Regional Pharmacy Transition Allowance

Regional Pharmacy Transition Allowance (RPTA) Program
The RPTA Program commenced on 1 September 2023, with program registration opening and first claims being paid during October 2023. More information can be found here. 
Note that September RPTA payments will be paid in two batches.
Eligible Service Providers with an application submitted by Friday 20 October will receive their September RPTA payment before the end of October.
Eligible Service Providers with an application submitted between 21 October and 31 October will receive their September RPTA payment at the same time that October payments are processed, in the first half of November.

The Regional Pharmacy Transition Allowance (RPTA) will provide additional Australian Government assistance to pharmacy owners in regional, rural, and remote Australia, as they transition business arrangements for 60-day prescriptions. When combined with the Regional Pharmacy Maintenance Allowance, the total support for some eligible pharmacies, on average, will largely offset reductions in dispensing revenue for 2023-24.

The RPTA was announced in July 2023 by the Australian Government, with the intent of providing temporary assistance to pharmacy owners in regional, rural, and remote Australia, as they transition business arrangements for 60-day prescriptions. When combined with the Regional Pharmacy Maintenance Allowance (RPMA), the total support for some eligible pharmacies, on average, will largely offset reductions in dispensing revenue for 2023-24.

The allowance will commence on 1 September 2023 with a monthly allowance paid in arrears to eligible proprietors of pharmacies approved under Section 90 of the National Health Act 1953. The allowance will be phased down across four years and cease on 30 June 2027.

The allowance is calculated based on the remoteness of the pharmacy according to the Modified Monash Model (MMM) as well as the pharmacy’s Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) prescription volume during the period 1 April 2022 to 31 March 2023. Pharmacies located within MMM categories 2 – 7 may be eligible for an allowance.

To be eligible to participate in the RPTA Program a Pharmacy must:

a.    Be approved to dispense pharmaceutical benefits as part of the PBS defined in Section 90 of the National Health Act 1953 (Cwlth) (Section 90 Pharmacy)

b.    Have been opened for business prior to 30 June 2023

c.    Ensure that a Registered Pharmacist is in attendance and the pharmacy is open for a minimum of:

  •       20 hours per week
  •       4 days each week
  •       48 weeks of each allowance year

d.    Be located in one of the following MMM categories to be deemed eligible:

  •       MMM 2 – Regional Centre
  •       MMM 3 – Inner Regional
  •       MMM 4 – Outer Regional
  •       MMM 5 – Rural
  •       MMM 6 – Remote
  •       MMM 7 – Very Remote

e.   Have had PBS and RPBS Script Volumes within set thresholds between April 2022 and March 2023, based on their MMM location at the time of their RPTA application. The tables in Appendix A of the RPTA Program Rules outline the script volume bands and MMM classifications that determine whether a pharmacy may be eligible for RPTA in a given year, and how much they will receive per financial year

f.     Be receiving the Regional Pharmacy Maintenance Allowance (for pharmacies located in MMM 3-7 locations).

Failure to maintain compliance with any or all of the above Eligibility Criteria may result in the Eligible Community Pharmacy being ineligible to participate in the RPTA Program.

Please note, if a pharmacy’s MMM location changes (due to either a pharmacy location change or broader updates to MMM categories) after their RPTA application has been approved, their RPTA payments and ongoing eligibility will continue to be based on their original MMM location as at 1 September 2023.  

 

Script volume thresholds where data is unavailable for the period 1 April 2022 – 31 March 2023

Where there is less than 12 months of PBS and RPBS prescription volume available for the period 1 April 2022 – 31 March 2023, a pharmacy’s script volume band will be determined by taking the average monthly script volume for the shortened period where script volume data is available and multiplying this value by 12.

In cases where a pharmacy was not open at all during the period 1 April 2022 – 31 March 2023, the same calculation will be performed, however using available PBS and RPBS prescription volume data for that pharmacy from when their Section 90 approval began.

Please note that new pharmacies that opened after 30 June 2023, after the 60-day prescription policy was announced in the 2023-2024 Budget will not be eligible for RPTA.

 

Ownership Changes

Where a full ownership change has occurred, the new Pharmacy Owner will need to register and apply for the RPTA Program. The application for the new pharmacy’s account will then be assessed and paid as per the old pharmacy’s MMM location/script volume band. Please note RPTA payments will only be made for applications with a valid Section 90 number as at the end of the month being paid. For example, where a pharmacy has a full ownership change during October, the October payment will be made in arrears in November to the new pharmacy (provided they have an approved RPTA application). No pro-rata payments will be made to the old pharmacy account. It is therefore the responsibility of the new and old owners to come to their own agreement regarding any split of RPTA funds.

Pharmacies will be able to register and apply once the Program has been released in the PPA Portal during October. Pharmacies will be advised as soon as the Program is available.

Registering for RPTA

Eligible Community Pharmacies that wish to claim the RPTA must register via the Pharmacy Programs Administrator Portal. The Main Authorised Person (MAP) for the pharmacy must register for the program.

Registration does not mean a pharmacy is eligible for payment. Pharmacies must also lodge an application for the Program, which will be individually assessed (see below).

Applying

After registering for the Program, an Eligible Community Pharmacy applying for the RPTA is required to complete a new application via the Pharmacy Programs Administrator Portal.

Further information on how to apply can be found in the Program Rules.

Eligible Community Pharmacies will receive confirmation of accepted applications via the Main Authorised Person email address provided during the registration process on the Portal. This process may take up to one month.

Eligible Community Pharmacies only need to apply for the RPTA once. Unlike the RPMA allowance, there is no annual renewal required for the RPTA Program.

The RPTA payment amounts have been calculated by the Department of Health and Aged Care and will be paid monthly to Eligible Community Pharmacies, based on the RPTA Payment Matrix for that financial year. The RPTA Payment Matrixes for each financial year the Program runs are available on the PPA website and in Appendix A of the RPTA Program Rules.

Please note, if a pharmacy’s MMM location changes (due to either a pharmacy location change or broader updates to MMM categories) after their RPTA application has been approved, their RPTA payments and ongoing eligibility will continue to be based on their original MMM location at the time of their initial application. 

Payments will be made into the bank account nominated during the Service Provider registration process via the Portal.

Regional Pharmacy Maintenance Allowance FAQ

  1. The RPTA Program will commence on 1 September 2023, with program registrations/applications opening via the PPA portal in October 2023.

  2. Eligible Service Providers with an application submitted by Friday 20 October will receive the September RPTA monthly payment during October 2023.

    Eligible Service Providers with an application submitted between 21 October and 31 October will receive their September RPTA payment at the same time that October payments are processed, in the first half of November.

    The first payment for Eligible Service Providers who submit an application from November onwards will be for the month in which they submit their RPTA application (paid in arrears the following month).

    For example, if you submit an RPTA application in November you will be eligible for the November payment. This will be paid in arrears in December.

  3. Please see Appendix A of the RPTA Program Rules for the payment matrix.

  4. Yes. The RPTA will temporarily support pharmacies in Modified Monash 2-7 locations with funding phasing down across four years, as pharmacy owners transition business arrangements to account for 60-day prescriptions.

    The Allowance will commence on 1 September 2023, with first claims being paid in October 2023, and finish on 30 June 2027.

  5. No. Your annual payment amount is divided by 12 and paid monthly in arrears for the remainder of the financial year, providing your pharmacy continues to meet the minimum opening hours. Please note that Appendix A of the RPTA Program Rules shows annual payment amounts.

  6. Please see the Portal User Guide – RPTA in the Program Rules and Other Downloads section.

  7. No. Only one initial application per Service Provider is required, as a pharmacy will remain in the same script band/MMM category for payment purposes for the duration of the Program.

  8. Please refer to the Eligibility Requirements set out in the RPTA Program Rules.

  9. Section 90 Pharmacies located in MMM categories 2 to 7 as at 1 September 2023 may be eligible to receive the RPTA.

    For more details please refer to the Eligibility Requirements set out in the RPTA Program Rules.

  10. Your pharmacy’s MMM category can be viewed on the Australian Government’s Health Workforce Locator website: https://www.health.gov.au/resources/apps-and-tools/health-workforce-locator/health-workforce-locator.

    Click on the MMM 2019 tickbox in the Classification Filter, type in your Pharmacy’s address and click Search Location.  Your MMM category will be displayed underneath your address and also on the map.

     

  11. No. If your pharmacy’s MMM location changes (due to either a pharmacy location change or broader updates to MMM categories) after your RPTA application has been approved, then your RPTA payments and ongoing eligibility will continue to be based on your original MMM location as at 1 September 2023.

  12. Section 90 Pharmacies located in MM 3-7 locations need to also be receiving the Regional Pharmacy Maintenance Allowance to be eligible to register for the RPTA.

  13. No. Pharmacies will not be entitled to claim for months where they did not have an approved application for the program – for example, a pharmacy that only registers and applies in January 2024 will not be eligible for payments for September to December 2023.

  14. If you do not meet the minimum opening hour requirements, you can submit an exceptional circumstances request found here. Details on how to apply can be found in the Program Rules. A case will be presented to the Department of Health and Aged Care who will approve or decline the applications. Approval could result in partial payments.

    Please note, no exceptional circumstances requests will be accepted in relation to your MMM category or determined PBS and RPBS prescription volume.

  15. If you are creating a new Pharmacy Service Provider account in the PPA Portal (i.e. your pharmacy has completely changed ownership) you will be required to submit a new RPTA application.

    If you are eligible, the Pharmacy will receive payment for the month in which you submit your RPTA application (paid in arrears the following month).

    The old owner will not be paid for the same month regardless of when the ownership change occurred during the month.

    Under these circumstances, it will be the responsibility of Community Pharmacy owners to ensure their contracts of sale include provision for sharing the payment or liability on a pro rata basis depending on the day of the month that the Section 90 Approval Number changed.

    No partial payments will be allowed for partial months of ownership.

  16. You are required under the Program Rules to inform the PPA of any change to the Pharmacy that can affect eligibility for any Program within 14 days of the change.

    No partial payments will be allowed for partial months of ownership.

    Payments will be made to the Service Provider account which held the valid Section 90 PBS approval number on the last day of the month being paid (providing they have submitted an eligible RPTA application within that month). For example if a pharmacy is sold in mid-January, the full January payment would be made in arrears in February to the new pharmacy account, providing the new pharmacy has submitted an eligible RPTA application in January. If the new pharmacy has not submitted an eligible RPTA application in January, then neither store will be paid the January instalment. 

    It is therefore the responsibility of Community Pharmacy owners to ensure their contracts of sale include provision for sharing the payment or liability on a pro rata basis depending on the day of the month that the Section 90 Approval Number changed.

  17. If eligible, the Pharmacy will receive payment for the first whole month in which the RPTA application is submitted via the PPA Portal.

    For example, if you submit an RPTA application in June you will be eligible for the June payment. This will be paid in arrears in July.

    Please note if your pharmacy is located in a MMM 3 – 7 location you will also need to ensure you are eligible for and have submitted a Regional Pharmacy Maintenance Allowance (RPMA) application in the PPA Portal.

  18. RPTA is intended to temporarily support eligible pharmacies as they transition business arrangements to account for the introduction of 60-day prescriptions. If your pharmacy was opened after 30 June 2023 (after the 60-day prescription policy was announced at the 2023-2024 Budget) then it is not eligible to receive RPTA payments.

  19. Inform the PPA as soon as possible. Failure to inform the PPA within 14 days of a change in eligibility may result in payments being recovered from you.

  20. As per Appendix A in the RPTA Program Rules, some MMM categories/script bands become eligible at different times throughout the program.

    If your pharmacy is in an MMM category/script band that becomes eligible for the allowance in the 2024-25 or 2025-26 payment years, you can register and apply for RPTA once the program is available in the PPA Portal from October 2023.

    The PPA will have the required information available to determine program eligibility for all applicants and for all years of the RPTA program. 

    Please note, your pharmacy will be assigned the MMM category current as at 1 September 2023 regardless of when your RPTA application is submitted.

    Where you have submitted your application but are not eligible for payment until a later payment year, your application will still be assessed and will show on the PPA Portal with a ‘Granted’ status. You will not however, receive payment until the year you are eligible for. If any eligibility criteria, such as opening hours, change after you submit your application you must still ensure you advise the PPA within 14 days of the changes having occurred, as your application may need to be cancelled.

  21. Where a change of ownership has occurred between 1 April 2022 – 31 March 2023, the PBS/RPBS script volume data recorded under both the new S90 number and any previous S90 numbers will be used to determine the pharmacy’s total script volume for the 12 month period.

Regional Pharmacy Transition Allowance Resources


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