Part 3 - Supply of Pharmaceutical Benefits
Supply of Pharmaceutical Benefits - Procedure by Community Pharmacists
16. A Community Pharmacist is required to supply a Pharmaceutical Benefit only upon the surrender of:
(a) a valid Standard Prescription Form; or
(b) a valid Authority Prescription Form; or
(c) a valid repeat authorisation form presented with a duplicate prescription in accordance with the requirements under the PBS;
provided that such documents are in accordance with State or Territory law, or this Scheme and the Explanatory Notes, and with any requirements which the Department or the Commission, from time to time, notifies.
Substitution of lesser priced alternative brand of drug
17. Where a valid prescription, issued by a Medical Practitioner, prescribes a brand of drug listed on the PBS or RPBS Schedule, a Community Pharmacist may substitute, with the approval of the prescriber, a lesser priced alternative PBS or RPBS listed brand of the drug in lieu of the brand prescribed and shall endorse the original, duplicate and repeat authorisation accordingly.
Community Pharmacist to be satisfied as to entitlement
18. (a) A Community Pharmacist shall not supply a Pharmaceutical Benefit to a person on terms that are appropriate for the supply of a Pharmaceutical Benefit to a holder of a Repatriation Health Card - For All Conditions or a Repatriation Health Card - For Specific Conditions unless the Community Pharmacist is satisfied that the person is entitled to receive the Pharmaceutical Benefit on those terms.
(b) Without limiting the generality of subparagraph (a), a Community Pharmacist may refuse to supply a Pharmaceutical Benefit to a person on terms that are appropriate for the supply of the Pharmaceutical Benefit to a holder of a Repatriation Health Card - For All Conditions or a Repatriation Health Card - For Specific Conditions, unless the person produces such a card to the Community Pharmacist that indicates that the person is entitled to receive the Pharmaceutical Benefit on those terms.
19. Prescriptions, including repeat authorisations, for items deleted from the RPBS Schedule or PBS Schedule may not be dispensed as Pharmaceutical Benefits as from the date of effect of deletion, unless the prescriptions for the items comply with Prior Approval arrangements under this Part.
Use of forms as notified by the Department or the Commission
20. When supplying a Pharmaceutical Benefit under this Scheme a Community Pharmacist will use and issue such forms, as are notified by the Department or the Commission from time to time, in the manner notified by the Department or the Commission.
21. In respect of each Pharmaceutical Benefit provided under this Scheme, the Commonwealth will accept financial responsibility for all of the dispensed price but the amount that would be payable by the person if the person were a "concessional beneficiary" under the National Health Act 1953.
Refund in certain circumstances
22. Where:
(a) a Community Pharmacist charges an Eligible Person an amount in respect of the provision of a Pharmaceutical Benefit; and
(b) information indicating the person's eligibility under this Scheme was not supplied to the Community Pharmacist; and
(c) the Commission is satisfied that, in the circumstances, the person should be treated as if the relevant information had been supplied,
the person is entitled to be paid by the Commonwealth an amount equal to any amount that the person paid that would not have been payable if the relevant information had been supplied.
23. Where a person would have been eligible to receive a pharmaceutical allowance under paragraph 118A(1)(c) of the Veterans' Entitlements Act 1986 during a period, but the Department:
(a) did not have the information needed to enable the Commission to make payment of the pharmaceutical allowance; and
(b) has obtained that information since that period and after 30 June 1992; and
the person:
(c) was not in receipt of that allowance during that period; and
(d) has incurred expenses in obtaining Pharmaceutical Benefits during that period which could be obtained under this Scheme; and
(e) has provided material which satisfies the Commission that the person has incurred those expenses,
the Commission may reimburse the person for any or all of those expenses. The maximum amount which may be reimbursed is the amount that the person would have been entitled to receive by way of pharmaceutical allowance during that period had the Department had the information needed to enable the Commission to make payment of the allowance.
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