Pharmacy software vendor assistance payment
** The Software Vendor Assistance Program closed on 30 June 2011. Only claims for installations on or prior to 30 June 2011 will be paid. Final payment will be made on 15 June 2013.
The Pharmaceutical Benefits Scheme (PBS) 2006 reforms included the software vendor assistance payment, which recognised increased demand from approved suppliers (pharmacies) to have Online eClaiming for PBS installed and supported.
24 monthly maintenance payments of between $100 and $200 are being made to software vendors who support approved suppliers. This payment is made to software vendors for approved suppliers who successfully transmit claims via Online eClaiming for PBS. An approved supplier must have submit their first claim via Online eClaiming for PBS no later than 30 June 2011 to be eligible for assistance payments. Monthly maintenance payments will continue to be made until 15 July 2013. At this time all payments under this scheme will cease.
This initiative is administered by Department of Human Services-Medicare on behalf of the Department of Health and Ageing. It is a separate initiative from the pre-existing Online claiming for PBS Incentive Scheme for software vendors that commenced in 2004.
From 2004, Department of Human Services-Medicare has paid assistance payments to software vendors for successfully connecting approved suppliers to Online eClaiming for PBS. Under the pre-existing scheme, software vendors would receive payments for approved suppliers who transmitted their first claim via the online channel on or before 15 November 2006.
The current scheme allows for a different payment to software vendors for approved suppliers who transmit their first claim via Online eClaiming for PBS on or after 16 November 2006.
Once a Request for Payment form and the associated disk is received by Medicare Australia for the installation payment, no further Request for Payment forms are required for Medicare Australia to pay monthly maintenance payments for those pharmacies. Medicare Australia will source this information based on the initial Request for Payment form, disk and PBS claim data already collected.
The only exception to the above rule is when an approved supplier changes software vendors. In this case the new software vendor will be entitled to monthly maintenance payments from the month after the change is made. (This is only the case if all 24 maintenance payments have not already been paid.). When this occurs, both the new and outgoing software vendors must advise Department of Human Services-Medicare of the change using the Request for Payment form and disk. The new software vendor will not be entitled to an installation payment for this approved supplier.
Maintenance payments will continue to be made for the remaining 24 months provided the approved supplier remains online.
Monthly maintenance payments will be made on the fifteenth day of each month, or the first working day after this day, for 24 months. The first monthly maintenance payment will be the month after the installation payment is made where the pharmacy successfully transmits a claim in that month. The software vendor assistance payments are to be calculated by Medicare Australia.
An approved supplier must submit their first claim via Online eClaiming for PBS by 30 June 2011 for a software vendor to be eligible for the assistance payments.
Monthly maintenance payments can be made up to 15 June 2013. At this time all payments under this scheme will cease - even if the software vendor has received less than 24 months of maintenance payments.
Where an approved supplier changes approval number, and where an installation payment has previously been made, the software vendor will not be entitled to another installation payment. Maintenance payments will continue to be made for the remaining months (maximum 24 months), provided the pharmacy remains online. Where an existing approved supplier ceases transmitting claims online for a period of one month or more, maintenance payments to the software vendor will also cease until the approved supplier starts transmitting online again. A second installation payment will not be paid in this case.
For example, an approved supplier has been claiming for four months but then suffers an interruption that lasts six months. At the time of the interruption, the software vendor has received an installation payment and three months maintenance payments. When the supplier begins claiming online again, no new installation payment is made but 21 maintenance payments remain to be paid.
A statement (recipient created tax invoice) will be provided to the software vendor following installation and maintenance payments. This statement will identify the total dollar amount of installation and/or maintenance payments, and the number of approved suppliers for which it was paid for that month.
For further enquiries relating to this initiative please contact at:
Phone: 1800 700 270 (option 5)
Postal: GPO Box 9826
Hobart Tasmania 7001
Last updated: 15 December, 2011