Remote Area Aboriginal Health Services (RAAHS or AHS) and the Pharmaceutical Benefits Scheme
RAAHS provide eligible Pharmaceutical Benefits Scheme (PBS) medicines for free to patients in remote areas.
Under section 100 (s100) of the National Health Act 1953, patients of approved RAAHS, also known as AHS, can get eligible PBS medicines from an approved AHS for free. Patients can still get PBS medicines by taking a prescription to an approved pharmacy under standard PBS arrangements.
The Department of Health is responsible for approving AHS participation in the s100 RAAHS program. For more information on AHS participation and approval, contact the Department of Health.
We provide approved AHS with a registration number following approval. The registration number must be used on all correspondence, including requests for pharmaceutical supplies.
How to order supplies of PBS medicines
An approved AHS must choose approved suppliers to provide PBS medicines. Approved suppliers are community or hospital pharmacies authorised under section 90 or section 94 of the National Health Act 1953 to supply PBS medicines.
Requests for eligible PBS medicines must be submitted to the approved supplier on an Aboriginal Health Services (AHS) pharmaceutical supplies request and claim form. Approved suppliers also use this form for claiming.
Electronic order form
If you’re an approved AHS, you can develop your own electronic order form and will need to request approval of your electronic order form by emailing us.
The form must:
- display a header that includes the AHS registration number, the name of the AHS and address
- display a footer that includes the approved supplier’s pharmacy approval number, claim reference number and page number
- include all the columns in the requested items section of the Aboriginal Health Services (AHS) pharmaceutical supplies request and claim form
If you have a previously approved electronic order form, it must be updated for the s100 RAAHS Patient Specific Medicine Supply Fee (PSMSF) to be claimed. To request approval of your updated electronic order form email us.
When you submit your electronic order form for claiming, make sure you:
- use the Aboriginal Health Services (AHS) pharmaceutical supplies request and claim form as a cover sheet
- write across the requested items section ‘please see attached order lists’, and complete all details and declarations in the form
Medicines not available under Aboriginal Health Service arrangements
All medicines contained in section 2 of the Schedule of Pharmaceutical Benefits are available under these arrangements, except:
- extemporaneously prepared items
- highly specialised drugs
- emergency drug (doctor’s bag) supplies
- Repatriation PBS medicines
- Schedule 8 medicines as defined by the drugs and poisons legislation in the relevant state or territory
Schedule 8 or extemporaneously prepared medicine must be prescribed on an approved prescription form and dispensed under standard PBS arrangements.
For a detailed listing of PBS medicines, go to the Schedule of Pharmaceutical Benefits on the Department of Health website.
Completing an order form
You must include the following details on the Aboriginal Health Services (AHS) pharmaceutical supplies request and claim form:
- AHS registration number
- AHS community name and address
- name and signature of the authorised person requesting pharmaceutical supplies. An authorised person is a health professional who’s employed or contracted by the AHS and is qualified to supply all medicines covered by these arrangements
AHS and approved suppliers complete different columns in section 4 of the form.
|Section 4 - Items requested columns||To be completed by|
Identifies how many items are listed in the claim for payment to be lodged with us.
Identifies the PBS medicine using the item code from the Schedule of Pharmaceutical Benefits.
|AHS or approved supplier|
Identifies the brand of PBS medicine using the manufacturer's code from the Schedule of Pharmaceutical Benefits. If a generic brand is suitable, the manufacturer's code can be left blank.
|AHS or approved supplier|
Descriptions of goods: item, form and strength
Describes the PBS medicine. The approved supplier can use this information to confirm that the item code matches the description. The description must contain enough detail to identify the item. For example:
To order the quantity required. Under the arrangements, medicines are ordered in multiples of the PBS maximum quantity, as set out in the Schedule.For example, if the medicine has a PBS maximum quantity of 30 capsules and the approved AHS needs 90 capsules total, the quantity required for supply is 3. Broken packs can't be ordered.
To confirm the quantity supplied to the AHS. If the quantity ordered is different from the quantity supplied, the variation is shown in this column.
Subset quantity supplied for an individual (if applicable)
To confirm the quantity of PBS medicine labelled and prepared for an individual patient.
Total number of items supplied for an individual for this claim
This is the total of the subset quantity supplied for an individual column.
Approved supplier’s claims for payment
The approved supplier must claim reimbursement from us by submitting a completed Aboriginal Health Services (AHS) pharmaceutical supplies request and claim form.
You need to separate claim packages by community name. Where there are multiple supply dates for a single community, claims need to be separated by date order and claim reference number.
For each PBS medicine supplied in bulk to an approved AHS under these arrangements, you’ll be paid the sum of:
- the approved price to pharmacist
- an amount equal to the administration, handling and infrastructure fee
- a handling fee of $3.12.
Incomplete claims, incorrect claims or electronic order forms that haven’t been approved by us will be returned. This may delay your claim or payment.
RAAHS patient specific medicine supply fee (PSMSF)
From 1 January 2018 we’ll pay eligible pharmacies the s100 RAAHS PSMSF. This fee is for each PBS medicine ordered on a RAAHS prescription and labelled for an individual patient for supply through an approved AHS. This is in addition to the handling fee paid to eligible pharmacies for the supply of bulk PBS medicines to an approved AHS.
The s100 RAAHS PSMSF is $4.91 for each PBS medicine labelled for an individual patient for supply through an approved AHS, on or after 1 July 2020.
Claims for payment of the s100 RAAHS PSMSF for pharmaceutical benefits provided before 1 January 2018 must be sent to the Pharmacy Guild of Australia.
Payments to approved suppliers
Approved AHS claims are paid by electronic funds transfer.
To register or update your bank account details for AHS payments, complete the Notification of Bank Account Details for Aboriginal Health Services program payments form.
For more information about eligibility criteria and approval of AHS, contact the Department of Health.
For more information about claiming and the supply of PBS medicines, contact us.
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Page last updated: 1 July 2020
This information was printed 2 December 2020 from https://www.servicesaustralia.gov.au/organisations/health-professionals/services/medicare/remote-area-aboriginal-health-services-raahs-or-ahs-and-pharmaceutical-benefits-scheme. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.