Agreement on scan rate as pharmacy moves to electronic claiming

Community pharmacies will receive a small incentive payment to encourage them to boost the scanning rates for electronic prescriptions under an agreement between the Pharmacy Guild and the Department of Health.

Pharmacies can receive at least $800 on meeting a target of scan rate of 15 per cent by next month, and $1200 if they meet a 30 per cent scanning target by September.

The original target announced for the first round was November 2013, but appears to have been extended.

Pharmacies must be eligible for the eHealth section of the Pharmacy Practice Incentive (PPI) Community Services Support priority area program, which includes the use of appropriate dispensing software, broadband internet connectivity, PBS Online claiming and the use of an electronic prescription exchange service.

The electronic prescription scanning incentive (ePSI) is an re-allocation of existing funds from the electronic transfer of prescriptions (ETP) budget in the Fifth Community Pharmacy Agreement (5CPA).

According to the guild, the measure will encourage more pharmacies to adjust their workflow to facilitate the scanning of barcodes on all electronic prescriptions, producing safer and more efficient dispensing for patients.

The required scanning rate for each ePSI payment will be determined automatically through data transmitted via PBS Online.

The two prescription exchange services, eRx and MediSecure, receive direct funding of 17c per eligible electronic prescription capped to a combined maximum of $900,000.

The guild has also negotiated with DoH to take over the direct administration of medication management programs funded under the 5CPA, agreeing to a cap on the provision of a number of programs such as home medicines reviews (HMRs), residential medication management reviews (RMMRs), and MedsCheck/Diabetes MedsCheck.

In a move that has created disquiet in the community pharmacy sector, caps have been placed on how many HMRs and MedsChecks can be provided per month per provider.

The life of HMR referrals has also been limited to three months, and both HMR and RMMR services will be delivered based on patient need rather than as routine.

In return, the responsibility for the administration of these programs, including the scanning incentive, will be taken over by the guild from the Department of Human Services (DHS) from next month.

According to the guild, this change is aimed at cutting red tape and streamlining processes by moving to an electronic claiming and payment system through the 5CPA website. The system has been designed by Fujitsu and will replace the current paper-based system for making claims.

However, the Society of Hospital Pharmacists Australia (SHPA) has called for a moratorium on these changes, saying they will reduce patient access to services that reduce the risk of hospitalisation.

According to the SHPA, the changes, which were announced on February 12 and will come into effect on March 1, were made without consultation with patients, GPs or pharmacists.

“Pharmacists may no longer be able to provide services ordered by the consumer's GP as medication management review services are to be rationed from [March 1],” the society said.

“Arbitrary caps rather than clinical need will dictate who receives a medication review by an accredited pharmacist.”

The Pharmaceutical Society of Australia (PSA) said the cap should be a short-term measure until a more appropriate funding model had been negotiated for the next CPA.

A notice on the 5CPA website says it is currently receiving "extremely high call volumes" about the new registration and claiming system.

Posted in Allied Health

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