Home Medicines Review
A Home Medicines Review (HMR) is a comprehensive clinical review of a patient’s medicines in their home by an accredited pharmacist on referral from the patient’s general practitioner (GP). The patient may choose to be referred to their usual community pharmacy or an accredited pharmacist who meets the patient’s needs.
The service involves cooperation between the GP, pharmacist, other health professionals and their patient (and, where appropriate, their carer). A HMR service improves the patient’s and health professionals’ knowledge and understanding about medicines, facilitates cooperative working relationships between members of the health care team in the interests of patient health and wellbeing and provides medication information to the patient and other health care providers involved in the patient’s care.
Home Medicines Review Eligibility
In order to be eligible for the HMR programme, Service Providers must accept and abide by the 6CPA General Terms and Conditions and the HMR Program Specific Guidelines. The Guild must approve an applicant’s request to provide HMR services before the services are provided.
Approval as a Service Provider must be sought via the 6CPA Registration and Claiming Portal registration process.
In order for a patient to be eligible, they must:
- be a current Medicare/Department of Veterans’ Affairs (DVA) cardholder;
- live in a community setting; and
- be at risk of experiencing medication misadventure.
The patient’s GP must confirm that there is an identifiable clinical need and the patient will benefit from a HMR service.
In-patients of public and private hospitals, day hospital facilities or permanent residents of a Government Funded Facility are ineligible for a HMR service.
HMR Rural Loading Allowance Eligibility
To be eligible for the HMR Rural Loading Allowance the applicant must:
- be a Community Pharmacy or an Accredited Pharmacist approved to provide the HMR Service;
- have received the signed HMR referral directly from the patient’s GP;
- have provided the HMR interview/s at the patient/s home, unless exceptional circumstances require the service to be provided at a different location;
- provide evidence that a round trip to the patient’s home and return to the original starting address has been undertaken to provide one or more HMR interviews;
- provide evidence that the round trip identified above is greater than 200km; and
- consent to the disclosure of personal information for the purpose of evaluating, monitoring, and managing the Allowance.
Location of Patient Interview
The patient interview must occur face-to-face at the patient’s home except in the following circumstances:
- For patient cultural reasons; or
- Because of pharmacist safety concerns relating to being inside the patient’s home.
If either circumstance applies, Prior Approval to conduct the HMR interview in an alternative location must be obtained. Approval for interviews conducted in an alternative location will not be granted retrospectively; interviews conducted in any location other than the patient’s home without Prior Approval will not be remunerated under the HMR Programme.
Rural Loading Allowance
The aim of the HMR Rural Loading Allowance is to improve access for patients residing in rural and remote areas to the HMR Service by funding up to $125 (ex GST) to contribute towards the travel costs incurred by the pharmacist to conduct the interview at the patient’s home. It is designed to contribute towards the costs incurred, not necessarily cover all costs. The Allowance is based on the location of the patient receiving the HMR Service.
Prior Approval is to be sought on a case by case basis for a patient interview to be conducted outside the patient’s home or for the patient interview to be conducted at the patient’s home by a Registered Pharmacist.
The HMR Service Provider must submit a completed Prior Approval Request form via email to email@example.com at least ten (10) working days prior to the proposed date of interview. Requests will be assessed on the evidence provided and the HMR Service Provider will be advised of the outcome via email within seven (7) working days from the date of submission.
It is the responsibility of the HMR Service Provider to explain the prior approval process to the patient (and to the Registered Pharmacist if one is to be involved at the interview stage) and seek consent for their details to be shared with the Department of Health and the Guild for the purpose of assessing the request for Prior Approval.
HMR Service Providers who conduct patient interviews outside a patient’s home or by utilising a Registered Pharmacist without Prior Approval will not be remunerated for those reviews. Approval will not be granted retrospectively.
Claiming and Payments
Each approved Service Provider may conduct and claim up to a total of twenty (20) HMR services in any calendar month. This cap applies to both the organization that is submitting the claim, as well as the individual Accredited Pharmacist who completes the service.
Claims must be submitted via the 6CPA Registration and Claiming Portal within 30 days from the date of service (patient interview). Claims submitted outside this timeframe will not be paid and cannot be resubmitted.
Claims that are submitted with incomplete information or incorrect Patient or Service Provider details will be required to be amended within thirty (30) days of the amendment notification. Claims that are not amended within thirty (30) days of the amendment notification will not be paid.
Claims that are submitted outside the required timeframe (within 30 days from the date of service) cannot be resubmitted.
Claims submitted that exceed a Service Provider’s monthly cap of twenty (20) HMR services will not be paid and cannot be resubmitted.
Applying for the Allowance
Applications for the HMR Rural Loading Allowance are to be submitted via the online application.
Services are payable to approved Service Providers for each HMR conducted after a referral by a GP. The payment rate for a HMR service conducted on or after the 1st July 2016 is $213.67.
In rural areas, funding of up to $125 is available to contribute towards travel costs incurred by the accredited pharmacist to conduct the interview at the patient’s home under the HMR Rural Loading Allowance.
Hospital Referral Pathway
A Hospital Referral Pathway has been developed under the existing HMR Programme. This pathway is aimed at those patients deemed most at risk of medication misadventure within ten days of discharge from hospital. This additional pathway aims to reduce the incidence of medicine misadventure and hence readmission post-discharge as well as improve continuity of care between the hospital and community sector. The pathway will provide an opportunity for patients in urgent need to be referred for a HMR where timely referral for a HMR service from their GP is not possible.
There will be a phased implementation of this pathway, with experiences gained and data collected to inform a potential national rollout at a later stage. The Department of Health has engaged Monash Medical Centre Clayton, Victoria and Calvary Hospital Lenah Valley, Tasmania as the hospitals to commence the phased implementation. HMR Service Providers and GPs located in the area/s nominated by the hospitals have received an invitation to participate in the phased implementation.