Note: Where available, the PDF/Word icon below is provided to view the complete and fully formatted document
Schedule 7—Safety net

Schedule 7 Safety net

   

National Health Act 1953

1  Subsection 84(1)

Insert:

value for safety net purposes means:

                     (a)  for the supply of a pharmaceutical benefit—the amount prescribed by regulations made for the purposes of subsection 84C(1E); and

                     (b)  for the supply of a repatriation benefit—the amount charged for the supply; and

                     (c)  for the supply of out-patient medication—the applicable amount in relation to the supply.

2  Subsection 84AAA(1)

Omit “(whether or not that supply is a supply of a kind described in paragraph 84C(4A)(a))”.

3  At the end of subparagraph 84AAA(1)(b)(iii)

Add “and”.

4  Paragraph 84AAA(1)(b)

Omit “whether or not the supply was a supply of the kind described in paragraph 84C(4A)(a); and”.

5  At the end of section 84AAA

Add:

             (4)  In this section, a reference to a pharmaceutical benefit includes a reference to a repatriation pharmaceutical benefit.

6  Subsections 84C(1AA) and (1C)

Repeal the subsections, substitute:

       (1AA)  A person who has been, at any time during a relevant entitlement period, a general patient is eligible to be issued with a concession card in respect of that period if the total value for safety net purposes of supplies of pharmaceutical benefits, repatriation pharmaceutical benefits and out-patient medication made:

                     (a)  to the person during the period; or

                     (b)  to the person and the person’s family during the period;

is not less than the amount of the general patient safety net (within the meaning of section 99F).

Note:          Supplies of pharmaceutical benefits may include supplies referred to in subsections 99(2A), (2AB) and (2B).

          (1B)  A person is eligible to be issued with a concession card at the time of the supply of a pharmaceutical benefit, repatriation pharmaceutical benefit or out-patient medication to the person or a member of the person’s family, if including the value for safety net purposes of the supply in the total mentioned in subsection (1AA) would fulfil that subsection.

          (1C)  A person who has been, at any time during a relevant entitlement period, a concessional beneficiary is eligible to be issued with an entitlement card in respect of that period if either of the following paragraphs applies:

                     (a)  the total of:

                              (i)  the value for safety net purposes of supplies of pharmaceutical benefits, repatriation pharmaceutical benefits and out-patient medication made to the person during the relevant entitlement period when the person was a concessional beneficiary; and

                             (ii)  where the person has, during the relevant entitlement period, been a general patient—the transferred value of supplies of pharmaceutical benefits, repatriation pharmaceutical benefits and out-patient medication made to the person during the period when the person was a general patient;

                            is not less than the amount of the concessional beneficiary safety net (within the meaning of section 99F);

                     (b)  the total of:

                              (i)  the value for safety net purposes of supplies of pharmaceutical benefits, repatriation pharmaceutical benefits and out-patient medication made to the person and the person’s family during the relevant entitlement period when the person was a concessional beneficiary; and

                             (ii)  where the person has, during the relevant entitlement period, been a general patient—the transferred value of supplies of pharmaceutical benefits, repatriation pharmaceutical benefits and out-patient medication made to the person and the person’s family during the period when the person was a general patient;

                            is not less than the amount of the concessional beneficiary safety net (within the meaning of section 99F).

Note:          Supplies of pharmaceutical benefits may include supplies referred to in subsections 99(2A), (2AB) and (2B).

          (1D)  A person is eligible to be issued with an entitlement card at the time of the supply of a pharmaceutical benefit, repatriation pharmaceutical benefit or out-patient medication to the person or a member of the person’s family if:

                     (a)  where the person is a concessional beneficiary at the time of the supply—including the value for safety net purposes of the supply; or

                     (b)  where the person is a general patient at the time of the supply—including the transferred value of the supply;

in the total mentioned in paragraph (1C)(a) or (b) would fulfil that paragraph.

          (1E)  The regulations may prescribe the value for safety net purposes of a supply of a pharmaceutical benefit.

           (1F)  Regulations made for the purposes of subsection (1E) must take into account the amount charged for the supply, but may make adjustments to the value for safety net purposes such as:

                     (a)  excluding certain components of the amount charged; or

                     (b)  setting a maximum limit on the value.

7  At the end of subparagraph 84C(4)(a)(ii)

Add “and”.

8  Paragraph 84C(4)(b)

Omit all the words after “supply,”, substitute “the person is not a holder of an entitlement card; and”.

9  Paragraphs 84C(4)(c) to (e)

Repeal the paragraphs, substitute:

                     (c)  in a case where the supply is made upon a general benefit prescription and the Commonwealth price for the pharmaceutical benefit exceeds $28.60—the amount received in respect of the supply is equal to the sum of the following:

                              (i)  $28.60 (less any allowable discount);

                             (ii)  if an amount may be charged for the supply under subsection 87(2A)—that amount;

                            (iii)  any charge for supply at a time outside normal trading hours;

                            (iv)  any charge for delivery in accordance with regulations made for the purposes of paragraph 87(4)(b); and

                     (d)  in a case where the supply is made upon a concessional benefit prescription and the Commonwealth price for the pharmaceutical benefit exceeds $4.60—the amount received in respect of the supply is equal to the sum of the following:

                              (i)  $4.60 (less any allowable discount);

                             (ii)  if an amount may be charged for the supply under subsection 87(2A)—that amount;

                            (iii)  any charge for supply at a time outside normal trading hours;

                            (iv)  any charge for delivery in accordance with regulations made for the purposes of paragraph 87(4)(b); and

                     (e)  in a case where the supply is taken, because of subsection 99(2A), (2AB) or (2B), to be a supply otherwise than under this Part, the amount charged or received in respect of the supply does not exceed the sum of the following:

                              (i)  the price worked out in accordance with a determination in force under subsection (7) for the pharmaceutical benefit;

                             (ii)  any amount charged or received by reason only that the supply was made at a time outside normal trading hours;

                            (iii)  any amount charged or received in accordance with regulations made for the purposes of paragraph 87(4)(b).

10  Subsection 84C(4AA)

Omit all the words after “of this section”, substitute “if it is an early supply of a specified pharmaceutical benefit”.

11  Subsection 84C(7)

Omit “this section”, substitute “subparagraph (4)(e)(i)”.

12  Section 84CA

Repeal the section, substitute:

84CA   Transferred value

                   For the purposes of subsections 84C(1C) and (1D), the transferred value for the supply of a pharmaceutical benefit, repatriation pharmaceutical benefit or out-patient medication is:

                     (a)  if the value for safety net purposes of the supply is less than $4.60—that lesser amount; and

                     (b)  in any other case—$4.60.

Note:          The figures expressed in this section in dollars are periodically adjusted under section 99G.

13  Subsection 87(1)

Omit “a medical practitioner”, substitute “an approved medical practitioner”.

14  Paragraph 87(2)(b)

Omit “has previously been charged, for supplies of pharmaceutical benefits, an amount that is not less than the amount of the general patient safety net (within the meaning of section 99F)”, substitute “is eligible to be issued with a concession card”.

15  Paragraph 87(2)(c)

Repeal the paragraph.

16  Paragraph 87(2)(e)

Omit “or (c)”.

17  Subsection 87(2) (note)

Omit “Note”, substitute “Note 1”.

18  At the end of subsection 87(2)

Add:

Note 2:       For when a person is eligible to be issued with a concession card, see subsection 84C(1AA).

19  Subsection 87(2AAA)

Omit “Paragraphs (2)(b) and (c) do not apply”, substitute “Paragraph (2)(b) does not apply”.

20  Subsections 87(2AA) and (2AB)

Repeal the subsections.

21  At the end of subsection 87A(3)

Add:

Note:          For when a person is eligible to be issued with a concession or entitlement card, see section 84C.

22  Subsection 99(2AB)

Omit “or (c)”.

23  Section 99F (definition of general patient reduced charge )

Omit “, or (c)”.

24  Transitional provision—indexation of charges

(1)       The repeal and substitution of paragraph 84C(4)(c) of the National Health Act 1953 by this Schedule does not affect the indexation of general patient charge that has occurred in each year after 2005 under Division 4A of Part VII of that Act, or the continuing operation of that Division.

(2)       The repeal and substitution of paragraph 84C(4)(d) and section 84CA of that Act by this Schedule does not affect the continued indexation of concessional beneficiary charge that has occurred in each year after 2005 under Division 4A of Part VII of that Act, or the continuing operation of that Division.