Residential Medication Management Review (RMMR)
On this page
- About RMMRs
- Service provider eligibility criteria
- How to become an RMMR service provider
- Who conducts an RMMR?
- Accreditation
- Patient eligibility criteria
- RMMR Service Agreements
- Application form
- Payment information
- Multi-lodgement claim form
- RMMRs in a multipurpose service (MPS)
- Change of details
- Frequently asked questions
- More information
A Residential Medication Management Review (RMMR) is a service provided to a permanent resident of an Australian Government funded aged care facility (ACF). This includes permanent residents of an Australian Government funded aged care facility (ACF) in flexible care arrangements (transitional care facilities).
When requested by a resident’s general practitioner (GP), an accredited pharmacist conducts an RMMR in collaboration with the GP and appropriate members of the eligible resident’s healthcare team. Information about the resident’s medicine is collated and a comprehensive assessment is undertaken to identify, resolve and prevent medication-related problems. A report of this assessment is provided to the resident’s GP.
About RMMRs
Under the Fifth Community Pharmacy Agreement (5CPA), the new RMMR program requires collaboration between pharmacists and GPs and allows for greater continuity of care for eligible aged care residents.
RMMR services must be conducted by a accredited pharmacist in collaboration with a GP. A pharmacist only RMMR may be claimed where exceptional circumstances exist and with prior approval from the Department of Health and Ageing (DoHA). For more information about exceptional circumstances go to the Department of Health and Ageing's website
.
Service provider eligibility criteria
To be eligible for approval by Medicare Australia as an RMMR service provider the applicant must be:
- an accredited pharmacist, or
- the owner of a Section 90 Pharmacy, or
- the proprietor of a business entity that employs or has a service contract with one or more accredited pharmacists to conduct RMMR services on its behalf.
The applicant must also:
- hold a current valid RMMR Service Agreement with an Australian Government funded ACF, for RMMR services to be provided in that ACF
- provide all information needed by Medicare Australia for assessment of the application, to determine eligibility to participate in the RMMR program
- agree to accept the service fee as full payment for the RMMR service as specified in the RMMR terms and conditions and at no cost to the eligible aged care resident or the ACF.
How to become an RMMR service provider
All applicants who want to be an RMMR service provider must agree to the terms and conditions [PDF, 162Kb]
, meet the eligibility criteria and complete the MMR programs service provider application form [PDF, 290Kb].
All applicants must receive written approval to be an RMMR service provider from Medicare before providing services.
Who conducts an RMMR?
A GP can refer a patient to a community pharmacy that employs an accredited pharmacist to conduct the RMMR service on their behalf, or directly to an accredited pharmacist to conduct the RMMR service. The community pharmacy and/or accredited pharmacist must have approval from Medicare to conduct RMMR services and a valid service agreement must be in place.
Accreditation
An accredited pharmacist is a pharmacist who has undertaken specified education programs or examinations and has received accreditation to conduct medication reviews from the Australian Association of Consultant Pharmacy (AACP) or the Society of Hospital Pharmacists of Australia (SHPA).
Patient eligibility criteria
To be eligible for an RMMR service, a patient must hold a current Medicare or Department of Veterans Affairs (DVA) card and be a permanent resident of an aged care facility, as defined by the Aged Care Act 1997 including those in flexible care arrangements, (transitional care facilities).
All Australian Government funded ACFs are eligible to access RMMR services by entering into an RMMR Service Agreement with a prospective RMMR service provider.
An RMMR service is generally provided once every 12 months, unless there is a major change to the resident’s condition or medication.
RMMR Service Agreements
On 30 September 2011, all RMMR Service Agreements that included associated Quality Use of Medicine (QUM) services were terminated by Medicare Australia.
To become an approved RMMR service provider, an RMMR Service Agreement must be in place. An RMMR Service Agreement is an agreement between a prospective RMMR service provider and an ACF, for the provision of RMMR services. All Australian Government funded residential ACFs are eligible to obtain access to RMMR services including those in flexible care arrangements (transitional care facilities).
The prospective RMMR service provider is responsible for making sure the agreement entered into with the ACF is a valid RMMR Service Agreement. The RMMR service provider makes sure RMMR services are conducted by an accredited pharmacist who is able to respond appropriately to requests from the resident’s GP or ACF and services adhere to recognised professional standards.
The agreement may be terminated by the ACF or the RMMR service provider with 30 days prior written notice. Only one RMMR service provider may be registered for a single ACF.
The RMMR Service Agreement provided is a model agreement and may be altered with agreement by both parties. Alterations must be consistent with the RMMR program terms and conditions.
Signing Service Agreements
An RMMR service agreement should be signed by a person who is authorised to sign the agreement on behalf of the Aged Care Facility and, if the service provider is not an individual (e.g. if the service provider is a company), a person who is authorised to sign the agreement on behalf of the service provider. If the service provider is an individual, the RMMR service agreement should be signed by that individual. The signatures of the authorised signatories should also be witnessed, with the witness signing in the space provided.
The model RMMR service agreement includes a signature block for use if the service provider is an individual and a signature block for use if the service provider is not an individual. You should delete whichever of those signature blocks is not applicable before signing the agreement.
Further information on Service Agreements is available at Department of Health and Ageing.
or call 1800 020 103
Application form
To apply to become an RMMR service provider, you must complete a Medication Management Review (MMR) program application form [PDF, 290Kb].
Note: To help reduce the amount of paperwork, a combined application form has been developed and can be used to apply for the Home Medication Review (HMR) program, the Residential Medication Management Review program and the Quality Use of Medicines (QUM) services.
The form must be signed by:
- the independent accredited pharmacist who is applying solely on his/her own behalf to become an approved RMMR service provider
- all owners of an approved section 90 (National Health Act 1953) pharmacy, where the application seeks approval of that pharmacy as an approved RMMR service provider
- the proprietor of any other business entity, where the application seeks approval of that business entity as an approved RMMR service provider.
Applicants must provide a copy of their current RMMR Service Agreement and certificates of accreditation with the MMR application form.
MMR Program service provider application form [PDF, 290Kb]
MMR Program terms and conditions [PDF, 162Kb]
Send your completed application form along with a copy of your Service Agreement to:
Community Pharmacy Agreement Officer
Pharmaceutical Benefits Branch
Department of Human Services
GPO Box 9826
Adelaide SA 5001
Fax: 08 8274 9373
Payment information
Payments for RMMR services will be made in arrears by Medicare Australia once the completed claim form is received from the RMMR service provider. The approved RMMR service provider will be paid a single prescribed fee applied to each eligible RMMR service.
RMMR payments will be paid by Medicare Australia on a monthly basis once the claim form is submitted and approved by Medicare Australia.
Payments will only be made for RMMR services provided by approved RMMR service providers.
Important: the payment rate for an RMMR service is $101.60 (indexed annually on 1 July).
Multi-lodgement claim form
Before claiming for an RMMR service you must apply to Medicare Australia for approval as a RMMR service provider.
The approved RMMR service provider will be paid once a valid RMMR multi-lodgment claim form has been received and approved by Medicare Australia.
The RMMR multi-lodgement claim form must be completed by the pharmacist and signed by the:
- director of nursing (DON) or their authorised representative
- approved service provider.
This certifies that the details on the claim form are true and correct and that all RMMR services claimed were conducted in accordance with the RMMR terms and conditions.
Claims for payment must be completed and submitted to Medicare Australia on the RMMR multi-lodgement claim form. Each payment application must include:
- name of RMMR service provider, pharmacy approval number and program ID number
- name and identification number of the ACF where the RMMR Services were conducted
- name, signature and accreditation number of the accredited pharmacist who performed the RMMR Services
- Medicare or DVA file number of the eligible resident
- details of the resident/s receiving the RMMR
- relevant code number if a pharmacist only review is conducted in exceptional circumstances (pharmacist-only reviews can only be claimed with DoHA approval)
- referring provider or prescriber number
- name of referring provider
- date RMMR report was provided to GP
- signature of approved RMMR service provider, certifying that the details on the claim form are true and correct and that all RMMR services claimed were conducted in accordance with the terms and conditions for the RMMR program
- signature and declaration that the services were provided from the DON or authorised representative
Payment will not be made where:
- RMMR services are provided before a RMMR Service Agreement is in place and approval as an approved RMMR service provider has been confirmed by Medicare Australia
- RMMR services are provided after the RMMR Service Agreement expires or is terminated
- RMMR services are provided after RMMR service provider status is revoked
- RMMR services claimed do not comply with the terms and conditions
Any overpayments will be recovered by Medicare Australia through debt recovery action.
The RMMR multi-lodgment claim form is available for use for any RMMR services provided on or after 1 October 2011.
Send your completed multi-lodgement claim form to:
Community Pharmacy Agreement Officer
Pharmaceutical Benefits Branch
Department of Human Services
GPO Box 9826
Adelaide SA 5001
Fax: 08 8274 9373
To claim for any RMMR service provided prior to 1 October 2011, see claiming information, which also provides the correct multi lodgment claim form.
RMMRs in a multipurpose service (MPS)
To become an approved RMMR service provider for a multipurpose service, an MPS RMMR Service Agreement must be in place. Applications to become an approved RMMR service provider for a multipurpose service are approved by the Department of Health and Ageing (DoHA). An MPS RMMR Service Agreement and application form must be completed and submitted to DoHA for approval.
Further information on MPS is available at: Department of Health and Ageing
Call: 1800 020 103
Change of details
To change your MMR program details, use the MMR Change of details form [PDF, 412Kb].
This form allows you to:
- (HMR and RMMR only) notify Medicare of new accreditation dates for existing accredited pharmacists - attach new accreditation certificate/s with form
- Add new pharmacists - attach new accreditation certificate/s with form, if necessary
- Cease existing pharmacists
- (RMMR and QUM only) Notify DHS of a change of ACF name
- (Non-Section 90 pharmacies only) change name, address and bank details
Note: Section 90 pharmacies cannot change their bank account details on this form. Refer to the Notification of bank account details for community pharmacy [PDF, 199Kb] form to this information.
If a Section 90 pharmacy changes approval number, a new MMR application form must be submitted to Medicare Australia.
If ownership of the business entity, section 90 pharmacy or ACF changes, a new MMR application form and Service Agreement [PDF, 29Kb]must be submitted to Medicare Australia.
Frequently asked questions
Who can provide the review?
Residential Medication Management Reviews (RMMRs) may only be provided by an approved RMMR service provider as part of an RMMR Service Agreement with an aged care facility (ACF). An approved RMMR service provider can be an accredited pharmacist, or can nominate an accredited pharmacist, to conduct RMMR services on the service provider’s behalf.
What is an accredited pharmacist?
An accredited pharmacist is a registered pharmacist who holds a valid accreditation certificate from an accreditation body to conduct medication management reviews. An accreditation body can be either the Australian Association of Consultant Pharmacy or the Society of Hospital Pharmacists of Australia.
Who is eligible for the RMMR service?
To be eligible for an RMMR a patient must hold a current Medicare or DVA card and be a permanent resident of a facility in which residential care services are provided, as defined in the Aged Care Act 1997, including those in flexible care arrangements (transitional care facilities).
How often can the service be provided?
An RMMR service is generally provided once every 12 months, unless there is a major change to the resident’s medication.
Can I fax forms relating to RMMR?
Yes. All forms can be faxed to 08 8274 9373.
How soon will I receive payment?
Payments are made in the first week of every month, provided your claim form is received within the first 14 days of the previous month.
More information
Changes to the RMMR program under the Fifth Community Pharmacy Agreement (5CPA)
A fact sheet on the changes to the RMMR Program under the 5CPA, including frequently asked questions are available from the Department of Health and Ageing.
For more information
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
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Last updated: 15 May, 2013