Yes, all completed and valid 12 Month Patient Consent Forms can be used until their renewal period expires. After 1 January 2023, eligible patients should have a 3 Year Patient Consent Form completed by their prescriber as their existing form nears the renewal date.
No, the 3 Year Patient Consent Form is only required for patients prescribed s100 Highly Specialised Drugs (HSDs). Patients prescribed s100 injectable and infusible chemotherapy medicine may sign a local pharmacy consent form when their prescription is filled through a pharmacy used by NSW public hospital oncology services.
Yes, the patient can present a photograph of their signed consent form with their prescription. All items of the consent form must be fully legible.
No, there is no requirement for NSW community or public hospital pharmacies to store or make copies of the 3 Year Patient Consent Form for the NSW Section 100 Co-payment Program.
The patient is responsible for maintaining their consent form, including presenting it each time they have their prescription/s and any repeats dispensed at a NSW public hospital pharmacy or NSW community pharmacy. Any storage, auditing or archiving of patient consent forms is at the discretion of the health district, facility or pharmacy, in conjunction with the patient.
No, the commitment only applies to patients prescribed s100 HSDs by NSW public hospitals prescribers or authorised community prescribers.
Patients who are charged the concessional PBS co-payment rate and meet the s100 Co-payment Program eligibility criteria will have their co-payments paid by NSW Health on their behalf for relevant medicines. Existing arrangements for NSW patients who hold a Commonwealth healthcare card for all other medicines are not affected by this change.
Will co-payments paid by NSW Health count towards the patient safety net?
No. For the s100 HSD Community access schedule, only prescriptions for HIV antiretroviral therapy, Hepatitis B and clozapine maintenance therapy are eligible for the co-payment program. NSW Health provides opioid dependence medicines free of charge in public services, however this is administered separately from the s100 Co-payment Program. Visit the NSW Health Alcohol and other drugs page for further information.
Border areas, or border communities, refers to NSW residents who live in a local government area that borders or is close to Victoria, Queensland or the Australian Capital Territory. Visit the NSW Government page for information about local government areas in NSW that are considered border communities.
The Pharmacy Guild of Australia manages s100 HSD co-payment claims and reimbursements to community pharmacies. Community pharmacies must register with the Pharmacy Guild of Australia online portal to submit s100 co-payment claims and receive re-imbursement from NSW Health. You do not need to be a member of the Pharmacy Guild of Australia to register.
In addition to the cost of the co-payment for eligible patients, pharmacies are paid a service fee for the work associated with submitting claims on behalf of patients. The fees are $2.23 (incl GST) for each co-payment claimed and a one off monthly administration fee of $13.42 (incl GST) for the first claim made each month.
Information on how to submit claims for the s100 Co-payment Program is available at The Pharmacy Guild of Australia.
Community pharmacies submit eligible patient co-payment claims for re-imbursement to the Pharmacy Guild of Australia via their online portal. The Pharmacy Guild processes claims and reimburses pharmacists for each eligible patient co-payment and invoices NSW Health accordingly.
This arrangement ensures pharmacists can comply with the National Health Act 1953, which requires community pharmacists to charge the Pharmaceutical Benefits Scheme (PBS) co-payment for s100 HSDs. This also ensures that eligible patients can access s100 HSDs from community pharmacies, without having to pay the co-payment. Different rules for charging co-payments apply to public hospital pharmacies.
NSW public hospitals are reimbursed for eligible patient co-payments based on iPharmacy reports submitted to the NSW Ministry of Health.
No. Prescriptions for medicines on the s100 HSD (Public Hospital) schedule dispensed in community pharmacy are not eligible for the co-payment to be paid by NSW Health. To have the co-payment paid by NSW Health, prescriptions for medicines on the s100 HSD (Public Hospital) schedule must be dispensed at a NSW public hospital pharmacy.
Eligible patients who have a prescription for HIV antiretroviral therapy, Hepatitis B and clozapine maintenance therapy medicines listed on the s100 HSD Community Access schedule may have their medicine dispensed by a NSW public hospital or NSW community pharmacy and have the co-payment paid by NSW Health.
Find out more about the s100 Co-payment Program.
NSW s100 co-payment enquires can be emailed to: NSWH-s100CoPayment@health.nsw.gov.au
