National Health (Concession or entitlement card fee) Amendment Determination 2014 (No. 1) (No. PB 98 of 2014)

Administered by Department of Health, Disability and Ageing

Legislation au F2014L01570 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

  NATIONAL HEALTH ACT 1953

National Health (CONCESSION OR ENTITLEMENT CARD FEE) AMENDMENT Determination 2014

PB 98 of 2014

Authority

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 Repatriation Pharmaceutical Benefits (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 safety net concession card or pharmaceutical benefits 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.  Subsection 84HA(2) of the Act provides that the Minister must not determine a fee unless the Pharmacy Guild of Australia has agreed in writing to the determination.

 

The National Health (Concession or entitlement card fee) Determination 2012 (PB 102 of 2011) (the Principal Determination), made under subsection 84HA(1) of the National Health Act 1953 (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.

 

Purpose

This Amendment Determination amends the current Principal Determination

(PB 102 of 2011) to replace the amount of $9.26 with $9.47 taking effect from 1 January 2015. This reflects the annual adjustment to 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).

 

Background

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.  On this occasion, the fee is calculated to be $9.47.

 

This fee is only payable if the card has been issued:

 

  • by an approved supplier, that is an approved pharmacist, an approved medical practitioner or an 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 Pharmaceutical Benefits Scheme (PBS) or Repatriation Pharmaceutical Scheme (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 Fifth Community Pharmacy Agreement has no provisions relating to determining the fee for issuing these cards.

 

The Pharmacy Guild of Australia 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 Determination.

 

This Determination will commence on 1 January 2015.

 

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

 

 

 


Statement of Compatibility with Human Rights

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

National Health (Concession or entitlement card fee) Amendment Determination 2014 (No. 1)   (PB 98 of 2014)

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 Amendment Determination amends the National Health (Concession or entitlement card fee) Determination 2012 (PB 102 of 2011) (Principal Determination) to replace the amount of $9.26 with $9.47 taking effect from 1 January 2015. This reflects the annual adjustment to 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). The amount of the fee is changed but the provision is unchanged.

Human rights implications

This legislative instrument engages Articles 2 and 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 PBS is a benefit scheme which assists with advancement of this human right by providing for subsidised access by patients to medicines.

Conclusion

This Legislative Instrument is compatible with human rights because it advances the protection of human rights.

 

Kimberley David Bessell

Assistant Secretary

Pharmaceutical Access Branch

Principal Pharmacy Advisor

Pharmaceutical Benefits Division

Department of Health

 

Overview

The National Health Act 1953, as amended by the National Health (Concession or Entitlement Card Fee) Amendment Determination 2014, pertains to the administration and regulation of the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits (RPBS) in Australia. This legislation was enacted to ensure the equitable and financially viable distribution of pharmaceutical benefits, particularly to eligible veterans under the RPBS. The amendment to the fee for issuing concession or entitlement cards under this Act addresses the need for an annual adjustment to the fee paid to approved pharmacists, medical practitioners, and hospital authorities for their services in issuing these cards, thereby reflecting changes in the Consumer Price Index (CPI). This amendment aims to maintain the financial viability of the scheme while ensuring that the cost of administering the PBS and RPBS remains reasonable for both the Commonwealth and the service providers. The amendment was enacted by the Australian Government and aligns with the human rights principles articulated in the International Covenant on Economic, Social and Cultural Rights, particularly in advancing the right to the highest attainable standard of physical and mental health.

Scope and Application

The National Health (Concession or Entitlement Card Fee) Amendment Determination 2014 amends the National Health (Concession or Entitlement Card Fee) Determination 2012 to adjust the fee payable for issuing safety net concession cards, pharmaceutical benefits entitlement cards, or their additional or replacement versions. This adjustment is effective from 1 January 2015, changing the fee from $9.26 to $9.47. This alteration is in line with the annual adjustment process, which is indexed based on the Consumer Price Index for the September quarter of the current year compared to the previous year. The fee is payable only when the cards are issued by approved suppliers, including approved pharmacists, approved medical practitioners, or approved hospital authorities, and in compliance with specific provisions of the National Health Act 1953 and the National Health (Pharmaceutical Benefits) Regulations 1960. This amendment ensures that the fee structure aligns with the current economic conditions and maintains the integrity of the Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits (RPBS) by providing financial protection to patients requiring a significant number of PBS or RPBS medicines.

Key Provisions

The National Health (Concession or entitlement card fee) Amendment Determination 2014 (PB 98 of 2014) amends the existing National Health (Concession or entitlement card fee) Determination 2012 (PB 102 of 2011) by adjusting the fee payable to approved pharmacists, medical practitioners, and hospital authorities for issuing safety net concession cards, pharmaceutical benefits entitlement cards, and additional or replacement cards. Specifically, section 1 of the Amendment Determination replaces the previous fee of $9.26 with a new fee of $9.47, effective from 1 January 2015. This adjustment reflects the annual reindexing of the fee based on changes in the Consumer Price Index (CPI) as required by subsection 84HA(1) of the National Health Act 1953. The new fee is applicable only if the card is issued by an approved supplier in accordance with Division 1A of Part VII of the Act and the relevant regulations. The Amendment Determination imposes obligations on approved pharmacists, medical practitioners, and hospital authorities who issue concession or entitlement cards under the Pharmaceutical Benefits Scheme (PBS) or the Repatriation Pharmaceutical Benefits Scheme (RPBS). These entities must adhere to the provisions of Division 1A of Part VII of the Act, which pertains to the safety net scheme designed to provide financial protection for patients requiring a significant number of PBS or RPBS medicines. They are also required to comply with the matters prescribed in Parts IIAA and IIA of the National Health (Pharmaceutical Benefits) Regulations 1960 when issuing these cards. Additionally, subsection 84HA(2) of the Act mandates that the Minister must not determine a fee unless the Pharmacy Guild of Australia has agreed in writing to the determination, which has been satisfied in this case. The National Health Act 1953 does not explicitly outline specific offences, penalties, or consequences for breaching the requirements related to the fee for issuing concession or entitlement cards. However, non-compliance with the provisions of the Act and the Regulations, or failure to adhere to the terms of the Determination, could potentially result in civil or administrative penalties. These could include fines or other sanctions, although the exact penalties would be determined by relevant authorities under the overarching legislative framework. The primary focus of the Determination is to ensure that the fee adjustment aligns with the statutory requirement for annual reindexing, thereby maintaining the integrity and financial sustainability of the PBS and RPBS schemes.

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Area of Law
Health Law
Instrument
Statutory Instrument
Concepts
Definitions & Interpretation
Regulatory Standards
Fee Adjustment

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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.