PB 126 of 2010
National Health (Supplies of out-patient medication) Determination 2010
I, FELICITY MCNEILL, Acting First Assistant Secretary, 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 10 December 2010
FELICITY MCNEILL
Acting First Assistant Secretary
Department of Health and Ageing
________________________________________________________________________
1. Name of Instrument
(1) This Determination is the National Health (Supplies of out-patient
medication) Determination 2010.
(2) This Determination may also be cited as PB 126 of 2010.
2. Commencement
This Determination commences on 1 January 2011.
3. Revocation
This Determination revokes the Determination made pursuant to subsection
84BA(2) of the National Health Act 1953 made on 8 December 2009, and
commencing on 1 January 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
$27.40.
(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.
