Patient—Closing the Gap co-payment eligibility indicator, code AAA[NNA]

Identifying and definitional attributes

• Commonwealth Department of Health, Standard 17/12/2015

Value domain attributes

Representational attributes

Collection and usage attributes

The first three characters of the code should be 'CTG', followed by a two-digit number incremented within the practice of the prescriber each time an eligible prescription is written. The sixth character is an alphabetic check digit.

After the numeric component of the codes used by the practice reaches '99', it resets to '01', i.e. the next code allocated by the practice would begin with 'CTG01'.

It is possible for a practice to allocate the same six-digit code more than once on the same day, i.e. if 100 or more eligible prescriptions are written. However, the date of prescription forms part of the check digit calculation algorithm, so while eligible prescriptions written within a practice may share a common first five characters, the check digit should change from day to day.

Source and reference attributes

Data element attributes

Collection and usage attributes

A non-blank response is indicative of the patient's eligibility for the Closing the Gap co-payment.

An eligible patient is an Aboriginal and Torres Strait Islander person of any age who presents with an existing chronic disease or is at risk of chronic disease, and who, in the opinion of the prescriber:

• would experience setbacks in the prevention or ongoing management of chronic disease if they did not take the prescribed medicine, and
• is unlikely to adhere to their medicines regimen without assistance through the measure.

Eligible patients can be registered at either:

• general practices participating in the Indigenous Health Incentive under the Practice Incentives Programme, or
• Indigenous Health Services in urban and rural settings.

The following prescribers are eligible to provide their patients with a Closing the Gap annotated script:

• any medical practitioner working in a practice that is participating in the Indigenous Health Incentive under the Practice Incentives Programme,
• any medical practitioner working in an Indigenous Health Service in rural or urban settings, or
• any medical specialist in any practice location, provided the patient is eligible under the Closing the Gap - PBS Co-payment Measure, and has been referred by a medical practitioner working in a practice that is participating in the Indigenous Health Incentive PBS Co-payment Measure under the Practice Incentives Programme.

The Closing the Gap (CTG) co-payment measure within the Pharmaceutical Benefits Scheme (PBS) is intended to improve access to PBS medicinal products for eligible Aboriginal and Torres Strait Islander patients who are living with, or at risk of, chronic disease.

Closing the Gap prescriptions attract a lower or nil patient co-payment for PBS medicinal products. General (non-concessional) patients who present a Closing the Gap prescription should be charged the current concessional rate for each PBS item on that prescription. Similarly, concessional patients who present a Closing the Gap prescription do not need to pay a patient co-payment each PBS item on that prescription.

Care should be taken when using this data element. While a non-blank response may be indicative of the Indigenous status of the patient for whom the prescription is written, it should not be regarded as a definitive alternative to an actual Indigenous status data element.

Source and reference attributes

Relational attributes