Commonwealth Consolidated Regulations

HUMAN SERVICES (MEDICARE) REGULATIONS 2017 - REG 24

  (1)   The following are prescribed functions of the Chief Executive Medicare:

  (a)   to detect persons who are prescription shoppers;

  (b)   to take appropriate preventative measure s in relation to persons who are prescription shoppers;

  (c)   the education and prevention function s ;

  (d)   the identification and detection function s ;

  (e)   the disclosure function;

  (f)   the evaluation and reporting function s .

  (2)   The Chief Executive Medicare may use PBS information (including personal information) for the performance of the functions mentioned in subsection   ( 1).

  (3)   The education and prevention function s are as follows:

  (a)   to promote awareness of the Prescription Shopping Program to healthcare providers, prescription shoppers and the general public;

  (b)   to promote measures to assist healthcare providers to manage prescription shoppers or people who may be at risk of becoming prescription shopp ers ;

  (c)   to educate healthcare providers and prescription shoppers about the law and requirements relating to the Prescription Shopping Program;

  (d)   to encourage prescription shoppers to have a nominated prescriber;

  (e)   to encourage prescribers to become nominated prescribers;

  (f)   to encourage communication between prescribers, approved suppliers and pharmacists;

  (g)   to discourage inefficient and improper use of pharmaceutical benefits.

  (4)   The identification and detection function s are as follows :

  (a)   to identify the following:

  (i)   prescription shoppers;

  (ii)   prescribers who prescribe pharmaceutical benefits to prescription shoppers;

  (iii)   approved suppliers supplying pharmaceutical benefits to prescription shoppers;

  (b)   to establish and maintain databases containing information about prescription shoppers;

  (c)   to detect and identify prescription shoppers who may be improperly using, stockpiling, swapping, diverting or illegally dealing with pharmaceutical benefits.

  (5)   The disclosure function is to disclose PBS information about whether a person is or is not a prescription shopper , or about a person who is a prescription shopper, to the f ollowing :

  ( a )   the person ;

  ( b )   a prescriber, in order to assist the prescriber to make decisions about prescribing to the person if the person visits the prescriber or is a patient of that prescriber;

  ( c )   an approved supplier who is proposing to supply, or has supplied, pharmaceutical benefits to the person , in order to assist the approved supplier (or a pharmacist employed by the approved supplier) to make decisions about supplying pharmaceutical benefits to that person .

  (6)   The Chief Executive Medicare may perform the disclosure function for the following purposes:

  (a)   administering and enforcing the Chief Executive Medicare's functions under the following:

  (i)   the National Health Act;

  (ii)   this section;

  (b)   protecting public revenue;

  (c)   discouraging inefficient and improper use of pharmaceutical benefits.

  (7)   The evaluation and reporting function s are to use PBS information and information collected by the Chief Executive Medicare under the National Health Act to:

  (a)   evaluate the Prescription Shopping Program; and

  (b)   report (using de - identified PBS information) to the Health Department and other bodies on the administration and outcomes of the Program.