Pharmacy Services Agreement 2010 Guide for Guild members

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confidential – for guild members onlyClause Change CommentSchedule H1Payment terms3.2Schedule J1Audit Framework3.2Updated Base Pharmacy Services Fee andMultipliers clause.3.3 Updated Pharmacy servicesand Pharmaceutical payments –General clause.3.6 Inserted Payment calculation for Provisionof Blood Glucose Test Strips clause.The Base Pharmacy Services Fee is $5.30. This is thesame fee as contained in the variation of 1 October 2008,which was an increase from the previous PSA.The table of multipliers has been updated to reflect thepossible inclusion in your Agreement of Special FoodsInfant Formulae Services (multiplier of 1.00) and SterileManufacturing Services (multiplier of 3.00).Updated “Prescription Form” to “Prescription Form, order,or NRT Exchange Card”.Updated the list of Purchase Unit descriptions to includeSpecial Foods Infant Formulae Services and SterileManufacturing Services, and to delete NRT Services.Updated to reflect that NRT services are now part ofBase Pharmacy Services. The payment calculation formulahas not changed.Some pharmacies supply test strips as per the Provision ofBlood Glucose Test Strips Service, rather than as part ofBase Pharmacy Services. This clause will not apply to themajority of members.Payment from the DHB under this service is the cost of thetest strips, plus a 10% mark-up, plus GST. There is nodispensing fee or co-payment.In addition, the provider of this service is able to charge apharmacy charge of $1.50 including GST to the ServiceUser.3.8 Inserted Online Claiming clause. This insertion pulls the online claiming variation that hasbeen rolling out throughout the country into the PSA.4 Deleted Subsidised Nicotine ReplacementTherapy Services clause.Amended Time frames for on-siteAudits clause.After being certified by your DHB and Sector Services asbeing capable of online claiming you are entitled to:1. A one-off payment of $500 plus GST for set-up costs,unless you have already claimed and received a one-offset-up payment previously (eg pharmacies in the metroAuckland area). Note that if you have already begunonline claiming but did not receive a one-off payment,you are now entitled to this payment (eg pharmacies inthe Capital and Coast area).2. A monthly payment of $100 plus GST.NRT Services are now part of Base Pharmacy Services.Subclause (e) inserted:“we will consider and decide upon actions in respectof the Audit report and provide our responses within20 Business Days of receiving it from the Auditor.”PAGE 14
confidential – for – for guild guild members only onlySection Three: PSA 2010 user guideThe purpose of this part of the document is to provide members with a general guide to the structure and requirements ofthe PSA. It is intended to be a useful introduction to members unfamiliar with this or previous PSAs. For members familiarwith previous PSAs “Section Two: Clause-by-clause analysis”, may provide a better starting place for understanding in detailthe changes made in PSA 2010.Layout of the Pharmacy Services AgreementThe layout of the PSA is the same as the previous Agreements since 2003. The PSA is broken up into 16 Parts, followed byfive Schedules. Each Part groups clauses covering similar aspects of the relationship together and each of the correspondingSchedules defines how the requirements of this part of the Agreement operate in practice. For example, Schedule H1 providesmore detail on the payment terms contained in Part H.Many of the individual clauses of the PSA are either identical or very similar to those applying to other primary careproviders. This gives greater commonality in the relationship between the DHB, pharmacies and other health providers, andfacilitates integration and teamwork between services.To help you work your way through the Agreement, the contents of each of the Parts and Schedules of the Agreement are:Part or Schedule Name Summary of section contentsPart A Guide to this Agreement General summary of the PSA and respectiveresponsibilities.Part B Key terms and execution of this Agreement Duration and term of the PSA, linkage to thePharmaceutical Schedule, the Data Specification and theProcedures Manual.Part C Summary of services to be provided Outline of Services, patient eligibility rules, and servicelocation rules.Part D General purposes and principles Purpose of the Agreement, service delivery principles andrelationship principles.Part E Definitions and construction Definitions for terms used in the PSA, and rules coveringthe construction of the PSA.Part F Maori health and other population groups Management of Maori health and other population grouphealth issues.Part G Quality specifications Quality management requirements and systems, serviceuser rights, access to services and service criteria.Part HPayment for services and Pharmaceuticals,claiming procedure and payment termsPayment for services, claiming dates, charges to patients,unnecessary dispensing, claim information, claim rejection,payment time frames, interest on late payment, and accessto records.Part I Meetings, reporting, and information Calling meetings between the parties and ad hocinformation requests.Part J Audits Purpose of audit, requirements and Advisory Committeematters.Part K Dispute resolution Dispute resolution process and use of facilitatednegotiation during PSA renewal or variation.Part L Variation of Agreement Reasons for varying the PSA, procedures for varying thePSA and renewal and consultation on future Agreements.PAGE 15
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Pharmacy Services Agreement 2010 Guide for Guild members

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