New resources for GPs – Closing Gap PBS co-payment program changes

Australian Medical Association

New resources are available for GPs about the changes to the Closing the Gap (CTG) PBS Co-payment program due to take effect on 1 July 2021.

The CTG PBS Co-payment program was established in July 2010 to improve access to affordable PBS medicines for Aboriginal and Torres Strait Islander people living with, or at risk of, chronic disease, and who in their doctor’s opinion would experience setbacks in the prevention or ongoing management of chronic disease if they did not take the prescribed medicine and would be unlikely to adhere to their medicines regimen without assistance through the program.

Changes include:

  • A new centralised patient registration database for the program, managed by Services Australia.

  • Any PBS prescriber or AHPRA registered Aboriginal and Torres Strait Islander Health Practitioner registered with Medicare as a provider can register eligible Aboriginal and Torres Strait Islander people for the program.

  • Eligible Aboriginal and Torres Strait Islander people can be registered for the program no matter where they live, and regardless of their chronic disease status.

  • Registration of eligible Aboriginal and Torres Strait Islander people will be via the Health Professional Online Services (HPOS).

  • This registration will cover Aboriginal and Torres Strait Islander people even if they move to a different health clinic.

  • PBS prescribers will no longer be legally required to write or electronically print ‘CTG’ on eligible PBS prescriptions for registered Aboriginal and Torres Strait Islander people. However, annotation of a PBS script will help community and Section 94 Approved Private Hospital pharmacists, when dispensing the medicines, know that the patient is registered for the program.

  • Any PBS prescriber can issue PBS General Schedule medicine prescriptions for Aboriginal and Torres Strait Islander people that are registered for the program.

  • PBS prescriptions issued by PBS prescribers within public hospitals will now be eligible to be dispensed by any community pharmacy or Section 94 Approved Private Hospital pharmacy.

  • If Aboriginal and Torres Strait Islander people are registered for the program the PBS Online claiming system will verify this in real time. If the “Closing The Gap’ field in the dispensing system has been completed, this will trigger the correct pricing. If that field has not been completed, a claim will be rejected and will need to be resubmitted.

Download Frequently Asked Questions and the fact sheet for Prescribers, Aboriginal and Torres Strait Islander Health Practitioners and Peak Bodies attached to this page.

/AMA/AusMed News. View in full here.