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NEW ZEALAND GAZETTE, No. 42

15 APRIL 2004

4.5 Nothing in clause 4.4 above shall affect the rights of a general practitioner in relation to any other service,
notwithstanding other services provided on the same occasion as that on which the vaccine or vaccines were
administered.

4.6 The subsidised fee for the administration of a vaccine episode on the childhood immunisation schedule as detailed in the
Immunisation Handbook, other than the influenza vaccine, shall be $18.00 (G.S.T. inclusive). The subsidised fee for the
administration of the influenza vaccine will be $11.00 (G.S.T. inclusive) plus the purchase cost (inclusive of G.S.T.) of
the vaccine from the nominated supplier. For the purposes of clarity, a vaccine episode is a visit on any given day for the
administration of any number of vaccines. The subsidised fee for immunisations will be reviewed annually.

4.7 The immunisation programmes, which are currently approved under this Schedule, are detailed in the Immunisation
Handbook and any subsequent amendment notified by the District Health Board and/or the Ministry of Health.

5 Claims for immunisation subsidised fees

5.1 Claims for payment of immunisation subsidised fees are to be submitted to Health Benefits electronically in accordance
with the Business Rules unless otherwise approved by us.

5.2 Each claim for any individual must clearly identify all of the following information:
(a) The name and date of birth of the person to whom the vaccine was or the vaccines were given; and
(b) either the NHI number or the address of the person to whom the vaccination was given; and
(c) the type of vaccine or vaccines given to each person; and
(d) the date that the vaccine was or the vaccines were given.

5.3 A subsidised fee will be paid to a general practitioner for the administration of a vaccine or vaccines as set out in this
Notice subject to the following conditions:
(a) The immunisation has not already been given and a reasonable effort has been made to check whether the
immunisation has not been given and the subsidised fee is claimed in accordance with the claiming and NHI
number requirements of this Notice, and the claim complies with the information requirements set out in the
information schedule of this agreement; and
(b) The general practitioner will not charge the patient for immunisation services where a subsidised fee is available
and payable under this Notice. If any general medical service other than immunisation is provided by the
practitioner at the same time as the consultation for the immunisation service, then the general practitioner may
charge for that other service (including claiming the General Medical Services Benefit if eligible). A simple check
of fitness (without clinical indication) for immunisation is considered part of the immunisation service.
(c) A practitioner will not be eligible to receive a payment unless the practitioner has made a reasonable effort to
check whether the immunisation service has been previously performed.

5.4 The NHI requirements for immunisation claims where all the immunisation claims will be paid in full are:
1 September 2001
80% of immunisation claims must have valid NHI numbers
1 July 2002
85 % of immunisation claims must have valid NHI numbers
Where the proportion of NHI numbers in a whole claim is less than the targets specified above, those single claims that
do not have NHI numbers will not be paid.

5.5 For all immunisations eligible for a payment of a subsidised fee, other than influenza immunisations, the subsidised fee
is currently $18.00 (G.S.T. inclusive) in respect of each immunisation episode as set out in this Notice. The subsidised
fee for immunisations will be reviewed annually by the Ministry of Health.

5.6 The following provisions apply to influenza immunisations:
(a) Subject to all other provisions of this Notice below, a payment comprising of the vaccine cost plus the
immunisation subsidised fee as advised by the Ministry of Health from time to time will be paid for influenza
immunisations administered to eligible people as defined by Ministry of Health Influenza Guidelines. The
Ministry of Health from time to time will also advise the vaccine cost, and the District Health Board will advise
any change to the vaccine cost one month prior to the commencement of the programme.
(b) The Ministry of Health Influenza Guidelines may be amended from time to time. The Ministry of Health will
consult with the sector on any change to such guidelines.
(c) Payments will be made only for influenza vaccinations administered between 1 January and 30 June in any
calendar year.
(d) The Ministry of Health will advise each general practitioner (in a manner to be determined by the Ministry of
Health) of the supplier from whom the vaccine is to be purchased and the price as required from time to time.

5.7 A subsidised fee of $18.00 (G.S.T. inclusive) will be paid for the administration of a vaccine or vaccines where:
(a) the person is a household contact or sexual contact of person with acute hepatitis B or a carrier of hepatitis B; or
(b) the person is a household contact of a person with measles, mumps or rubella.
This subsidised fee will be reviewed annually by the Ministry of Health.

5.8 A subsidy of $18.00 (G.S.T. inclusive) will be paid for administering a MeNZB™ vaccine episode.

5.9 If the general practitioner administers more than one vaccine on the same occasion and one of those vaccines is
MeNZB™, the general practitioner is entitled to receive a subsidy for MeNZB™ in addition to any other immunisation
subsidy to which the general practitioner is entitled under this Schedule.

Appendix 1 to Schedule 3

2002 Eligibility criteria for fully subsidised influenza vaccine

(a) Any person aged 65 years and over; and

(b) Any person under the age of 65 years with one or more of the following conditions:
(i) cardiovascular diseases, including: