EXPLANATORY STATEMENT
NATIONAL HEALTH ACT 1953
DETERMINATION UNDER SUBSECTION 84HA(1)
Part VII of the National Health Act 1953 (the Act) regulates the Pharmaceutical Benefits Scheme (PBS), which provides for the supply of listed drugs and medicinal preparations as pharmaceutical benefits. Eligible veterans are also entitled to additional benefits through the Repatriation Pharmaceutical Benefits Scheme (RPBS), in accordance with the Veterans’ Entitlements Act 1986.
Subsection 84HA(1) of the Act provides that an approved pharmacist, an approved medical practitioner or an approved hospital authority who issues a concession card or entitlement card (or an additional or replacement concession card or entitlement card) in accordance with the Act and the National Health (Pharmaceutical Benefits) Regulations 1960 (the Regulations) is entitled to be paid a fee by the Commonwealth. The Minister shall seek an agreement from the Pharmacy Guild of Australia prior to determining this fee.
The purpose of the Determination under subsection 84HA(1) of the Act is to determine the fee payable to an approved pharmacist, an approved medical practitioner or an approved hospital authority for issuing a concession card or entitlement card (or an additional or replacement concession card or entitlement card). This fee is indexed on 1 January of each year by the ratio of the Consumer Price Index (CPI) for September quarter for the current year and CPI for September quarter for the previous calendar year. On this occasion, the fee is calculated to be $8.58.
This fee is only payable if the card has been issued:
- by an approved pharmacist, approved medical practitioner or approved hospital authority within the meaning of subsection 84(1) of the Act; and
- in accordance with the provisions of Division 1A of Part VII of the Act, and the matters prescribed in Parts IIAA and IIA of the Regulations.
Division 1A of Part VII of the Act provides for a “safety net scheme” in relation to pharmaceutical benefits and repatriation pharmaceutical benefits (as defined in subsection 84(1) of the Act). The safety net scheme is designed to provide financial protection for those patients and their families who require a large number of PBS or RPBS medicines.
At the person’s request, a pharmacist records the supply of PBS and RPBS medicines to that person and the cost of the supply. When a person reaches a certain spending level on PBS or RPBS medicines (“the safety net threshold”), that person may be eligible for a safety net concession card or a pharmaceutical benefits entitlement card in respect of a relevant entitlement period. The issuing of such a card to a person enables that person to receive PBS or RPBS medicines at a reduced rate or free of charge for the remainder of the relevant entitlement period. The relevant entitlement period for the safety net scheme is a calendar year, that is, from 1 January to 31 December.
Consultation
The Pharmacy Guild of Australia has been consulted on this matter and has agreed, in writing, to the making of this Determination, as required under subsection 84HA(2) of the Act.
This Determination will commence on 1 January 2011.
The Determination is a legislative instrument for the purpose of the Legislative Instruments Act 2003.