Phased Dispensing Rules 2017

If you have attended any of our classes to date you will remember that  I had explained to you that “phasing” which is done on the GMS only is going through a lot of changes at the moment , and now a bigger change has occurred. The HSE has decided to change the ways a pharmacist may be allowed to claim a phased prescription dispensing fee for a patient  and how patients will be able to qualify for the phased dispensing

 

During the class I would have explained the financial incentives for a pharmacist to phase a prescription on the GMS and how this had led to what the HSE views as abuse of the system. Most pharmacists offer a blister packing service and the fees from phased dispensing are usually used to cover the costs and manpower required to provide this service , so this will be very disruptive to a lot of pharmacies .  The new rules will affect new patients who are getting their prescriptions filled from the 1st of May. The new rules will apply when the reason for a phased is either

 

• At the request  of a patient’s physician
• In exceptional circumstances where  the  patient is incapable of safely and effectively managing  the  medication regimen ( requested by the pharmacist)

 

All patients effectively who get their medicines phased will be subject to pre-approval before the HSE pays out the extra dispensing fee if the reasons indicated are one of the two above (usually from the drop down menu on the computer system) , initially it will be focused on new patients but after a period of time ( not yet specified ) all patients including those who are currently being phased will be subject to the same rules . So how will it work ?

 

Approval must be sought using the pharmacy application  suite on the PCRS website ( this is like the pharmacy’s account page on the PCRS website but can only be accessed usually from the pharmacy computer ) . A new link will be put up which will be specifically for phased dispensing called the phased dispensing approval requests. Pharmacists must then insert the medical card number of the patient and then also indicated the reason , if it is at the request of the physician or where the patient can’t manage .

 

For cases where the reason indicated is at the request of the prescriber , the prescription will first have to have the phased dispensing instructions written on by the prescriber i.e phased dispensing  . If this is done the pharmacist will also then need to scan a copy of that prescription or take a photograph and attach it to that person’s file on the pharmacy suite. It is still unclear how often a pharmacist will have to carry out the step but the GP also has the option of applying for a phased request on behalf of the patient if he does not want to write the phased instructions on the prescription and this will be available for pharmacists to view on the pharmacy suite using the patient’s medical card number. It should be noted that if a GP applies on behalf of a patient , it is automatically approved .

 

 

If the pharmacist decides that the patient has to be phased because they can not manage the road to approval is slightly different and all of these criteria must be met

 

• Patient is  over 80 years
• Patient is  on  one or more  psychotropic  medicines  (with  the  5 digit codes of  the relevant medicines provided)
• Patient is  on  5 or more oral medicines in a month

 

As well as the following information provided

• PSI Registration of Pharmacist  conducting the assessment
• Date of Pharmacist assessment of patient

 

If one or  more of the above confirmations cannot be  provided, the  application  will require further assessment and  it  may be  24 hours (Monday  to Friday, or the first  working day  after a weekend) before approval or non-approval  will be  communicated back  to the  pharmacy  by the PCRS through the application suite.  While  the application is  under  consideration, pending will be  displayed  on the  screen.

 

What to do in times of non-approval :

 

If an application for a phased dispensing service is  Not Approved, and the Pharmacist wishes to appeal the HSE decision in  this regard, an  appeal  can be registered by  the  pharmacist  by providing additional information on the patient’s particular  circumstances  to  the HSE Pharmacist in  whose operational area of  responsibility the  pharmacy is located.  The  quickest mechanism for approval in these  circumstances  would be where  the  patient’s GP  also believes that  the  patient  cannot safely  and effectively manage  their medication regimen, in which circumstance, if the GP  submits the patient’s Medical Card  Number a  phased dispensing  service will  be  automatically  approved.
This has not come into effect yet so expect some teething problems as usual with .

 

As a locum pharmacist the main things to be aware of right now is that from May if a patient has not being phased in the month prior approval will be required for the HSE to pay out the phased dispensing fee and this approval will be able to be found on the pharmacy suite of PCRS website . You will need to ask staff that work there for details  or highlight it to the regular pharmacist with a note if they do not have the login details .