply of such information in relation to the person;

(da) in the case of information that the person to whom the prescription relates is a holder of an entitlement card—a tick or a cross in the square provided on the prescription for the supply of such information in relation to the person; and”;

(n) by inserting in paragraph (2) (e) “, (1) (ba) (ii)” after “(1) (b) (ii)”; and

(p) by omitting from sub-regulation (3) “sub-section 84aa (2)” and substituting “sub-sections 84aa (2) and (3)”.

Supply of pharmaceutical benefits on prescriptions

5. Regulation 21 of the Principal Regulations is amended—

(a) by omitting from paragraph (2) (c) “in the case of an approved pharmaceutical chemist—”; and

(b) by adding at the end the following sub-regulation:

“(3) An approved hospital authority is not authorised to supply a pharmaceutical benefit upon presentation of a prescription for its supply (being a prescription written upon an authority issued pursuant to regulation 13 or 14) unless—

(a) the authority or a copy of the authority is surrendered to the medical practitioner or pharmacist by whom, or under whose direct supervision, the pharmaceutical benefit is supplied;

(b) the approved hospital authority causes that medical practitioner or pharmacist to write on the authority, or copy of the authority, the name of the approved hospital authority and the number of its approval under the Act;

(c) the approved hospital authority causes that medical practitioner or pharmacist to allot to the prescription a number that will identify the prescription and to write that number on the authority, or copy of the authority;

(d) the prescription is duly written in accordance with these Regulations; and

(e) the prescription is dated within 12 months before the date of its presentation.”.

Supply of pharmaceutical benefit on first presentation of prescription

6. Regulation 23 of the Principal Regulations is amended—

(a) by omitting from paragraph (b) “in the case of an approved pharmaceutical chemist—”; and

(b) by adding at the end the following sub-regulation:

“(2) An approved hospital authority is not authorised to supply a pharmaceutical benefit upon presentation of a prescription for its supply (not being a prescription written upon an authority issued pursuant to regulation 13 or 14) unless the approved hospital authority causes the medical practitioner or pharmacist by whom, or under whose direct supervision, the pharmaceutical benefit is supplied—

(a) to write on the paper on which the prescription is written and on the duplicate of the prescription the name of the approved hospital authority and the number of its approval under the Act; and

(b) to allot to the prescription a number which will identify the prescription and to write that number on the paper on which the prescription is written and on the duplicate of the prescription.”.

Repeat authorisations

7. Regulation 26 of the Principal Regulations is amended by inserting in paragraph (1) (d) “, an entitlement card prescription” after “pensioner benefit prescription”.

Deferred supply authorisation

8. Regulation 26a of the Principal Regulations is amended by inserting in paragraph (2) (c) “, an entitlement card prescription” after “pensioner benefit prescription”.

Repeal of regulation 29

9. Regulation 29 of the Principal Regulations is repealed.

Receipts

10. Regulation 31 of the Principal Regulations is amended—

(a) by omitting from sub-regulation (1b) “or a pensioner benefit prescription” and substituting “, a pensioner benefit prescription or an entitlement card prescription”; and

(b) by omitting from that sub-regulation “or a dependant of a pensioner” and substituting “, a dependant of a pensioner or a holder of an entitlement card”.

Schedule 7

11. Schedule 7 to the Principal Regulations is repealed.

 

NOTES

1. Notified in the Commonwealth of Australia Gazette on 31 October 1986.

2. Statutory Rules 1960 No. 17 as amended to date. For previous amendments see Note 2 to Statutory Rules 1986 No. 38 and see also Statutory Rules 1986 Nos. 38 and 194.

 

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