Hospital authority
About hospital authority approvals
Approval to supply pharmaceutical benefits, and/or highly specialised drugs can be granted to a hospital authority in respect of a particular hospital, under section 94 or section 100 of the National Health Act 1953
(Cth) (National Health Act) (ComLaw website - Attorney General's Department).
An approval granted under section 94 of the National Health Act to a hospital authority, in respect of a particular hospital, enables the hospital authority to supply pharmaceutical benefits and/or highly specialised drugs in certain circumstances to patients receiving treatment in or at the hospital.
An approval granted under section 100 of the National Health Act to a hospital authority, in respect of a particular public hospital, enables a public hospital authority that does not have a dispensary or pharmacy at the hospital to claim for the supply of highly specialised drugs. The highly specialised drugs may be supplied to patients receiving treatment in or at the public hospital, where supply of those drugs is undertaken by a third party.
In order for a particular hospital to be eligible, a statement must have been made under subsection 121-5(6) of the Private Health Insurance Act 2007 (Cth) that the hospital is a private or public hospital.
If the hospital authority operates more than one hospital, a separate application to supply pharmaceutical benefits and/or highly specialised drugs is required in respect of each hospital.
Public hospitals only
A hospital authority approved in respect of a public hospital participating in the Pharmaceutical Reform Arrangements under the National Health Care Agreement can:
(a) under section 94 of the National Health Act, access PBS subsidised medicines, chemotherapy drugs and highly specialised drugs; or
(b) under section 100 of the National Health Act, access highly specialised drugs.
A hospital authority approved in respect of a public hospital that is not participating in the Pharmaceutical Reform Arrangements can, under section 94 or section 100 of the National Health Act access highly specialised drugs for patients receiving treatment in or at the hospital.
Private hospitals only
A private hospital wishing to access medicines funded under the Highly Specialised Drugs Program must also be approved by the Department of Health and Ageing. Hospitals can contact the Department of Health and Ageing on (02) 6289 2331 to obtain the relevant application.
Applications for approval
An application to supply pharmaceutical benefits and/or highly specialised drugs may be made by completing the application below.
Applications can be submitted to Medicare Australia by mail to:
Pharmacy Program Officer
Medicare Australia
GPO Box 9826
in your capital city
Payments
Payments will be made directly to the state or territory health department’s nominated bank account as supplied to Medicare Australia on the Highly Specialised Drugs program – State or Territory Health department bank account details form [PDF, 131Kb]
.
Change of bank account details
The Medicare Australia Highly Specialised Drugs program – State or Territory Health department bank account details form [PDF, 131Kb] can also be used to advise Medicare Australia of any subsequent changes to those bank account details.
Medicare Australia must be notified in writing, on the approved Medicare Australia bank details form, of changes to bank account details at least five working days before the change is to take effect.
Authority for authorised person(s) to sign forms
The Authority for authorised person(s) to sign forms on behalf of a hospital authority (8944) [PDF, 143Kb] can be used to authorise another person to lodge claims on on behalf of a hospital authority.
Forms/references
- Application for a hospital authority to supply pharmaceutical benefits and/or highly specialised drugs
- National Health Act 1953 (the ACT) (ComLaw website – Attorney General’s Department)
Post approval information
After approval has been granted to a hospital authority to supply pharmaceutical benefits and/or highly specialised drugs, please note that you will need to notify Medicare Australia in writing if any of the following circumstances occur:
- a change of hospital status from ‘private’ to ‘public’ or ‘public’ to ‘private’;
- a change of ownership of the hospital authority or a change to the hospital authority name;
- a change in the provision of pharmacy services (pharmacist / service provider);
- a change in the authorised or approved persons for signing claim forms; or
- a change in the location of the hospital.
Contact details
PBS general enquiry line
Phone: 132 290 (Mon-Fri) and ask for the Pharmacy Program Officer in your state.
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Last updated: 20 May, 2013