Home Medicines Reviews are aimed at improving the Quality Use of Medicines for eligible Patients who may be at risk of adverse events or need assistance in understanding the best way to use their medicines. A Home Medicines Review is provided by an Accredited Pharmacist in the Patient’s home.

A Home Medicines Review (HMR) is a clinical process that considers the Patient’s medicines and health in order to enhance the Quality Use of Medicines (QUM) and reduce the number of adverse medicines events. A General Practitioner (GP) may request a HMR for their Patient. When a GP provides a referral for an HMR, the Patient has a choice of whether this referral is provided to their usual Community Pharmacy or to another Accredited Pharmacist.

An HMR is a collaborative process between the Patient, their GP, the Accredited Pharmacist, the Patient’s usual Pharmacist (if this is not the Accredited Pharmacist), and other health professionals where relevant.

During the HMR Interview process, the Accredited Pharmacist will aim to improve the Patient’s understanding of their medicines. After the Interview, the Accredited Pharmacist will produce a HMR Report that outlines their findings. The report will be provided to the referring GP, and the Patient may request that the report is also provided to their usual pharmacy. The HMR Report aims to improve the GP’s understanding of how the Patient is using their medicines and provide recommendations that will assist the GP and Patient in developing a medication management plan.

Home Medicines Review Eligibility

Community Pharmacies and business entities that employ an Accredited Pharmacist (including sole traders) may register to become an Approved HMR Service Provider, providing they meet all eligibility requirements and agree to abide the Pharmacy Programs Administrator General Terms and Conditions and the HMR Program Rules.

Applications to register as an HMR Service Provider can be made through the Pharmacy Programs Administrator Portal.

Patients are eligible to participate in a HMR if:

  • They hold a current Medicare card or Department of Veterans’ Affairs (DVA) card
  • They live in a community setting
  • They are at risk of medication misadventure
  • Their GP confirms that there is an identifiable clinical need and they will benefit from an HMR.

A patient is not eligible for an HMR service if they are currently an in-patient at a public hospital, private hospital, day hospital facility, transition care facility or if they are a resident of an Aged Care Facility.

(Also known as Prior Approval)

There are two types of Program Variations that may be requested by the HMR Service Provider.

These are:

  • Location of HMR Interview
  • HMR Interview conducted by a Registered Pharmacist (see details below on each type of Program Variation).

The Approved HMR Service Provider must submit a Program Variation request through the Pharmacy Programs Administrator Portal at least 10 working days prior to the proposed date of the HMR Interview. Requests will be forwarded by the Pharmacy Programs Administrator to the Australian Government Department of Health to assess based on the evidence provided. The Pharmacy Programs Administrator will advise the HMR Service Provider of the outcome via email within seven working days from the date of submission. Additionally, HMR Service Providers will be able to see the approval status of their Program Variation request on the Pharmacy Programs Administrator Portal.

Prior to submitting a Program Variation, the HMR Service Provider must discuss the Program Variation process with the Patient. Consent must be sought from the Patient and Registered Pharmacist (if relevant) for their details to be provided in the Program Variation request to the Australian Government Department of Health and the Pharmacy Programs Administrator.

Approval for an alternative location, or for a Registered Pharmacist to conduct the Interview cannot be provided after the HMR Interview has occurred. In instances where a HMR Interview is conducted in a venue other than the Patient’s home, or with a Pharmacist who is not accredited, and a Program Variation request has not been received and approved, the HMR service will not be remunerated.

Location of Patient Interview

The HMR Interview is a face-to-face interaction between the Accredited Pharmacist and the Patient. This is required to occur in the Patient’s home, except in the following circumstances:

  • For cultural reasons as specified by the Patient
  • If the Accredited Pharmacist has concerns about safety relating to being inside the Patient’s home.

In circumstances where the HMR Interview cannot occur in the Patient’s home, the Service Provider must submit a Program Variation request for an alternative location to be eligible for remuneration under the HMR Program.

Approval will not be granted in instances where an alternative location is sought for the convenience or business practices of the Accredited Pharmacist or their employer.

Interview Conducted by Registered Pharmacist

A Program Variation may also be sought for a Registered Pharmacist to conduct the HMR Interview in the Patient’s home, in the instance where an Accredited Pharmacist is not available to conduct the interview.

Claiming

Approved HMR Service Providers and Accredited Pharmacists are subject to a service cap of 20 HMR services per calendar month. The service cap applies to both the HMR Service Provider claiming the services and the individual Accredited Pharmacist who provides the service.

Claim Submission

Services are claimed online via the Pharmacy Programs Administrator Portal by the end of the next calendar month following the service (e.g. services undertaken in May must be claimed by 30 June). Late claims are not eligible for payment and cannot be resubmitted.

Claims submitted that exceed a HMR Service Provider’s monthly cap of 20 HMR services will not be paid and cannot be resubmitted.

Payments

HMR Service Providers will receive a payment of $219.69 for each eligible HMR service conducted.

The HMR Rural Loading Allowance aims to facilitate access to HMR services for Patients who live in rural or remote areas. During the provision of an HMR service, the Accredited Pharmacist may have to travel significant distances to conduct the HMR Interview in the Patient’s home.

The Rural Loading Allowance funds up to $125 (GST exclusive) to contribute towards the travel costs incurred by the Pharmacist in travelling to the Patient’s home. This Allowance is designed to contribute to the costs involved and may not cover all such costs. Eligibility for the Allowance is based on the location of the Patient.

HMR Rural Loading Allowance Eligibility

In order to apply for the HMR Rural Loading Allowance, the applicant must:

  • Be an Approved HMR Service Provider
  • Have been provided with the signed HMR referral directly from the Patient’s GP
  • Provide the HMR Interview(s) at the Patient(s)’ home, unless Program Variation(s) were requested and approved for the Interview(s) to occur in a different location (see Program Variations above)
  • Provide evidence that the Accredited Pharmacist travelled to the Patient(s)’ home to conduct one or more HMR Interviews, and returned to the original starting address
  • Provide evidence that the round trip undertaken was 200 km or greater
  • Consent to the disclosure of personal information and its use in the evaluation, monitoring and management of the Allowance.

Applying for the Rural Loading Allowance

Service Providers will need to register and apply for the HMR Rural Loading Allowance via the Pharmacy Programs Administrator Portal.

As the Allowance is an initiative of the HMR Program, Service Providers need to register and be approved for the HMR Program in order to be eligible to register and apply for the HMR Rural Loading Allowance.

Home Medicines Review FAQ

  1. The cap for HMRs is 20 per month for both the Service Provider claiming and the Accredited Pharmacist conducting the Service (irrespective of how many Service Providers they provide HMR Services on behalf of).

    Please note that once an Accredited Pharmacist has conducted more than 20 HMRs, additional HMR services they conduct cannot be claimed for, regardless of if the Service Provider making the claim has not yet reached their own Service Provider cap.

  2. Yes, if you are an Accredited Pharmacist.

    You must also have an ABN to register as a Service Provider on the Pharmacy Programs Administrator Portal.

    Remember though, that any Service you perform for another Service Provider will count towards your personal pharmacist cap of 20.

  3. An Accredited Pharmacist must conduct the HMR Service. The same Accredited Pharmacist should conduct the interview, assessment and report writing steps of a HMR Service (unless prior approval has been given for a Registered Pharmacist to conduct the Interview).

  4. The HMR Service Provider in receipt of the referral must lodge the claim for payment.

    This means if you are an Accredited Pharmacist and you intend to claim for the HMR Service as a Sole Trader, the GP referral should be written directly to you.

    A Community Pharmacy or Business Entity (other than a Sole Trader) may claim for a HMR Service performed by any Accredited Pharmacist employed by them, providing the referral was written to the Community Pharmacy or Business Entity (rather than to a specific Accredited Pharmacist).

    For further details on who is eligible to register and claim as a HMR Service Provider please see the HMR Program Rules.

  5. This is up to you and is dependent on how your business is set up.

    If you are all Sole Traders, you may choose to register yourselves separately as individual HMR Service Providers. The monthly cap of 20 HMRs will apply to each individual HMR Service Provider.

    If you are not Sole Traders, you may choose to register yourselves as a HMR Service Provider together as a Business if this is how you operate. There will need to be one main authorised person who will be the only person able to change bank details and contact details of the Service Provider on the Portal. If others in the Business are approved as authorised contacts, they will be able to submit claims on behalf of the Business. Please note the monthly claiming cap of 20 HMRs will still apply to this type of HMR Service Provider, regardless of how many Pharmacists are providing services on behalf of the Service Provider.

    If you are only providing services on behalf of a Community Pharmacy, the Community Pharmacy must register as a HMR Service Provider to submit claims.

  6. Claims are due at the end of the next calendar month after the Service was completed, e.g. a Service completed on 15/02/2019 should be submitted by 31/3/2019.

    For claiming purposes, the Service date entered in the Pharmacy Programs Administrator Portal should be the date you conducted the Patient Interview.

  7. A separate claim entry will need to be made for each individual HMR Service conducted.

    You may choose to wait until you have conducted all HMR Services for that month and submit them all on the same day or you may choose to submit them separately once you have completed each HMR Report.

    This is up to you, so long as each HMR Service is claimed by the end of next calendar month following the date you undertook the Patient Interview.

  8. You have 90 days to complete the HMR Interview; however, if you are unable to perform the Interview within 14 days of receiving the referral you should contact the GP and discuss when the service will happen.

  9. No; however, you will be required to confirm you hold written Patient consent.

    The Patient Consent Form is to be kept on your records for seven years for auditing purposes.

  10. Yes, as the HMR Service consists of a Patient Interview, clinical assessment and written HMR report, the claim can only be submitted if the HMR Report has been sent to the GP.

  11. A Registered Pharmacist can conduct the HMR Interview step of the HMR Service if the Service Provider is unable to source an Accredited Pharmacist to conduct the Interview however, a Program Variation must be requested through the Pharmacy Programs Administrator Portal at least 10 days prior to the Interview.

    If a request is not submitted or a request is submitted and subsequently rejected, and a Registered Pharmacist conducts the Interview, the claim will not be paid.

    An Accredited Pharmacist must still assess the information attained and write the HMR Report.

  12. Yes, where possible, to ensure the effectiveness of the Service the Interview should be held at the Patient’s home.

    If entering the Patient’s home is not possible due to either cultural or safety concerns, then a Program Variation can be requested to complete the Interview outside the home.

    A Program Variation must be requested through the Pharmacy Programs Administrator Portal at least ten days prior to the Interview.

  13. Details about Program Variations (also known as Prior Approvals) can be found in the HMR Program Rules.

    Program Variation requests are required to be submitted through the Pharmacy Programs Administrator Portal at least 10 days before the intended Patient Interview.

    The Pharmacy Programs Administrator will forward this request to the Department.

    The request will be approved or declined and the outcome will be provided to you within seven days of the request being submitted in the Pharmacy Programs Administrator Portal.

    Please note that approval is required before completing the Service and retrospective approval will not be granted.

  14. Yes; however, a request will need to be submitted for both types of Program Variations.

  15. Each Patient is allowed to have a HMR Service once every 24 months. However, if a GP believes that another HMR is clinically necessary within the 24 months, for example in circumstances where there has been a significant change to the Patient’s condition or medication regimen, more Services can be performed and claimed.

    Please note though, that Services are intended to only be conducted when required and must not be triggered solely by an ‘anniversary’ date.

  16. Please refer to the HMR RLA User Guide.

  17. Payments are up to $125 (GST exclusive) for each HMR RLA claim. This is regardless of the distance travelled or number of HMRs performed on your round trip.

  18. No, only an approved HMR Service Provider is able to submit a HMR Service claim; therefore, it must be the same HMR Service Provider who makes the associated HMR RLA claim as this is essentially an extension of the HMR Program.

    If you have conducted the HMR Services but are not making the HMR claims you may need to discuss this with the Service Provider to see if they can submit the HMR RLA claim on your behalf.

  19. No, but you will have to provide tax invoices for your travel. Payments are still up to $125 (GST exclusive) regardless of your mode of transport.

  20. The distance travelled to undertake a HMR Service(s) must be at least 200km as a round trip in order to apply for the HMR RLA.

    The round trip claimed must have been undertaken in order to provide one or more HMR Interviews.

  21. Yes, you may conduct as many as you like (remembering the HMR cap of 20 per month).

    Remember if you have conducted multiple HMR(s) on your trip you will need to enter into your HMR RLA application the associated HMR Service claim ID number(s) for each HMR you conducted.

  22. Yes, to ensure safety the start and end dates of the HMR RLA claim can be on consecutive days, remembering the claim must still be for a round trip.

  23. No, the travel must be a round trip, starting and finishing at the same address.

  24. Yes; however, the flight distance must be at least 350 kms to be eligible for the HMR RLA.

  25. A Patient must be located in a PhARIA 2 to 6 location for a HMR RLA claim to be eligible.

    PhARIA information can be found here.

  26. Yes, if the Patient’s home(s) you are travelling to are located in a PhARIA 2 to 6 location. Eligibility for the Allowance is based on the Patient’s location, not the Service Provider’s location.