Guide to understanding the PSA - Pharmacy Guild of New Zealand

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From Stage 2 onwards, payments to pharmacies mayalso include a Quality Incentive Payment (3.1 (i)). Thedetails of Quality Incentive Payments have yet to bedecided but they will be dealt with as a variation,according to clauses L2 to L6 (3.1 (i)).Stage 1 - During this stage pharmacies are paid theTransition Payment and make claims for providingServices. The Handling Fee is set at $1 and Multipliersare:• Core Services 1.00• Extemp Services 7.95• LTC Services 1.00• ARRC Services 5.30• Class B CDs (including Methadone)Services 6.89• NPPA A Services 5.30• NPPA B Services 7.95The following additional Services if listed in ClauseC2 of Schedule C1:• Aseptic 26.50• Sterile 26.50• Special Foods 5.30• Clozapine 10.60The formula (3.1 (c) (i)) for calculating the payment(R) on a claim for dispensing an item under the CoreService is:• [Schedule subsidy for the PharmaceuticalPlus the stock holding cost margin (4% to$150, 5% above $150)]• Plus [Handling fee multiplied by theMultiplier]• Plus [GST]• Minus [the Co-payment.]This formula remains consistent throughout the termof the PSA (2.3 (a)). Similar formulae are found forPSO, BSO, LTC, Specific, Extemp, NPPA A and NPPAB Services (3.1 (c) (ii) to (g)). These formulae alsoremain consistent throughout the term of the PSA.Stage 2 – At this point Transition Payments (3.2(f)) will decrease and Fees will begin to be paidto pharmacies for Core Services (3.2 (a) (ii)) andLTC Services (3.2 (b) (ii)). These Fees are subject toamendment under the TCM so their exact levels arecurrently unknown (3.2 (g)). Qualifying pharmaciesmay receive a Quality Incentive Payment (3.2 (i)). Theformulae for calculating payments for PSOs, BSOs,Core, LTC, Specific, Extemp, NPPA A and NPPA BServices remain the same as in Stage 1 (3.2 (a) to (e)but the Service Fee (3.2 (g)) and/or the Multiplier maybe varied (3.2 (h)).Stage 3 – The transition process continues on thesame track. Pharmacies will receive a further reducedTransition Payment (3.3 (f)) with increased Fees forCore Services (3.3 (a) (ii)) and LTC Services (3.3 (b) (ii)).Again, these fees are subject to amendment underthe TCM so their exact levels are currently unknown(3.3 (g)) and again, qualifying pharmacies may receiveQuality Incentive Payments (3.3 (i)). The formulaefor calculating payments for PSOs, BSOs, Core, LTC,Specific, Extemp, NPPA A and NPPA B Servicesremain the same as in Stage 1 and 2 (3.3 (a) to (e) butthe Service fee (3.3 (g)) and/or the Multiplier may bevaried (3.3 (h)).Post Transition – The payment terms for this periodare found in clauses 2.2 to 2.6 and differ from Stage3 only in that there is no provision for TransitionPayments.pharmacy guild of new zealandPage 16
Guide to understanding the PsaA guide to the acronyms and abbreviationsused in this document:ARRCAseptic ServicesBSOCCPClass B CDClozapine ServicesCore ServicesCPAMCPSGGCPSOGDHBEnvelopeExtempFeeLTCLTC Eligibility FormLTC ServicesLTC ProtocolMethadone ServicesMultiplierNPPAPHARMACPSOPSA or AgreementScheduleSpecific ServicesSterile ServicesTCMAge Related Residential CareAseptic Pharmacy ServicesBulk Supply OrderContribution to Cost PressureClass B Controlled DrugPharmacy Clozapine ServicesCore Pharmacy ServicesCommunity Pharmacy Anti-coagulation ManagementCommunity Pharmacy Services Governance GroupCommunity Pharmacy Services Operational GroupDistrict Health BoardAnnual Funding EnvelopeExtemporaneously CompoundedService FeeLong Term ConditionsLTC Service Eligibility Assessment FormLTC Pharmacy ServicesLong Term Conditions (LTC) Pharmacy Services ProtocolPharmacy Methadone Services for Opioid DependenceHandling Fee MultiplierNamed Patient Pharmaceutical AssessmentPharmaceutical Management AgencyPractitioner Supply Order2012 Community Pharmacy Services AgreementNew Zealand Pharmaceutical ScheduleSpecific Pharmacy ServicesSterile Manufacturing ServicesTransitional Change Mechanism.Page 17
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Guide to understanding the PSA - Pharmacy Guild of New Zealand

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