New Conditions of Approval for Approved Pharmacists

Page last updated: 1 December 2014

Amendments to the National Health (Pharmaceutical Benefits) (Conditions of approval for approved pharmacists) Determination 2007 are effective from 1 December 2014. 

The National Health Act 1953 (the Act) allows for payment of a claim for the supply of a pharmaceutical benefit where the supply has been made at or from premises for which a pharmacist is approved under the Act.  An approved pharmacist is a pharmacist who is approved under Part VII of the Act to supply pharmaceutical benefits at particular premises (approved premises).

The Act also provides that payment to an approved pharmacist for the supply of a pharmaceutical benefit cannot be made if it was supplied at or from unapproved premises, or otherwise than in accordance with a condition of approval [para 99(3)(b) of the Act].

To emphasise the importance of making a correct claim, an additional condition has been added to the National Health (Pharmaceutical Benefits) (Conditions of approval for approved pharmacists) Determination 2007 (the Determination).  This follows consultation with industry stakeholders on a draft amendment in September/October 2014.

The new condition clearly states that an approved pharmacist must not make a claim for payment for the supply of a pharmaceutical benefit unless the pharmaceutical benefit was supplied at or from the pharmacist’s approved premises.

A breach of the conditions of approval can be deemed an ‘abuse’ of approval and may lead to an investigation by a Pharmaceutical Services Federal Committee of Inquiry.  Such an investigation may result in the suspension or revocation of the pharmacist’s approval [s.92A(3) and s.95 of the Act]. 

There are some limited exceptions to the new condition for certain types of existing supply arrangements.  These are discussed further in the Frequently Asked Questions.

Further information can be found at the information web pages for pharmacists.