Commonwealth Numbered Acts

HEALTH LEGISLATION AMENDMENT ACT (No. 2) 1986 No. 94 of 1986 - SECT 19

19. After section 84A of the Principal Act the following Division is inserted:

"Division 1A-Pharmaceutical benefits entitlement cards Family relationships

"84B. (1) For the purposes of this Division, the following are the members of
a person's family:

   (a)  the person's spouse;

   (b)  any dependent child of the person.

"(2) For the purposes of this section, a person who is, at any time during a
relevant entitlement period, a dependent child of another person shall be
taken to be a dependent child of that other person throughout the remainder of
that period.

"(3) For the purposes of this section, a person shall not be taken to have the
custody of a child unless the person, whether alone or jointly with another
person, has the right to have, and to make decisions concerning, the daily
care and control of the child.

"(4) In this section-
'child' means a person who-

   (a)  is under the age of 16 years; or

   (b)  is a student child;
'dependent child', in relation to a person, means-

   (a)  a child under the age of 16 years who is-

        (i)    in the custody, care and control of the person; or

        (ii)   where no other person has the custody, care and control of the
               child - is wholly or substantially in the care and control of
               the person; or

   (b)  a student child who is wholly or substantially dependent on the
        person;
'spouse', in relation to a person, means-

   (a)  a person who is legally married to, and is not living, on a permanent
        basis, separately and apart from, that person; and

   (b)  a de facto spouse of that person;
'student child' means a person who-

   (a)  has attained the age of 16 years but has not attained the age of 25
        years; and

   (b)  is receiving full-time education at a school, college or university.
        Eligibility for pharmaceutical benefits entitlement cards

"84C. (1) A person is not eligible to be issued with an entitlement card in
respect of a relevant entitlement period unless-

   (a)  the number of pharmaceutical benefit supplies made, during that
        period, to the person is equal to or exceeds 25; or

   (b)  the aggregate of the number of pharmaceutical benefit supplies made,
        during that period, to the person and to the person's family is equal
        to or exceeds 25.

"(2) For the purposes of this section, a pharmaceutical benefit supply shall
be taken to have been made, during a relevant entitlement period, to a
person's family if and only if the supply was made, during that period, to-

   (a)  a person who is, at the time when an application is made by the person
        under section 84E for the issue of an entitlement card in respect of
        that period, a member of the person's family; or

   (b)  a person who was, at the time of supply, a member of the person's
        family.

"(3) Where-

   (a)  a prescription is for the supply of a pharmaceutical benefit to a
        person (in this sub-section referred to as the 'patient'); and

   (b)  the benefit referred to in the prescription is given to another
        person, as agent for the patient, for supply to the patient, the
        benefit shall, for the purposes of this section, be taken to have been
        supplied to the patient upon the prescription.

"(4) A pharmaceutical benefit supply to a person shall not be taken into
account for the purposes of this section unless-

   (a)  the pharmaceutical benefit is supplied-

        (i)    by an approved pharmacist, at or from premises in respect of
               which the pharmacist is for the time being approved, on
               presentation of a prescription written by a medical
               practitioner or a participating dental practitioner in
               accordance with this Act and the regulations, or, in such
               circumstances as are prescribed for the purposes of paragraph
               89 (a), on communication to the pharmacist, in the manner
               prescribed for the purposes of that paragraph, of a
               prescription of a medical practitioner or a participating
               dental practitioner; or

        (ii)   in accordance with section 92 or 94;

   (b)  at the time of supply, the person-

        (i)    was not a pensioner;

        (ii)   was not a dependant of a pensioner; and

        (iii)  was not a holder of an entitlement card;

   (c)  in a case where the supply is made upon a general benefit prescription
        and the Commonwealth price for the pharmaceutical benefit exceeds $10
        - the amount received in respect of the supply is equal to or exceeds
        the aggregate of $10 and the special patient contribution (if any) in
        relation to the pharmaceutical benefit;

   (d)  in a case where the supply is made upon a concessional benefit
        prescription and the Commonwealth price for the pharmaceutical benefit
        exceeds $2.50 - the amount received in respect of the supply is equal
        to or exceeds the aggregate of $2.50 and the special patient
        contribution (if any) in relation to the pharmaceutical benefit; and

   (e)  in a case where the supply is deemed, by virtue of sub-section 99 (2A)
        or (2B), to be a supply otherwise than under this Part-

        (i)    the amount demanded or received in respect of the supply does
               not exceed the aggregate of-

                (A)  the agreed price for the pharmaceutical benefit;

                (B)  any charge demanded or received by reason only that the
                     supply was made at a time outside normal trading hours;
                     and

                (C)  any charge demanded or received in accordance with
                     regulations made for the purposes of paragraph 87 (4)
                     (b); and

        (ii)   if there is in force, at the time of supply, a determination by
               the Minister, pursuant to paragraph 85A (2) (a), that is
               applicable to the supply - the quantity or number of units
               supplied is not less than the maximum quantity or number
               specified in the determination.

"(5) Where an approved pharmacist, approved medical practitioner or approved
hospital authority supplies a pharmaceutical benefit to a person in accordance
with a direction included in a prescription pursuant to sub-section 88 (6),
there shall, for the purposes of this section, be deemed to have taken place a
number of pharmaceutical benefit supplies to the person that is equal to the
minimum number of occasions of supply that would have had to be directed if
the medical practitioner had prescribed the same total quantity or number of
units of the pharmaceutical benefit by way of repeated supplies.

"(6) The reference in paragraph (4) (e) to the agreed price for a
pharmaceutical benefit is a reference to the agreed price for the benefit
ascertained in accordance with a determination in force under sub-section (7).

"(7) The Minister may determine the manner in which the agreed price for all
or any pharmaceutical benefits is to be ascertained for the purpose of this
section.

"(8) A manner determined under sub-section (7) shall-

   (a)  in the case of a ready-prepared pharmaceutical benefit - take as a
        basis-

        (i)    the approved price to pharmacists of the pharmaceutical benefit
               concerned; or

        (ii)   if the pharmaceutical benefit concerned is a form of a drug or
               medicinal preparation to which a substance has, or substances
               have, been added in accordance with a determination in force
               under sub-section 85 (3) relating to that drug or medicinal
               preparation - the approved price to pharmacists of that form of
               that drug or medicinal preparation, that is applicable on the
               first day of the month of the year in which the supply occurs;

   (b)  in the case of other pharmaceutical benefits - take as a basis the
        basic wholesale price of each ingredient that is applicable on the day
        on which the supply occurs;

   (c)  provide for the addition of such fees and other amounts as are
        determined by the Tribunal for the purposes of paragraph 98B (2) (c);
        and

   (d)  provide for the addition of such other fees and other amounts as are
        determined by the Minister.

"(9) The Minister shall not determine an amount for the purpose of paragraph
(8) (d) unless the Pharmacy Guild of Australia has agreed in writing to the
making of that determination.

"(10) A determination under sub-section (7) shall-

   (a)  be made by notice in writing published in the Gazette; and

   (b)  come into operation on such date as is specified in the determination.

"(11) In this section, unless the contrary intention appears-
'approved price to pharmacists' has the same meaning as in section 98B;
'basic wholesale price' has the same meaning as in section 98B;
'Commonwealth price' has the same meaning as in section 99;
'pharmaceutical benefit supply' means a supply or a repeated supply of a
pharmaceutical benefit;
'ready-prepared pharmaceutical benefit' has the same meaning as in section
98B. Pharmaceutical benefits prescription record forms

"84D. (1) Upon application, the Secretary shall issue to a person a
pharmaceutical benefits prescription record form in accordance with
sub-sections (3) and (4).

"(2) An approved pharmacist, approved medical practitioner or approved
hospital authority may issue to a person a pharmaceutical benefits
prescription record form in accordance with sub-sections (3) and (4).

"(3) A pharmaceutical benefits prescription record form shall-

   (a)  be in accordance with the form approved by the Secretary; and

   (b)  include the prescribed particulars of the person to whom the form is
        issued.

"(4) A pharmaceutical benefits prescription record form issued to a person may
include the prescribed particulars of any person who is a member of the
person's family and-

   (a)  is not a pensioner;

   (b)  is not a dependant of a pensioner; and

   (c)  is not a holder of an entitlement card.

"(5) Where a pharmaceutical benefits prescription record form is issued to a
person, the person and each member of the person's family whose particulars
are included in the form in accordance with sub-section (4) shall be taken,
for the purposes of this section, to be a holder of the form.

"(6) Where-

   (a)  an approved pharmacist, approved medical practitioner or approved
        hospital authority supplies a pharmaceutical benefit to a holder of a
        pharmaceutical benefits prescription record form;

   (b)  the form is presented at the time of supply; and

   (c)  the supply is, in accordance with sub-section 84C (4), a
        pharmaceutical benefit supply to be taken into account for the
        purposes of section 84C, the pharmacist, medical practitioner or
        authority shall record the supply of that pharmaceutical benefit on
        the form.

"(7) A record made for the purposes of sub-section (6) shall include -

   (a)  the prescribed particulars of the prescription upon which the
        pharmaceutical benefit is supplied;

   (b)  the date on which the pharmaceutical benefit is supplied; and

   (c)  such other particulars in relation to the supply of the pharmaceutical
        benefit as are prescribed, and shall be signed by-

   (d)  in a case where the record is made by an approved pharmacist - the
        pharmacist;

   (e)  in a case where the record is made by an approved medical practitioner
        - the medical practitioner; or

   (f)  in a case where the record is made by an approved hospital authority -
        the medical practitioner or pharmacist by or under whose supervision
        the pharmaceutical benefit is dispensed.

"(8) An approved pharmacist may authorise a person to record, on behalf of the
pharmacist, the supply of pharmaceutical benefits for the purposes of
sub-section (6).

"(9) A reference in sub-section (7) to an approved pharmacist includes a
reference to a person authorised by a pharmacist under sub-section (8) to
record, on behalf of the pharmacist, the supply of pharmaceutical benefits.
Issue of pharmaceutical benefits entitlement card

"84E. (1) Where-

   (a)  a person applies to the Secretary for a pharmaceutical benefits
        entitlement card in respect of a relevant entitlement period; and

   (b)  the Secretary is satisfied that the person is eligible to be issued
        with a pharmaceutical benefits entitlement card in respect of that
        period, the Secretary shall issue a pharmaceutical benefits
        entitlement card to the person in respect of that period.

"(2) Where-

   (a)  a person applies to an approved pharmacist, approved medical
        practitioner or approved hospital authority for a pharmaceutical
        benefits entitlement card in respect of a relevant entitlement period;
        and

   (b)  the pharmacist, medical practitioner or authority is satisfied that
        the person is eligible to be issued with a pharmaceutical benefits
        entitlement card in respect of that period, the pharmacist, medical
        practitioner or authority may issue a pharmaceutical benefits
        entitlement card to the person in respect of that period.

"(3) An application under sub-section (1) or (2) shall-

   (a)  be in accordance with the form approved by the Secretary;

   (b)  contain such particulars, and be accompanied by such documents, as are
        prescribed; and

   (c)  be signed by the person making the application.

"(4) Where an application is made to a person for the issue of an entitlement
card, the person to whom the application is made shall, in determining whether
to issue an entitlement card, have regard to-

   (a)  the matters contained in the application;

   (b)  any record form or other document that accompanies the application;
        and

   (c)  such other matters as the person considers relevant.

"(5) Where-

   (a)  a person applies to an approved pharmacist, approved medical
        practitioner or approved hospital authority for a pharmaceutical
        benefits entitlement card in respect of a relevant entitlement period;
        and

   (b)  the pharmacist, medical practitioner or authority issues a
        pharmaceutical benefits entitlement card to the person in respect of
        that period, the pharmacist, medical practitioner or authority shall
        retain the application and any other relevant document that
        accompanied the application for the period of 12 months, or such other
        period as is prescribed by the regulations, commencing on the day on
        which the entitlement card is issued.

"(6) The Secretary may, by notice in writing given to an approved pharmacist,
approved medical practitioner or approved hospital authority, require the
pharmacist, medical practitioner or authority to deliver, within such period
(not being a period of less than 7 days) as is specified in the notice, a
specified document retained by the pharmacist, medical practitioner or
authority in accordance with sub-section (5) to-

   (a)  the Secretary; or

   (b)  such other person as is specified in the notice, and the pharmacist,
        medical practitioner or authority shall comply with the notice.

"(7) In sub-section (5), 'relevant document' means a document relating to the
number of supplies or repeated supplies of pharmaceutical benefits made to a
person. Form of entitlement card

"84F. (1) An entitlement card shall be in accordance with the form approved by
the Secretary for the purposes of this section.

"(2) Without limiting the generality of sub-section (1), an entitlement card
shall include particulars of-

   (a)  the relevant entitlement period in respect of which the card is
        issued; and

   (b)  the person to whom the card is issued and each person who is, at the
        time when the card is issued, a member of the person's family.

"(3) The omission from an entitlement card of particulars of a person who is,
at the time when the card is issued, a member of the family of the person to
whom the card is issued does not affect the validity of the card. Persons
covered by entitlement card

"84G. Subject to sub-section 84H (3), where an entitlement card is issued to a
person, the person and each person who is, at the time when the card is
issued, a member of the person's family shall be taken, for the purposes of
this Act, to be a holder of the card. Additional and replacement entitlement
cards

"84H. (1) Where an entitlement card has been issued under section 84E, an
additional card may, in accordance with the regulations, be issued to a person
who is a holder of the card.

"(2) Without limiting the generality of sub-section (1), regulations made for
the purposes of that sub-section may provide for the issue of an additional
card to a person-

   (a)  who is or was a holder of an entitlement card that has been lost,
        stolen, damaged or destroyed; or

   (b)  who is a holder of an entitlement card but whose particulars are not
        included on the card.

"(3) Where-

   (a)  an entitlement card has been issued to a person (in this sub-section
        referred to as the 'original card holder') under section 84E in
        respect of a relevant entitlement period; and

   (b)  a person (in this sub-section referred to as the 'new family member')
        becomes, after the issue of the card and during that period, a member
        of the original card holder's family, a replacement card may, in
        accordance with the regulations, be issued to the original card
        holder, being a card that includes particulars of the holders of the
        original card and of the new family member and, where such a
        replacement card is issued, each holder of the original card and the
        new family member shall be taken, from the time when the replacement
        card is issued, to be a holder of the replacement card.

"(4) Regulations made for the purposes of sub-section (1) or (3) may provide
for application to be made to the Administrative Appeals Tribunal for review
of a decision of a person refusing to issue an additional card or a
replacement card. Period of effect of entitlement card

"84J. An entitlement card issued in respect of a relevant entitlement period
commences to have effect on the day on which it is issued and ceases to have
effect at the end of that period. Return of entitlement card

"84K. Where an entitlement card is issued to a person who is not eligible to
be issued with the entitlement card, the Secretary may, by notice in writing
to a holder of the card, require the holder to deliver the card, within such
period (not being a period of less than 7 days) as is specified in the notice,
to-

   (a)  the Secretary; or

   (b)  such other person as is specified in the notice, for cancellation and
        the holder shall comply with the notice. Offences

"84L. (1) An approved pharmacist, approved medical practitioner or approved
hospital authority shall not knowingly issue an entitlement card to a person
who is not eligible to be issued with the entitlement card.
Penalty: $5,000 or imprisonment for 2 years, or both.

"(2) An approved pharmacist, approved medical practitioner or approved
hospital authority shall not knowingly include in an entitlement card, as the
name of a member of a person's family, the name of a person who is not a
member of the person's family.
Penalty: $5,000 or imprisonment for 2 years, or both.

"(3) A person shall not, without reasonable excuse, fail to comply with a
notice given to the person under section 84K.
Penalty: $2,000 or imprisonment for 12 months, or both.

"(4) A person shall not, without reasonable excuse, fail to comply with a
notice given to the person under sub-section 84E (6).
Penalty for contravention of this sub-section: $2,000 or imprisonment for 12
months, or both.".