Commonwealth Numbered Regulations

HUMAN SERVICES (MEDICARE) REGULATIONS 2017 (F2017L01008) - 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 measures in relation to persons who are prescription shoppers;

                     (c)  the education and prevention functions;

                     (d)  the identification and detection functions;

                     (e)  the disclosure function;

                      (f)  the evaluation and reporting functions.

             (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 functions 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 shoppers;

                     (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 functions 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 following:

                     (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 functions 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.