NSW s100 HSD Co-Payment Program

To be eligible a patient must:

• Be NSW residents.
• Be patients of a NSW public hospital or an authorised NSW community prescriber.
• Be prescribed eligible Section 100 HSD Community Access medicines.
• Present a completed NSW 3-Year Patient Consent Form to the pharmacy when receiving their medicine.

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 New South Wales Health, Section 90 approved NSW community pharmacies must create a user account to access to the online claiming portal.

Claims will either be submitted by uploading the S100 HSD Claim Template (maximum of 100 claims) or by entering the dispensing details directly into the online claiming portal (maximum of 10 claims).

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.