PIP Indigenous Health Incentive and PBS Co-Payment Measure

26 Aug 2010

Basic Background

What is the purpose of the PIP Indigenous Health Incentive and PBS co-payment measure?  The incentive supports general practices and Indigenous health services to provide better care to Indigenous Australians.  In particular, the PBS co-payment measure provides eligible patients with access to cheaper medicines. 

Which practices can participate?  Practices must be registered for the PIP to participate in this incentive. 

What does the incentive provide to practices?  Practices receive a $1000 one-off payment for agreeing to undertake specified activities to improve the provision of care to their Aboriginal and Torres Strait Islander patients with a chronic disease. Practices also receive $250 annually for each eligible patient they register.  In addition, they may qualify for outcomes payments of Tier 1 - $100 and Tier 2 - $150 per registered patient for whom a target level of care has been provided. Click here for more information.

Additional Information about the PBS Co-Payment measure

What is the benefit to patients of the PBS co-payment measure?   Eligible patients (self identified Aboriginal and/or Torres Strait Islander with chronic disease or at risk of) registered for the PBS co-payment measure will be eligible for cheaper PBS medicines.  Concession cardholders will pay no co-payment and general patients will only pay a concessional co-payment. Click here for more information and go to Attachment A.

What confirmation do I get that my patient is registered for the PBS co-payment measure?  Once your patient (during a consultation or otherwise) has signed the consent form and you have completed and signed the patient registration form, the patient is considered registered.  Annotate the patient’s scripts from this point on.  Submit the registration form to Medicare Australia.  The patient is eligible if you assess them to be so in accordance with the guidelines.

How do GPs know whether the CTG annotation functionality is in their software package?  GPs should check with their software provider to ascertain when upgrades will be available.  Most prescribing software already has this functionality.  It is our understanding that Medical Director will include CTG functionality in its November upgrade.  If the annotation function is not yet in your software print CTG at the top of the script or to the right of the patient’s name and initial or sign next to the annotation. Click here for more information on annotating scripts.

What happens to valid repeats for prescriptions written before 1 July 2010? The PBS Co-payment Measure commenced on 1 July 2010.  It is not a retrospective program and therefore scripts written before 1 July 2010 are not valid for the purposes of the PBS Co-payment Measure.  For repeat scripts doctors may issue a new prescription with the CTG annotation for registered patients at the next consultation or recall to enable patient access to cheaper medicines under the measure.  

Where do I get more information?

Email queries to:pip@medicareaustralia.gov.au

Click here for PIP Indigenous Health Incentive forms and guidelines.

Click here for the Closing the Gap Tackling Indigenous Chronic Disease website

PDF version can be downloaded here