EXPLANATORY STATEMENT
National Health Act 1953
National Health (Epworth Eastern Private Hospital Paperless Prescribing and Claiming Trial) Special Arrangement 2012
PB 25 of 2012
Authority
Subsection 100(1) of the National Health Act 1953 (the Act) enables the Minister to make special arrangements for the supply of pharmaceutical benefits. Subsection 100(2) of the Act provides that the Minister may vary or revoke a special arrangement made under subsection 100(1).
Subsection 100(3) of the Act provides that Part VII of the Act, and instruments made for the purposes of Part VII of the Act have effect subject to a special arrangement made under subsection 100(1).
Purpose
The purpose of this instrument is to allow Epworth Eastern Private Hospital (the Epworth Hospital), located in Box Hill, Victoria, to utilise electronic and paper based medication charts to prescribe and claim PBS benefits.
This Special Arrangement revokes and replaces the previous special arrangement for the Epworth Eastern Private Hospital Paperless Prescribing and Claiming Trial and in doing so implements a number of minor changes.
The Department expects that the results of the Epworth Eastern Private Hospital paperless prescribing and claiming trial will contribute to the development of national eHealth guidelines and policy, and more specifically ePrescribing strategies. The Epworth Eastern Private Hospital Paperless Prescribing and Claiming Trial commenced on 16 June 2008.
The Trial allows prescribers to use electronic or paper based medication charts, instead of paper based prescriptions. The medication charts are prepared and signed by the prescribers involved in the trial.
The Approved Supplier supplies the pharmaceutical benefit using a paper copy of the medication chart and then submits a claim to the Chief Executive Medicare without a paper copy of the medication chart.
The Approved Supplier must then create an electronic record of the medication chart.
Copies of all electronic pharmacy records are stored by each Approved Supplier for not less than one year after the date the pharmaceutical benefit is supplied to allow the Chief Executive Medicare to audit the claim if required.
This Special Arrangement makes changes from the previous special arrangement (PB 16 of 2009) to:
- allow authorised midwives and authorised nurse practitioners to prescribe under this Special Arrangement, provided they meet their usual prescribing requirements under the Act, reflecting the addition of midwives and nurse practitioners as PBS prescribers under the Act by the Health Legislation Amendment (Midwives and Nurse Practitioners) Act 2010;
- reflect amendments made to section 100 by the National Health Amendment (Pharmaceutical Benefits Scheme) Act 2010;
- reflect the change in title from Medicare Australia CEO to Chief Executive Medicare that occurred on 1 July 2011 as a result of paragraph 99(2)(a) of Schedule 1 to the Human Services Legislation Amendment Act 2011, which provided that a reference to the Medicare Australia CEO in an instrument that was in effect prior to 1 July 2011 is to be read as a reference to the Chief Executive Medicare;
- reflect that pharmaceutical benefits with authority required procedures are not prescribed using medication charts; and
- reflect updated cross-references to the new claims and under co-payment rules made under subsections 99AAA(8) and 98AC(4) of the Act that come into effect on 1 April 2012.
Consultation
The Department of Health and Ageing consulted with the Department of Human Services, Epworth Eastern Private Hospital and Slade Pharmacy during the development of the Epworth Eastern Private Hospital paperless prescribing and claiming trial. As a result of these consultations all parties are satisfied with the outcomes and terms and conditions of the Epworth Eastern Private Hospital paperless prescribing and claiming trial.
A provision by provision description of this Special Arrangement is contained in the Attachment.
This Special Arrangement commences on 1 June 2012.
This instrument is a legislative instrument for the purposes of the Legislative Instruments Act 2003.
ATTACHMENT
PROVISION BY PROVISION DESCRIPTION OF THE NATIONAL HEALTH (EPWORTH EASTERN PRIVATE HOSPITAL PAPERLESS PRESCRIBING AND CLAIMING TRIAL) SPECIAL ARRANGEMENT 2012 (PB 25 of 2012)
Section 1 Name of Special Arrangement
This section provides that the Special Arrangement is the National Health (Epworth Eastern Private Hospital Paperless Prescribing and Claiming Trial) Special Arrangement 2012 and that it may also be cited as PB 25 of 2012.
Section 2 Commencement
This section provides that the Special Arrangement commences on 1 June 2012.
Section 3 Revocation
This section revokes instrument PB 126 of 2009, the previous special arrangement concerning the Epworth Eastern Private Hospital Paperless Prescribing and Claiming Trial.
Section 4 Definitions
This section defines a number of expressions that are used in the Special Arrangement, including ‘approved supplier’, ‘hospital’ and ‘in-patient of the hospital’.
Section 5 Application of Part VII of the Act
Subsection 100(3) of the Act provides that Part VII of the Act, and regulations or other instruments made for the purposes of Part VII have effect subject to a special arrangement made under subsection 100(1).
Section 5 provides that the pharmaceutical benefits supplied under this Special Arrangement are supplied under Part VII. This is the situation under the Act and this section confirms that this is not intended to be modified by the Special Arrangement.
Section 6 Pharmaceutical benefits covered by this Special Arrangement
This section provides for the pharmaceutical benefits that are covered by this Special Arrangement. The pharmaceutical benefits covered are all pharmaceutical benefits except those that are supplied only under another special arrangement.
Section 7 Prescribing of Pharmaceutical Benefits
This section provides for the circumstances in which a medication chart prepared by a PBS prescriber will be taken to be a validly written prescription and the information that the PBS prescriber needs to include on a medication chart. This modifies the requirements for a prescription in Regulation 19 of the National Health (Pharmaceutical Benefits) Regulations 1960 (the Regulations).
This section also provides limitations on prescribing using medication charts. PBS prescribers are not allowed to direct a repeated supply or supply all on one occasion. If they direct a repeated supply that direction is invalid. If they direct supply all on one occasion on a medication chart it is deemed to be a direction to supply the maximum quantity for that pharmaceutical benefit determined under paragraph 85A(2)(a) of the Act. PBS prescribers are also not allowed to prescribe a pharmaceutical benefit requiring an authority prescription using a medication chart.
Section 8 Supply and Claiming of Pharmaceutical Benefits
This section provides that this Special Arrangement applies to approved suppliers listed in column 2 of the Schedule to this Special Arrangement when supplying pharmaceutical benefits to in-patients of the hospitals listed in column 1 of the Schedule to this Special Arrangement.
This section provides that an approved supplier cannot defer the supply of any pharmaceutical benefit supplied under this Special Arrangement. This section also modifies the requirements in Regulation 31 of the Regulations for eligible persons to confirm receipt of pharmaceutical benefits and date of supply by allowing an approved supplier to certify on a medication chart that the in-patient of the hospital has received the pharmaceutical benefit/s prescribed on the medication chart.
This section also provides for the keeping of electronic pharmacy records of pharmaceutical benefits supplied under this Special Arrangement where the approved supplier is making a claim under section 99AAA of the Act and that the Chief Executive Medicare can request a copy of electronic pharmacy records or medication charts for pharmaceutical benefits supplied under this Special Arrangement. The information included in the electronic pharmacy records is required to comply with the requirements for a prescription record for an online claim in the rules for claiming made under subsection 99AAA(8) of the Act. This need not include under
co-payment data provided under section 98AC of the Act.
This section also provides that approved suppliers are required to submit claim and under co-payment data to the Chief Executive Medicare as required by the rules under subsections 99AAA(8) and 98AC(4) of the Act.
Section 9 Transitionals
This section provides transitional arrangements so that approved suppliers can make a valid claim where pharmaceutical benefits prescribed under the previous special arrangement have not been supplied prior to 1 April 2012.
The Schedule
The Schedule provides the name and address of the hospital participating in this Special Arrangement and the name, address and approval number of the approved supplier associated with the hospital participating in this Special Arrangement.