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National Health (Paraplegic and Quadriplegic Program) Special Arrangement 2010 (PB 118 of 2010)

made under subsection 100(1) of the

National Health Act 1953

Compilation No. 13

Compilation date:   1 December 2016

Includes amendments up to:            PB 102 of 2016

Registered:   16 December 2016

About this compilation

This compilation

This is a compilation of the National Health (Paraplegic and Quadriplegic Program) Special Arrangement 2010 (PB 118 of 2010) that shows the text of the law as amended and in force on 1 December 2016 (the compilation date).

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register ( The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Editorial changes

For more information about any editorial changes made in this compilation, see the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.

Self-repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

Contents

Part 1—Preliminary  1

1  Name of Special Arrangement.................................................................................................. 1

3  Definitions................................................................................................................................ 1

4  Pharmaceutical benefits covered by this Special Arrangement................................................. 1

5  Application of Part VII of the Act............................................................................................ 2

6  Responsible person.................................................................................................................. 2

7  No prescriber or prescription.................................................................................................... 2

Part 2—Supply for the paraplegic and quadriplegic program  4

9  Paraplegic and quadriplegic associations.................................................................................. 4

10  Eligible persons...................................................................................................................... 4

11  Maximum amount.................................................................................................................. 4

12  Supply.................................................................................................................................... 4

13  Co‑payment etc not to be made............................................................................................... 5

14  Payment from Commonwealth............................................................................................... 5

15  Charge for delivery................................................................................................................. 6

16  Claims for payment................................................................................................................ 6

17  Stock of pharmaceutical benefits etc....................................................................................... 6

Schedule 1—Pharmaceutical benefits covered by this Special Arrangement and related information   7

Schedule 2—Responsible Person Codes   9

Endnotes10

Endnote 1—About the endnotes  10

Endnote 2—Abbreviation key  11

Endnote 3—Legislation history  12

Endnote 4—Amendment history  13

Endnote 5—Editorial changes  14

Part 1—Preliminary

1  Name of Special Arrangement

(1)  This Special Arrangement is the National Health (Paraplegic and Quadriplegic Program) Special Arrangement 2010.

(2)  This Special Arrangement may also be cited as PB 118 of 2010.

3  Definitions

In this Special Arrangement:

ABN has the same meaning as in the A New Tax System (Australian Business Number) Act 1999.

Act means the National Health Act 1953.

authorised association means a paraplegic and quadriplegic association authorised to supply pharmaceutical benefits under this Special Arrangement by section 9.

eligible person means a person that is eligible to receive pharmaceutical benefits under section 10.

other Special Arrangement means another Special Arrangement under section 100 of the Act.

Note: Terms used in this Special Arrangement have the same meaning as in the Act—see section 13 of the Legislative Instruments Act 2003. These terms include:

·     approved ex‑manufacturer price

·     brand

·     claimed price

·     listed drug

·     pack quantity

·     pharmaceutical benefit

·     pharmaceutical item

·     proportional ex‑manufacturer price

·     responsible person.

4  Pharmaceutical benefits covered by this Special Arrangement

(1)  This Special Arrangement applies to each pharmaceutical benefit mentioned in Schedule 1.

(2)  Each pharmaceutical benefit to which this Special Arrangement applies is a brand of a listed drug mentioned in Schedule 1:

(a)  in the form mentioned in Schedule 1 for the listed drug; and

(b)  with the manner of administration mentioned in Schedule 1 for the form of the listed drug.

Note:          Each listed drug mentioned in Schedule 1 has been declared by the Minister under subsection 85(2) of the Act. The form, manner of administration and brand mentioned in Schedule 1 have been determined by the Minister under subsections 85(3), (5) and (6) of the Act respectively.

  1. Application of Part VII of the Act

(1)  Each pharmaceutical benefit supplied in accordance with this Special Arrangement is supplied under Part VII of the Act.

(2)  A provision of Part VII of the Act, or of regulations or other instruments made for Part VII of the Act, applies subject to this Special Arrangement.

Note: See subsection 100(3) of the Act.

6  Responsible person

(1)  If a code is mentioned in the column in Schedule 1 headed ‘Responsible Person’ for a brand of a pharmaceutical item, the person mentioned in paragraph (2)(a) is the responsible person for the brand of the pharmaceutical item.

(2)  For subsection (1):

(a)  the person is the person mentioned in Schedule 2 for the code, with the ABN, if any, mentioned in Schedule 2 for the person; and

(b)  the pharmaceutical item is the listed drug mentioned in Schedule 1:

(i)  in the form mentioned in Schedule 1 for the listed drug; and

(ii)  with the manner of administration mentioned in Schedule 1 for the form of the listed drug.

Note:          A person identified by a code in the column headed ‘Responsible Person’ in Schedule 1 has been determined by the Minister, under section 84AF of the Act, to be the responsible person for the brand of the pharmaceutical item.

7  No prescriber or prescription

(1) Subsection 88(1) of the Act (authorising medical practitioners to prescribe pharmaceutical benefits) does not apply to the supply of a pharmaceutical benefit under this Special Arrangement.

(2)  If a pharmaceutical benefit is supplied in accordance with this Special Arrangement, the following determinations do not apply to the supply:

(a) a determination made under section 88 of the Act about authorised prescribers for the pharmaceutical benefit;

(b) a determination made under paragraph 85(7)(b) of the Act about the circumstances in which a prescription for the pharmaceutical benefit may be written;

(c) a determination made under paragraph 85A(2(a) of the Act about the maximum quantities or number of units of the pharmaceutical item in the pharmaceutical benefit that may, in 1 prescription, be directed to be supplied on any 1 occasion;

(d) a determination made under paragraph 85A(2)(b) of the Act about the maximum number of occasions on which the pharmaceutical benefit may be directed to be supplied in a prescription.

Part 2—Supply for the paraplegic and quadriplegic program

9  Paraplegic and quadriplegic associations

The following paraplegic and quadriplegic associations are authorised to supply pharmaceutical benefits under this Special Arrangement:

(a)  The Paraplegic & Quadriplegic Association of N S W (ABN 42 000 355 948);

(b)  Spinal Injuries Association Inc (ABN 39 293 063 049);

(c)  Paraquad Victoria (ABN 80 973 805 243).

10  Eligible persons

A person is eligible to receive a pharmaceutical benefit from an authorised association if the person:

(a)  is an eligible person within the meaning of the Health Insurance Act 1973; and

(b)  has paraplegia or quadriplegia; and

(c)  is a member of the association.

11  Maximum amount

(1)  The maximum amount of the pharmaceutical item in a pharmaceutical benefit that may, during a month, be supplied by an authorised association to an eligible person is the amount mentioned in the column in Schedule 1 headed ‘Maximum Amount’ for the pharmaceutical benefit.

(2)  For subsection (1):

(a)  the pharmaceutical item is the listed drug mentioned in Schedule 1:

(i)  in the form mentioned in Schedule 1 for the listed drug; and

(ii)  with the manner of administration mentioned in Schedule 1 for the form of the listed drug; and

(b)  the pharmaceutical benefit is the brand of the listed drug mentioned in Schedule 1:

(i)  in the form mentioned in Schedule 1 for the listed drug; and

(ii)  with the manner of administration mentioned in Schedule 1 for the form of the listed drug.

12  Supply

(1)  An authorised association may supply a pharmaceutical benefit to an eligible person:

(a)  on the person’s request; and

(b) despite section 89 of the Act, without a prescription written for the supply to the person.

Note: Section 89 of the Act provides for pharmaceutical benefits to be supplied only on prescription.

(2)  The association may supply the pharmaceutical benefit to the person by:

(a)  making the pharmaceutical benefit available to be picked up by the person at the association’s premises; or

(b)  sending the pharmaceutical benefit to the person.

13  Co‑payment etc not to be made

An authorised association must not demand or receive a payment or other valuable consideration for the supply of a pharmaceutical benefit under this Special Arrangement, other than:

(a)  a payment from the Commonwealth under section 14.

(b)  a charge mentioned in section 15.

14  Payment from Commonwealth

(1)  An authorised association that supplies a pack quantity of a pharmaceutical benefit is entitled to be paid by the Commonwealth for the supply the amount worked out under subsection (2).

(2)  For subsection (1), the amount is:

(a) if there is no claimed price for the pack quantity of the pharmaceutical benefit:

(i) the price to pharmacists for the pack quantity worked out under the determination under paragraph 98B(1)(a) of the Act; and

(ii)  a handling fee of 2.75% of that amount; or

(b)  if there is a claimed price for the pack quantity of the pharmaceutical benefit:

(i)  the claimed price for the pack quantity  plus a wholesale mark‑up calculated in accordance with subsection (3); and

(ii)  a handling fee of 2.75% of that amount.

(3) For paragraph (2)(b), the wholesale mark‑up for the pack quantity of the pharmaceutical benefit is to be worked out using the methodology for calculating the wholesale mark‑up for ready‑prepared pharmaceutical benefits in the determination under paragraph 98B(1)(a) of the Act, subject to the following:

(a)  for the purposes of identifying the appropriate wholesale mark‑up formula in Step 2 of the methodology, the ex‑manufacturer price for the relevant quantity is to be worked out proportionately from the approved ex‑manufacturer price or proportional ex‑manufacturer price for the pack quantity of the pharmaceutical benefit; and

(b)  otherwise, the methodology is to be applied as if the claimed price for the pack quantity of the pharmaceutical benefit were the approved ex‑manufacturer price or proportional ex‑manufacturer price for the pack quantity.

15  Charge for delivery

If an authorised association supplies a pharmaceutical benefit by sending it to a person the association may charge the person an amount that is equal to the cost of sending the pharmaceutical benefit to the person.

16  Claims for payment

(1)  An authorised association that wants to receive payment for the supply of a pharmaceutical benefit under this Special Arrangement must make a claim for payment to the Medicare Australia CEO.

(2) Despite section 99AAA of the Act, the association must submit its claims for the supplies it makes during a month on a form approved in writing by the Medicare Australia CEO for this section.

Note: Section 99AAA of the Act provides for rules to be made by the Minister about procedures for claims for payment.

17  Stock of pharmaceutical benefits etc

An authorised association may:

(a)  order a pharmaceutical benefit from:

(i)  the responsible person for the brand of the pharmaceutical item in the pharmaceutical benefit; or

(ii)  a wholesaler for the pharmaceutical benefit; and

(b)  keep in stock at its premises an adequate supply of pharmaceutical benefits for supply to its members under this Special Arrangement.

Schedule 1—Pharmaceutical benefits covered by this Special Arrangement and related information

(sections 4, 6 and 11)

Listed Drug Form Manner of Administration Brand Responsible Person Maximum Amount
Bisacodyl Tablet, 5mg oral Bisalax AS 400
Lax‑Tab AE 400
Suppositories 10mg, 10 rectal Dulcolax BY 9
Petrus Bisacodyl Suppositories PP 9
Suppositories 10mg, 12 rectal Petrus Bisacodyl Suppositories PP 8
Enemas 10mg in 5mL, 25 rectal Bisalax AS 2
Macrogol 3350 Sachets containing powder for oral solution 13.125g with electrolytes, 30 oral APO-MACROGOL plus ELECTROLYTES TX 2
Chemists’ Own Macrogol with Electrolytes RW 1
LaxaCon EA 2
lax-sachets AE 2
Macrovic RF 1
Molaxole HM 2
Movicol NE 2
Sorbitol with Sodium Citrate and Sodium Lauryl Sulfoacetate Enemas 3.125g‑450mg‑45mg in 5mL, 12 rectal Micolette AE 4
Sterculia with Frangula Bark Granules 620mg‑80mg, per g, 500g oral Normacol Plus NE 2

Schedule 2—Responsible Person Codes

(section 6)

Code Responsible Person Australian Business Number
AE AFT Pharmaceuticals Pty Ltd 29 105 636 413
AS Aspen Pharmacare Australia Pty Limited 51 096 236 985
BY Boehringer Ingelheim Pty Ltd 52 000 452 308
EA Amneal Pharmaceuticals Pty Ltd 11 163 167 851
HM Meda Pharmaceuticals Pty Ltd 59 155 308 679
NE Norgine Pty Ltd 78 005 022 882
PP Petrus Pharmaceuticals Pty Ltd 21 108 884 126
RF Arrow Pharma Pty Ltd 33 605 909 911
RW Arrow Pharma Pty Ltd 33 605 909 911
TX Apotex Pty Ltd 52 096 916 148

Endnotes

Endnote 1—About the endnotes

The endnotes provide information about this compilation and the compiled law.

The following endnotes are included in every compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Abbreviation key—Endnote 2

The abbreviation key sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.

Editorial changes

The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.

If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.

Misdescribed amendments

A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.

If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.

Endnote 2—Abbreviation key

ad = added or inserted o = order(s)
am = amended Ord = Ordinance
amdt = amendment orig = original
c = clause(s) par = paragraph(s)/subparagraph(s)
C[x] = Compilation No. x     /sub‑subparagraph(s)
Ch = Chapter(s) pres = present
def = definition(s) prev = previous
Dict = Dictionary (prev…) = previously
disallowed = disallowed by Parliament Pt = Part(s)
Div = Division(s) r = regulation(s)/rule(s)
ed = editorial change reloc = relocated
exp = expires/expired or ceases/ceased to have renum = renumbered
    effect rep = repealed
F = Federal Register of Legislation rs = repealed and substituted
gaz = gazette s = section(s)/subsection(s)
LA = Legislation Act 2003 Sch = Schedule(s)
LIA = Legislative Instruments Act 2003 Sdiv = Subdivision(s)
(md) = misdescribed amendment can be given SLI = Select Legislative Instrument
    effect SR = Statutory Rules
(md not incorp) = misdescribed amendment Sub‑Ch = Sub‑Chapter(s)
    cannot be given effect SubPt = Subpart(s)
mod = modified/modification underlining = whole or part not
No. = Number(s)     commenced or to be commenced

Endnote 3—Legislation history

Name Registration Commencement Application, saving and transitional provisions
PB 118 of 2010 29 Nov 2010 (F2010L03133) 1 Dec 2010 (s 2)
PB 42 of 2012 30 May 2012 (F2012L01116) 1 Apr 2012 (s 2)
PB 91 of 2012 28 Sept 2012 (F2012L01974) 1 Oct 2012 (s 2)
PB 51 of 2013 31 July 2013 (F2013L01481) 1 Aug 2013 (s 2)
PB 66 of 2013 24 Sept 2013 (F2013L01738) 1 Oct 2013 (s 2)
PB 87 of 2013 18 Nov 2013 (F2013L01947) 1 Dec 2013 (s 2)
PB 94 of 2013 24 Dec 2013 (F2013L02193) 1 Jan 2014 (s 2)
PB 35 of 2014 17 Apr 2014 (F2014L00427) 1 May 2014 (s 2)
PB 79 of 2014 26 Sept 2014 (F2014L01287) 1 Oct 2014 (s 2)
PB 62 of 2015 1 July 2015 (F2015L01068)) 1 July 2015 (s 2)
PB 97 of 2015 1 Oct 2015 (F2015L01602) 1 Oct 2015 (s 2)
PB 118 of 2015 1 Dec 2015 (F2015L01893) 1 Dec 2015 (s 2)
PB 15 of 2016 1 Mar 2016 (F2016L00216) 1 Mar 2016 (s 2)
PB 35 of 2016 2 May 2016 (F2016L00622) 1 May 2016 (s 2)
PB 102 of 2016 13 Dec 2016 (F2016L01930) 1 Dec 2016 (s 2)

Endnote 4—Amendment history

Provision affected How affected
Part 1
s 2........................................ rep LA s 48D
s 3........................................ am PB 91 of 2012
s 8........................................ rep PB 91 of 2012
Part 2
s 14...................................... am PB 42 and 91 of 2012
Schedule 1
Schedule 1........................... rs PB 91 of 2012
am PB 51, 66, 87 and 94 of 2013; PB 35 and 79 of 2014; PB 62, 97 and 118 of 2015 (md not incorp); PB 15, 35 and 102 of 2016
ed C14
Schedule 2
Schedule 2........................... am PB 51 and 66 of 2013; PB 79 of 2014; PB 62 and 97 of 2015; PB 15 of 2016

Endnote 5—Editorial changes

In preparing this compilation for registration, the following kinds of editorial change(s) were made under the Legislation Act 2003.

Schedule 1, entry for Sorbitol with Sodium Citrate and Sodium Lauryl Solfoacetate

Kind of editorial change

Give effect to the misdescribed amendment as intended

Details of editorial change

Schedule 1 item 1 of the National Health (Paraplegic and Quadriplegic Program) Special Arrangement Amendment Instrument 2016 (No. 3) (PB 102 of 2016) instructs to amend the entry for “Sorbital + Citrate + Lauryl Sulfoacetate Sodium”.

The words “Sorbital + Citrate + Lauryl Sulfoacetate Sodium” do not appear in Schedule 1. However the words “Sorbitol with Sodium Citrate and Sodium Lauryl Solfoacetate” do appear.

This compilation was editorially changed to amend the entry for “Sorbitol with Sodium Citrate and Sodium Lauryl Solfoacetate” and give effect to the misdescribed amendment as intended.

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