On 2 December 2015, the Parliament strengthened the rules relating to claims for pharmaceutical benefits under the National Health Act (Determination). The Determination provides that approved pharmacists must not make a claim for payment from the Commonwealth in relation to the supply of a pharmaceutical benefit unless it was supplied at or from approved premises for the pharmacist. As a result, we have received several queries from pharmacists that do own more than one pharmacy about the implications of having a prescription transferred from one of their unapproved pharmacy premises to one of their approved pharmacy premises.
So, can you transfer prescriptions?
The answer to this question is that the Determination allows these types of claims so long as:
- The pharmaceutical benefit is being held at the approved premises
- The prescription for the pharmaceutical benefit is being transferred to the approved premises before dispensing
- The pharmaceutical benefit is being dispensed at the approved premises by the approved pharmacist who is claiming the benefit
- The pharmaceutical benefit is being supplied at or from the approved premises, and
- The claim is being made from the approved premises.
To not inconvenience their customers in requiring them to pick up their prescribed items from the approved pharmacy, you may choose to have the prescribed items delivered directly to your customers’ homes from your approved pharmacy premises. Online pharmacies do it and it generally seems to be acceptable under the National Health Act and the Determination. There are, however, some things you will need to be aware of when delivering any form of medication to your customer’s home.
What are those things?
If you are supplying medications indirectly to a patient, it is important that you comply with all relevant State or Territory, and Commonwealth legislation, in particular, any laws relating to controlled drugs and drugs of dependence, the Pharmacy Board of Australia’s Guidelines for Dispensing of Medicines and established practice and quality assurance standards. In addition, you should also be aware of the following implications when delivering medications to your customers’ homes from your approved pharmacy premises:
- Prescription-only medicines may be dispensed only on presentation of an original physical prescription signed by hand by a doctor holding an Australian provider number. Online pharmacies have attempted to deal with this by requiring the prescription to be posted to the pharmacy or handed to the courier in return for the medicine. You should, therefore, ensure that the original prescription is transferred to your approved pharmacy before the medication is dispensed.
- Further, a customer receiving a pharmaceutical benefit item must sign and date a receipt for it. If the customer is not the patient, the customer must also endorse the PBS prescription or repeat authorisation with his/her address.
Since the pharmaceutical benefit will be delivered to the customers’ homes, obtaining a signed receipt may not be practical in every case. Where a signed receipt cannot be obtained, the pharmacist must certify on the PBS prescription or repeat authorisation that the benefit has been supplied, and write the date of supply and details of how it was delivered. For example, if a pharmaceutical benefit was delivered to a patient on 1 April 2015, the pharmacist should write: “Certified supplied – delivered to patient 1 April 2015 (name of pharmacist) (signature of pharmacist) (date of certification)”. Please note in this regard that only the pharmacist approved to supply pharmaceutical benefits can certify supply.
- In addition, a customer’s Medicare card number and concession card number should be recorded and verified before dispensing PBS medications. This could potentially be done by providing to the approved pharmacy a copy of the Medicare card and any concession card when transferring the original prescription to it.
Finally, if you choose to go down this route, it is important that you openly disclose to your customers that the pharmaceutical benefit will be transferred to, dispensed at and supplied from your approved premises.
What happens if I do not comply?
Where there is evidence of a breach of the provisions contained in the Determination, the Secretary of the Department of Health or the Minister for Health may refer the matter to the Pharmaceutical Services Committee of Inquiry for investigation. The Committee will then investigate suspected abuse of the above-mentioned conditions, following which the Committee may provide a report to the Minister for Health with a series of recommendations. Based on this report, the Minister may choose to do the following: recover the monies obtained by falsely claiming pharmaceutical benefits; suspend or revoke approval; and/or prosecute for a criminal offence under the National Health Act or the Criminal Code.
How to avoid penalties and negative consequences?
To avoid these negative consequences you should ensure that you comply with all relevant legislation. If you are unsure about any of the provisions under the National Health Act and the Determination contact one of our Pharmacy Law Experts.