8 things you need to know about the Continuing Medication Program… What it is, who is eligible, and how to get involved
1. A long-time program: The Continuing Medication Program (CMP) was established in October 1990. The Australian Government subsidises the cost of the CMP under Section 100 of the National Health Act 1953 (special arrangements).
2. Reimbursement: Through the program, the Federal Government reimburses organisations which pay for the patient co-payment for PBS prescription items on behalf of their clients who are homeless.
The Department will only pay the concessional co-payment rate, meaning the organisation is out-of-pocket for the difference. The current concessional co-payment rate for 2017 is $6.30.
Organisations must be not-for-profit, providers of care to homeless people, and not receiving any other pharmaceutical funding from the government.
They need to establish an account with a pharmacy and ensure medication is supplied only to clients who meet eligibility requirements of homelessness.
Pharmacies with whom the organisation establishes an account must have the capacity to:
– Operate an account that provides an invoice/receipt for each PBS item dispensed to eligible clients of the organisation, which includes patient name; prescription number; drug name; date of dispensing; eligibility number (where possible);
– Maintain safety net records for clients whose payments are charged to this account;
– Ensure account will attract only entries that comply;
– Provide service to the organisation in urgent situations.
4. Defining homelessness:
Under the CMP, primary homelessness is defined as lack of conventional accommodation, such as people living on the streets, sleeping parks, squatting in derelict buildings, or using cars or railway carriages for temporary shelter.
And secondary homelessness is defined as people who move frequently from one form of temporary shelter to another. It covers people using emergency accommodation, teenagers staying in youth refuges, and women and children escaping domestic violence (staying in women’s refuges).
5. Application process: Organisations must provide the Department of Health and Ageing with a statement of services; a copy of its most recent annual report; estimate of monthly expenditure; details of the pharmacy with which the organisation has an account; and certificate of currency for insurance.
6. Requirements: All organisations are required to provide a correctly rendered tax invoice for PBS medications. It is also a requirement of all organisations participating in the CMP that they continually check their clients who are obtaining medications under the CMP that they remain eligible.
7. What is not covered under the CMP? The following items are not reimbursed: administrative fees; where a client arrives at the Concessional Safety Net Threshold – further items should be supplied free of charge for the remainder of the year; Brand Price Premium or Therapeutic Group Premium included in the coast of the prescription; Repatriation Pharmaceutical Benefits Scheme prescriptions; other prescriptions not subsidised under the PBS e.g. dressings, vitamins or private prescriptions; claims with insufficient information supplied on pharmacy invoices.
8. Contact: You can get in touch with the Continuing Medication Program Officer for more information:
Tel: (02) 6289 4093
Fax: (02) 6289 3175