6th community pharmacy agreement Flashcards
What are some examples of community pharmacy programs? Briefly describe what they entail.
Medication adherence programs or Pharmacy Practice Incentives (PPIs)
- DAAs
- Staged supply
- Clinical interventions
Medication management programs
- Home Medicines reviews
- Residential Medication Management reviews
- MedsChecks and Diabetes MedsChecks
Rural support programs
- Rural Pharmacy workforce program
- Rural pharmacy maintenance allowance
Aboriginal and Torres Strait Islander Programs
eHealth
- Electronic prescription fee
What does a community pharmacy need to have to be eligible to receive payments for DAA, staged supply or CI programs?
- be approved under Section 90 of the National Health Act
- be accredited by an approved Pharmacy Accreditation Program such as the Quality Care Pharmacy Program (QCPP)
- agree to publicly display and comply with the Community Pharmacy Service Charter and Customer Service Statement
- abide by the 6CPA General Terms and Conditions
- register for the program via the 6CPA Registration and Claiming Portal
What is required for recording keeping and auditing for 6CPA programs? How LONG must record be kept? who is responsible for auditing 6CPA programs?
- Service Providers participating in 6CPA Programs must keep all relevant records for seven (7) years, inclusive of service records, claim records and patient information for Program evaluation. The records may be electronic or hard copy
- The Department of Health is responsible for auditing 6CPA Programs. Anomalies observed by the 6CPA Administrator will be reported to the Department. If an audit is conducted, the Service Provider will be required to produce supporting documentation within a specified timeframe. Service Providers found to be in breach of the Program Rules may be subject to harsh penalties.
For Dose administration aids (DAAs);
A) What is it?
B) What do patients need to have to get DAA?
C) What is the remuneration community pharmacies get?
D) What info do pharmacies have to provide to the 6CPA administrator to get fees?
A)
A well-sealed, tamper-evident device that allows individual medicine doses to be organised according to the prescribed dose schedule
B)
- Have a Medicare Card and/or Department of Veterans’ Affairs (DVA)
- Hold a current government issued concession card
- Live at home in a community setting and have difficulties managing their medications due to literacy or physical disability
- taking five or more prescription medicines and is experiencing difficulties with medication management
C)
- Community pharmacies participating in the DAA program receive a fee of $6 per patient per week as a contribution towards the cost of providing the service to patients that meet the eligibility criteria (monthly claims)
D)
- Section 90 approval number
- Pharmacy Accreditation ID
- Patient’s Medicare/DVA Card Number
- Date(s) of provision of the DAA
For staged supply;
A) What does it mean?
B) What does a patient have to do to get it?
C) What remuneration do pharmacists get?
A)
supply of PBS medicines in quantities less than the prescribed amount, at agreed intervals, with the balance of quantity being held by the pharmacy
- Requested by the prescriber
- Installments may be daily, weekly, or as otherwise agreed with the prescriber
- Excludes medicines supplied under the Section 100 Opioid Dependence Treatment Program
- Claims sent in monthly
B)
- Be a Medicare and/or DVA cardholder
- Be living at home in a community setting
- Hold a current government issued concession card
- Be referred by a prescriber
- Be prescribed medicine from some PBS categories such as opioid analgesics, antidepressants and others
C)
- $7.90 for the Provision of the first Staged Supply service undertaken each week (this will be the first time the patient picks up their medicine each week)
- $4.00 for each additional time the patient receives a Staged Supply Service during the week per patient
- The service is capped at four patients per community pharmacy
For Clinical intervention (CIs);
A) What does it mean?
B) How to classify it? What are some recommendations after the problem has been classified?
C) What should pharmacists document for CIs
D) What remuneration do pharmacists get?
E) What other professional pharmacy services may it identify?
A)
- Identify, resolve and document drug-related problems that are identified with community pharmacy to improve patient health outcomes the quality use of medicines
- any professional activity by the pharmacist directed towards improving the quality use of medicines and resulting in a change in the patient’s medication therapy, means of administration or medication taking behaviour
B)
Drug-related problem (DRP)
classified by DOCUMENT
- Drug selection
- Over or under dose
- Compliance
- Undertreated
- Monitoring
- Education
- Not classified
- Toxicity or adverse reaction
Recommendations: change of therapy, referral required, provision of information, monitoring
C)
- date of the intervention
- drugs involved, including those central to the DRP, and any recommendations for the resolution of the DRP (strengths and doses of medicines should also be recorded where possible)
- consumer details, including age range and gender
- any communication with the consumer’s prescriber
- DOCUMENT and recommendation codes to classify the DRP and clinical intervention
- consumer history (clinical) notes, including any follow-up, outcomes or resolution details
D)
- Complicated calculation for remuneration received per clinical intervention based on the number of CI services and pharmacy size (e.g. prescription volume)
- A CI must relate to a medicine and must be recorded using the D.O.C.U.M.E.N.T. classification system
E)
See attached image
What are some examples of medication management programs?
- Home medicines review (HMR)
Comprehensive clinical review of a patient’s medicines in their home by an accredited pharmacist on referral from the patient’s general practitioner (GP
- Residential Medication Management Reviews (RMMR) and QUM
- MedsChecks and Diabetes MedsChecks
What is the process for medscheck?
- Identify need
- Obtain consent
- Medication reconciliation
- Consultation
> Pharmacist is not responsible for dispending or undertaking other professional duties during consultation
> Obtain and verify all necessary medication information
> Agree to follow-up actions and date of follow-up
> Six monthly follow-up
- Documentation
> Action plan
> Medication profile
- Communication
For MedsChecks and Diabetes MedsChecks;
A) What does a pharmacy need to do to have eligibility
B) What does a patient need to do have eligibility for Med Checks
C) What does a patient need to do have eligibility for Diabetes Med Checks
A)
- Approved under Section 90 of the National Health Act and services must be conducted in an area defined with the Program Rules
- Abide by the 6CPA General Terms and Conditions
- Deliver the services in accordance with the most current version of the 6CPA MedsCheck and Diabetes MedsCheck Program Rules and relevant Professional Standard
B)
- be a Medicare and/or Department of Veterans’ Affairs (DVA) cardholder
- have not received a MedsCheck, Diabetes MedsCheck, Home Medicines Review (HMR) or Residential Medication Management Review (RMMR) in the last 12 months
- be living at home in a community setting
- be taking five or more prescription medicines;
- has had a recent significant medical event. or
- is taking a medication associated with a high risk of adverse events
C)
- be a Medicare and/or Department of Veterans’ Affairs (DVA) cardholder
- have not received a MedsCheck, Diabetes MedsCheck, Home Medicines Review (HMR) or Residential Medication Management Review (RMMR) in the last 12 months
- be living at home in a community setting
- is unable to gain timely access to existing diabetes education/health services in their community
- has recently been diagnosed with type 2 diabetes (in the last 12 months)
- or has less than ideally controlled type 2 diabetes
What information must be retained for seven years for pharmacy medscheck records
- Section 90 number at the time of the provision of the service
- Pharmacy accreditation ID at the time of the provision of the service
- Copy of the patient consent form, where relevant
- Patient’s name and address
- Patient’s Medicare/DVA card number
- Record of how the patient has satisfied eligibility criteria
- List of all prescription and non-prescription medicines the patient is taking at the time when the MedsCheck, Diabetes MedsCheck or follow-up service is provided
- A copy of the action plan developed as a result of the service
- Date of patient consultation for the MedsCheck, Diabetes MedsCheck or follow up service
What remuneration do pharmacists receive for meds check and diabetes meds check services? Whats the max number allowed in a month?
- $64.70 MedsCheck service
- $97.05 Diabetes MedsCheck service
Each approved Service Provider may conduct and claim up to a total of twenty (20) MedsCheck services (MedsCheck and Diabetes MedsCheck) in any calendar month
Pharmacies are required to collect and provide data to the 6CPA administrator (through the 6CPA Registration and Claiming Portal. What remuneration do phamacies get for doing this audit? Provide asnwers for DAA, stage supply and meds checks.
- DAA: Collect data for five patients that receive services at baseline and at six months. Receive $31.90 per patient, per time point.
- Stage supply: Collect data for four patients that receive services at baseline and at six months. Receive $31.90 (Ex GST) per patient, per time point
- MedsChecks: Receive $31.90 (Ex GST) per patient, per time point
What are the FOUR pillars of pharmacy practice
- Professional services
- Law, ethics and professionalism
Privacy and confidentiality: “Pharmacists must respect and safeguard the consumer’s privacy and confidentiality at all times, particularly in relation to information acquired in the course of providing professional services”
- Communication
Building trusting relationships: “To perform clinical interventions in an efficient manner, it is critical to have effective collaboration with, and communication between, relevant members of the healthcare team, including GPs, medical specialists, other pharmacists, consumers, carers, nurses and other healthcare providers
- Medication safety
The objective of all professional services are to improve the quality use of medicine
