NSW s100 HSD Co-Payment Program

To be eligible a patient must:

• be NSW residents who are patients of a NSW public hospital or a NSW authorised community prescriber
• be prescribed s100 HSD Community Access drugs (excluding opioid dependence medicines)
• hold a valid 3 Year Patient Consent Form signed by both the prescriber and the patient
• present the 3 Year Consent Form at a NSW community pharmacy at every dispensing

The NSW Government pays co-payments for a wide range of s100 drugs and medicines. However, the Program administered by the Guild pays only the co-payments of s100HSD Community Access scheduled drugs (excluding opioid dependence medicines) dispensed at NSW Community Pharmacies.

s100 HSD Community Access scheduled drugs include, for example:

• Entecavir
• Tenofovir
• Clozapine

Claiming

To submit s100 co-payment claims and receive re-imbursement from NSW Health, Section 90 approved NSW community pharmacies must create a user account to access to the online claiming portal.

The pharmacy then uses the S100 HSD Claim Template to claim any waived co-payments when eligible patients present a completed 3 Year Patient Consent Form with their prescriptions.

Payments

In addition to the cost of the co-payment for eligible patients, pharmacies are paid a service fee for the work associated with submitting claims on behalf of patients.

The fees are $2.23 (incl GST) for each co-payment claimed and a one-off monthly administration fee of $13.42 (incl GST) for the first claim made each month.