National Health (Concession Card or Entitlement Card Fee) Amendment Determination 2022

Administered by Department of Health, Disability and Ageing

Legislation au F2022L01559 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

National Health Act 1953

National Health (Concession Card or Entitlement Card Fee) Amendment Determination 2022

PB 110 of 2022

Authority

This instrument is made under subsection 84HA(1) of the National Health Act 1953 (the Act), which provides that an approved pharmacist, approved medical practitioner or approved hospital authority who issues a safety net concession card, a pharmaceutical benefits entitlement card, or an additional or replacement card in relation to any of these cards, is entitled to be paid by the Commonwealth, in respect of the issue of the card, the fee determined by the Minister for Health and Aged Care.

Subsection 84HA(2) of the Act provides that a determination under subsection 84HA(1) can only be made where the Pharmacy Guild of Australia (the Guild) has agreed in writing to the making of that determination. The Guild has agreed in writing to the making of this instrument.

This Determination is a legislative instrument for the purpose of the Legislation Act 2003.

Reliance on subsection 33(3) of the Acts Interpretation Act 1901

Under subsection 33(3) of the Acts Interpretation Act 1901, where an Act confers a power to make, grant or issue any instrument of a legislative or administrative character (including rules, regulations or by-laws), the power shall be construed as including a power exercisable in the like manner and subject to the like conditions (if any) to repeal, rescind, revoke, amend, or vary any such instrument.

Purpose

The National Health (Concession Card or Entitlement Card Fee) Amendment Determination 2022 (PB 110 of 2022) (the Amendment Determination) amends the National Health (Concession Card or Entitlement Card Fee) Determination 2021 (PB 133 of 2021) (the Determination) to index the fee for issue of a safety net concession card or pharmaceutical benefits entitlement card (or an additional or replacement concession card or entitlement card).

The Determination commenced on 1 January 2022 and reflects annual adjustments to the safety net concession or entitlement card issue fee. This fee is indexed on 1 January of each year by the ratio of the Consumer Price Index (CPI) for the September quarter for the current year and the CPI for the September quarter for the previous calendar year.

This Amendment Determination increases the fee from $10.65 to $11.42. This increase takes effect on 1 January 2023.

Background

Part VII of the Act regulates the Pharmaceutical Benefits Scheme (PBS), which provides for the supply of listed drugs and medicinal preparations as pharmaceutical benefits. The PBS allows the Commonwealth to subsidise medicines to make them more affordable for the benefit of all Australians. Eligible veterans are also entitled to access the Repatriation Pharmaceutical Benefits Scheme (RPBS), in accordance with the Veterans’ Entitlements Act 1986. The RPBS allows access to all pharmaceutical items available to the general community under the PBS and also an additional list contained in the RPBS. 

Subsection 84HA(1) of the Act provides that an approved pharmacist, an approved medical practitioner or an approved hospital authority that issues a safety net concession card or pharmaceutical benefits entitlement card (or an additional or replacement concession card or entitlement card) is entitled to be paid a fee determined by the Minister. Subsection 84HA(2) of the Act provides that the Minister must not determine a fee unless the Guild has agreed in writing to making of the determination. The Guild provided written agreement to the fee increase in November 2022.

The Determination, made under subsection 84HA(1) of the Act, determines the amount payable for the issuing of each safety net concession card, each pharmaceutical benefits entitlement card, and each additional or replacement card in relation to any of these cards.

Division 1A of Part VII of the Act provides for a safety net scheme in relation to pharmaceutical benefits and repatriation pharmaceutical benefits. 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 a patient’s request, a pharmacist records the supply of PBS and RPBS medicines to that patient and the cost of the supply. When a patient reaches a certain spending level on PBS or RPBS medicines (the safety net threshold), that patient 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 patient enables that patient 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.

Details

A provision-by-provision description of the instrument is contained in Attachment A.

Consultation

The Guild has been consulted on this matter as required under subsection 84HA(2) of the Act, and has agreed in writing, to the amendment made by this Amendment Determination.

Commencement

This Amendment Determination will commence on 1 January 2023.

 


Attachment A

 

Details of the National Health (Concession Card or Entitlement Card Fee) Amendment Determination 2022

 

Section 1 - Name of Instrument

This section provides that this instrument is the National Health (Concession Card or Entitlement Card Fee) Amendment Determination 2022, and that it may also be cited as PB 110 of 2022.

 

Section 2 - Commencement

This section provides that this instrument commences on 1 January 2023.

 

Section 3 - Authority

This section provides that this instrument is made under section 84HA of the National Health Act 1953.

 

Section 4 - Schedule

This section provides that each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned.  It also provides that any other item in a Schedule to this instrument has effect according to its terms.

 

Schedule 1 - Amendments

National Health (Concession Card or Entitlement Card Fee) Determination 2021 (PB 133 of 2021)

 

Item 1: Section 6

This item repeals and replaces section 6 of the Principal Determination.  This amendment has been made to increase the fee for issuing cards from $10.65 to $11.42.  This increase has been calculated with regards to the increase in Consumer Price Index (CPI) for the September quarter for the current calendar year compared to CPI for the September quarter for the previous calendar year and takes effect from 1 January 2023.


Statement of Compatibility with Human Rights

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

National Health (Concession Card or Entitlement Card Fee) Amendment Determination 2022

PB 110 of 2022

This legislative instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Overview of the legislative instrument

This legislative instrument amends the National Health (Concession Card or Entitlement Card Fee) Determination 2021 (PB 133 of 2021) to increase the fee payable to an approved pharmacist, an approved medical practitioner or an approved hospital authority for issuing a safety net concession card or pharmaceutical benefits entitlement card (or an additional or replacement concession card or entitlement card) from $10.65 to $11.42.  The increase will take effect from 1 January 2023.

Human rights implications

This legislative instrument engages Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) by assisting with the progressive realisation by all appropriate means of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

The Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) are benefit schemes which assist with advancement of this human right by providing for subsidised access of medicines to patients.  Efficient operational arrangements for the PBS and RPBS support effective administration of these schemes.

This legislative instrument supports the right to attainment of the highest standard of physical and mental health, by assisting approved pharmacies, approved medical practitioners or approved hospital authorities to issue safety net concession card or pharmaceutical benefits entitlement card to eligible persons, who in turn can receive subsidised pharmaceutical items and medicines at a reduced rate or free of charge for the relevant entitlement period.

The amendment made by this legislative instrument does not change the protection of human rights to health for all Australians in relation to implementation of the PBS or RPBS.

Conclusion

This legislative instrument is compatible with human rights because it continues to promote the right to health.

 

 

Elsy Brammesan

Acting Assistant Secretary

Pharmacy Branch

Technology Assessment and Access Division

Department of Health and Aged Care

Overview

The National Health (Concession Card or Entitlement Card Fee) Amendment Determination 2022 is an instrument made under the National Health Act 1953, designed to address the need for regular adjustments to the fees associated with the issuance of safety net concession cards and pharmaceutical benefits entitlement cards. This Determination, which will take effect on 1 January 2023, amends the previously established fee of $10.65 to $11.42, reflecting the annual changes in the Consumer Price Index. The objective of this amendment is to ensure that the fees align with inflation, thereby maintaining the financial sustainability of the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS). These schemes are integral to providing affordable access to medications for eligible Australians, including veterans, by subsidising the costs of necessary pharmaceutical items. This legislative instrument was enacted by the Australian Parliament and was developed in consultation with the Pharmacy Guild of Australia, which agreed to the amendment in writing. The determination aims to uphold the integrity and efficiency of the PBS and RPBS by providing adequate remuneration to approved pharmacists, medical practitioners, and hospital authorities who issue these concession and entitlement cards. This ensures that these healthcare professionals can continue to support patients in accessing necessary medications at reduced or no cost for the remainder of the entitlement period, thereby promoting the highest attainable standard of physical and mental health for all Australians.

Scope and Application

The National Health (Concession Card or Entitlement Card Fee) Amendment Determination 2022 applies to approved pharmacists, approved medical practitioners, and approved hospital authorities who issue safety net concession cards or pharmaceutical benefits entitlement cards, or additional or replacement cards related to these. This Amendment Determination, made under the National Health Act 1953, modifies the fee payable for the issuance of these cards by increasing it from $10.65 to $11.42, effective from 1 January 2023. This increase is indexed annually based on the Consumer Price Index for the September quarter. The Amendment Determination operates nationally across Australia, given its foundation under the Commonwealth's legislative framework. The Amendment Determination does not explicitly outline exclusions, exemptions, or thresholds beyond the specified fee adjustment. While the primary Act and the subordinate instrument do not explicitly mention the extension or restriction of application through subordinate instruments, the legislative process under the National Health Act 1953 allows for such modifications, subject to the agreement of the Pharmacy Guild of Australia.

Key Provisions

The main operative sections of the National Health (Concession Card or Entitlement Card Fee) Amendment Determination 2022 (PB 110 of 2022) involve the amendment of the National Health (Concession Card or Entitlement Card Fee) Determination 2021 (PB 133 of 2021). Specifically, the Amendment Determination increases the fee for issuing safety net concession cards or pharmaceutical benefits entitlement cards from $10.65 to $11.42. This adjustment is set to take effect on 1 January 2023, and it reflects the annual indexation of the fee based on the Consumer Price Index (CPI) for the September quarter. Section 4 of the Amendment Determination outlines these changes, with the principal amendment being found in Schedule 1, Item 1, which repeals and replaces Section 6 of the Principal Determination. The Amendment Determination imposes specific obligations and requirements on the parties involved in the issuance of safety net concession cards and pharmaceutical benefits entitlement cards. Approved pharmacists, approved medical practitioners, and approved hospital authorities who issue these cards are entitled to the fee determined by the Minister for Health and Aged Care. This entitlement is subject to the condition that the Pharmacy Guild of Australia (Guild) has agreed in writing to the making of the determination, as mandated by subsection 84HA(2) of the National Health Act 1953. The Amendment Determination ensures that these professionals receive appropriate compensation for their services in issuing these cards, which are crucial for providing financial protection and access to subsidised medicines for eligible patients. The Amendment Determination does not explicitly outline specific offences, penalties, or civil/criminal consequences for breach within its text. However, the overarching legislative framework of the National Health Act 1953 and related administrative instruments may impose penalties for non-compliance with requirements set forth therein. The Act generally provides for various enforcement mechanisms, including fines and other penalties for breaches of its provisions. The determination of specific penalties would depend on the nature and severity of the breach, as well as any applicable administrative or judicial processes. Overall, the National Health (Concession Card or Entitlement Card Fee) Amendment Determination 2022 aims to ensure that the fee for issuing safety net concession cards and pharmaceutical benefits entitlement cards is appropriately indexed, thereby maintaining the financial viability of the Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS). By doing so, it supports the broader objective of providing affordable access to essential medicines for eligible Australians.

Legal classification tags

Area of Law
Health Law
Instrument
Statutory Instrument
Concepts
Definitions & Interpretation
Fee Adjustments
Consumer Protection
Catchwords
Fees for Services

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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.