National Health (Medication Program for Homeless People) Special Arrangement 2021

National Health (Medication Program for Homeless People) Special Arrangement 2021

PB 73 of 2021

made under section 100 of the

National Health Act 1953

Compilation No. 2

Compilation date: 1 July 2024

Includes amendments: F2024L00807

Registered: 18 July 2024

About this compilation

This compilation

This is a compilation of the National Health (Medication Program for Homeless People) Special Arrangement 2021 that shows the text of the law as amended and in force on 1 July 2024 (the compilation date).

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Editorial changes

For more information about any editorial changes made in this compilation, see the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the Register for the compiled law.

Self‑repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

Contents

Part 1—Preliminary

1 Name

3 Authority

4 Simplified outline of this instrument

5 Definitions

6 Definition of homeless

7 Application of this instrument

Part 2—Special arrangement supplies of eligible pharmaceutical benefits

Division 1—Preliminary

8 Definition of special arrangement supply

Division 2—Special arrangement supplies of eligible pharmaceutical benefits

9 Limited charges for supplies (no co‑payment)

10 Value for safety net purposes for supplies

11 No supply without prescription (continued dispensing)

Division 3—Payment for special arrangement supplies of eligible pharmaceutical benefits

12 Payment for supply of benefits

13 Claims for payment for supply of benefits

Part 3—Administration

Division 1—Approved organisations

14 Organisations may apply for approval

15 Decision on application

16 Monthly reporting by approved organisations

17 Secretary may request further information from approved organisations

18 Approved organisations to supply information on request

Division 2—Nominated pharmacists

19 Nominating approved pharmacists

Division 3—Approved forms

20 Secretary may approve forms

Division 4—Review of decisions

21 Internal review of decisions

Endnotes

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Part 1—Preliminary

1  Name

 (1) This instrument is the National Health (Medication Program for Homeless People) Special Arrangement 2021.

 (2) This instrument may also be cited as PB 73 of 2021.

3  Authority

  This instrument is made under section 100 of the National Health Act 1953.

4  Simplified outline of this instrument

Note: Part VII of the Act, and regulations or other instruments made for the purposes of that Part, have effect subject to this instrument (see subsection 100(3) of the Act).

5  Definitions

Note: The expression Secretary used in this instrument is defined in the Act.

  In this instrument:

Act means the National Health Act 1953.

approval number has the meaning given by subparagraph 15(1)(a)(ii).

approved hospital authority has the same meaning as in Part VII of the Act.

approved organisation means an organisation for which an approval under section 15 is in force.

approved pharmacist has the same meaning as in Part VII of the Act.

concessional beneficiary has the same meaning as in Part VII of the Act.

eligible patient: a person is an eligible patient if:

 (a) the person is a concessional beneficiary; and

 (b) the person is homeless; and

 (c) the person has a paper‑based prescription, or a repeat authorisation, for an eligible pharmaceutical benefit; and

 (d) the person is unlikely to receive the benefit without assistance under this instrument because the person is incapable of managing the person’s affairs; and

 (e) undesirable medical or social consequences are likely to occur if the person does not receive the benefit.

eligible pharmaceutical benefit means a pharmaceutical benefit, other than a pharmaceutical benefit that can only be supplied under Part VII of the Act:

 (a) in accordance with a special arrangement under section 100 of the Act; or

 (b) under the prescriber bag provisions.

Note: See sections 85AAA and 85AA of the Act.

homeless has the meaning given by section 6.

nominated pharmacist, for an approved organisation, means an approved pharmacist for which a nomination by the organisation is in effect under section 19.

not‑for‑profit entity means:

 (a) an entity that is entitled to be registered under the Australian Charities and Not‑for‑profits Commission Act 2012; or

 (b) a non‑profit body (within the meaning of the Electronic Transactions Act 1999).

paper‑based prescription has the same meaning as in the Regulations.

pharmaceutical benefit has the same meaning as in Part VII of the Act.

prescriber bag provisions has the same meaning as in Part VII of the Act.

Regulations means the National Health (Pharmaceutical Benefits) Regulations 2017.

repeat authorisation has the same meaning as in the Regulations.

special arrangement supply has the meaning given by section 8.

value for safety net purposes has the same meaning as in Part VII of the Act.

6  Definition of homeless

 (1) A person is homeless if:

 (a) the person does not have conventional accommodation; or

 (b) the person moves frequently from one form of temporary shelter to another.

Note 1: For example, paragraph (a) covers persons living on the streets, sleeping in parks, squatting in derelict buildings or using cars or railway carriages for temporary shelter.

Note 2: For example, paragraph (b) covers persons using emergency accommodation (such as hostels for the homeless or night shelters), teenagers staying in youth refuges, and women and children escaping domestic violence (staying in women’s refuges).

 (2) For the purposes of this instrument, a person is not homeless if the person is a care recipient of residential care within the meaning of the Aged Care Act 1997.

7  Application of this instrument

  This instrument applies to a supply of an eligible pharmaceutical benefit that is made on or after 1 July 2021.

Part 2—Special arrangement supplies of eligible pharmaceutical benefits

Division 1—Preliminary

8  Definition of special arrangement supply

  A supply of an eligible pharmaceutical benefit is a special arrangement supply of the benefit if the benefit is:

 (a) for supply to an eligible patient; and

 (b) supplied by a nominated pharmacist for an approved organisation; and

 (c) supplied on the basis of a paper‑based prescription, or a repeat authorisation, that is annotated with the organisation’s approval number by:

 (i)  the approved organisation; or

 (ii) in exceptional circumstances, the nominated pharmacist as authorised by the approved organisation.

Division 2—Special arrangement supplies of eligible pharmaceutical benefits

9  Limited charges for supplies (no co‑payment)

  Subsection 87(2) of the Act does not apply to a special arrangement supply of an eligible pharmaceutical benefit.

10  Value for safety net purposes for supplies

 (1) The value for safety net purposes of a special arrangement supply of an eligible pharmaceutical benefit for an eligible patient is the amount that the patient could have been charged for the supply under paragraph 87(2)(a) of the Act if section 9 of this instrument did not apply to the supply.

 (2) This section has effect despite section 17A of the Regulations.

11  No supply without prescription (continued dispensing)

  Section 89A of the Act does not apply to a special arrangement supply of an eligible pharmaceutical benefit.

Division 3—Payment for special arrangement supplies of eligible pharmaceutical benefits

12  Payment for supply of benefits

 (1) An approved pharmacist who has made a special arrangement supply of an eligible pharmaceutical benefit for an eligible patient is, subject to section 99AAA of the Act and to the conditions determined under section 98C of the Act and applicable at the time of the supply, entitled to be paid by the Commonwealth an amount that is equal to the amount that the patient could have been charged for the supply under paragraph 87(2)(a) of the Act if section 9 of this instrument did not apply to the supply.

 (2) This section has effect in addition to section 99 of the Act.

13  Claims for payment for supply of benefits

 (1) A claim for payment of an amount to which an approved pharmacist is entitled under section 12 in respect of a special arrangement supply of an eligible pharmaceutical benefit must include the approval number of the approved organisation annotated on the prescription or repeat authorisation for the supply.

 (2) This section has effect in addition to section 99AAA of the Act.

Part 3—Administration

Division 1—Approved organisations

14  Organisations may apply for approval

 (1) An organisation may apply to the Secretary to be approved for the purposes of this instrument.

 (2) The application must:

 (a) be made in writing; and

 (b) include one or more nominations of approved pharmacists under section 19; and

 (c) be made in the form (if any) approved under section 20.

15  Decision on application

 (1) If the Secretary receives an application in accordance with section 14 to approve an organisation, the Secretary must, as soon as is reasonably practicable:

 (a) if the Secretary is reasonably satisfied of the matters mentioned in subsection (2):

 (i) approve the organisation; and

 (ii) allocate a unique number (the organisation’s approval number) to the organisation; or

 (b) otherwise—refuse the application.

 (2) For the purposes of paragraph (1)(a), the matters are as follows:

 (a) the organisation is a not‑for‑profit entity;

 (b) the organisation has a function of providing care to homeless people;

 (c) the organisation is not an approved pharmacist or an approved hospital authority;

 (d) were the organisation to be approved, the organisation would assist eligible patients to receive special arrangement supplies of eligible pharmaceutical benefits in accordance with this instrument.

 (3) The Secretary must give the organisation notice in writing of:

 (a) the decision; and

 (b) the date the decision takes effect; and

 (c) if the decision was to approve the organisation—the organisation’s approval number.

16  Monthly reporting by approved organisations

 (1) Within 14 days after the end of a month, an approved organisation must give the Secretary a report of the total number of prescriptions and repeat authorisations presented by the organisation to nominated pharmacists for the organisation for special arrangement supplies of eligible pharmaceutical benefits in the month.

 (2) The report must be made:

 (a) in writing; and

 (b) in the form (if any) approved under section 20.

17  Secretary may request further information from approved organisations

 (1) The Secretary may, in writing, ask an approved organisation to give the Secretary further information in relation to prescriptions and repeat authorisations mentioned in section 16.

 (2) A request for information must:

 (a) be in writing; and

 (b) specify a day for complying with the request which is at least 28 days after the day of the request.

18  Approved organisations to supply information on request

  If an approved organisation receives a request for information under section 17, the organisation must comply with the request by the day specified in the request.

Division 2—Nominated pharmacists

19  Nominating approved pharmacists

 (1) An organisation may nominate an approved pharmacist for the purposes of making special arrangement supplies of eligible pharmaceutical benefits only if the approved pharmacist would be able to:

 (a) ensure that prescriptions and repeat authorisations for such supplies are annotated with the organisation’s approval number; and

 (b) maintain records of the value for safety net purposes of such supplies; and

 (c) make such supplies in urgent circumstances.

 (2) A nomination under this section must:

 (a) be included in an application under section 14; or

 (b) be made to the Secretary:

 (i) in writing; and

 (ii) in the form (if any) approved under section 20.

Division 3—Approved forms

20  Secretary may approve forms

  The Secretary may, in writing, approve a form for the purposes of a provision of this instrument.

Division 4—Review of decisions

21  Internal review of decisions

Application for review

 (1) A person who is affected by a decision of the Secretary under this instrument may apply to the Secretary for review of the decision.

 (2) An application for review must:

 (a) be in writing; and

 (b) be made in the form (if any) approved under section 20; and

 (c) be made within:

 (i) 28 days after the day the decision first came to the notice of the applicant; or

 (ii) if the Secretary allows a longer period (whether before or after the end of the 28‑day period referred to in subparagraph (i))—that longer period.

Review of decision

 (3) On receiving an application, the Secretary must:

 (a) review the decision; and

 (b) affirm, vary or set aside the decision; and

 (c) if the Secretary sets aside the decision—make a new decision in substitution for the decision set aside.

 (4) The decision (the decision on review) of the Secretary takes effect:

 (a) on the day specified in the decision on review; or

 (b) if a day is not specified—on the day the decision on review was made.

Notice of decision

 (5) After the Secretary makes a decision under this section, the Secretary must give the applicant a written notice stating the following:

 (a) the terms of the decision;

 (b) the reasons for the decision.

Endnotes

Endnote 1—About the endnotes

The endnotes provide information about this compilation and the compiled law.

The following endnotes are included in every compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Abbreviation key—Endnote 2

The abbreviation key sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.

Editorial changes

The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.

If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.

Misdescribed amendments

A misdescribed amendment is an amendment that does not accurately describe how an amendment is to be made. If, despite the misdescription, the amendment can be given effect as intended, then the misdescribed amendment can be incorporated through an editorial change made under section 15V of the Legislation Act 2003.

If a misdescribed amendment cannot be given effect as intended, the amendment is not incorporated and “(md not incorp)” is added to the amendment history.

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history