Data collection payments to stop

Payments for the collection of patient registration and six-month follow-up data for the Dose Administration Aids, MedsCheck/Diabetes MedsCheck and Staged Supply 6CPA programs will cease from 1 March this year.

While the Health Outcomes Data used for the evaluation of the clinical and cost effectiveness of these programs will continue, the Department of Health has announced that the fees will stop. Pharmacies may continue to collect and provide the relevant information, but it is no longer a requirement.

The cessation of payments refers to claims submitted from 1 March 2020, regardless of when the patient registration or six-month follow up was undertaken by the pharmacy.

Claims submitted on the Pharmacy Programs Administrator (PPA) portal from 1 March will show a payment value of $0 on the claim history screen and the associated remittance advice.

PSA National President Associate Professor Chris Freeman said: ‘Ideally we would have continuation of the reimbursement program for pharmacists to provide health outcome data for pharmacy agreement programs.

‘Moving into the 7th Community Pharmacy agreement it’s important that any data collection requirements are seamless and are linked to assessing the meaningful impact of the programs that are delivered by pharmacists.’

Dose Administration Aids

Pharmacies can provide a Dose Administration Aid (DAA) service (in individual medicine doses) on a weekly basis for eligible patients. 

Claims for provision of a weekly DAA service will continue at $6.17 per patient.

Payment for data collection at initial patient registration for 5 patients ($31.90) and at six-monthly followup for 5 patients ($31.90) will cease.

MedsCheck and Diabetes MedsCheck

MedsCheck and Diabetes MedsCheck services involve the provision of an in-pharmacy discussion between a pharmacist and a patient to improve the quality use of medicines and to address any patient concerns.  

Fees payable for an initial MedsCheck service ($66.53) and Diabetes MedsCheck service ($99.79) will continue. 

Data collection payments at registration and follow-up ($31.90) will cease.

Staged supply

Staged supply services provide PBS medicines in instalments when requested by the prescriber. The program is designed to help patients at risk of drug dependency or who are otherwise unable to manage their medicines safely.

Fees payable for provision of the service on the first day of each week ($8.12) and any additional provision during the week ($4.12) will continue. 

Data collection payments at registration and follow-up ($31.90) will cease.

Documentation

All relevant records must be kept for seven years, in electronic or hard copy form. 

Anomalies observed by the Pharmacy Program Administrator will be reported to the Department, which may conduct audits of the programs. Service providers in breach of the Program Rules may be subject to penalties.

Reference

1. Pharmacy Programs Administrator. Updates. Health outcomes data payments ceasing. 2020. At: www.ppaonline.com.au/health-outcomes-ceasing