Acts and Regulations

P-15.01 - Prescription Drug Payment Act

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Full text
Current to 1 January 2024
CHAPTER P-15.01
Prescription Drug Payment Act
Assented to June 13, 1975
Her Majesty, by and with the advice and consent of the Legislative Assembly of New Brunswick, enacts as follows:
Definitions
1In this Act
“authorized charges” means charges to be made directly to a beneficiary for entitled services;(frais autorisés)
“beneficiary” means any resident(bénéficiaire)
(a) who has attained the age of sixty-five years, is registered under the Medical Services Payment Act and regulations under that Act, and
(i) is in receipt of the monthly guaranteed income supplement authorized to be paid under the Old Age Security Act (Canada), or
(ii) meets the eligibility requirements prescribed by regulation,
(b) who is a person or of a class of persons as determined by the Lieutenant-Governor in Council by regulation, or
(c) who is a person determined to be a beneficiary by the Minister or by a person authorized in writing by the Minister to make such a determination;
“benefit” means an entitled service that is furnished to a beneficiary pursuant to this Act and the regulations, or the payment to a beneficiary in the nature of a reimbursement for the purchase of an entitled service or a premium paid on behalf of a beneficiary;(prestation)
“department” means the Department of Health;(ministère)
“entitled service” means a drug, good or service that is determined by the Minister to be an entitled service;(service assuré)
“interchangeable pharmaceutical product” means an interchangeable pharmaceutical product as defined by regulation;(produit pharmaceutique interchangeable)
“Minister” means the Minister of Health and includes any person designated by the Minister to act on the Minister’s behalf;(ministre)
“participating provider” means a participating provider as defined and determined by regulation;(dispensateur participant)
“pharmacy” means a pharmacy as defined by regulation;(pharmacie)
“premium” means an amount paid in consideration of a contract or plan of insurance that provides coverage for entitled services, and includes a premium required to be paid by a beneficiary under this Act or the regulations;(prime)
“programme” means the programme established under this Act and the regulations;(régime)
“resident” means a person lawfully entitled to be or to remain in Canada, who makes his home and is ordinarily present in New Brunswick, but does not include a tourist, transient or visitor to the Province;(résident)
“Review Committee”  means the Inspection Review Committee established under section 3.8;(Comité d’examen)
1983, c.66, s.1; 1986, c.8, s.104; 1987, c.42, s.1; 1988, c.71, s.1; 1990, c.29, s.1; 1992, c.53, s.1; 2000, c.26, s.247; 2006, c.16, s.140; 2020, c.1, s.2
Establishment of programme
2020, c.1, s.2
1.1There is established a prescription drug programme for the purpose of ensuring that a beneficiary receives reimbursement, or payment on his or her behalf, for the cost of entitled services that are provided to the beneficiary or receives payment of premiums on his or her behalf.
2020, c.1, s.2
Powers of Minister
Repealed: 2020, c.1, s.2
2020, c.1, s.2
2Repealed: 2020, c.1, s.2
1992, c.53, s.2; 2020, c.1, s.2
Appointment of Director
2020, c.1, s.2
2.001(1)The Minister shall appoint an employee of the Civil Service, as defined in the Civil Service Act, as Director of the programme.
2.001(2)The Director shall exercise the powers and perform the duties as provided for under this Act and the regulations.
2.001(3)The Director may access any database or information system of the Minister for the purpose of exercising or performing his or her powers or duties under this Act and the regulations.
2.001(4)The Director may designate one or more persons to act on the Director’s behalf.
2020, c.1, s.2
Appointment of Programme Administrator
2020, c.1, s.2
2.002The Minister shall appoint a Programme Administrator to exercise the powers and perform the duties as provided for under this Act and the regulations.
2020, c.1, s.2
Agreements
2020, c.1, s.2
2.003The Minister may enter into agreements with any organization, agency, person or Minister of the Crown or with the government of a province or territory of Canada or the Government of Canada if the Minister considers the agreements necessary or expedient for the administration of this Act.
2020, c.1, s.2
Policies and guidelines
2020, c.1, s.2
2.004(1)The Minister may establish provincial policies and guidelines related to the administration of the programme.
2.004(2)A policy or guideline established under subsection (1) shall be published by the Minister as soon as practicable on the Department of Health website.
2.004(3)The Regulations Act does not apply to provincial policies and guidelines established under subsection (1).
2020, c.1, s.2
Non-eligibility of persons for benefits
2.01(1)Notwithstanding the definition “beneficiary”, no person is eligible to receive benefits under the programme if the person has, or is covered by, a contract or plan of insurance that, in the opinion of the Minister, provides benefits similar to the benefits provided under the programme.
2.01(1.1)Subsection (1) does not apply to a person who has been diagnosed with multiple sclerosis by a neurologist and who has a prescription from a neurologist for the drug Avonex, Betaseron, Copaxone or Rebif for treatment of the multiple sclerosis.
2.01(1.2)Subsection (1.1) is limited in its effect to those entitled services to which a person diagnosed with multiple sclerosis is entitled under the programme.
2.01(2)Notwithstanding the definition “beneficiary”, no person is eligible to receive benefits under the programme if the person is eligible to receive a drug, good or service under the terms of a statute prescribed by regulation.
1992, c.53, s.3; 2000, c.23, s.1; 2020, c.1, s.2
Determination of entitled services
2.1(1)Subject to subsection (1.1), the Minister may determine a drug, good or service to be an entitled service for the purposes of the programme.
2.1(1.1)An interchangeable pharmaceutical product shall not be determined under subsection (1) to be an entitled service unless
(a) the conditions prescribed by regulation are met, or
(b) if the conditions prescribed by regulation have been varied by the Minister in accordance with the regulations, those conditions, as varied, are met.
2.1(1.2)The Minister may revoke a determination that a drug, good or service, other than an interchangeable pharmaceutical product, is an entitled service if he or she considers it advisable to do so.
2.1(1.3)The Minister may revoke a determination that an interchangeable pharmaceutical product is an entitled service if
(a) he or she considers it advisable to do so, or
(b) the conditions prescribed by regulation or those conditions, as varied by the Minister in accordance with the regulations, have been breached.
2.1(2)The Minister shall prepare, maintain and publish a New Brunswick Prescription Drug Program Formulary which shall specify the drugs, goods and services that are determined by the Minister to be entitled services.
2.1(3)Notwithstanding any other provision of this Act, the Minister may determine the unit prices that are paid under the programme in respect of those drugs that are provided as an entitled service and that are
(a) single source products specified by the Minister, or
(b) interchangeable pharmaceutical products.
2.1(4)A manufacturer shall provide the Minister with any information that the Minister requires for the purposes of determining the unit price of a drug.
2.1(5)The Minister shall prepare, maintain and publish a list which shall specify the unit prices of interchangeable pharmaceutical products as determined under subsection (3).
2.1(6)For greater certainty and notwithstanding subsections (1.1) and (1.3), an interchangeable pharmaceutical product determined by the Minister to be an entitled service that was listed on the New Brunswick Prescription Drug Program Formulary immediately before the commencement of this subsection continues, subject to this Act and the regulations, to be an entitled service until the Minister revokes the determination in accordance with this Act.
1990, c.29, s.2; 1998, c.2, s.1; 2011, c.27, s.1; 2020, c.1, s.2
Payment by manufacturer
2.11(1)Where a manufacturer requests that the Minister include a drug produced by it in the New Brunswick Prescription Drug Program Formulary, the manufacturer shall
(a) provide the Minister with the information prescribed by regulation and any other information that the Minister requires, and
(b) pay to the Minister an amount in respect of expenses incurred or to be incurred by the Minister or any advisory committee advising the Minister with respect to a determination as to the listing of the drug in the New Brunswick Prescription Drug Program Formulary.
2.11(2)The Minister may, before or after a determination in respect of a drug as to its suitability for listing in the New Brunswick Prescription Drug Program Formulary, assess the manufacturer for the expenses incurred or to be incurred by the Minister or an advisory committee advising the Minister with respect to the determination.
2.11(3)When making an assessment under subsection (2), the Minister shall take into consideration
(a) the portion of the expenses of the Minister and the members of any advisory committee advising the Minister that relate to the determination,
(b) the expenses of any experts or consultants retained by the Minister or any advisory committee advising the Minister that relate to the determination, and
(c) such other costs and expenses that the Minister considers reasonable that are incurred by the Minister or any advisory committee advising the Minister that relate to the determination.
2.11(3.1)Members of all advisory committees who are not employees of the Civil Service, as defined in the Civil Service Act, are entitled to daily allowances fixed by the Minister.
2.11(4)Within sixty days after the decision of the Minister in respect of the suitability of the drug for listing in the New Brunswick Prescription Drug Program Formulary, the Minister shall
(a) rebate the manufacturer the amount by which the expenses assessed under subsection (2) exceed the actual expenses of the Minister and any advisory committee advising the Minister,
(b) assess the manufacturer for the amount by which the actual expenses of the Minister and any advisory committee advising the Minister exceed the expenses assessed under subsection (2), or
(c) assess the manufacturer for the actual expenses incurred by the Minister and any advisory committee advising the Minister, if no assessment has been made.
1993, c.26, s.1; 1998, c.2, s.2; 2011, c.27, s.2; 2020, c.1, s.2
Cancellation or suspension of benefits
2.2The Minister may cancel or suspend the benefits of a person if the person fails to pay any premium required by the regulations by the date set out in the regulations or if the person fails to provide information required to determine the person’s continuing eligibility to receive benefits under the programme.
1992, c.53, s.4; 2020, c.1, s.2
Recovery of cost of benefits
2.3The Minister may, in accordance with the regulations, recover the cost of benefits provided to a person where the person has received benefits under this Act or the regulations to which the person is not entitled or which the person no longer requires for the person’s use.
1992, c.53, s.4; 2020, c.1, s.2
Maximum aggregate amount of drugs
2.4(1)The Minister may fix from time to time, in respect of a drug listed in the New Brunswick Prescription Drug Program Formulary, the maximum aggregate amount of the drug to which a beneficiary is entitled under the programme during a calendar year.
2.4(2)A maximum aggregate amount fixed under subsection (1) may vary
(a) for different categories of beneficiaries, and
(b) for beneficiaries within the same category, and
the Minister, in fixing the maximum aggregate amount, shall take into consideration the age of the beneficiaries and any other factors or information that the Minister considers relevant.
2.4(3)The Minister shall inform participating providers of a maximum aggregate amount fixed under this section and the date on which the amount is effective.
2.4(4)The programme shall not provide payment for a beneficiary in respect of those amounts of a drug obtained by the beneficiary during the calendar year that exceed the maximum aggregate amount of the drug fixed by the Minister under this section.
2.4(5)Notwithstanding subsection (4), where the Minister first fixes the maximum aggregate amount for a drug or subsequently decreases the maximum aggregate amount for the drug, the programme shall provide payment for a beneficiary in respect of those amounts of the drug obtained by the beneficiary before the date on which the maximum aggregate amount is effective that exceed the maximum aggregate amount first fixed or to which it was decreased, as the case may be, less any authorized charges payable by the beneficiary.
1993, c.26, s.2; 1998, c.2, s.3; 2020, c.1, s.2
Minister may fix amount of money available to beneficiary
2020, c.1, s.2
2.5(1)In this section
“class or classes of drugs” means a class or classes of drugs as set out in the New Brunswick Prescription Drug Program Formulary.
2.5(2)The Minister may, in respect of any beneficiary, review that beneficiary’s drug utilization profile under the programme and where the quantity or nature of drug usage by the beneficiary appears, in the opinion of the Minister, inappropriate, the Minister may, notwithstanding any other provision of this Act, fix an amount of money that is available under the programme to the beneficiary for a specified period of time for use towards a specified class or classes of drugs.
2.5(3)The Minister shall, in fixing the amount of money that is available under the programme to the beneficiary and in specifying the class or classes of drugs towards which the money may be used, take into consideration
(a) the duplication of drug usage by the beneficiary within the specified class or classes of drugs,
(b) any other usage by the beneficiary that appears inappropriate with respect to the specified class or classes of drugs as appears from the beneficiary’s drug utilization profile, and
(c) any other factors or information that the Minister considers relevant.
2.5(4)The Minister shall send the beneficiary a notice in writing by ordinary mail specifying
(a) the amount of money fixed under subsection (2),
(b) the class or classes of drugs towards which the amount of money fixed under subsection (2) is to be used, and
(c) the period of time during which the amount of money fixed under subsection (2) is available.
2.5(5)The notice referred to in subsection (4) shall be deemed to have been received seven days after being mailed.
2.5(6)The Minister may, where the Minister considers it reasonable to do so, alter or revoke the amount of money fixed under subsection (2), subject to such terms and conditions that the Minister may reasonably impose.
2.5(7)Where the beneficiary exceeds the amount of money referred to in paragraph (4)(a) for the class or classes of drugs referred to in paragraph (4)(b) before the period of time specified in paragraph (4)(c) expires, the programme shall not pay, in respect of that beneficiary, for those drugs obtained by that beneficiary within the class or classes of drugs after the amount of money has been exceeded and before the period of time expires.
1993, c.26, s.2; 1998, c.2, s.4; 2020, c.1, s.2
Agreements between Minister and participating providers
2020, c.1, s.2
3The Minister may enter into an agreement with a participating provider and the agreement may provide for
(a) the amount to be paid by the Minister to the participating provider for an entitled service so provided;
(b) the amount of a dispensing fee that can be charged by the participating provider for providing professional services in the dispensing of entitled services;
(c) the payment by the Minister for all or any part of the dispensing fee being charged by a participating provider for an entitled service;
(d) the participating provider to provide such information to the Minister as he may require for the purpose of the agreement; and
(e) any other matter agreed upon between the parties to the agreement.
2020, c.1, s.2
Claims
2020, c.1, s.2
3.1(1)A participating provider who provides an entitled service to a beneficiary shall submit a claim to the Programme Administrator with the information prescribed by regulation within the time prescribed by regulation.
3.1(2)The Minister shall determine the amount to be paid to a participating provider in respect of any entitled service provided as a benefit in accordance with a method of determining the amount prescribed by regulation.
3.1(3)Despite subsection (2), the Director shall determine the amount to be paid to a participating provider in respect of any entitled service provided as a benefit for which payments cannot be determined in accordance with the regulation.
3.1(4)A participating provider shall not submit a claim for the cost of an entitled service if the participating provider has not provided the entitled service.
2020, c.1, s.2
Non-compliance
2020, c.1, s.2
3.11(1)If the Director believes, on reasonable grounds, that a participating provider or a beneficiary has violated or failed to comply with a provision of this Act or the regulations, the Director may
(a) issue a warning letter to the provider or beneficiary,
(b) make an order suspending the participation of the provider or beneficiary in the programme for the period specified in the order, and
(c) make an order cancelling the participation of the provider or beneficiary in the programme.
3.11(2)An order under paragraph (1)(b) or (c) shall be served on the participating provider or the beneficiary by personal service or registered mail.
2020, c.1, s.2
Inspectors
2020, c.1, s.2
3.2(1)The Minister may designate persons as inspectors for the purposes of this Act and the regulations.
3.2(2)The Minister shall issue to an inspector a certificate of appointment bearing the Minister’s signature or a facsimile of it.
2020, c.1, s.2
Inspections
2020, c.1, s.2
3.21(1)An inspector may
(a) require to be produced any record or document or copies or extracts of any record or document, and
(b) make those examinations and inquiries of any person that the inspector considers necessary to ensure compliance with the provisions of this Act and the regulations.
3.21(2)A person shall produce a record or document or copies or extracts of a record or document required by the inspector under paragraph (1)(a) without delay.
3.21(3)At any reasonable time, an inspector may enter and inspect premises at which a participating provider practises or operates for the purpose of ensuring compliance with this Act and the regulations.
3.21(4)An inspector who enters and inspects premises under subsection (3) shall produce his or her certificate of appointment on request.
3.21(5)Every person shall give an inspector all reasonable assistance to enable the inspector to carry out an inspection under this section, including providing the inspector with the information that the inspector reasonably requires.
2020, c.1, s.2
Confidentiality of information
2020, c.1, s.2
3.3A statement, declaration, record or document made or given by a person on request of an inspector in the course of an inspection is confidential and for the information and use of the Minister only and may not be inspected by any other person without the written authorization of the Minister.
2020, c.1, s.2
Obstruction of inspector
2020, c.1, s.2
3.4No person shall obstruct or interfere with an inspector who is carrying out or attempting to carry out an inspection under section 3.21.
2020, c.1, s.2
Powers of the Minister
2020, c.1, s.2
3.5After an inspection has been conducted, the Minister may order, in writing, the participating provider to pay an amount owing to the Minister.
2020, c.1, s.2
Results of inspection
2020, c.1, s.2
3.6(1)An inspector shall report the results of an inspection in writing to the participating provider who is the subject of the inspection.
3.6(2)Within 30 days after receiving the results of an inspection, a participating provider may make a request to the inspector that the inspector reconsider the results of the inspection.
3.6(3)A request under subsection (2) shall indicate the reasons for which the request is made and include additional relevant information, if any.
3.6(4)Within 30 days after receiving a request for a reconsideration, the inspector shall send the participating provider confirmation of the original inspection results or the amended inspection results and notice of the participating provider’s right to make a request that the Review Committee review those results.
2020, c.1, s.2
Review of results
2020, c.1, s.2
3.7(1)Within 30 days after receiving the results of a reconsideration, a participating provider may make a request to the Director that the Review Committee review those results.
3.7(2)On receiving a request for review, the Director shall send the request without delay to the Review Committee.
3.7(3)The Review Committee shall send its decision to the participating provider within 60 days after receiving the request for review.
3.7(4)A decision of the Review Committee may affirm or vary the results of the reconsideration and shall be consistent with this Act, the regulations and any provincial policies and guidelines established under this Act.
3.7(5)Within 60 days after the date of the decision of the Review Committee, the participating provider may appeal the decision to a judge of The Court of King’s Bench of New Brunswick.
2020, c.1, s.2; 2023, c.17, s.206
Inspection Review Committee
2020, c.1, s.2
3.8(1)There is established the Inspection Review Committee.
3.8(2)The Minister shall appoint an employee of the Department of Health as a non-voting member of the Review Committee who shall serve as secretary.
3.8(3)Members of the Review Committee who are not employees of the Civil Service, as defined in the Civil Service Act, are entitled to daily allowances fixed by the Lieutenant-Governor in Council.
3.8(4)The Review Committee may adopt the rules and procedures that it considers advisable.
2020, c.1, s.2
Overpayments
2020, c.1, s.2
3.9The Minister may deduct from any amount payable to a participating provider an amount equal to the amount of any overpayment made as determined as a result of an inspection under section 3.21.
2020, c.1, s.2
Records and related requirements
Repealed: 2020, c.1, s.2
2020, c.1, s.2
4Repealed: 2020, c.1, s.2
1979, c.41, s.96; 2020, c.1, s.2
Communication of information by Minister
2020, c.1, s.2
4.1Notwithstanding any other provision of this Act, the Minister may, for purposes of
(a) controlling, reducing or discontinuing the inappropriate use of entitled services, or
(b) controlling or preventing abuses of the programme,
communicate to a regional health authority as defined in the Regional Health Authorities Act, physician, nurse practitioner or pharmacist, subject to any terms or conditions the Minister may impose, any information obtained by or on behalf of the Minister under this Act.
1981, c.63, s.1; 1992, c.52, s.26; 2002, c.1, s.17; 2002, c.23, s.8; 2020, c.1, s.2
Offences
5(1)Every person
(a) who makes a false or misleading statement in an application or a claim for a payment under this Act or the regulations;
(a.1) who makes a false or misleading statement in an application to be designated a beneficiary under this Act or the regulations;
(a.2) who provides false or misleading information in respect of that person’s eligibility or continuing eligibility;
(a.3) who knowingly fails to provide any information, document or record;
(b) who submits a claim or makes a request for reimbursement
(i) for the cost of an entitled service that was not provided, or
(ii) for an amount in excess of the cost of the entitled service that was provided;
(c) who issues a prescription for an entitled service or dispenses an entitled service knowing that the entitled service is to be used by a person other than a beneficiary;
(d) who obtains an entitled service that is not for the use of a beneficiary; or
(e) who, for the purpose of the eventual dispensing of an interchangeable pharmaceutical product as an entitled service under this Act by a participating provider, sells the drug to the participating provider for a price that is higher than its unit price listed by the Minister under subsection 2.1(5);
commits an offence.
5(2)Repealed: 2020, c.1, s.2
5(3)A person who violates or fails to comply with subsection 5(1) commits an offence that is punishable under Part 2 of the Provincial Offences Procedure Act as a category F offence.
5(4)A person who violates or fails to comply with section 3.4 commits an offence that is punishable under Part 2 of the Provincial Offences Procedure Act as a category E offence.
5(5)A person who violates or fails to comply with a provision of the regulations commits an offence that is punishable under Part 2 of the Provincial Offences Procedure Act as a category B offence.
5(6)Despite subsection (5), a person who violates or fails to comply with a provision of the regulations in respect of which a category has been prescribed under paragraph 7(m.2) commits an offence of the category prescribed by regulation.
1990, c.61, s.114; 1992, c.53, s.5; 2011, c.27, s.3; 2020, c.1, s.2
Continuing offence
2020, c.1, s.2
5.1If an offence under this Act or the regulations continues for more than one day,
(a) the minimum fine that may be imposed is the minimum fine set by the Provincial Offences Procedure Act multiplied by the number of days during which the offence continues, and
(b) the maximum fine that may be imposed is the maximum fine set by the Provincial Offences Procedure Act multiplied by the number of days during which the offence continues.
2020, c.1, s.2
Certificate of Minister as evidence
2020, c.1, s.2
6In an action under section 5 a certificate signed or purporting to be signed by the Minister or by any person authorized by the Minister in writing for the purpose, may be received and considered by the court for the purpose of this Act and regulations as evidence of the contents thereof and also of the office, authority and signature of the person signing, without proof of his appointment, authority or signature.
2020, c.1, s.2
No action lies relating to interchangeable pharmaceutical products
6.1No action or other proceeding lies or shall be instituted against a person who owns or operates a pharmacy on the grounds that an interchangeable pharmaceutical product other than the one prescribed was dispensed under the programme, if
(a) the interchangeable pharmaceutical product dispensed was listed as interchangeable in the New Brunswick Formulary, and
(b) the prescriber did not prohibit the dispensing of an interchangeable pharmaceutical product other than the one prescribed.
1987, c.42, s.2; 1990, c.29, s.3; 2020, c.1, s.2
Debt due to the Province
2020, c.1, s.2
6.2(1)An amount owing to the Minister under this Act or the regulations becomes a debt due to the Province.
6.2(2)The Minister may issue a certificate stating the amount of the debt due and the name of the debtor.
6.2(3)A certificate issued under subsection (2) may be filed in The Court of King’s Bench of New Brunswick and entered and recorded in the Court and when entered and recorded may be enforced as a judgment obtained in the Court by the Crown in right of the Province against the person named in the certificate for a debt of the amount specified in the certificate.
6.2(4)All reasonable costs and charges resulting from the filing, entering and recording of a certificate under subsection (3) may be recovered as if the amount had been included in the certificate.
6.2(5)The Minister may charge interest on an amount owing to the Minister under this Act or the regulations at an interest rate prescribed by regulation.
2020, c.1, s.2; 2023, c.17, s.206
Immunity
2020, c.1, s.2
6.3No action or other proceeding may be brought against any of the following persons for anything done or not done, or for any neglect, in the performance or exercise, or the intended performance or exercise, in good faith of a power or duty under the authority of this Act or the regulations:
(a) the Minister;
(b) the Director;
(c) the Programme Administrator; or
(d) a person acting under or who has acted under the authority of this Act or the regulations.
2020, c.1, s.2
Regulations
7For the purposes of carrying out the provisions of this Act according to their intent, the Lieutenant-Governor in Council may make regulations
(a) respecting the establishment of a prescription drug programme;
(a.1) respecting the procedure to be followed by the Minister before making a determination that a drug, good or service is an entitled service or revoking a determination that a drug, good or service is an entitled service;
(a.2) respecting eligibility requirements to be met by a person for the purposes of subparagraph (a)(ii) of the definition “beneficiary” in section 1;
(b) determining the person or class of persons who are beneficiaries for the purposes of paragraph (b) of the definition “beneficiary” in section 1;
(b.1) providing for premiums to be paid by the beneficiaries described in paragraphs (b) and (c) of the definition “beneficiary” in section 1;
(c) Repealed: 1990, c.29, s.4
(d) respecting entitled services provided to beneficiaries, including the entitled services provided to persons who are beneficiaries for the purposes of paragraph (c) of the definition “beneficiary” in section 1;
(e) defining and determining who is a participating provider;
(e.1) defining “interchangeable pharmaceutical product” and “single source product”;
(e.2) defining “pharmacy”;
(e.3) prescribing conditions for the purposes of subsection 2.1(1.1) or (1.3), which conditions may vary for different interchangeable pharmaceutical products or classes of interchangeable pharmaceutical products;
(e.4) respecting exemptions from any condition prescribed under paragraph (e.3);
(e.5) authorizing the Minister to vary any condition prescribed under paragraph (e.3) in certain circumstances;
(e.6) respecting the circumstances referred to in paragraph (e.5), including authorizing the Minister to determine if the circumstances exist;
(f) respecting the manner and form under which any person may make application to be designated a beneficiary under the programme, and the information required and the proof required to sustain an application;
(f.1) providing for investigation into an application by a person to be designated a beneficiary and into the eligibility and continuing eligibility of the person to receive benefits under the programme;
(f.2) providing for the determination of questions respecting eligibility and continuing eligibility of a person to receive benefits under the programme and for the information to be provided by a person in respect of that person’s eligibility or continuing eligibility;
(f.3) prescribing information to be provided to the Minister under subsection 2.11(1);
(g) respecting the time, manner and form in which the accounts are to be rendered and in which any other information required in connection with the account is to be submitted;
(h) prescribing the method of assessing accounts with respect to the cost of entitled services and of determining the amounts payable therefor;
(i) respecting the manner and form of regulating payments to those persons who provide, directly or indirectly, entitled services under this Act or regulations in the Province in accordance with any system of payment that provides reasonable compensation for entitled services rendered;
(i.1) respecting premiums that may be paid on behalf of beneficiaries for a contract or plan of insurance that provides for the furnishing of entitled services and the circumstances under which such premiums may be paid;
(j) respecting reimbursement to beneficiaries for entitled services for which they have paid and to the extent that no claim therefor has been made by the person supplying such a service, including the limiting of time within which application thereof is to be made;
(j.1) providing for authorized charges, which charges may vary for different beneficiaries or classes of beneficiaries, and providing for terms and conditions respecting the application and administration of authorized charges;
(j.2) exempting different beneficiaries or classes of beneficiaries from the payment of authorized charges;
(j.3) respecting the recovery of the cost of benefits provided to a person where the person has received benefits under this Act or the regulations to which the person is not entitled or which the person no longer requires for the person’s use;
(j.4) prescribing statutes for the purposes of subsection 2.01(2);
(j.5) respecting forms for the purposes of this Act and the regulations;
(k) respecting the appointment of advisory committees and the powers and duties of such committees;
(k.1) respecting the size, composition and quorum of advisory committees;
(l) respecting the reimbursement of expenses to be paid to a person appointed to an advisory committee;
(l.1) setting out the powers and duties of the Director and the Programme Administrator;
(l.2) conferring additional powers and duties to inspectors;
(l.3) providing for appointments to the Review Committee, including the size, composition and quorum of the Review Committee and the term of office, qualifications and compensation of its members;
(l.4) prescribing information to be provided to the Programme Administrator by a participating provider for the purposes of subsection 3.1(1);
(l.5) prescribing the time within which the participating provider shall submit a claim for the purposes of subsection 3.1(1);
(l.6) prescribing the method of determining the amount to be paid by the Minister to a participating provider under subsection 3.1(2), including the circumstances in which a reassessment may be conducted and an adjustment to the amount may be made;
(m) respecting appeals from anything done under this Act or regulations and the procedures therefore;
(m.1) defining any word or expression used in but not defined in this Act for the purposes of this Act, the regulations or both;
(m.2) prescribing, in respect of offences under the regulations, categories of offences for the purposes of Part 2 of the Provincial Offences Procedure Act;
(m.3) setting an interest rate for the purposes of subsection 6.2(5);
(n) generally for the administration of this Act.
1983, c.66, s.2; 1987, c.42, s.3; 1988, c.71, s.2; 1990, c.29, s.4; 1992, c.53, s.6; 1998, c.2, s.5; 2011, c.27, s.4; 2020, c.1, s.2
Regulations may be retroactive
7.1A regulation made under section 7 may be made retroactive in its operation.
2000, c.23, s.2
Commencement
8This Act comes into force on a date to be fixed by proclamation.
N.B. This Act was proclaimed and came into force October 1, 1975.
N.B. This Act is consolidated to June 16, 2023.