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Medications and pharmacy items
Cover title subhead
The Victorian WorkCover Authority (operating as WorkSafe Victoria) can pay for the reasonable costs of medications and other pharmacy items that you need for your work-related injury or illness, provided they meet the pharmacy policy requirements.
Pharmaceutical Benefi ts Scheme
The Australian Government’s Pharmaceutical Benefi ts Scheme (PBS) has been integral to
maintaining the health and wellbeing of Australians by ensuring access to high quality,
affordable medications.
All workers with a Medicare card are eligible for PBS listed medications and associated concession and safety net entitlements. Your medical practitioner or dentist should prescribe your medications through the PBS when clinically appropriate and available.
More information about your eligibility for the PBS can be found at www.medicareaustralia.gov.au or worksafe.vic.gov.au What medications WorkSafe will pay for
WorkSafe can pay the reasonable costs of medications that are:
requested by a medical practitioner or dentist provided in line with the PBS, where clinically appropriate and available, and registered (not listed) in the Australian Register of Therapeutic Goods. Medications and pharmacy items
What medications WorkSafe cannot pay for
WorkSafe cannot pay for medications that:
are for injuries or illnesses other than your work-related injury or illness are requested by someone other than a medical practitioner or dentist are provided by someone other than a registered pharmacist are prescribed as part of a clinical trial you needed before your work-related injury or illness fail to meet our invoicing requirements.
Complementary and over the counter medications
Complementary medications include vitamins, minerals, herbal remedies and nutritional
supplements. Over the counter items are those sold by a pharmacist without a prescription and
include an active ingredient e.g. analgesics and laxatives.
WorkSafe can pay for the reasonable costs of complementary and over the counter medications that you need for your work-related injury or illness and are: • registered (not listed) in the Australian Register of Therapeutic Goods • supplied by a registered pharmacist, and • supported by a letter from your medical practitioner or dentist explaining why you need the item.
More information about the Australian Register of Therapeutic Goods can be found at www.tga.gov.au or worksafe.vic.gov.au Other pharmacy items
WorkSafe can pay for the reasonable costs of non-drug pharmacy items (e.g. bandages) that:
• you need for your work-related injury or illness • are supplied by a registered pharmacist, and • are supported by a letter from your medical practitioner or dentist explaining why you need the Policies on specifi c medications
WorkSafe has policies on specifi c medications which were developed in line with community
standards and current best practice, including policies on:
• drugs of addiction known as Schedule 8 medication • topical non-steroidal anti-infl ammatory drug (NSAID) creams and gels (e.g. Voltaren Emulgel).
More information on specifi c medication policies can be found at worksafe.vic.gov.au Medications and pharmacy items
Restrictions on the supply of medications
Due to the risks associated with certain types and quantities of medications, WorkSafe has placed
restrictions on the funding and supply of:
drugs of addiction known as Schedule 8 medication that are not listed on the PBS or not prescribed through the PBS • medication supplied in quantities exceeding the manufacturer’s maximum therapeutic dose, and • bulk supply of a medication e.g. for overseas travel.
In these circumstances your medical practitioner or dentist must provide your Agent with a letter explaining why you need the medication before prescribing it. The Agent will review this information and let you know whether or not they will pay for the medication.
How medications and pharmacy items are paid
WorkSafe can reimburse payments for medications and pharmacy items that you need for your
work-related injury or illness, provided they meet the pharmacy policy requirements.
WorkSafe prefers that your pharmacist invoices your employer or Agent directly. You need to make sure that your pharmacist has: a supporting letter from your medical practitioner or dentist which explains the direct relationship between any complementary, over the counter or non-drug pharmacy items, and your work-related injury or illness.
You should advise your pharmacist if the Agent managing your claim changes. If you pay for your own medications and pharmacy items for your work-related injury or illness, you can seek reimbursement from your employer or Agent. All pharmacy accounts you submit for reimbursement must include: • a fully itemised receipt showing the pharmacist’s name and address, the date of purchase, a description of the item and total amount paid, and • for all medications, the details of the name of the medication, the strength and quantity and if on prescription, whether it is a PBS item or non-PBS (private) item.
Your pharmacy receipt should already contain the information required. However, you may wish to confi rm this with your pharmacist.
You should confi rm with your pharmacist that you have been charged for medications and pharmacy items in line with the pharmacy policy.
You should send accounts and receipts to your employer or Agent as soon as possible, or at least within six months of the date of supply. It is recommended you retain copies of all receipts and prescriptions for your own records.
Medications and pharmacy items
If you disagree with a decision
If you disagree with a decision made about your medication or pharmacy items, you are encouraged
to talk to your medical practitioner to discuss your needs.
If this doesn’t help to resolve your issue, there are a range of people you can contact: The WorkSafe Advisory Service on freecall 1800 136 089 or (03) 9641 1444 or email info@worksafe.vic.gov.au The Accident Compensation Conciliation Service (ACCS). This is a free, independent service that can help resolve your dispute without a solicitor or going to court. For more information or to get a Request for Conciliation form, call the ACCS on freecall 1800 635 960 or (03) 9940 1111 or visit www.conciliation.vic.gov.au To get assistance
For assistance with disputed claims and the ACCS you can contact:
Union Assist. This is a free service set up and run by the Victorian Trades Hall Council. For more information go to www.vthc.org.au or call (03) 9639 6144.
WorkCover Assist. This is a free service provided by WorkSafe to help you if you have a problem with your claim. Call (03) 9941 0537. Need more information?
Contact the WorkSafe Advisory Service on freecall 1800 136 089 or (03) 9641 1444,
email info@worksafe.vic.gov.au or visit worksafe.vic.gov.au
For information about WorkSafe in your own language, call our Talking your Language service
The information contained in this publication is protected by copyright. WorkSafe encourages free transfer, copying and printing of the information in this guidance material if such activities support the purpose for which this guidance material was intended.
WorkSafe Victoria
WorkSafe Advisory Service
Fax . . . . . . . . . . . . . (03) 9641 1353 Freecall . . . . . . . . . . 1800 136 089 Web . . . . . . . . . worksafe.vic.gov.au

Source: http://www.gallagherbassett.com.au/Portals/0/Medication_Pharmacy_Items.pdf

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