15 May, 2020

COVID-19 NACCHO Medicines and Pharmacy Update May 15, 2020

Medicine Review Changes

Over the past weeks, there have been several changes to improve how ACCHO clients can receive medicines reviews.  These changes are summarised below and include enabling telehealth delivery of medicines reviews, funding pharmacist follow-ups after the initial review, increasing the number of Home Medicine Reviews (HMRs) pharmacists can do, updating medicines review guidelines and broadening who can initiate a medicines review.

Telehealth medicines reviews – HMRs, RMMRs and MedsChecks

Pharmacists can now deliver the following medicines reviews via telehealth:

  • Home Medicines Reviews (HMRs)
  • Residential Medication Management Reviews (RMMRs)
  • MedsChecks and Diabetes MedsChecks. 

Patients who meet the criteria as being vulnerable to COVID-19, such as people with a chronic disease or Aboriginal or Torres Strait Islander people over 50, can receive a medicines review without a face-to-face consultation with a pharmacist. This is a temporary measure in response to the COVID-19 pandemic.  

Extension of monthly cap to 30 HMRs

The monthly cap on individual pharmacists providing HMRs has been lifted from 20 to 30. This should allow more Aboriginal and Torres Strait Islander patients to access HMRs, where limited access to accredited pharmacists has been a barrier. The measure may improve the longer-term viability for accredited pharmacist to work with ACCHOs and travel to rural or remote areas to conduct face to face medicines reviews.

New ‘Guidelines for comprehensive medication management reviews’

The Pharmaceutical Society of Australia (PSA) has recently updated guidelines that outline best practice for pharmacists providing comprehensive medicines reviews (e.g. HMRs). They consider recent medicines review program changes, emerging pharmacist practice settings (e.g. reviews conducted within ACCHOs) and specifically address pharmacists’ collaboration and follow-up activities.

Follow up services

After receiving an HMR or RMMR, clients can now receive up to two funded follow up appointments with the pharmacist, within nine months of the initial review.  During the follow up service the pharmacist can revisit and address medication-related issues that were identified at the initial review. More details on HMR follow up services can be found here.

Referrals for HMRs and RMMRs by non-GP medical practitioners

Program rules now allow medical practitioners to refer clients for HMRs and RMMRs.  Previously on GP could make this referral.  For example, an aged care specialist could refer a client for a medication review when a GP is unavailable.

MBS item 900 is not available via telehealth

Currently the MBS item 900 allowing primary care services to claim a payment for HMRs (in addition to the pharmacist payment) is not listed on the COVID-19 telehealth list.  NACCHO continues to seek an amendment to this measure to allow GPs to be able to claim MBS item 900 via telehealth during the COVID-19 crisis to enable continuation of this essential service. HMR referrals to pharmacists are valid for 3 months and there is no fixed time limit on the GP follow up period. ACCHOs may consider how time spent following up an HMR via telehealth may be claimable under other MBS telehealth consultations, in cases where item 900 cannot be claimed.