HMR cap raised, but more help needed

The monthly cap for the Home Medicines Review Program is set to increase from 20 to 30 HMRs in March

The Department of Health announced the change to the cap on Friday.

The Pharmacy Programs Administrator advised that, “this means each approved HMR Service Provider may claim up to a total of 30 HMR Services that have been conducted within a calendar month and each Accredited Pharmacist may conduct up to 30 HMR Services per calendar month, irrespective of the number of approved HMR Service Providers they provide HMR Services on behalf of”.

“Please note the cap is based on the date the HMR service was conducted not the date the claim was submitted to the Pharmacy Programs Administrator (PPA) Portal,” it noted.

“Any claims submitted in March with a service date in February will therefore be assessed against the February monthly cap of 20.”

A spokesperson for the Pharmacy Guild welcomed the move but said that more needed to be done.

“We welcome additional investment in medication management programs for the benefit of patients and in the interests of quality use of medicines,” the spokesperson said.

“However, the interim report of the Royal Commission into Aged Care called for measures specific to residential aged care, and these remain to be addressed.”

He said that further measures more directly beneficial to aged care facility residents would include:

  • Amending the RMMR patient eligibility criteria to incorporate people in residential respite care and transitional care;
  • Focusing Compliance and Audit activity on RMMR services and QUM program provision;
  • Funding participation by pharmacists in case conferencing arrangements; and
  • Amending the RMMR Program Rules to allow for more than one RMMR Service Provider to be contracted for a single Residential Aged Care Facility to facilitate patient choice and enable RMMRs to be conducted locally and more responsively to patient need.

The PSA said that older Australians would be better supported to avoid medicine-related harms as a result of the change.

“PSA welcomes this change which will help increase consumer access to HMRs across the country,” said National President Associate Professor Chris Freeman.

“PSA have been calling for better access to medicine reviews for some time, most recently through recommendations contained in our Medicine Safety: Aged care report released earlier this week.

“Medicine-related problems lead to 250,000 hospital admissions each year costing $1.4 billion annually.

“Medicine review services undertaken by accredited pharmacists, such as HMRs, are a key way in which problems with medicines are identified and resolved in partnership with consumers and their general practitioner.”

Home Medicine Reviews not only can improve a patient’s quality of life, but can save lives, he said, observing that patients who take more than one medicine can be at risk of major problems associated with their medicines.

Home Medication Reviews can improve the outcomes from medicine use in Australia, said A/Prof Freeman.

“Our members have told us of significant delays consumers have experienced waiting for the calendar to tick over to the next month before being able to receive a HMR from their pharmacist who has hit their HMR cap for the month.

“Australians living in rural and remote parts of the country are one of the main groups to struggle with health care accessibility.

“The cap of 20 HMRs per month particularly hits hard on consumers living in rural communities where there is usually no other accredited pharmacists available to provide the service.

“PSA has called for the removal of these caps since their inception. We would like to thank the Minister for Health for this announcement today on behalf of all pharmacists and their patients.

“We are pleased with today’s announcement as a first step and we are committed to continue working with Government to further improve access to medicine review services.”

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  1. Debbie Rigby

    This a great news and hopefully just the first step in improving access to HMRs and RMMRs and changing the programs rules to reflect best practice. The doubling of QUM remuneration recently also helps address the problems of medicines safety in aged care facilities. It is also great that the Guild is calling for improvements.

    For individual accredited pharmacists it’s a time to reflect on their offer and processes, their value, their level of collaboration, and up-to-date knowledge. We can always do better.

  2. Kevin Hayward

    Over the last two years I have been providing medicines reviews (and education) to my practices without limits. This means of course that I have had to develop strategies to privately fund those done in excess of the HMR cap.
    The project has worked surprisingly well, the inclusion of a case conference for these patients has increased the level of multidisciplinary working, reinforced the relevance of the medicines reviews and hopefully improved the quality of the resulting care.
    This small project also shows me that there is still a strong demand for this service, and well in excess of the new cap.

    • Karalyn Huxhagen

      A case conference would assist greatly. I would love to work as collaboratively as you do.

  3. Karalyn Huxhagen

    The increase in caps is a major step forward. I would still ask for two things for pharia 2-6 patients. A cap of 20/week and an increase in the travel allowance to include an accomodation subsidy . The costs to provide rural services are much higher. The distances and poor access means the quality and type of vehicle needs to better; accomodation, food and fuel prices are higher.
    We cannot neglect the rural and remote patients just cos it is simpler to work in metropolitan areas.

    • Kevin Hayward

      Virtual consults for remote areas would be a solution. I spent several years teaching remote students via the internet. Once you have the communication skill set sorted it is a very focused and productive medium, with very little cost element. Maybe your PHN could help you to set up a trial?

      • Karalyn Huxhagen

        PHNs are now a commissioning entity and they commision what they identify as an issue. Have tried taking ideas and programs to my PHN with no outcomes achieved. Virtual consults are conducted by many of the other providers I work with e.g. rheumatologist, wound care clinic etc. The funding is not available in the present system. I do know of some locations that are delivering HMR consults by remote but they use a different model of payment.
        In speaking with my colleagues who do remote consults for cardiology and rheumatology they tell me the first consult should be face to face and follow up is video link. They have tested it and found the best outcomes is achieved this way.

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