What's new?

August 2013

The Department of Human Services Compliance Program for 2013-15 has been released.

Indigenous Health

Indigenous Access Program

The life expectancy of Aboriginal and Torres Strait Islanders is some 15 to 20 years less than other Australians, with levels of disease roughly 3 times that of non-Indigenous people.

The Australian Government has implemented a range of health measures specifically tailored to the needs of Aboriginal and Torres Strait Islander people.

Medicare administers a number of these programs such as the health assessments (55 years and over) and the adult health check [PDF, 93Kb]PDF reader required.

Medicare’s promise is that we will deliver great service to all Australians and we are working with Indigenous communities and health care providers to improve access to our services. One way that we are working towards this is through our Indigenous Access ProgramExternal link.

Within each of the States and the Northern Territory, Medicare has a network of Medicare Liaison Officers for Indigenous Access with a diverse range of culturally appropriate skills and expertise. These officers work closely with Indigenous communities, Aboriginal Medical Services and other health service providers nationally.

Aboriginal and Torres Strait Islander Access Line

We have a free-call telephone service to support Aboriginal and Torres Strait Islander customers and health workers.

The Access line is supported by the Medicare Liaison Officers for Indigenous Access who are culturally aware of the special conditions that may affect Indigenous people. Call - 1800 556 955.

What is the Voluntary Indigenous Identifier?

Medicare promotes voluntary identification within Aboriginal and Torres Strait Islander communities. Identifying as Aboriginal and/or Torres Strait Islander is completely voluntary and has been incorporated into all Medicare forms.

The information captured will be used to assess the effectiveness of current and new initiatives and programs to enhance quality health services. It will be used to improve Indigenous people’s access to health programs, by directing services and funding to those locations which require them most.

All data we collect is held securely and protected by privacy rules. When information is grouped for statistics or reports, it contains no names or identifying facts.

For more information, please call the Medicare Aboriginal and Torres Strait Islander Access line on 1800 556 955.

For a copy of the forms:

These can be returned to:

Indigenous Access Program
PO Box 1001
Tuggeranong DC ACT 2901

Remote Area Aboriginal Health Services (RAAHS) and the Pharmaceutical Benefits Scheme (PBS)

Special arrangements exist for approved Remote Area Aboriginal Health Services (RAAHS) to supply PBS medicines to patients. Under the provisions of section 100 of the National Health Act 1953, patients of approved RAAHS can receive free PBS medicines from the Aboriginal Health Service (AHS) without a prescription.

A patient who receives PBS medicines under these arrangements can still receive medicine under standard PBS arrangements by taking a prescription to a pharmacy.

The Department of Health is responsible for approving AHS participation in these arrangements. Once approved, the Department of Human Services (Human Services) will provide the approved AHS with a registration number. The AHS registration number must be included on all correspondence, including requests for pharmaceutical supplies.

Eligibility

To be eligible to participate under these arrangements an AHS must:

  • have a primary function of meeting the healthcare needs of Aboriginal and Torres Strait Islander people
  • operate a clinic or healthcare facility, where medicines are supplied to patients, in a remote zone as defined in the Rural, Remote and Metropolitan Areas Classification, 1991 Census Edition
  • not be part of an arrangement, such as a coordinated care trial, for which PBS funds have already been provided
  • employ or be in a contractual relationship with health professionals who are qualified to supply all medicines covered by these arrangements
  • make sure all medicines are supplied under the direction of those health professionals
  • have storage facilities that:
    • prevent access by unauthorised persons
    • maintain the quality, for example chemical and biological stability and sterility, of the medicine
    • comply with any special conditions specified by the manufacturer of the medicine

Note: you can check if your AHS is in a remote zone using the RRMA searchExternal link.

Ordering supplies of PBS medicines

An approved AHS must choose an approved supplier to provide PBS medicines. An approved supplier is a community or hospital pharmacy that has been approved to supply PBS medicines at particular premises. Each participating AHS will keep a stock of PBS medicines, ordered on a bulk supply basis from an approved supplier, to dispense as needed.

Requests for PBS medicines must be submitted to an approved supplier on a Aboriginal Health Services (AHS) pharmaceutical supplies request (4056) form [PDF, 248Kb]PDF reader required. The approved supplier will claim reimbursement from Human Services using the completed order form. An approved supplier can’t supply PBS medicines if the order has not been requested on an approved form.

The Request for pharmaceutical supplies for Aboriginal Health Services form has four copies. The first three copies (white, pink and green) must be sent by the AHS to the supplying pharmacy. The final copy (yellow) is kept by the AHS.

The approved supplier will return the triplicate (green copy) with the PBS medicines so the AHS can match the items supplied against the original request.

An approved AHS can develop an electronic order form to suit their operational needs. The form must display the name of the AHS, the AHS registration number and details of the approved supplier. The form should reflect the style of the existing Human Services order form. Any electronic form needs to be approved by Human Services.

Note: if an electronic form is used to order PBS medicines, the Human Services Request for pharmaceutical supplies for Aboriginal Health Services order form, with all necessary details and declarations completed, must be used as a coversheet.

Completing an order form

The following details must be provided on the order form:

  • AHS registration number
  • AHS community name and address, and
  • name and signature of the authorised person requesting pharmaceutical supplies

Note: an authorised person is a health professional who is employed or contracted by the AHS and is qualified to supply all medicines covered by these arrangements.

The AHS must complete columns 2 to 5. The approved supplier will complete columns 1 and 6.

Column 1—serial number
This column is used by the approved supplier to identify how many items are listed in the claim for payment to be lodged with Human Services.

Column 2—code
This column identifies the PBS medicine using the item code from the Schedule of Pharmaceutical BenefitsExternal link (the Schedule).

Column 3—manufacturer’s code
This column identifies the brand of PBS medicine using the manufacturer’s code from the ScheduleExternal link. If a generic brand is suitable, the manufacturer’s code can be left blank.

Column 4—description of goods (item, form and strength)
This column describes the PBS medicine. The information will be used by the approved supplier to confirm the item code matches the description. The description must be detailed enough for the item to be identified when there are items with a similar description.

An example of an item’s description including form and strength is:

Item name Form Strength
Amoxycillin Capsule 500mg

Column 5—quantity required
This column is used to order the quantity required. Under the arrangements, medicines are ordered in multiples of the PBS Maximum Quantity (MQ), as set out in the ScheduleExternal link. For example, if the medicine has a MQ of 30 capsules and the AHS needs 90 capsules total, the quantity required for supply is three. Broken packs can’t be ordered.

Column 6—quantity supplied (multiples of PBS maximum)
This column is used by the approved supplier to confirm the quantity supplied to the AHS. If the quantity ordered is different to the quantity supplied, the variation is shown in this column.

Medicines not available under remote area AHS arrangements

The following medicines are not available under remote area AHS arrangements:

  • extemporaneously prepared items
  • Highly Specialised drugs
  • Emergency Drug (Doctor’s Bag) supplies
  • Repatriation Pharmaceutical Benefit medicines
  • medicines which are Schedule 8 medicine as defined by the drugs and poisons legislation in the relevant state or territory

If a Schedule 8 or extemporaneously prepared medicine is required it must be prescribed on an approved prescription form and dispensed under standard PBS arrangements.

For a detailed listing of medicines available under the PBS, refer to the ScheduleExternal link.

Approved suppliers claims for payment

Approved suppliers should bundle claim packages by community name. Where there are multiple supply dates for a single community, claims should be sorted by date order.

When completing a claim, the approved supplier must provide the following details:

  • serial number
  • the number of maximum quantities supplied
  • pharmacy approval number
  • pharmacy name and address, and
  • signed and dated by the pharmacist

For each medicine supplied to an approved AHS under the arrangements, the approved supplier receives a reimbursement that is the sum of:

  • the approved price to pharmacist
  • a mark up, as appropriate for the cost of the item, and
  • a handling fee of $2.83

Cost of transportation and cold chain maintenance are included in the reimbursement formula.

Claims can be sent to:

Remote Area Aboriginal Health Services
Pharmaceutical Benefits Branch
Department of Human Services
PO Box 9826
Brisbane QLD 4001

For more information

For more information about eligibility criteria and approval of AHS
Email: pbs-indigenous@health.gov.auEmail
Web: health.gov.auExternal link
Phone: (02) 6289 2409*

For more information about claiming and the supply of PBS medicines or to order additional forms
Email: qld.ahs@humanservices.gov.auEmail
Phone: 132 290*

Forum newsletter

Forum newsletter is published by Medicare eight times a year and covers Medicare and related issues for medical practitioners and practice staff.

Bulletin Board newsletter

Bulletin Board newsletter is published by Medicare eight times a year and covers important information on the PBS for pharmacists.

More information

The Indigenous Access ProgramExternal link page contains useful information, brochures, forms and links for Aboriginal and Torres Strait Island people. Including:

  • Enrolling with Medicare
  • Medicare Safety Net
  • Aboriginal and Torres Strait Islander Access Line
  • Voluntary Indigenous Identifier
  • Where to go for Medicare services
  • Other programs and services available

Some documents on this page may require the free Adobe PDF reader.

Last updated: 18 November, 2013