EXPLANATORY STATEMENT
NATIONAL HEALTH ACT 1953
COMMONWEALTH PRICE (PHARMACEUTICAL BENEFITS SUPPLIED BY APPROVED MEDICAL PRACTITIONERS) DETERMINATION 2010
Summary
This Determination provides that the Commonwealth price for a pharmaceutical benefit that is supplied by a medical practitioner is the price determined under the Commonwealth price (Pharmaceutical benefits supplied by approved pharmacists) Determination 2010.
Purpose and operation
Part VII of the National Health Act 1953 (the Act) is the legislative basis of the Pharmaceutical Benefits Scheme (PBS) by which the Commonwealth provides reliable, timely, and affordable access to a wide range of medicines for all Australians.
Subsection 85(1) provides that benefits are to be provided by the Commonwealth in accordance with Part VII in respect of pharmaceutical benefits.
Paragraph 98C(1)(a) of the Act provides that the Minister may, from time to time, determine the manner in which the Commonwealth price for all or any pharmaceutical benefits is to be worked out for the purpose of payments to approved medical practitioners for the supply of pharmaceutical benefits.
The determination under paragraph 98C(1)(a) of the Act determines the Commonwealth price in respect of the supply of pharmaceutical benefits by approved medical practitioners is the price determined under the Commonwealth price (Pharmaceutical benefits supplied by approved pharmacists) Determination 2010.
A provision-by-provision description of this determination is contained in the Attachment.
The Determination commences 1 July 2010.
The Determination is a legislative instrument for the purposes of the Legislative Instruments Act 2003.
Consultations
This determination has been made in consultation with the Office of Legislative Drafting and Publishing. The amendments to the determination are machinery in nature and do not alter any current procedures or the manner in which the Commonwealth price is currently calculated for the supply of Pharmaceutical benefits by approved medical practitioners. The purpose of redrafting this determination is purely to ensure its consistency with the Legislative Instruments Act 2003.
ATTACHMENT
Paragraph 1 provides that the name of the Determination is the Commonwealth price (Pharmaceutical benefits supplied by approved medical practitioners) Determination 2010.
Paragraph 2 provides that the Determination commences on 1 July 2010.
Paragraph 3 revokes, as of 1 July 2010, the previous determination made on 16 July 1996.
Paragraph 4 defines terms used in the Determination.
Paragraph 5 provides that the Commonwealth price is the price determined under the Commonwealth price (Pharmaceutical benefits supplied by approved pharmacists) Determination 2010, as if the pharmaceutical benefit was supplied by an approved pharmacist.
Overview
The National Health Act 1953 establishes the Pharmaceutical Benefits Scheme (PBS) which ensures that all Australians have access to affordable and timely medications. The Commonwealth price (Pharmaceutical benefits supplied by approved medical practitioners) Determination 2010 was enacted to clarify the pricing structure for pharmaceuticals supplied by approved medical practitioners, aligning it with the pricing mechanism for those supplied by approved pharmacists. The purpose of this Determination is to ensure consistency in the pricing of pharmaceutical benefits across different suppliers while maintaining the integrity and affordability of the PBS. Enacted by the Commonwealth Parliament, the policy objective of this Determination is to streamline the administrative process of determining the Commonwealth price for pharmaceutical benefits, thereby ensuring a cohesive and efficient operation within the PBS. This legislative instrument commenced on 1 July 2010 and was developed in consultation with relevant drafting authorities to ensure compliance with the Legislative Instruments Act 2003.
Scope and Application
The Commonwealth Price (Pharmaceutical Benefits Supplied by Approved Medical Practitioners) Determination 2010 applies to pharmaceutical benefits supplied by approved medical practitioners under the National Health Act 1953. This legislation governs the pricing of pharmaceuticals within the Pharmaceutical Benefits Scheme (PBS) to ensure affordable access to medicines for all Australians. The Determination specifies that the Commonwealth price for these benefits is determined by the price set out in the Commonwealth Price (Pharmaceutical Benefits Supplied by Approved Pharmacists) Determination 2010, effectively aligning the pricing for medical practitioners with that of pharmacists. The scope of this Determination is national, extending across the Commonwealth of Australia and impacting the healthcare industry by regulating the financial aspects of pharmaceutical supply by medical practitioners. The Determination commenced on 1 July 2010, replacing the previous determination made on 16 July 1996, and is a legislative instrument under the Legislative Instruments Act 2003. The redrafting was undertaken to ensure consistency with current legislative standards without altering existing procedures or calculations.
Key Provisions
The Commonwealth price (Pharmaceutical benefits supplied by approved medical practitioners) Determination 2010 (the Determination) establishes the price that the Commonwealth will pay for pharmaceutical benefits supplied by approved medical practitioners under the Pharmaceutical Benefits Scheme (PBS). According to section 5, the Commonwealth price for these pharmaceutical benefits is the same as the price determined under the Commonwealth price (Pharmaceutical benefits supplied by approved pharmacists) Determination 2010, as if the benefit was supplied by an approved pharmacist. This aligns the pricing for medical practitioners with that of pharmacists, ensuring consistency across the supply of pharmaceutical benefits. Section 2 of the Determination specifies that it commences on 1 July 2010, replacing the previous determination made on 16 July 1996, as detailed in section 3.
Entities and parties governed by this Determination, primarily approved medical practitioners who supply pharmaceutical benefits, must adhere to the specified Commonwealth price for these benefits. This means that when an approved medical practitioner supplies a pharmaceutical benefit, they must accept the price determined under the referenced Determination as the basis for Commonwealth payment. This requirement ensures that all approved medical practitioners are compensated at a rate consistent with that of approved pharmacists, maintaining fairness and uniformity within the PBS.
The Determination also outlines the potential consequences for non-compliance with the established price. Although the text does not specify particular offences or penalties, it is reasonable to infer that any breach of the set Commonwealth price could lead to legal repercussions under the National Health Act 1953. Non-compliance could potentially result in financial penalties, enforcement actions, or other administrative consequences as prescribed by the Act. The precise penalties and enforcement mechanisms would be guided by the broader legislative framework of the Act and any relevant regulations or subsidiary legislation.