Residential Medication Management Review and Quality Use of Medicines

The intent of the 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 Accredited 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.

COVID-19 UPDATE 
Please see the Telehealth section below or the RMMR Program Rules for more information on temporary telehealth services during the COVID-19 pandemic.

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 accredited 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 Accredited 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).

From 21 April 2020, 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 Accredited 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 an Accredited 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 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 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 an Accredited 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 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 one QUM Service each quarter. This entitles the Service Provider to claim a base payment of $60 plus $6 per eligible aged care bed within the Facility each quarter.

For QUM claiming quarters starting on or after 1 January 2020 a new base payment amount of $125 plus $12.50 per eligible aged care bed within the Facility will apply.

RMMRs should, where possible, be provided in the Facility where a Patient is a permanent resident, or the Transition Facility if the Patient is eligible.

However, in response to the COVID-19 pandemic, RMMRs may temporarily be undertaken via telehealth where a Patient meets any of the following eligibility criteria:

  • Meets the current national triage protocol criteria for suspected COVID-19 infection after consultation with either the national COVID-19 hotline, relevant state COVID-19 hotline, a registered medical or nursing practitioner or COVID-19 trained health clinic triage staff;
  • is aged over 70;
  • identifies as an Aboriginal and Torres Strait Islander person and is aged over 50;
  • has a chronic health condition or is immunocompromised; or
  • is pregnant, or a parent with a new baby.

Telehealth services are the preferred approach for substituting a face-to-face consultation. However, if video is not available, Service Providers will also be able to offer audio-only services via telephone.

In the case where a Facility is restricting access due to a confirmed case of COVID-19, it is recommended that the referring medical practitioner be contacted to confirm whether or not a Service is still clinically appropriate and, if so, the Service may be undertaken remotely.

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.  

    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. All services completed on or after 10 June 2020 are required to have a filled in patient consent form before completing the Patient Interview.

  7. Yes. If you are completing follow-ups on services on any initial services performed before the patient consent form was required, then the Patient should sign a consent form before the next follow-up service you complete.

  8. 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.

    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 7CPA.

  9. Previously the advice available to the PPA was that the form signed by a Patient upon entry into a Facility covered the Patient receiving a RMMR service. Recent advice provided to the PPA indicates that some forms signed by Patients upon their entry into the Facility may not cover the Patient’s personal information being provided to third parties such as the PPA and the Department of Health. Due to this, the PPA and Department of Health have developed and provided a patient consent form to help Service Providers ensure they have the required consent before passing on a Patient’s details.

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

  11. 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 an Accredited Pharmacist.  This includes an Accredited 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.

  12. 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
    • 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.

  13. 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 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.
  14. 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.
  15. 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.

  16. From 21 April 2020, 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).

  17. 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).

  18. 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.

  19. 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.

  20. 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.

  21. The same Accredited 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 Accredited Pharmacist to undertake the follow-up services, an alternative Accredited Pharmacist may undertake these, if required, in collaboration with the Accredited Pharmacist who completed the initial Patient Interview and RMMR Report and the health care team.

    Where it is not possible for an alternative Accredited Pharmacist to undertake follow-up services, a Registered Pharmacist may undertake follow-up services, in collaboration with the Accredited 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.

  22. 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.

  23. 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 on the evidence provided. 

  24. 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.

  25. 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).

  26. 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 an Accredited 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 Accredited Pharmacist they have a relationship with, 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 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.

  27. 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.

  28. 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.

  29. 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.

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

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

  32. 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.

  33. 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.

  34. Yes; however, you must have an active ABN to register for the Program and be an Accredited Pharmacist, or have a relationship with an Accredited 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.

  35. 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. From 21 April 2020, Facilities may contract more than one Service Provider to provide RMMRs.

  36. From 21 April 2020 the requirement that only one Service Provider may be contracted for a single Facility was removed from the RMMR Program Rules. A Facility may therefore have RMMR Service Agreements with multiple Service Providers.

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

  38. A copy of the RMMR contract template is available from the Downloads section of this page.

  39. No. To ensure that the Service Agreement entered into with the Facility is consistent with the current RMMR Program Rules, Service Providers should use the new RMMR Service Agreement template which is available from the Downloads section of this page.

    In future, new Service Agreements uploaded to the PPA Portal which use the old Service Agreement template (in which there is a clause stating a Facility may only have a contract with one Service Provider) will not be accepted.

  40. 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.

  41. 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.

  42. 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.

  43. Please inform the Pharmacy Programs Administrator as soon as the Service Agreement is terminated. This can be done by sending an email 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.

  44. The RMMR Program Rules are available from the Downloads section of this page. If you have further queries, you can also email the Pharmacy Programs Administrator on call us on 1800 951 285.

  45. 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.

  46. 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.

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 an Accredited 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 an Accredited 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
    • 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 an Accredited Pharmacist or Registered Pharmacist.

  4. Yes; however, you must have an active ABN to be registered for the Program. Accredited 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. Yes, the Pharmacy Programs Administrator can inform you if a Facility has a contracted Service Provider; however, for privacy reasons, we are unable to tell you who the Service Provider is.

  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 contacting the Pharmacy Programs Administrator Support Centre via email or 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 activity is 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 also email the Pharmacy Programs Administrator on call us on 1800 951 285.