PB 103 of 2011
 
National Health (Supplies of out-patient medication) Determination 2011
 
 
I, FELICITY McNEILL, First Assistant Secretary (Acting), Pharmaceutical Benefits Division, Department of Health and Ageing, delegate of the Minister for Health and Ageing, make this Determination under subsection 84BA(2) of the National Health Act 1953.
 
Dated       9 December 2011
 
 
 
 
 
 
 
 
 
FELICITY McNEILL
 
First Assistant Secretary (Acting)
Department of Health and Ageing
________________________________________________________________________
 
 
1.      Name of Instrument
      
(1)      This Determination is the National Health (Supplies of out-patient
          medication) Determination 2011.
 
(2)      This Determination may also be cited as PB 103 of 2011.
 
 
2.     Commencement
      
This Determination commences on 1 January 2012.
3.         Revocation
      
       This Determination revokes the National Health (Supplies of out-patient medication) Determination 2010.
 
4.         Interpretation
      
            (1)  In this Determination:
 
      National Healthcare Agreement means the National Healthcare
Agreement which is a schedule to the Intergovernmental Agreement
       on Federal Financial Relations (IGA). The IGA is referred to in the Federal
       Financial Relations Act 2009, and provides an overarching framework
       for financial transfers between the Commonwealth and the
       States and related collaboration on policy development and service delivery.
 
       out-patient medication has the same meaning as in subsection 84(1) of the
       Act. 
 
       the Act means the National Health Act 1953.
 
      the amount referred to in paragraph 87(2)(a) of the Act means the amount 
       as periodically adjusted under section 99G of the Act.
 
       the amount referred to in paragraph 87(2)(e) of the Act means the amount
        as periodically adjusted under section 99G of the Act.
 
       the maximum value of the supply of out-patient medication means the
        amount specified in section 6, 7, 8 or 9 as appropriate.
 
            (2)  Unless the contrary intention appears, a word or expression that is defined in
                    the Act shall be taken to have the same meaning as in the Act.
 
5.         Amount taken to have been paid to a public hospital for the supply    of out-patient medication
      
                  The amount that, for the purposes of Part VII of the Act, will be taken to
                    have been paid to a public hospital for a supply of out-patient medication to
                    a person is the lesser of:
                       
                   (a) the maximum value of the supply of out-patient medication; or
 
                   (b) the amount charged.
 
 
 
6.         Maximum value of the supply of out-patient medication to a person who is a concessional beneficiary, a dependent of a concessional beneficiary or a holder of a concession card
      
                   The maximum value of the supply of out-patient medication to a person who
                    is a concessional beneficiary, a dependant of a concessional beneficiary or
                    the holder of a concession card is an amount that is equivalent to the amount
                    referred to in paragraph 87(2)(a) of the Act for the supply of a
                    pharmaceutical benefit by an approved pharmacist or approved medical
                    practitioner.
 
7.         Maximum value of the supply of out-patient medication to a person who is a general patient and who is not a holder of a concession card
 
(1)   The maximum value of the supply of out-patient medication to a person
                    who is a general patient and who is not the holder of a concession card is
                    $28.30.
 
         (2) This section does not apply to supplies of out-patient medication made by:
               
                     (a)   a public hospital located in the State of Queensland; or
 
                     (b)   a public hospital that is participating in Pharmaceutical Reform               
                            Arrangements within the meaning of the National Healthcare      
                            Agreement.
 
8.         Maximum value of the supply of out-patient medication by a
          Queensland public hospital to a person who is a general patient and who is not a holder of a concession card
 
            (1) This section applies to supplies of out-patient medication made by a public hospital located in the State of Queensland.
      
            (2)  For supplies of outpatient medication mentioned in subsection (1), the
                    maximum value of the supply of out-patient medication to a person who is a
                    general patient and who is not the holder of a concession card is:
 
(a)      where the medication is a drug or medicinal preparation that is a pharmaceutical benefit and the Commonwealth price for that pharmaceutical benefit exceeds the amount referred to in paragraph 87(2)(e) of the Act — an amount that is equivalent to the amount referred to in paragraph  87(2)(e) of the Act for the supply of a pharmaceutical benefit by an approved pharmacist or approved medical practitioner; or
(b)      where the medication is a drug or medicinal preparation that is a pharmaceutical benefit and the Commonwealth price for that pharmaceutical benefit does not exceed the amount referred to in paragraph 87(2)(e) of the Act — the price for that pharmaceutical benefit ascertained in accordance with the determination under subsection 84C(7) of the Act as in force from time to time; or
 
         (c)   where the medication is a drug or medicinal preparation which is not a  
                  pharmaceutical benefit — the amount ascertained by taking as a basis
                  the cost to the hospital of that drug or medicinal preparation and
                  applying, as if that cost were the approved price to pharmacists, the
                  determination under subsection 84C(7) of the Act as in force from time
                  to time.
 
9.         Maximum value of the supply of out-patient medication by a
             participating public hospital to a person who is a general patient and
             who is  not a holder of a concession card
 
            (1)   This section applies to supplies of out-patient medication made by a public hospital that is participating in Pharmaceutical Reform Arrangements within the meaning of the National Healthcare Agreement, except if the public hospital is located in the State of Queensland.
 
            (2)  For supplies of out-patient medication mentioned in subsection (1), the
                     maximum value of the supply of out-patient medication to a person who is a
                     general patient and who is not the holder of a concession card is:
 
         (a)   where the medication is a drug or medicinal preparation that is a   
                  pharmaceutical benefit — the maximum value of the pharmaceutical
                  benefit ascertained in accordance with subregulation  9A(5) of the
                  National Health (Pharmaceutical Benefits) Regulations 1960 as if the
                  pharmaceutical benefit had been supplied by an approved pharmacist or
                  an approved medical practitioner; or
 
         (b)   where the medication is a drug or medicinal preparation that is not a
                  pharmaceutical benefit — the amount ascertained by taking as a basis
                  the cost to the hospital of that drug or medicinal preparation and
                  applying, as if that cost were the approved price to pharmacists, the
                  determination under subsection 84C(7) of the Act as in force from time
                  to time.
 
Note
1. All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See http://www.frli.gov.au.