Pharmacy Practice Incentive Program
On 1 July 2011, the Pharmacy Practice Incentive (PPI) Program started under the Fifth Community Pharmacy Agreement (5CPA). The PPI Program provides incentive payments to accredited community pharmacies that deliver high quality services, information and advice to help improve patient health outcomes. This includes helping patients to better manage their medicines and avoid the misuse of medicines and associated hospitalisation.
The PPI Program aims to achieve these objectives through six PPI priority areas:
Primary Health Care
Primary Health Care is an annual payment for community pharmacies that offer at least two of five Primary Health Care elements. The current five elements are:
- diabetes
- respiratory disease
- cardiovascular disease
- mental health conditions, and
- health promotion.
It is expected that the range of elements and minimum number of elements to be delivered will increase over the 5CPA.
Community Services Support
Community Services Support is an annual payment for pharmacies that provide at least two of five Community Service Support elements to the quality requirements of an approved pharmacy accreditation program (such as QCPP). The five elements are:
- Needle and Syringe Program
- Opioid Substitution Program
- Return Unwanted Medicines (RUM)
- staff training, and
- eHealth.
It is expected that the minimum number of elements to be delivered will increase over the 5CPA.
Working with Others
Working with Others is an annual payment for pharmacies that collaborate with other registered health professionals as currently defined by the Australian Health Practitioner Regulation Agency (AHPRA). Pharmacies must clearly record specific cases where they have collaborated with at least two health professionals from different registered health professional groups in the interests of the care of patients. It is expected that the number of inter-profession collaborations will increase over the 5CPA.
Staged Supply
Staged Supply is an annual payment for community pharmacies that supply PBS medicines in instalments to patients when requested by the prescriber.
Dose Administration Aids
Dose Administration Aids (DAA) provides incentives for community pharmacies that deliver DAAs to help patients living in the community better manage their medicines. This incentive is paid periodically upon successful claim to Medicare.
Pharmacies must keep records of the number of patients who received a DAA during the claiming period, for two years.
Clinical Interventions
Clinical Intervention (CI) provides incentives for community pharmacies that identify, resolve and document issues relating to medicines for patients within community pharmacy. This incentive is paid periodically upon successful claim to Medicare.
Pharmacies must keep records of the number of CI services delivered during the claiming period, for two years.
Incentive payments
From July–September 2011, the Department of Human Services (Human Services) made payments under the PPI Program to pharmacies who registered through the 5CPA online registration system
that met PPI eligibility requirements. Start up payments were processed for:
- Staged Supply
- Dose Administration Aids, and
- Clinical Interventions.
In early 2012, Human Services will start making annual payments to eligible accredited pharmacies registered to receive PPI payments that have submitted valid claims. This includes annual payments for:
- Primary Health Care
- Community Services Support, and
- Working with Others, and
- Staged Supply.
The first eligible claiming period for Dose Administration Aids and Clinical Interventions was 1 July to 30 September 2011. To receive payment, pharmacies needed to submit a valid claim form to Human Services within 14 days from the end of the eligible claiming period. Human Services will start making payments for Clinical Interventions and Dose Administration Aids claims from January 2012.
Payments will be made with other Guild payments to pharmacies using existing bank account details stored by Human Services. Information about payments for the PPI Program will be included on the PBS Payment Advice and PPI Statement of Benefits.
Claim form
To claim for PPI payments you need to submit the Pharmacy Practice Incentives – Periodic payment(s) application form [PDF, 93Kb]
to:
Mail:
Community Pharmacy Agreement Officer
Pharmaceutical Benefits Branch
Department of Human Services
GPO Box 9826
Adelaide SA 5001
Fax: 08 8274 9373*
For help submitting a valid claim form see the DAA and Clinical Interventions Claiming fact sheet.
For more information
For more information on the PPI Program see the PPI specific guidelines and the PPI terms and conditions.
Email: sa.guild.govt.programs@humanservices.gov.au
Mail:
Community Pharmacy Agreement Officer
Pharmaceutical Benefits Branch
Department of Human Services
GPO Box 9826
Adelaide SA 5001
Call: 08 8274 9641*
*Call charges apply.
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Last updated: 15 May, 2013