PBS On­line to re­ject in­valid HSD claims

Pharmacy Daily - - NEWS -

THE Depart­ment of Hu­man Ser­vices has an­nounced changes to PBS On­line, which ef­fec­tive 05 Nov will au­to­mat­i­cally re­ject claims made by phar­ma­cies when they are not au­tho­rised to sup­ply a pre­scrip­tion un­der the Highly Spe­cialised Drug (HSD) pro­gram.

The up­date will re­duce the risk for phar­ma­cies who may ac­ci­den­tally sup­ply HSD items, with new “rea­son code mes­sages” to alert the pharmacist that the pre­scrip­tion can­not be claimed.

Pa­tients will then need to visit a phar­macy that meets pre­scrib­ing rules, or re­turn to the pre­scriber for an amended pre­scrip­tion.

Drugs on the HSD list in­clude HIV an­tiretro­vi­ral ther­apy (ART), cloza­p­ine for main­te­nance ther­apy, and hep­ati­tis B drugs, ac­cess to which has now been sim­pli­fied un­der HSD Com­mu­nity Ac­cess (CA) ar­range­ments.

Com­mu­nity phar­ma­cies and friendly so­ci­eties may not have ac­cess to pub­lic hos­pi­tal HSD item codes and there­fore may be un­able to claim for th­ese items.

How­ever, they can dis­pense and claim pub­lic hos­pi­tal CAR HSD and PBS breast can­cer treat­ment trastuzumab pre­scrip­tions.

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