National Health (Concession or entitlement card fee) Amendment Determination 2020 (PB 133 of 2020)

Administered by Department of Health, Disability and Ageing

Legislation au F2020L01651 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

National Health Act 1953

National Health (Concession or entitlement card fee) Amendment Determination 2020

PB 133 of 2020

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. For the purpose of section 84HA, the fee to be paid for the issue or replacement of cards, is determined by the Minister for Health. 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.

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

This instrument amends the National Health (Concession or entitlement card fee) Amendment Determination 2012 (PB 102 of 2011) (the Principal 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 Principal Determination commenced on 1 January 2012 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 instrument increases the fee from $10.27 to $10.34. This increase takes effect on 1 January 2021.

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 the determination. The Guild provided written agreement to the fee increase in December 2020.

The Principal 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 Determination.

The Office of Best Practice Regulation has been consulted on the change being made by this determination and has confirmed that it is exempt from the requirement for a Regulatory Impact Statement.

This Determination will commence on 1 January 2021.

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

 


Attachment A

 

Details of the National Health (Concession or entitlement card fee) Amendment Determination 2020

 

Section 1 - Name of Instrument

This section provides that this instrument is the National Health (Concession or entitlement card fee) Amendment Determination 2020, and that it may also be cited as PB 133 of 2020.

 

Section 2 - Commencement

This section provides that this instrument commences on 1 January 2021.

 

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 or entitlement card fee) Determination 2012 (PB 102 of 2011)

 

Item 1: Section 3

This item repeals and replaces section 3 of the Principal Determination.  This amendment has been made to increase the fee for issuing cards from $10.27 to $10.34.  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 2021.


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 2020

PB 133 of 2020

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 or entitlement card fee) Determination 2012 (PB 102 of 2011) 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 $10.27 to $10.34.  The increase will take effect from 1 January 2021.

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.

 

 

Mariana Crank

Acting Assistant Secretary

Pharmacy Branch

Technology Assessment and Access Division

Department of Health

Overview

The National Health (Concession or entitlement card fee) Amendment Determination 2020, also known as PB 133 of 2020, was enacted to amend the fee payable for issuing safety net concession cards or pharmaceutical benefits entitlement cards. This determination, made under subsection 84HA(1) of the National Health Act 1953, aims to index the fee in accordance with the Consumer Price Index (CPI). The Pharmacy Guild of Australia agreed in writing to this amendment, allowing the fee to increase from $10.27 to $10.34, effective from 1 January 2021. This change is intended to ensure that the fee reflects current economic conditions and maintains the operational efficiency of the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS). By providing these cards to eligible patients, the scheme enables them to access subsidised pharmaceutical items and medicines at a reduced rate or free of charge, thereby supporting the progressive realisation of the right to the highest attainable standard of physical and mental health as recognised under the International Covenant on Economic, Social and Cultural Rights.

Scope and Application

The National Health (Concession or entitlement card fee) Amendment Determination 2020 (PB 133 of 2020) amends the National Health (Concession or entitlement card fee) Determination 2012 to adjust the fee for the issuance of safety net concession cards, pharmaceutical benefits entitlement cards, and their additional or replacement counterparts. This legislative instrument applies to approved pharmacists, approved medical practitioners, and approved hospital authorities who issue these cards under the National Health Act 1953. The Act itself is a Commonwealth statute, thus the amendment operates on a national level. The fee adjustment is based on the Consumer Price Index, reflecting an increase from $10.27 to $10.34, effective from 1 January 2021. The amendment was made in accordance with subsection 84HA(1) of the Act, subject to the agreement of the Pharmacy Guild of Australia as required by subsection 84HA(2). The purpose of this adjustment is to maintain the operational efficiency of the Pharmaceutical Benefits Scheme and the Repatriation Pharmaceutical Benefits Scheme, which provide subsidised access to medicines for Australians and eligible veterans respectively. The legislative instrument is deemed compatible with human rights, particularly the right to health as outlined in the International Covenant on Economic, Social and Cultural Rights.

Key Provisions

The National Health (Concession or entitlement card fee) Amendment Determination 2020 (the Determination) amends the National Health (Concession or entitlement card fee) Determination 2012 (PB 102 of 2011) by increasing the fee for issuing a safety net concession card or pharmaceutical benefits entitlement card from $10.27 to $10.34. This change is set to take effect from 1 January 2021. The Determination is made under section 84HA(1) of the National Health Act 1953, with the agreement of the Pharmacy Guild of Australia as required by subsection 84HA(2). This agreement ensures that the determination aligns with the existing provisions of the Act and the Pharmaceutical Benefits Scheme (PBS), which aims to make medicines more affordable for all Australians. The primary obligation imposed by this Determination is on approved pharmacists, approved medical practitioners, and approved hospital authorities to issue safety net concession cards or pharmaceutical benefits entitlement cards, as well as additional or replacement cards, to eligible patients. These entities are entitled to be paid a fee determined by the Minister for Health, with the current fee set to increase from $10.27 to $10.34 as of 1 January 2021. The fee is indexed annually based on the Consumer Price Index (CPI) for the September quarter, ensuring that the fee reflects inflation and maintains the purchasing power of the fee. The Determination also ensures that the fee increase is in line with the agreement provided by the Pharmacy Guild of Australia, as mandated by the Act. There are no specific offences, penalties, or civil or criminal consequences outlined in the Determination for breach of its provisions. However, any non-compliance with the fee payment requirements or failure to adhere to the terms of the card issuance could potentially lead to administrative actions under the National Health Act 1953. Such actions might include fines or other penalties as prescribed by the Act, although the exact penalties are not detailed in the Determination itself. The focus of the Determination is on ensuring that the fee for card issuance is appropriately indexed to reflect economic changes, thereby supporting the continued operation of the PBS and Repatriation Pharmaceutical Benefits Scheme (RPBS) in providing affordable access to necessary medicines.

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Area of Law
Health Law
Instrument
Legislative Instrument
Concepts
Definitions & Interpretation
Regulatory Standards
Fee Adjustment Mechanism
Consultation Requirements
Catchwords
Fee Adjustment

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