Residential Medication Management Review and Quality Use of Medicines

The intent of the Residential Medication Management Review and Quality Use of Medicines (RMMR) Program is to support the quality use of medicines and assist minimising adverse medicine events for people living in approved Australian Government-funded Aged Care Facilities through medication reviews conducted by Credentialed Pharmacists in the aged care facility.

The Quality Use of Medicines (QUM) Program supports the delivery of services and activities by pharmacists aimed at supporting the quality use of medicines, including the safe use of medicines, within Australian Government-funded Aged Care Facilities.

Further extension of transition period for Medication Management Review Credentialed Pharmacists
The Department of Health and Aged Care has confirmed the current transition period for Medication Management Review Credentialed (previously known as accredited) Pharmacists will be further extended to 30 June 2025, or until an updated MRN has been issued as a result of undertaking an Australian Pharmacy Council accredited Medication Management Review recognition of prior learning process or training program– whichever occurs sooner. Additional information can be found in the FAQ section of this page and in the PPA Website update posted on 30 April 2024. 

A Residential Medication Management Review (RMMR) is a service provided to an eligible Patient residing in an eligible Australian Government-funded Residential Care Facility with the intended purpose of identifying, resolving, and preventing medication-related problems.

A Pharmacist credentialed to provide RMMR services will conduct a RMMR for a Patient when requested to do so by the Patient’s Referring Medical Practitioner. This review will be conducted in collaboration with the Patient’s Referring Medical Practitioner and appropriate members of their healthcare team.

The RMMR consists of a comprehensive assessment of the Patient’s medications and medication-related healthcare interventions.

After the initial Interview, the Credentialed Pharmacist will provide a RMMR Report to the Referrer for consideration of the issues raised. The Report should also be uploaded to the Patient’s My Health Record (if the patient has one).

If clinically indicated, up to two follow-up service(s) can be conducted, with a focus on the resolution of medication-related problems identified at the initial Interview.

If required, a first face-to-face follow-up Interview should be undertaken no earlier than one month and no later than nine months after the initial Interview.

If a second face-to-face follow-up Interview is required, it should be undertaken no earlier than one month after the first follow-up Interview and no later than nine months after the initial Interview.

An indication of whether follow-up service(s) are required should be included in the RMMR Report following the initial Patient Interview.

The Quality Use of Medicines (QUM) Service is a separate service provided by a Registered or Credentialed Pharmacist. A QUM Service is designed to improve procedures and practices related to Quality Use of Medicines within Australian Government-funded Facilities.

RMMR

S90 Community Pharmacies and business entities that have a relationship with a Credentialed Pharmacist (including sole traders) may register to become an Approved Service Provider, providing they meet all eligibility requirements and agree to abide by the Pharmacy Programs Administrator General Terms and Conditions and undertake RMMR Services in accordance with the RMMR Program Rules and the Guidelines for Comprehensive Medication Management Reviews (PSA Standards).

They must have in place a current RMMR Service Agreement with an eligible Australian Government-funded Residential Care Facility that sets out the provision of RMMR services to that Facility. Service Providers can register for the Program on the Pharmacy Programs Administrator Portal.

Patients are eligible to participate in a RMMR if they meet the following eligibility criteria:

  • They are a current Medicare or Department of Veterans’ Affairs (DVA) cardholder
  • They are currently experiencing, or at risk of experiencing, medication misadventure
  • The Referring Medical Professional confirms that there is an identifiable clinical need for the Patient to have a RMMR Service
  • The Patient is:
    • A permanent resident of an Australian Government-funded Aged Care Facility as defined by the Aged Care Act 1997; or
    • A permanent resident of a Multi-Purpose Service Facility; or
    • A permanent resident in a facility receiving funding under the National Aboriginal and Torres Strait Islander Flexible Aged Care program; or
    • A resident in an Australian Government-funded Transition Care Facility for more than 14 consecutive days.

Full participation requirements are outlined in the RMMR Program Rules.

QUM

S90 Community Pharmacies and business entities that have a relationship with a Credentialed Pharmacist or Registered Pharmacist (including sole traders) may register to become an Approved Service Provider, providing they meet all eligibility requirements and agree to abide by the Pharmacy Programs Administrator General Terms and Conditions and undertake QUM Services in accordance with the QUM Program Rules and the Guidelines for Quality Use of Medicines Services (PSA Standards).

They must have in place a current valid QUM Service Agreement with an eligible Australian Government-funded Residential Care Facility that sets out the provision of QUM Services to that Facility. Service Providers can register for the Program on the Pharmacy Programs Administrator Portal.

Full participation requirements are outlined in the QUM Program Rules.

RMMR and QUM Contract Verification

A copy of a completed Service Agreement between the Service Provider and the Facility must be supplied to the Pharmacy Program Administrator for verification in order to claim for RMMR and QUM Services. These must be submitted online via the Pharmacy Programs Administrator Portal. The Pharmacy Program Administrator must be notified if the contract between the Service Provider and the Facility is cancelled or expires.

RMMR Claim Submission

RMMR initial services and follow-up services must be claimed via the Pharmacy Programs Administrator Portal by the end of the next calendar month after the initial Interview or follow-up Interview was conducted (e.g. Interviews undertaken in March must be claimed by 30 April).

Claims that are outside this timeframe, that are incomplete, or that do not meet Program Rules cannot be submitted and will not be paid.

QUM Claim Submission

The QUM Service fee is paid to Service Providers quarterly in arrears. The quarterly period commences on the date the Service Agreement between the eligible Facility and the Service Provider is signed.

Claims for QUM Services provided must be claimed by the end of the next calendar month following the last day of the claiming quarter (e.g. a quarter that ends on 14 March must be claimed by 30 April).

Claims that are outside this timeframe, that are incomplete, or that do not meet Program Rules cannot be submitted and will not be paid.

RMMR Payments

Description Fee (per patient)
Provision of initial RMMR Service (includes the initial Interview, assessment and RMMR Report)  $112.65
First follow-up service $56.33
Second follow-up service $28.16

QUM Payments

Pharmacists who provide QUM Services to an approved Facility must provide at least two QUM activities each quarter. This entitles the Service Provider to claim a base payment of $125 plus $12.50 per eligible aged care bed within the Facility each quarter.

Accreditation Transition Process FAQ

  1. Pharmacists currently using an active AACP MRN (Medication Review Number) issued prior to the closure of AACP will have until 30 June 2025 to select a new education provider to transfer to. These pharmacists may continue to use their AACP MRN in the PPA Portal until 30 June 2025, or until an updated MRN has been issued as a result of completing an Australian Pharmacy Council (APC) accredited Medication Management Review (MMR) recognition of prior learning (RPL) process or training program, whichever occurs sooner. Education providers with an APC accredited MMR training program are considered as recognised education providers for the purpose of this FAQ. Further details can be found on the APC webpage.

    All pharmacists seeking to continue claiming HMR and RMMR services on the PPA Portal beyond 30 June 2025 will need to select a recognised education provider and ensure their transfer has been completed by this date.

  2. Pharmacists previously using an active AACP MRN issued prior to the closure of AACP who have transferred to either ACP or PSA will continue to use their AACP MRN in the PPA Portal until either 30 June 2025, or until an updated MRN has been issued as a result of completing an APC accredited MMR recognition of prior learning process or training program, whichever occurs sooner.

    Pharmacists will not be able to continue using their AACP MRN in the PPA Portal once they have received their new MRN from a recognised education provider.

  3. Pharmacists previously using an active AACP MRN who have transferred to SHPA will need to use their new SHPA number in the PPA Portal until either 30 June 2025, or until an updated MRN has been issued as a result of completing an APC accredited MMR recognition of prior learning process or training program, whichever occurs sooner.

    Pharmacists will not be able to continue using their AACP MRN in the PPA Portal once they have received their new credential number from SHPA.

  4. ACP/PSA will continue to provide pharmacists with an AACP MRN to use in the PPA Portal until 30 June 2025 or until they become a recognised education provider, whichever occurs first.

    Pharmacists will have a new MRN issued to them as a result of completing an APC accredited MMR recognition of prior learning process or training program. Pharmacists will not be able to continue using their AACP MRN in the PPA Portal once they have received their new MRN from a recognised education provider.

    SHPA will provide pharmacists with a SHPA specific number to use in the PPA Portal until 30 June 2025, for HMR/RMMR claiming.

  5. Yes. Pharmacists will be able to use their ACP/PSA/SHPA details in the PPA Portal until 30 June 2025, or until an updated MRN has been issued as a result of completing an APC accredited MMR recognition of prior learning process or training program, whichever occurs sooner.

  6. If your accreditation MRN is valid, this will remain valid until 30 June 2025. If your current education provider does not offer an APC accredited MMR training program, a recognised education provider will need to be sought and an APC accredited MMR recognition of prior learning process or training program will need to be completed by 30 June 2025.

  7. Where a pharmacist has changed providers and been given a new MRN they will need to use this number in the PPA Portal for HMR/RMMR claiming purposes. This is because providers send lists of their pharmacist members and their MRN to PPA. Once these lists are uploaded into the PPA Portal any older MRN under an old provider becomes de-activated and can no longer be used to claim.

Residential Medication Management Review FAQ

  1. No. However, you will need to keep the patient consent form on your records for seven years for auditing purposes.

  2. The consent form should be signed by the Patient receiving the RMMR service, or if the Patient is unable to sign for themselves, by someone who has the legal authority to sign on the Patient’s behalf (for example, a guardian or a person appointed under an enduring power of attorney or otherwise authorised to give this consent in your State or Territory).  Please note, the Director of Nursing or Facility administrator is not able to sign the consent form, unless they specifically hold the legal authority to do so in accordance with the laws in the relevant State or Territory.

  3. No. The consent form signed before the initial Patient Interview covers all parts of the RMMR service, including the initial Interview and up to two follow-ups, if required. Should you conduct a new initial service however, a new consent form is required.

  4. No. The form signed at the time of entry into the Facility may not always provide permission for the Patient’s details to be shared with the PPA and the Department of Health and Aged Care.  

    The patient consent form that a Service Provider should use to obtain this permission from the Patient or their authorised legal representative (in accordance with the laws in the relevant State or Territory) is available for download in the Program Rules and other Downloads section below. 

  5. Where the Patient is unable to provide consent themselves, you may obtain either written or verbal consent from the individual who has the legal authority to consent on the Patient’s behalf.

  6. In all circumstances before conducting a review of a patient’s medication under the RMMR program, you should obtain the written consent of the patient where indicated on the RMMR patient consent form. 

    Occasionally, you may become aware that a patient does not have capacity to provide their consent, and there is no other suitable person who is able to provide consent on behalf of that patient, such as a guardian or a person appointed under an enduring power of attorney.

    In such circumstances:

    • You should promptly bring this to the attention of the management of the patient’s facility, and the patient’s referring health practitioner, and ask for their confirmation that they believe the patient is unable to provide consent, but there is no suitable person who can provide consent on behalf of that patient.
    • It is not your responsibility to arrange for the appointment of a suitable person to act on behalf of the patient. You can ask the facility what it is doing to arrange for a suitable person to be appointed (and when a suitable person is likely to be appointed).
    • If there is no person who can provide consent on behalf of the patient at the time of your intended review of the patient’s medication, you can still collect that patient’s personal information (and conduct your review), if you consider that without doing so:
      – the patient’s physical or mental health or safety may be significantly and detrimentally impacted;
      – the patient may be exposed to a potentially life-threatening situation; and/or
      – the patient might reasonably be exposed to serious injury or illness.If you form such a view, your collection, use and disclosures of the patient’s information under the RMMR program will be permitted under the Privacy Act 1988 (Cth).You should indicate that you have formed this view by ticking the relevant box where indicated on the RMMR patient consent form, instead of obtaining a signature from the patient or other suitable person.
    • You can then conduct your review under the RMMR program, including providing the required reporting, in accordance with the normal procedures.
  7. As part of claiming for this service you will be entering the Patient’s personal information into the PPA Portal. The Patient/Patient’s authorised legal representative is consenting to the Patient’s personal information being provided to the PPA and Department of Health and Aged Care.

    If they do not provide you with consent to pass on their information you may still provide them with a medication review however it would not be eligible for payment under the RMMR Program.

  8. Not unless you consider that you are required to do so to ensure your organisation’s compliance with privacy legislation.

  9. To be eligible to become a RMMR Service Provider you must be:

    • An owner of an approved Section 90 Community Pharmacy
    • A business entity with an Australian Business Number (ABN) with a relationship with a Credentialed Pharmacist.  This includes a Credentialed Pharmacist operating as a sole trader.

    Service Providers who are not eligible are:

    • Any organisation that is able to initiate a referral for the RMMR Service
    • A Section 94 Pharmacy
    • A public or private hospital.

    A RMMR Service Provider must have an executed RMMR Service Agreement with an eligible Residential Care Facility.

  10. For a Facility to participate in the Program it must be either:

    • An Aged Care Facility that receives residential care facility subsidy from the Australian Government in accordance with the Aged Care Act 1997; or
    • A Facility receiving funding under the National Aboriginal and Torres Strait Islander Flexible Aged Care (NATSIFAC) program
    • An Australian Government funded transition care facility; or
    • A Multi-Purpose Service providing integrated health and aged care services to small rural and remote communities.

    Wholly privately-owned facilities are not eligible for the Program.

  11. To be eligible for a RMMR Service, the Patient must meet the following criteria:

    • The Patient is a current Medicare or DVA card holder
    • The Patient is at risk of, or currently experiencing, medication misadventure
    • The Patient is:
      • A permanent resident of an Australian Government-funded Aged Care Facility, as defined by the Aged Care Act 1997; or
      • A permanent resident in a facility receiving funding under the National Aboriginal and Torres Strait Islander Flexible Aged Care program; or
      • A permanent resident of a Multi-Purpose Service Facility; or
      • A resident in an Australian Government-funded Transition Care Facility for more than 14 consecutive days
    • The Referring Medical Professional confirms that there is an identifiable clinical need for the Patient to have a RMMR Service.
  12. A RMMR referral can be written by any of the following types of medical practitioners registered with the Medical Board of Australia:

    • General Practitioner (GP)
    • Specialists in Pain Medicine;
    •  Specialist Physicians;
    • Specialist Psychiatrists; or
    • Specialists in Palliative Medicine.
  13. A RMMR Service consists of a Patient Interview, clinical assessment and written initial RMMR report provided to the Referrer and the multidisciplinary team and up to two follow-up services if clinically indicated.

  14. If clinically indicated, up to two follow-up service(s) can be conducted, with a focus on the resolution of medication-related problems identified at the initial Interview.

    A follow-up service will follow a similar, but less complex, process to the initial Patient Interview.

     

    Further information on what should be included in the follow-up service can be found in the Guidelines for Comprehensive Medication Management Reviews (PSA Standards).

  15. If required, the first face-to-face follow up Interview with the Patient (and, if required, their carer or appropriate Facility staff) should take place no earlier than one month and no later than nine months after the initial Interview. Written correspondence should be forwarded to the Referrer, the GP (if this is not the Referrer) and other relevant members of the patient’s healthcare team (with the Patient’s consent) and include an indication of whether a second follow-up Interview is clinically indicated.

    If clinically necessary, the second face-to-face follow up Interview with the Patient (and, if required, their carer or appropriate Facility staff) should take place no earlier than one month after the first follow-up Interview, and no later than nine months after the initial Interview. Written correspondence should be forwarded to the Referrer, the GP (if this is not the Referrer) and other relevant members of the patient’s healthcare team (with Patient’s consent).

    In both cases, the written record of the follow-up and any actions or recommendations should also be uploaded to the Patient’s My Health Record (if the Patient has one).

  16. No; a RMMR Service consists of the initial Patient Interview, clinical assessment, initial RMMR Report and up to two follow-up services if clinically necessary therefore, a separate referral is not required for any follow-up services undertaken. However, an indication of whether or not a follow-up is recommended should be included in the RMMR Report provided to the Referrer after the Initial Patient Interview.

  17. If a new initial Patient Interview from a subsequent RMMR referral has taken place, then claims for follow-up service(s) associated with the older RMMR referral cannot be undertaken and submitted in the PPA Portal. Follow-up(s) can only be conducted on the most recent RMMR referral.

    Information such as the date and Service Provider who conducted the last RMMR Service cannot be made available in the PPA service history checker due to privacy reasons.

    It is therefore important that Service Providers communicate with the Patient, Referrer and other members of the Patient’s healthcare team (including the Facility) to ensure a more recent RMMR Patient Interview has not taken place prior to undertaking any follow-up services.

  18. No, the RMMR Program is not capped; however, initial services are intended to be performed only when identified as required by a Referring Medical Practitioner. One RMMR Service (including initial review and if required up to two follow-ups) can be conducted per eligible Patient upon referral. A subsequent RMMR Service may only be conducted if more than 24 months has elapsed since the date of the most recent Patient Interview, or when the Patient’s Medical Practitioner (Referrer) specifically deems a subsequent RMMR Service is clinically necessary.

    Please note, provision of a subsequent RMMR must not be triggered solely by an ‘anniversary’ date; the Service is not intended to be part of an ongoing review cycle.

  19. The same Credentialed Pharmacist must conduct the initial Patient Interview, assessment and RMMR Report and should ideally conduct any associated follow-up services.

    Where it is not possible for the same Credentialed Pharmacist to undertake the follow-up services, an alternative Credentialed Pharmacist may undertake these, if required, in collaboration with the Credentialed Pharmacist who completed the initial Patient Interview and RMMR Report and the health care team.

    Where it is not possible for an alternative Credentialed Pharmacist to undertake follow-up services, a Registered Pharmacist may undertake follow-up services, in collaboration with the Credentialed Pharmacist who completed the initial Patient Interview and RMMR Report and the health care team.

    The Service Provider in receipt of the referral must lodge the claim for payment for both the initial service and any follow-up services.

  20. Each Patient is allowed to have a RMMR Service once every 24 months. However, if a Referrer believes that another RMMR is clinically necessary, 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 at any time.

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

  21. Yes, if you make repeated attempts and are unable to contact a Referring Medical Practitioner who has an ongoing clinical relationship with the Patient, you can apply for a Program Variation to conduct a Pharmacist Only Review. Applications are made via the Pharmacy Programs Administrator Portal. Please note that applications for a Program Variation must be made at least 10 working days prior to the proposed date of the Patient Interview. Retrospective approval will not be granted. The RMMR Service Provider must provide information that outlines a detailed and reasonable justification for a service to be conducted without a Medical Practitioner’s involvement.  The Applications will be assessed by the Department of Health and Aged Care on the evidence provided. 

  22. You have 90 days to complete the initial RMMR Interview; however, if you are unable to perform the initial Interview within 14 days of receiving the referral you should contact the Referrer and discuss when the initial Interview will happen.

  23. Yes, as the RMMR Service consists of a Patient Interview, clinical assessment and written RMMR report, the claim can only be submitted if the RMMR Report has been provided to the Referrer. As the RMMR Service also includes any follow-up services, written correspondence should also be provided to the Referrer after any follow-up Interviews.

    Any written correspondence from the initial RMMR report and follow-up service(s) should also be uploaded to the patient’s My Health Record (if the patient has one).

  24. The Service Provider in receipt of the referral must lodge the claim for payment following both the initial review and any required follow-up services.

    This means if you are a Credentialed Pharmacist and you intend to claim for the RMMR Service as a Sole Trader, the RMMR Referral should be written directly to you. A Community Pharmacy or Business Entity (other than a Sole Trader) may claim for a RMMR Service performed by any Credentialed Pharmacist they have a relationship with, providing the referral was written to the Community Pharmacy or Business Entity (rather than to a specific Credentialed Pharmacist). For further details on who is eligible to register and claim as a Service Provider please see the RMMR Program Rules.

    Remember the Service Provider submitting the claim must also have a valid RMMR Service Agreement with the Facility as per the RMMR Program Rules.

  25. Initial RMMR services and follow-up services must be claimed by the end of the next calendar month after the initial Interview or follow-up Interview was conducted e.g. a Service completed on 21/04/2020 should be submitted by 31/5/2020. For claiming purposes, the Service date entered in the PPA Portal should be the date you conducted the Patient Interview.

  26. A separate claim entry will need to be made for each individual RMMR Service conducted.

    You may choose to wait until you have conducted all RMMR 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 service. This is up to you, so long as each RMMR Service is claimed by the end of next calendar month following the date you undertook the Patient Interview.

  27. No. A claim for each Interview must be submitted by the end of the next calendar month after it occurs. Follow-up interviews can occur up to nine months after the initial Interview.

  28. No, if you miss the timeframe you will not be eligible to make a claim.

  29. No; You must have an approved initial RMMR Service claim in the PPA Portal in order to submit any associated follow-up service claims.

  30. No; You must have successfully claimed for both the initial RMMR Service and the associated first follow-up service in order to submit a claim for any associated second follow-up service.

  31. Follow-up services can only be conducted and submitted if they are associated with the most recent RMMR Service.

    If the follow-up service you are trying to claim for was undertaken after a more recent initial RMMR Service (based off a new RMMR Referral) has been undertaken and claimed by either yourself or another Service Provider, you will not be able to claim for that follow-up service.

    Information such as the date and Service Provider who conducted the last RMMR Service cannot be made available in the PPA service history checker due to privacy reasons. It is therefore important that Service Providers communicate with the Patient, Referrer and other members of the Patient’s healthcare team (including the Facility) to ensure a more recent RMMR Patient Interview has not taken place prior to undertaking any follow-up services.

  32. Yes; however, you must have an active ABN to register for the Program and be an Credentialed Pharmacist, or have a relationship with an Credentialed Provider to deliver the Service. Remember, though, that there must be a RMMR Service Agreement in place between yourself and the Facility before completing any RMMR Services.

  33. Yes. A Service Provider will not be able to submit claims for RMMR Services without first providing an executed Service Agreement (contract) between the Service Provider and the Facility. Note, Facilities may contract more than one Service Provider to provide RMMRs.

  34. Yes: A Facility may have RMMR Service Agreements with multiple Service Providers.

  35. Yes; however, a Facility must only have one contracted  QUM Service Provider.

  36. A copy of the RMMR Service Agreement is available from the Downloads section of this page.

  37. At the next available opportunity, any existing RMMR Service Agreements with a Facility should be replaced with the updated RMMR Service Agreement. While existing Service Agreements are in place, it is a condition of eligibility for payment of claims for RMMR Services that Service Providers do not take steps to prevent a Facility it has a Service Agreement with from entering into arrangements with other Service Providers.

  38. Yes: if you have extended an existing RMMR Service Agreement with an Facility you can upload a contract extension into the PPA Portal. Information on how to do this can be found in the RMMR Portal User Guide available in the Downloads section.

    Please confirm new extension arrangements prior to the end of your current agreement and before you make a claim against the new contract period.

  39. You must log in and register as a Service Provider if you have not already done this step and then register the Facility in the Pharmacy Programs Administrator Portal.  A copy of the Service Agreement is to be uploaded into the Portal prior to making a claim.

    Information on how to register a Facility can be found in the RMMR Portal User Guide available in the Downloads section of this page.

  40. Please inform the Pharmacy Programs Administrator as soon as the Service Agreement is terminated. This can be done by emailing support@ppaonline.com.au or contacting the Pharmacy Programs Administrator Support Centre on 1800 951 285. Failure to provide this information may result in recovery of payments made to you.

  41. The RMMR Program Rules are available from the Downloads section of this page. If you have further queries, you can email the Pharmacy Programs Administrator at support@ppaonline.com.au or call us on 1800 951 285.

  42. The PPA cannot provide specific information on MBS items as we do not administer the Medicare Benefits Schedule. Pharmacists and GPs with MBS item questions will instead need to contact the administrator of the Medicare Benefits Schedule, Services Australia.

  43. No, follow-up services are pharmacist initiated and do not require a referral by a medical practitioner.  The PPA cannot provide specific information on MBS items as we do not administer the Medicare Benefits Schedule. Pharmacists and GPs with MBS item questions will instead need to contact the administrator of the Medicare Benefits Schedule, Services Australia.

  44. No. All RMMR services must be conducted face-to-face with the patient in the patient’s place of residence (Aged Care Facility, Multi-Purpose Service or Transitional Care Facility).

  45. No, if a Facility is participating in the Aged Care On-Site Pharmacist Measure, it is unable to participate in the RMMR program. See also 48.

  46. Should the Facility engage a pharmacist under the Aged Care On-Site Pharmacist Measure, you will have 30 days from the date you are notified of termination of your RMMR service agreement to complete any RMMR services. Normal claiming deadlines will apply to services delivered during this 30-day period. During these 30 days the pharmacist engaged under the Aged Care On-site Pharmacist Measure may also be undertaking activities at the Facility.

    At no time can RMMR services be undertaken by a pharmacist in a residential aged care home where they are engaged as an aged care on-site pharmacist.

  47. No, at no point in time can a pharmacist provide RMMR services in a residential aged care home where they are engaged as an ACOP. See also 47 above.

  48. Yes, a Facility can return to the RMMR program if it has previously participated in the Aged Care On-site Pharmacist Measure. The aged care on-site pharmacist Service Authorisation/ engagement must be terminated with 30 days prior written notice.

Quality Use of Medicines FAQ

  1. To be eligible to become a QUM Service Provider you must be either of the following:

    • An owner of an approved Section 90 Community Pharmacy
    • A business entity with an Australian Business Number (ABN). This includes a Credentialed Pharmacist or Registered Pharmacist operating as a sole trader.

    Business entities who are not eligible to become a QUM Service Provider include:

    • Any organisation that is able to initiate a referral for an RMMR Service
    • A pharmacist embedded in an eligible Facility where they draw a salary or are otherwise funded by the Commonwealth to undertake quality use of medicines activities
    • A Section 94 Pharmacy
    • A public or private hospital.

    A QUM Service Provider must have executed a QUM Service Agreement with an eligible Residential Care Facility.  QUM Services must be delivered by a Credentialed Pharmacist or Registered Pharmacist.

  2. For a Facility to participate in the QUM Program it must be either:

    • An Aged Care Facility that receives residential care facility subsidy from the Australian Government in accordance with the Aged Care Act 1997; or
    • A Facility receiving funding under the National Aboriginal and Torres Strait Islander Flexible Aged Care (NATSIFAC) program
    • An Australian Government funded Transition Care Facility; or
    • A Multi-Purpose Service providing integrated health and aged care services to small rural and remote communities.

    Wholly privately-owned facilities are not eligible for the Program. 

  3. All QUM activities must be undertaken by a Credentialed Pharmacist or Registered Pharmacist.

  4. Yes; however, you must have an active ABN to be registered for the Program. Credentialed Pharmacists or Registered Pharmacists can provide QUM Services. Remember, though, that there must be a QUM Service Agreement in place between yourself and the Facility before completing any QUM Services.

  5. Yes, each Facility must only have one contracted QUM Service Provider. You will not be able to submit a claim for QUM without first providing an executed Service Agreement (contract) between your Service Provider and the Aged Care Facility.

  6. Yes; If the contracted QUM Service Provider holds a valid RMMR Service Agreement with the Facility they may also provide RMMR Services.

    A Facility may hold RMMR Service Agreements with multiple Service Providers.

  7. A copy of the QUM Service Agreement template is available from the Downloads section of this page. 

  8. You should first reach out to the Facility to confirm if they already hold a QUM Service Agreement with another Service Provider. If the Facility are unaware of whether they have a QUM Service Agreement then the PPA can inform a Service Provider if a Facility already has a contracted QUM Provider; however, for privacy reasons, we are unable to tell you who the Service Provider is.
    Please note a Facility can only hold a QUM Service Agreement with one Service Provider. If they are intending to change QUM Providers the example QUM Service Agreement states that they must give 30 days written notice to their current QUM Provider of the change.

  9. Yes; If you have extended an existing QUM Service Agreement with an Aged Care Facility you can upload a contract extension into the Pharmacy Program Administrator Portal. Information on how to do this can be found in the QUM Portal User Guide available in the Downloads section of this page.

    Please confirm new extension arrangements prior to the end of your current agreement and before you make a claim against the new contract period.

  10. You must log in and register as a Service Provider if you have not already done so and then register the Facility in the Pharmacy Programs Administrator Portal.  A copy of the Service Agreement must be uploaded into the Portal and approved by the Pharmacy Programs Administrator prior to making a claim.

    Information on how to register a Facility can be found in the QUM Portal User Guide available in the Downloads section of this page.

  11. Please inform the Pharmacy Programs Administrator as soon as the Service Agreement is terminated. This can be done by emailing support@ppaonline.com.au or contacting the Pharmacy Programs Administrator Support Centre on 1800 951 285. Failure to provide this information may result in recovery of payments made to you.

  12. Claims for QUM services provided to an eligible Aged Care Facility must be claimed by the end of the next calendar month following the quarterly service period.  For example, if the Service Agreement commences on 1 January, then the quarterly service period will be from 1 January to 31 March.  The claiming window will open at the end of the quarter and will close at the end of the following month (e.g. a period that ends in March must be claimed by 30 April). Claims outside this timeframe cannot be submitted and will not be paid.

  13. At least two activities a quarter must be provided to claim a QUM payment from the list of QUM activities listed in the QUM Program Rules; however, more than two activities are encouraged to be completed.

    The Work Plan included in the Service Agreement should detail the types and frequency of the QUM activities agreed to between the Facility and the Service Provider.

  14. Yes, if the final period of your Aged Care Facility Service Agreement is not three whole months and you are not extending your Service Agreement.

    The Portal will allow you to claim a pro-rata payment at the end of your contract. Simply select the New Claim button when it becomes available at the end of the contract period. Please note that submitting a pro-rata claim for a period less than 3 months means that you are unable to claim for that Facility again. If you extend the contract with that Facility you will have to register the Facility again on the Portal. Please note that you have until the end of the following month after the contract has finished to submit a pro-rata claim.

  15. If there is no break in the timing of the Service Agreement, i.e. if the new Service Agreement begins on the day after the previous Service Agreement ends, then you can upload a contract extension in the Pharmacy Programs Administrator Portal and submit one claim for the three-month period. Information on how to upload a contract extension into the PPA Portal can be found in the QUM Portal User Guide available in the Downloads section of this page.

    Please confirm new extension arrangements prior to the end of your current agreement and before you make a claim against the new contract period.

    If there is a break between Service Agreements, the Facility will need to be registered again with the new QUM Service Agreement. You will then need to submit a pro-rata claim for the final period of the initial Service Agreement (see question 14 above). A claim under the new Service Agreement can be submitted once the next claiming quarter ends (based on the new Service Agreement start date).

  16. No, claims should be sequential. If you miss a three-month period then unfortunately those three months are missed.

  17. The QUM Program Rules are available from the Downloads section of this page. If you have further queries, you can email the Pharmacy Programs Administrator at support@ppaonline.com.au or call us on 1800 951 285.

  18. An Eligible aged care bed means an operational bed that may be occupied by a resident in a Facility. This can include permanent resident beds, respite care and transitional care beds.

  19. No, if a Facility is participating in the Aged Care On-site Pharmacist Measure, it is unable to participate in the QUM program. See also 20 below.

  20. Should the Facility engage a pharmacist under the Aged Care On-site Pharmacist Measure, you will have 30 days from the date you are notified of the termination of your QUM service agreement to complete any QUM services. Normal claiming deadlines will apply to services delivered during this 30-day period. During these 30 days the pharmacist engaged under the ACOP Measure may also be undertaking activities at the Facility.

    At no time can QUM services to be claimed under the QUM Program be undertaken by a pharmacist in a residential aged care home where they are engaged as an aged care on-site pharmacist.

  21. No, at no point in time can a pharmacist provide QUM services to be claimed under the QUM Program in a facility they are engaged as an aged care on-site pharmacist. See also 19.

  22. Yes, a Facility can return to the QUM program if it has previously participated in the Aged Care On-site Pharmacist Measure. The aged care on-site pharmacist Service Authorisation/ engagement must be terminated with 30 days prior written notice.