Approved supplier may request provision of medicare number
86B Approved supplier may request provision of medicare number
Approved supplier may request provision of medicare number
If:
an approved supplier is presented with a prescription for the supply of a pharmaceutical benefit to a person; and
the person presenting the prescription claims to be, or to be the agent of, the person to whom the prescription relates; and
the person presenting the prescription does not request that the drug or medicinal preparation to which the prescription relates not be supplied as a pharmaceutical benefit;
the approved supplier may request the person presenting the prescription to provide to the approved supplier a medicare number applicable to the person to whom the prescription relates and the expiry date in relation to the number.
Inclusion of medicare number in a prescription does not prevent later request
The approved supplier may make the request under subsection (1) whether or not:
the prescription already contains a medicare number as a number applicable to the person to whom the prescription relates; or
the approved supplier’s records already contain such a number (whether with or without the expiry date in relation to that number) recorded and retained in accordance with section 86D.
Approved supplier’s powers if medicare number is provided
If a medicare number is provided to the approved supplier as a number applicable to the person following a request under subsection (1), or is included as such a number in the approved supplier’s records in accordance with section 86D, the approved supplier may:
if the prescription has already been endorsed with a medicare number as such a number, check the number so provided or included against the endorsed number and:
confirm that they are the same; or
if they are not the same and the approved supplier considers the number so provided or included more reliable than the endorsed number—alter the endorsed number to the number so provided or included or insert the number so provided or included in the CTS claim relating to the prescription, noting the discrepancy; or
if they are not the same and the approved supplier considers the endorsed number more reliable than the number so provided or included—disregard the number so provided or included and, if making a CTS claim, insert the endorsed number in the CTS claim relating to that prescription; and
if the prescription has not already been endorsed with a medicare number as such a number:
endorse the prescription with the medicare number so provided or included as a number applicable to the person; or
insert the number so provided or included in the CTS claim relating to that prescription; and
if the approved supplier has also been provided with, or has, in the approved supplier’s records, the expiry date in relation to the medicare number ultimately supplied to the Chief Executive Medicare—confirm that the supply of a pharmaceutical benefit authorised by the prescription is not being sought after the expiry date.
Approved supplier’s powers in respect of prescription (other than communicated prescription) covering person included in class determined under subsection 86E(1)
If:
the prescription for the supply of a pharmaceutical benefit that is presented to the approved supplier does not contain a medicare number as a number applicable to the person to whom the prescription relates; and
despite a request under subsection (1), a medicare number is not provided to the approved supplier as such a number; and
a medicare number is not retained in the approved supplier’s records in accordance with section 86D as such a number; and
the approved supplier is satisfied that the person to whom the prescription relates is included within a class of persons identified by the Minister under subsection 86E(1);
the approved supplier may:
endorse on the prescription the special number applicable to the person as a member of that class; or
insert that number in the CTS claim relating to that prescription.
Approved supplier’s powers in respect of written version of communicated prescription not containing medicare number
If:
a prescription for the supply of a pharmaceutical benefit is not presented to an approved supplier as described in subsection (1) but is communicated to the approved supplier in circumstances set out in regulations made for the purposes of paragraph 89(a); and
the approved supplier later receives a written version of the prescription that does not contain a medicare number as a number applicable to the person to whom the prescription relates;
the approved supplier may, after the written version of the prescription is received, endorse on the written version, or insert in the CTS claim relating to the prescription:
if a medicare number is already retained in the approved supplier’s records in accordance with section 86D as a number applicable to the person to whom the prescription relates—that medicare number; or
if a medicare number is not so retained as a number applicable to the person to whom the prescription relates—the special number applicable to the person under subsection 86E(1) as a person in respect of whom a prescription has been so communicated.
This Act’s bill:Second reading speech
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