Quality Prescribing IncentiveGuidelines – October 2013

Introduction

The Practice Incentives Program (PIP) is aimed at supporting general practice activities that encourage continuing improvements and quality care, enhance capacity and improve access and health outcomes for patients.

For more information on the incentives that the PIP offers and overall PIP eligibility, go the PIP guidelines at humanservices.gov.au/healthprofessionals then Incentives and AllowancesPractice Incentives ProgramForms and guidelines.

PIP Quality Prescribing Incentive

The PIP Quality Prescribing Incentive (QPI) aims to encourage practices to keep up-to-date with information on the quality use of medicines. The PIP QPI rewards participation by practices in a range of activities recognised or provided by the National Prescribing Service (NPS).

The NPS helps GPs to achieve more effective, quality prescribing through a range of education, support and prescribing information. The NPS is a professional organisation, run independently of the Australian Government, with broad GP representation and leadership.

Eligibility

To be eligible for the PIP QPI, the practice must:

•participate in the PIP

•meet the minimum participation level by 30 April each year (three recognised activities, including one clinical audit per Full Time Equivalent (FTE) GP each year), and

•make sure the NPS is correctly advised of activities completed by practice GPs by 30 April each year.

Minimum Participation Levels

To qualify for a payment through the PIP QPI, practices must participate in three activities in the reference period 1 May to 30 April for each FTE GP each year, on average. One of the activities must be a clinical audit. Any changes in the number of GPs employed by the practice will impact on the total number of QPI activities to be completed. Although each activity is carried out by the individual GP, payments are made based on practices meeting a minimum participation level in QPI activities.

Recognised activities include:

•a clinical audit of prescribing for specific drug groups, using materials approved or produced by the NPS (available to all practices three to four times a year)

•case studies using problem-based distance learning provided by the NPS. The case studies present a clinical scenario with a set of questions designed to help participants refine their clinical decision-making skills, and

•practice visit(s) by an independent pharmaceutical detailer as approved by the NPS. These ‘academic detailing’ visits are a resource for GPs and promote the quality use of medicines. The availability of this option may be geographically limited.

For example, a practice with one FTE GP must participate in three activities, including at least one clinical audit, to receive a payment. A practice with five FTE GPs must participate in at least 15 activities, including five clinical audits, to receive a payment. Some GPs in the practice may participate in more or less activities, so long as the practice as a whole averages three activities per FTE GP.

The NPS may recommend additional activities for inclusion in the PIP QPI. Practices will be notified if additional activities become available.

For more information on the NPS or recognised PIP QPI activities, go to nps.org.au or call 02 8217 8700 (call charges apply).

Payments

The PIP QPI payments are calculated at $1.00 per Standardised Whole Patient Equivalent (SWPE) per year.

The payment for the PIP QPI is made to the practice annually in the May quarter.

The Department of Human Services (Human Services) calculate payments using information supplied by the NPS on the number of activities undertaken by each GP. To make sure the practice receives the correct payment, each GP must provide their name, contact details, provider and prescriber numbers on the relevant forms to the NPS when undertaking a recognised activity.

Human Services will advise practices through the PIP quarterly payment advice of the expected number of PIP QPI activities that must be completed to be eligible for the payment. The number of required activities may vary from quarter to quarter, depending on the activities already undertaken and size of the practice. For information on the number of activities completed, call the NPS on 02 8217 8700 (call charges apply).

Applying

Practices registered for the PIP don’t need to apply for this incentive. However, practices should consult their PIP quarterly payment advices and complete the required activities by 30 April each year. To receive the annual QPI payment in May each year, practices must also make sure the NPS is advised that the required activities have been completed by 30 April each year. To make sure that payments are accurately calculated, it’s important that practice GPs provide the NPS with correct details, including provider and prescriber numbers, when undertaking a recognised activity.

If your practice is not currently in the PIP, you can apply:

•through Health Professional Online Service (HPOS), at humanservices.gov.au/HPOS

•by completing the PIP application form at humanservices.gov.au/healthprofessionals then Incentives and AllowancesPractice Incentives ProgramsForms and guidelines, and sending it along with the required supporting documentation to:

Mail: Incentive Programs

Department of Human Services

GPO Box 2572

ADELAIDE SA 5001

Fax: 1300 587 696

Obligations of the practice

The practice must:

•give information to us as part of the ongoing audit process to verify that the practice has met eligibility requirements

•make sure the information given to us is correct, and

•advise us of any changes to practice arrangements. This can be done:

  • online via HPOS. Changes via HPOS are immediate and can be made up to, and on, the relevant point-in time date
  • by completing the PIP Change of Practice Details form, or
  • by advising us in writing by no later than seven days prior to the relevant point-in-time date.

Refer to the PIP guidelines for more information.

The point-in-time date corresponds to the last day of the month before the next PIP quarterly payment.

On joining the PIP, the practice must nominate an authorised contact person(s), who will confirm, on the practice’s behalf, any changes to information for PIP claims and payments.

Appeals process

The PIP has an established appeals process. To ask for a review of a decision, the authorised contact person or the owners of the practice must write to us within 28 calendar days of the date of the letter informing the practice of the decision. Human Services will review the decision and advise the practice in writing of the outcome.

For more information

Online:humanservices.gov.au/healthprofessionals then Incentives and AllowancesPractice Incentive Program

Email:

Call:1800 222 032** 8.30 am to 5.00 pm, Monday to Friday, Australian Central Standard Time

** Call charges apply from mobile and pay phones only.

Disclaimer

These guidelines are for information purposes and provide the basis on which PIP payments are made. While it is intended that the Australian Government will make payments as set out in these guidelines, the making of payments is at its sole discretion. The Australian Government may alter arrangements for the Practice Incentives Program at any time and without notice.

The Australian Government does not accept any legal liability or responsibility for any injury, loss or damage incurred by the use of, reliance on, or interpretation of the information provided in these guidelines.