Discovery Health Independent Pharmacy Contracts 2019

 

 

 

 

 

 

 

Discovery Health has embarked on a project to recontract all pharmacies that are on the Discovery Health Network with an updated contract that has the following changes:

  • Align the VAT to 15%, the previous contracted fees were inclusive of VAT at 14%
  • Update the contracts with the product changes made to MedXpress and Performance Based Remuneration
  • Discovery Health may make available to ICPA Head Office the compliance reports of member pharmacies.
  • Obtaining updated email addresses

There is no change in the quantum of the dispensing fee for 2019.

Summary of the dispensing fees:

 

 

 

 

 

ICPA is acutely aware of the stagnant dispensing fees and has addressed this with Discovery Health at every opportunity. Discovery Health is of the view that a Performance-Based Remuneration (PBR) is available to pharmacies that participate and qualify, which effectively increases the dispensing fee to above what most funders are reimbursing. In addition, Discovery Health reimburses independent pharmacies at a higher dispensing fee than they do to corporate and courier pharmacies, the latter not able to qualify for PBR.

Performance-Based Remuneration (Discovery Health Medical Scheme Chronic Illness Benefit)

PBR dispensing fees apply retrospectively to pre-authorised chronic medicine claims, paid from chronic benefits.

Excluding 

  • KeyCare & Delta plans
  • Non SEP items (unregistered medicine, Schedule 0 medicines and surgical items)
  • Couriers

Oncology, HIV and claims paid from other benefit pools, Variable PBR dispensing fees for independent pharmacies are for:

 

 

If you intend to contract with Discovery Health as a network pharmacy, then please ensure that your agreement is completed and submitted before the closing date as listed in the table below.

 

 

 

 

Send your completed agreement to provider_administration@discovery.co.za and to your software vendor to ensure that the dispensing fees are hard-coded for your pharmacy.

Timeous submission of your agreement will ensure continuity of your network arrangements and avoid unnecessary discomfort for yourself and your clients.

Click here to download a copy of the Discovery Health Pharmacy Network Agreement.

Click here to download the PBR and MedXpress communique.

Date: October 5, 2018