National Health Amendment Act 1987

Administered by Department of Health, Disability and Ageing

Legislation au C2004A03431 Not in force Act

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No. 22 of 1987

An Act to amend the National Health Act 1953, and for related purposes

[Assented to 26 May 1987]

BE IT ENACTED by the Queen, and the Senate and the House of Representatives of the Commonwealth of Australia, as follows:

Short title etc.

1. (1) This Act may be cited as the National Health Amendment Act 1987.

(2) The National Health Act 19531 is in this Act referred to as the Principal Act.

Commencement

2. (1) This Act (other than subsections 3 (1) and 4 (1) and section 5) shall come into operation on the day on which it receives the Royal Assent.

(2) Subsection 3 (1) shall be deemed to have come into operation immediately after the commencement of subsection 14 (3) of the Health Legislation Amendment Act (No. 2) 1986.

(3) Subsection 4 (1) shall be deemed to have come into operation immediately after the commencement of section 19 of the Health Legislation Amendment Act (No. 2) 1986.

(4) Section 5 shall come into operation on a day to be fixed by Proclamation.

Interpretation

3. (1) Section 4 of the Principal Act is amended by omitting “or (2)” from paragraph (ba) of the definition of “pensioner” in subsection (1) and substituting “, (2) or (3)”.

(2) Section 4 of the Principal Act is amended by inserting after subsection (1a) the following subsection:

“(1aa) Where a bodily specimen is obtained from a person while the person is an in-patient of a hospital or day hospital facility, any pathology service performed in relation to that specimen after the person ceases to be such an in-patient shall, for the purpose of paragraph (da) of the definition of ‘basic private table’ or ‘basic table’ in subsection (1), be deemed to have been rendered to the person while the person was such an in-patient.”.

(3) Subsection 4 (1aa) of the Principal Act as amended by subsection (2) of this section applies only where the bodily specimen is obtained after the commencement of subsection (2) of this section.

Eligibility for pharmaceutical benefits entitlement cards

4. (1) Section 84c of the Principal Act is amended by omitting subparagraph (4) (e) (ii) and substituting the following subparagraph:

“(ii) if there is in force, at the time of supply, a determination by the Minister pursuant to paragraph 85a (2) (a) that is applicable to the supply of the pharmaceutical benefit—the quantity or number of units supplied is not less than:

(a) in a case where there was in force, at the time when the prescription referred to in subparagraph (a) (i) of this subsection was written or communicated (in this subparagraph referred to as the ‘earlier time’), a determination by the Minister pursuant to paragraph 85a (2) (a) that would have been applicable to the supply of the pharmaceutical benefit at the earlier time, and the maximum quantity or number of units specified in the determination that would have been applicable to the supply of the pharmaceutical benefit at the earlier time is less than the maximum quantity or number of units specified in the determination that is applicable at the time of supply—that first-mentioned maximum quantity or number of units; or

(b) in any other case—the maximum quantity or number of units specified in the determination that is applicable at the time of supply.”.

(2) Section 84c of the Principal Act is amended by inserting after subsection (4) the following subsections:

“(4a) The Minister may determine that, in respect of the supply of a pharmaceutical benefit, or pharmaceutical benefits in a class of pharmaceutical benefits, specified in the determination, the requirement set out in subparagraph (4) (e) (ii) does not apply.

“(4b) A determination under subsection (4a) shall:

(a) be made by notice in writing published in the Gazette; and

(b) come into operation on such day as is specified in the determination.”.

Issue of pharmaceutical benefits entitlement card

5. (1) Section 84e of the Principal Act is amended:

(a) by omitting from subsection (5) all the words after “shall” and substituting “submit the application, and all relevant documents that accompanied or supported the application, to the Secretary by lodging them at a prescribed office within one month (or such longer period as is prescribed) after the day on which the entitlement card is issued”; and

(b) by omitting subsection (6).

(2) Subsection 84e (5) of the Principal Act as amended by subsection (1) of this section applies in relation to pharmaceutical benefits entitlement cards issued before the commencement of this section as if the reference in that first-mentioned subsection to the day on which the entitlement card is issued were a reference to the day on which this section comes into operation.

6. After section 84h of the Principal Act the following section is inserted:

Fee to approved pharmacist etc. for issuing entitlement card etc.

“84ha. (1) An approved pharmacist, approved medical practitioner or approved hospital authority who issues a pharmaceutical benefits entitlement card or an additional or replacement card is entitled to be paid by the Commonwealth, in respect of the issue of the card, the fee determined by the Minister, for the purposes of this section, for the issue of cards generally or for the issue of cards of that kind, as the case requires.

“(2) The Minister shall not determine a fee for the purposes of this section unless the Pharmacy Guild of Australia has agreed in writing to the making of that determination.

“(3) A determination under subsection (1) shall:

(a) be made by notice in writing published in the Gazette; and

(b) come into operation on such day as is specified in the determination.”.

Offences

7. Section 84l of the Principal Act is amended by omitting from subsection (4) “a notice given to the person under subsection 84e (6)” and substituting “subsection 84e (5)”.

Determination of special patient contribution in respect of certain drugs etc.

8. (1) Section 85b of the Principal Act is amended by adding at the end the following subsection:

“(2) Notwithstanding paragraph (1) (c) of this section, where, under regulations made for the purposes of subsection 85a (3), the maximum quantity or number of units (in this subsection called the ‘excess quantity or number’) of a pharmaceutical benefit that may be supplied to a person, on any one occasion, in accordance with a prescription exceeds the maximum quantity or number of units (in this subsection called the ‘normal quantity or number’) determined under paragraph 85a (2) (a), the amount that is, for the purposes of this Part, to be taken to be the special patient contribution in relation to a supply of the pharmaceutical benefit to the person in accordance with the prescription is the amount calculated in accordance with the formula:

where:

A is the amount determined under paragraph (1) (c) of this section;

E is:

(a) in a case where the excess quantity or number is not a multiple of N—the nearest higher number that is a multiple of N; or

(b) in any other case—the excess quantity or number; and

N is the normal quantity or number.”

(2) Subsection 85b (2) of the Principal Act as amended by subsection (1) of this section applies only where the supply of the pharmaceutical benefit occurs after the commencement of this section.

Limited charges for pharmaceutical benefits

9. Section 87 of the Principal Act is amended by omitting subsection (2b).

Payment for supply of benefits

10. Section 99 of the Principal Act is amended:

(a) by omitting from subsection (2a) “(other than a pharmaceutical benefit in respect of which there was in force, at the time of supply, a determination under section 85b)”;

(b) by omitting from paragraph (2a) (a) “exceed $10.00” and substituting “exceed:

(i) in a case where there was not in force, at the time of supply, a determination under section 85b in respect of the pharmaceutical benefit—$10.00; or

(ii) in any other case—the sum referred to in paragraph 87 (2a) (c)”;

(i) in a case where there was not in force, at the time of supply, a determination under section 85b in respect of the pharmaceutical benefit—$10.00; or

(ii) in any other case—the sum referred to in paragraph 87 (2a) (c)”;

(d) by omitting from paragraph (2a) (b) “exceed $10.00” and substituting “exceed:

(i) in a case where there was not in force, at the time of supply, a determination under section 85b in respect of the pharmaceutical benefit—$10.00; or

(ii) in any other case—the sum referred to in paragraph 87 (2a) (c)”;

(e) by omitting from subsection (2b) “(other than a pharmaceutical benefit in respect of which there was in force, at the time of supply, a determination under section 85b)”;

(f) by omitting from paragraph (2b) (a) “exceed $2.50” and substituting “exceed:

(i) in a case where there was not in force, at the time of supply, a determination under section 85b in respect of the pharmaceutical benefit—$2.50; or

(ii) in any other case—the sum referred to in paragraph 87 (2a) (b)”;

(g) by omitting from paragraph (2b) (b) “exceed $2.50” and substituting “exceed:

(i) in a case where there was not in force, at the time of supply, a determination under section 85b in respect of the pharmaceutical benefit—$2.50; or

(ii) in any other case—the sum referred to in paragraph 87 (2a) (b)”; and

(h) by omitting from paragraph (2b) (c) “exceed $2.50” and substituting “exceed:

(i) in a case where there was not in force, at the time of supply, a determination under section 85b in respect of the pharmaceutical benefit—$2.50; or

(ii) in any other case—the sum referred to in paragraph 87 (2a) (b)”.

11. After section 99a of the Principal Act the following section is inserted:

Advances

“99ab. (1) An advance, on account of an amount that may become payable to a person under section 99 in relation to the supply of a pharmaceutical benefit, may be made to the person on such terms and conditions (if any) as are approved by the Secretary in writing.

“(2) If a person receives, by way of advances on account of an amount that may become payable to the person under section 99 in relation to the supply of a pharmaceutical benefit, an amount that exceeds the amount that becomes payable to the person under section 99 in relation to the supply of the pharmaceutical benefit, the person is liable to repay to the Commonwealth the amount of the excess.

“(3) If:

(a) a person receives an amount by way of advances on account of an amount that may become payable to the person under section 99 in relation to the supply of a pharmaceutical benefit; and

(b) no amount becomes payable to the person under section 99 in relation to the supply of the pharmaceutical benefit;

the person is liable to repay to the Commonwealth the amount so received.

“(4) Where a person is liable to repay an amount to the Commonwealth under this section, the Commonwealth may recover the amount as a debt due to the Commonwealth by action in a court of competent jurisdiction.

“(5) Where a person is liable to repay an amount to the Commonwealth under this section, an amount not exceeding that amount may be deducted from any other amount that is payable to the person under this Part and, where an amount is so deducted, the other amount shall, notwithstanding the deduction, be deemed to have been paid in full to the person.”.

NOTE

1. No. 95, 1953, as amended. For previous amendments, see No. 68, 1955; Nos. 55 and 95, 1956; No. 92, 1957; No. 68, 1958; No. 72, 1959; No. 16, 1961; No. 82, 1962; No. 77, 1963; No. 37, 1964; Nos. 100 and 146, 1965; No. 44, 1966; Nos. 14 and 100, 1967; No. 100, 1968; No. 102, 1969; No. 41, 1970; No. 85, 1971; No. 114, 1972; Nos. 49 and 202, 1973; No. 37, 1974; Nos. 1, 13 and 93, 1975; Nos. 1, 60, 91, 99, 108, 157 and 177, 1976; Nos. 98 and 100, 1977; Nos. 36, 88, 132 and 189, 1978; Nos. 54, 91 and 122, 1979; Nos. 117 and 131, 1980; Nos. 40, 74, 92, 118, 163 and 176, 1981; Nos. 49, 80 and 112, 1982; Nos. 35, 54 and 139, 1983; Nos. 46, 63, 72, 120, 135 and 165, 1984; Nos. 24, 53, 65, 70, 95, 127 and 167, 1985; and Nos. 28, 75, 94 and 115, 1986.

[Minister’s second reading speech made in—

House of Representatives on 25 February 1987

Senate on 20 March 1987]

Overview

The National Health Amendment Act 1987, enacted by the Commonwealth Parliament, serves as an amendment to the National Health Act 1953, addressing gaps and updating provisions within Australia's national health framework. The Act aims to refine the administration and financial aspects of pharmaceutical benefits, ensuring more precise application of regulations regarding the supply of pharmaceuticals and the fees associated with their administration. Key changes include amendments to the eligibility criteria for pharmaceutical benefits, modifications to the procedures for issuing entitlement cards, and adjustments to the fees paid to entities that issue these cards. Additionally, the Act introduces provisions for the calculation of special patient contributions for certain drugs, alongside measures for the repayment of excess advances to the Commonwealth. These amendments are designed to enhance the efficiency and accuracy of the national health system's operations concerning pharmaceutical benefits. The policy objective of the National Health Amendment Act 1987 is to ensure that the national health system operates with greater precision and accountability, particularly in the realm of pharmaceutical benefits. By updating the legal framework, the Act seeks to align the administration of these benefits more closely with the evolving needs of the healthcare system and its beneficiaries, ultimately aiming to improve access to affordable and necessary medications for Australians.

Scope and Application

The National Health Amendment Act 1987 applies to the Commonwealth of Australia and amends the National Health Act 1953. It primarily targets the administration and regulation of pharmaceutical benefits within the healthcare sector. The Act applies to entities and individuals involved in the supply and administration of pharmaceutical benefits, including approved pharmacists, approved medical practitioners, and approved hospital authorities. It also applies to patients who are recipients of pharmaceutical benefits. The Act modifies eligibility criteria for pharmaceutical benefits entitlement cards and alters provisions regarding the issue of such cards and the payment of fees to approved pharmacists, approved medical practitioners, and approved hospital authorities for issuing entitlement cards. The Act extends its reach to any person or entity involved in the supply or administration of pharmaceutical benefits under the National Health Act 1953, which includes both Commonwealth and state-level healthcare providers and beneficiaries. The Act does not specify any exclusions or thresholds but rather extends its application through the amendments made to the Principal Act. Any further implementation or specific application of the Act may be detailed in subordinate instruments or regulations made under the authority of the Act.

Key Provisions

The National Health Amendment Act 1987 amends the National Health Act 1953 (Principal Act) in several key areas. Firstly, section 3 amends the definition of "pensioner" in the Principal Act, expanding the categories of individuals who may be considered pensioners for the purposes of the Act. Section 4 modifies the criteria for eligibility for pharmaceutical benefits entitlement cards, particularly concerning the quantity or number of units supplied under a Minister's determination. Section 5 revises the process for issuing pharmaceutical benefits entitlement cards, requiring applicants to submit relevant documents to the Secretary within a specified period after the card is issued. It also provides for the payment of fees to approved pharmacists, approved medical practitioners, or approved hospital authorities for issuing these cards, subject to the agreement of the Pharmacy Guild of Australia. The obligations imposed by the Act include ensuring that applications for pharmaceutical benefits entitlement cards are submitted within the stipulated timeframe and that all relevant documents accompany the application. Approved pharmacists, approved medical practitioners, or approved hospital authorities must also comply with the fee determination process as stipulated in section 6. Additionally, the Act requires adherence to the new rules regarding the calculation of special patient contributions for pharmaceutical benefits and compliance with the provisions for limited charges and payment for supply of benefits. The Act also outlines several offences and penalties for breaches. For instance, section 7 amends the Principal Act to clarify the offence related to the submission of applications for pharmaceutical benefits entitlement cards. Non-compliance with the requirements for the issue of entitlement cards, as well as failure to repay advances under section 99ab, can lead to civil consequences, including financial liability and recovery of amounts as debt. Additionally, there may be administrative penalties for non-compliance with the provisions regarding the calculation of special patient contributions and payment for supply of benefits. The specific maximum penalties are not detailed within the Act itself but would be determined in accordance with other relevant legislation or regulations.

Area of Law: Health Law
Instrument: Act
Concepts: Commencement Provisions; Offence Provisions; Reporting & Disclosure Obligations; Fee to approved pharmacist etc. for issuing entitlement card etc.

Interactions

Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.

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