Acts and Regulations

2014-27 - General

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Full text
Current to 1 November 2023
NEW BRUNSWICK
REGULATION 2014-27
under the
Prescription and Catastrophic Drug Insurance Act
(O.C. 2014-75)
Filed March 28, 2014
Under section 63 of the Prescription and Catastrophic Drug Insurance Act, the Lieutenant-Governor in Council makes the following Regulation:
CITATION AND DEFINITIONS
Citation
1This Regulation may be cited as the General Regulation - Prescription and Catastrophic Drug Insurance Act.
Definitions for the purposes of the Act and this Regulation
2The following definitions apply in the Act and this Regulation.
“co-payment” means the portion of the total cost of an entitled service that is required to be paid by a member of the Plan at the time a benefit is provided or that is not reimbursed to a member of the Plan, except an amount under subsection 22(2).(quote-part)
“income” means the total income in the year immediately preceding the current year, or, if the total income for that year is not available, the income of the year prior to that year, as declared on Line 150 of an individual’s income tax return less any elected split-pension amount as declared on Line 116.(revenu)
Definitions for the purposes of this Regulation
3The following definitions apply in this Regulation.
“Act” means the Prescription and Catastrophic Drug Insurance Act.(Loi)
“actual acquisition cost” means the unit price of a drug to a participating provider, based on reasonable and customary purchasing practices, which is calculated by deducting from the total amount paid or payable to purchase the drug, excluding franchise fees and shipping charges, the value of any price reduction.(coût d’achat réel)
“brand name product” means the drug for which the first notice of compliance has been issued in respect of a particular active ingredient or combination of particular active ingredients, the drug’s strength and the drug’s dosage form.(produit de marque)
“controlled drug” means a controlled drug as defined in Part G of the Food and Drug Regulations under the Food and Drugs Act (Canada).(médicament contrôlé)
“extemporaneous preparation” means a drug compounded by a provider that does not duplicate the formulation of a manufactured drug.(préparation extemporanée)
“manufacturer’s list price” means the unit price of a drug as provided by a manufacturer to the Minister and published by the Minister, excluding any markup for distribution and the value of any price reduction.(prix courant du fabricant)
“maximum allowable price” means the unit price of a drug determined by the Minister in accordance with subsection 30(1) of the Act.(prix maximal autorisé)
“narcotic” means a narcotic as defined in the Narcotic Control Regulations under the Controlled Drugs and Substances Act (Canada).(stupéfiant)
“notice of compliance” means the notice of compliance issued for a drug under the Food and Drug Regulations under the Food and Drugs Act (Canada).(avis de conformité)
“original product” means a drug that(produit original)
(a) is the brand name product, and
(b) is or was marketed in Canada by the drug’s innovator or a person acting under a licence granted by the drug’s innovator before the issuance of any subsequent notice of compliance for another drug having the same active ingredient or combination of active ingredients.
“pharmaceutical alternative” means a drug that contains the same therapeutic moiety as another drug but (substitut pharmaceutique)
(a) different salts, esters or complexes of that moiety, or
(b) in a different dosage form or strength.
“pharmaceutical equivalent” means a drug that contains identical amounts of identical medicinal ingredients as another drug in a similar dosage form.(équivalent pharmaceutique)
“price reduction” means a rebate, an allowance, a refund, free goods or any other similar advantage granted to a participating provider by a manufacturer or pharmaceutical distributor in respect of the purchase of a drug and includes(réduction de prix)
(a) a discount, unless the discount is for prompt payment that is made within 30 days after the drug is delivered to the participating provider and that does not exceed 2% of the net purchase price, and
(b) a delayed payment, unless the payment is made within 120 days after the drug is delivered to the participating provider, in which case the delayed payment is deemed to be a profit of 1.5% of the net purchase price per month.
“reasonable and customary purchasing practices” means purchasing sufficient quantities to satisfy anticipated sales of a drug and maintenance of appropriate inventory levels based on generally accepted business principles.(pratiques d’achat raisonnables et courantes)
“targeted substance” means a targeted substance as defined in the Benzodiazepines and Other Targeted Substances Regulations under the Controlled Drugs and Substances Act (Canada).(substance ciblée)
2020, c.1, s.3
GOVERNANCE
Duties of the Director
4For the purposes of subsection 6(2) of the Act, the Director shall perform the following duties:
(a) Repealed: 2015-8
(b) evaluate the Plan; and
(c) inform the public with respect to the Plan.
2015-8
Information relating to an entitled person
5For the purposes of subsection 6(4) of the Act, the personal information and personal health information is as follows:
(a) the identification number of the family unit; and
(b) in relation to each member of the family unit, the member’s
(i) name,
(ii) Medicare number,
(iii) address,
(iv) date of birth,
(v) date of death, if applicable, and
(vi) gender.
Duties of the Plan Administrator
6For the purposes of section 7 of the Act, the Plan Administrator shall perform the following duties:
(a) support the evaluation of Plan funding;
(b) process claims and requests;
(c) assess and collect premiums;
(d) determine eligibility for the Plan;
(e) determine whether a member of the Plan is eligible for an entitled service referred to in paragraph 29(2)(b) of the Act;
(f) provide for the administration with respect to entitled services;
(f.1) recover overpayments in accordance with the results of an inspection;
(g) manage communications; and
(h) store, analyse and report on Plan data.
2015-8; 2020, c.1, s.3
Agreements
7(1)For the purposes of subsection 8(2) of the Act, the Minister may enter into agreements for the following purposes:
(a) to establish an entitlement to benefits;
(b) to establish an obligation to pay an amount under the Act or this Regulation and the amount owing;
(c) to identify a situation in which information was not provided or was provided incorrectly;
(d) to establish a person’s permanent residence; or
(e) to evaluate the Plan.
7(2)For the purposes of subsection 8(2) of the Act, the Minister may enter into agreements with the following entities:
(a) the Minister of Employment and Social Development Canada;
(b) the Minister of Social Development; and
(b.1) Repealed: 2019, c.2, s.112
(c) the regional health authorities as defined in the Regional Health Authorities Act.
2015-8; 2016, c.37, s.146; 2019, c.2, s.112
Advisory Committee
Repealed: 2015-8
2015-8
8Repealed: 2015-8
2015-8
Meetings of the Advisory Committee
Repealed: 2015-8
2015-8
9Repealed: 2015-8
2015-8
Conflict of interest of a member of the Advisory Committee
Repealed: 2015-8
2015-8
10Repealed: 2015-8
2015-8
Matters referred to the Advisory Committee
Repealed: 2015-8
2015-8
11Repealed: 2015-8
2015-8
VOLUNTARY MEMBERSHIP
2015-8
Voluntary membership
12(1)For the purposes of subsection 12(8) of the Act, notice shall be provided by registered mail.
12(2)The notice under subsection (1) shall be deemed to have been received by the person to whom it was sent on the earlier of the fifth day after mailing and the day its receipt was acknowledged in writing by the person to whom it was sent.
Information provided by an entitled person
13(1)For the purposes of subsection 13(2) of the Act, the information to be provided is as follows:
(a) in relation to each member of the family unit, the member’s
(i) name,
(ii) Medicare number,
(iii) date of birth,
(iv) gender,
(v) marital or cohabitation status, and
(vi) current drug coverage;
(b) in relation to each dependant in the family unit, whether the dependant is a person with a disability;
(c) the address, phone number and email address of the family unit; and
(d) the preferred official language of the family unit.
13(2)An entitled person shall provide the information referred to in subsection (1) within 30 days after the Director makes the request.
13(3)For the purposes of subsection 13(3) of the Act, an entitled person shall make the statement on a form provided by the Minister that includes the following information:
(a) an undertaking to notify the Director of any change that would affect eligibility of the entitled person within 30 days after the change;
(b) an undertaking to notify the provider who provides an entitled service to the entitled person of all of his or her drug coverage; and
(c) an undertaking to repay a benefit or a portion of a benefit for which the entitled person is not eligible.
Premiums and co-payments for voluntary members
14(1)For the purposes of subsection 15(1) of the Act, premiums are set as follows:
(a) at the request of an entitled person, by taking into account the income level of the family unit and the composition of the family unit in accordance with Schedule A, or
(b) in any other case, an amount equal to the highest annual premium payable by a member of the Plan under Schedule A.
14(2)For the purposes of paragraph (1)(a), a dependant is only a member of a family unit that obtains coverage for that dependant under the Plan.
14(3)An entitled person who requests that his or her premium be set under paragraph (1)(a) shall provide the Director with the following information in relation to each member of the family unit other than a dependant:
(a) social insurance number; and
(b) an authorization to the Minister under subsection 241(5) of the Income Tax Act (Canada) to obtain information directly from the Canada Revenue Agency.
14(4)The premium under subsection (1) shall be paid on or before the first day of each full month in which the member of the Plan is entitled to benefits.
14(5)If a member of the Plan provides banking information to the Plan Administrator, the premium under subsection (1) may be paid by preauthorized payment.
14(6)For the purposes of subsection 15(2) of the Act, a member of the Plan may make a request for reimbursement by regular mail or electronic transmission on a form provided by the Minister within 12 months after the date the overpayment was made.
14(7)A member of the Plan shall pay a co-payment of 30% of the total cost of an entitled service that is provided to the member but not more than the amount set out in Schedule B.
14(8)Despite subsection (7), a member of the Plan referred to in subsection 22(2) shall pay a co-payment of 30% of the total cost, including the dispensing fee, the markup and the cost of the lowest cost pharmaceutical equivalent or pharmaceutical alternative but not more than the amount set out in Schedule B.
14(9)A member of the Plan who has an approval under subsection 29(4) of the Act for a brand name product shall pay a co-payment of 30% of the total cost, including the dispensing fee, the markup and the cost of the brand name product but not more than the amount set out in Schedule B.
14(10)Nothing in this section prevents a participating provider from refunding a member of the Plan the amount, or a portion of the amount, referred to in subsection (7), (8) or (9).
2015-2; 2015-8; 2020, c.1, s.3; 2022-67
Phase-in of premium increase
2022-67
14.1(1)In this section, “base premium” means the amount of the premium payable by the member of the Plan immediately before the commencement of this section.
14.1(2)This section applies to a person who was a member of the Plan on July 1, 2022, and whose premium on that date was set under paragraph 14(1)(a).
14.1(3)Despite paragraph 14(1)(a), the premium payable by a member of the Plan referred to in subsection (2) for the current year is the lesser of
(a) the premium set under paragraph 14(1)(a), and
(b) the premium determined under subsection (4).
14.1(4)The premium payable by a member of the Plan referred to in subsection (2) shall be the following:
(a) from November 1, 2022, to October 31, 2023, the annual premium set under Schedule A that is nearest to, but does not exceed, the sum of the base premium and $150; and
(b)  on and after November 1, 2023, the annual premium set under Schedule A that is nearest to, but does not exceed, the sum of the amount that was payable for the year immediately preceding the current year and $150.
14.1(5)The phase-in of premium increases in accordance with this section has effect until November 1, 2027, or the earliest of the following:
(a) the date of any change in the income level of the family unit or the composition of the family unit which would result in a higher premium being set under paragraph 14(1)(a) for the member of the Plan;
(b) the member of the Plan fails to provide any information required by the Director under subsection 14(3); or
(c) the date of cancellation of membership in the Plan, even if the former member of the Plan reinstates membership after that date.
14.1(6)A member of the Plan to whom this section applies shall notify the Director immediately of any change referred to in paragraph (5)(a).
14.1(7)On cessation of the phase-in of premium increases under subsection (5), the premium for the member of the Plan shall be set in accordance with subsection 14(1).
2022-67
MEMBERS OF THE PLAN
Repealed: 2015-8
2015-8
Certificate of private individual drug insurance
Repealed: 2015-8
2015-8
15Repealed: 2015-8
2015-8
Mandatory membership
Repealed: 2015-8
2015-8
16Repealed: 2015-8
2015-8
Private group drug insurance
Repealed: 2015-8
2015-8
17Repealed: 2015-8
2015-8
Information provided by or relating to an entitled person
Repealed: 2015-8
2015-8
18Repealed: 2015-8
2015-8
PROVIDERS
Participating providers
19For the purposes of subsection 22(1) of the Act, a provider may participate in the Plan by providing the Director with the following information:
(a) the provider’s name, the business name of the pharmacy, the store number of the pharmacy and the name of the owner of the pharmacy;
(b) the licence or accreditation number of the provider;
(c) the phone number, fax number and email address of the provider;
(d) the mailing and physical address of the provider;
(e) the signing authority of the provider for claim submissions;
(f) payment information of the provider;
(g) the software vendor of the provider; and
(h) any change to the information provided in paragraphs (a) to (g) and the effective date of the change.
Information provided by non-participating providers
20When a provider who is not participating in the Plan provides an entitled service that is a drug to a client, the provider shall provide to the client the following information:
(a) the prescription number and the number of refills;
(b) the name, licence number and address of the prescriber;
(c) the name, physical address and licence or accreditation number of the provider;
(d) the drug name, strength and dosage form;
(e) the drug identification number assigned by Health Canada or the product identification number assigned by the Director;
(f) the intervention or exception code;
(g) the quantity of the drug;
(g.1) the day supply of the drug;
(h) the total cost, including a breakdown of the cost as follows:
(i) the dispensing fee;
(ii) Repealed: 2014-62
(iii) the drug cost; and
(iv) any other costs; and
(i) the date of service and the date the drug was dispensed.
2014-62; 2020, c.1, s.3
Information provided by participating providers
21(1)When a participating provider provides an entitled service that is a drug to a member of the Plan, the participating provider shall provide to the member the following information:
(a) the prescription number and the number of refills;
(b) the name of the prescriber and the prescriber identification number assigned by the Director;
(c) the name and physical address of the participating provider and the participating provider identification number assigned by the Director;
(d) the drug name, strength and dosage form;
(e) the drug identification number assigned by Health Canada or the product identification number assigned by the Director;
(f) the intervention or exception code;
(g) the quantity of the drug;
(g.1) the day supply of the drug;
(h) the amount of the co-payment under subsection 14(7), (8) or (9);
(i) the total cost, including a breakdown of the cost as follows:
(i) the dispensing fee; and
(ii) Repealed: 2014-62
(iii) the drug cost; and
(j) the date of service and the date the drug was dispensed.
21(2)When a participating provider provides a brand name product that has a pharmaceutical equivalent or a pharmaceutical alternative to a member of the Plan who does not have an approval under subsection 29(4) of the Act for the brand name product, the participating provider shall provide to the member the following information:
(a) that the amount that the Plan pays to a participating provider under the Plan shall not exceed the maximum allowable price of the lowest cost pharmaceutical equivalent or pharmaceutical alternative; and
(b) that the member shall pay the difference in price between the actual acquisition cost of the brand name product and the maximum allowable price of the lowest cost pharmaceutical equivalent or pharmaceutical alternative if the member elects to receive the brand name product.
2014-62; 2015-2; 2020, c.1, s.3
Sale to member of the Plan by participating provider
22(1)For the purposes of section 25 of the Act, a participating provider shall not charge a member of the Plan an amount that is greater than the amount determined under subsection 27(2) of the Act.
22(2)Despite subsection (1), when a prescription is for a brand name product that has a pharmaceutical equivalent or a pharmaceutical alternative and the member of the Plan does not have an approval under subsection 29(4) of the Act for the brand name product, the member shall pay the difference in price between the actual acquisition cost of the brand name product and the maximum allowable price of the lowest cost pharmaceutical equivalent or pharmaceutical alternative if the member elects to receive the brand name product.
22(3)A participating provider shall not require a member of the Plan to pay an amount, in addition to a co-payment or an additional charge under subsection (2), as a condition to providing a benefit.
Claims by participating providers
23(1)If a participating provider charges a member of the Plan an amount for an entitled service that is equal to the amount determined by the Minister in accordance with section 25 of the Act, the participating provider is not required to submit a claim to the Plan Administrator under subsection 27(1) of the Act.
23(2)For the purposes of subsection 27(1) of the Act, a claim by a participating provider shall be accompanied by the information as provided for in the pharmacy claim standard of the Canadian Pharmacists Association.
23(3)A participating provider shall submit a claim in electronic format within three months after the date an entitled service was provided to the member of the Plan or in non-electronic format within one year after the date an entitled service was provided to the member of the Plan.
2020, c.1, s.3
Reassessment of claims
24(1)A participating provider may request a reassessment of a claim by resubmitting a claim in electronic format within three months after the date an entitled service was provided to the member of the Plan or in non-electronic format within one year after the date an entitled service was provided to the member of the Plan.
24(2)The Minister may conduct a reassessment of a claim and adjust the amount that he or she is required to pay to a participating provider if an error or omission exists with regard to the claim.
Amount to be paid to a participating provider
25(1)The following classes of entitled services are established:
(a) Class A drugs; and
(b) Class B drugs.
25(2)For the purposes of subsection 27(2) of the Act, if a benefit provided by a participating provider is a Class A drug, the amount to be paid to the participating provider is the sum of the following amounts:
(a) an amount that is equal to or less than the manufacturer’s list price;
(b) a dispensing fee of up to $11; and
(c) up to 8% of the manufacturer’s list price.
25(3)For the purposes of subsection 27(2) of the Act, if a benefit provided by a participating provider is a Class B drug, the amount to be paid to the participating provider is the sum of the following amounts:
(a) an amount that is equal to or less than the maximum allowable price;
(b) a dispensing fee of up to $11; and
(c) up to 8% of the maximum allowable price.
25(4)Despite subsections (2) and (3), the amount to be paid to a participating provider if a benefit provided by the participating provider is an extemporaneous preparation, is the sum of the following amounts:
(a) an amount that is equal to or less than the actual acquisition cost of each ingredient; and
(b) a dispensing fee of up to $16.50.
25(5)Despite subsections (2) to (4), the amount to be paid to a participating provider if a benefit provided by the participating provider is a drug used to treat opioid dependence, is the sum of the following amounts:
(a) an amount that is equal to or less than the maximum allowable price; and
(b) a dispensing fee of up to $9.50.
2014-62
Frequency of dispensing
26(1)A dispensing fee shall be paid to a participating provider in the following circumstances:
(a) the amount of the drug provided to a member of the Plan is a continuous 28-day supply; or
(b) the amount of the drug provided to a member of the Plan is at least a one-day supply and either
(i) the member’s drug therapy cannot be managed if the amount of the drug provided to the member is a continuous 28-day supply, or
(ii) the drug is used to treat opioid dependence.
26(2)Despite subsection (1), if a drug is classified according to the anatomical therapeutic chemical classification system, a dispensing fee shall be paid to the participating provider in the following circumstances:
(a) the amount of the drug provided to a member of the Plan is a continuous 60- or 90-day supply according to the drug’s classification;
(b) the amount of the drug provided to a member of the Plan is a continuous 30-day supply and the member has not received the drug in the past 12 months; or
(c) the amount of the drug provided to a member of the Plan is at least a one-day supply and the member’s drug therapy cannot be managed if the amount of the drug provided to the member is a continuous 60- or 90-day supply.
Restrictions and conditions on days supply
27(1)A member of the Plan is not entitled to reimbursement and a participating provider is not entitled to payment under the Plan in respect of a drug if the amount of the drug provided exceeds a 100-day supply unless the dosage regimen of the drug requires that it be administered at an interval that exceeds a 100-day supply.
27(2)Despite subsection (1), a member of the Plan is not entitled to reimbursement and a participating provider is not entitled to payment under the Plan in respect of a narcotic, a controlled drug or benzodiazepine or another targeted substance if the amount of the drug provided exceeds a 35-day supply.
27(3)A member of the Plan is not entitled to reimbursement and a participating provider is not entitled to payment under the Plan
(a) in respect of a refill of a prescription that is dispensed on the same day as a fill or refill of the same prescription, or
(b) in respect of a refill of a prescription unless 80% of the previous days’ supply has elapsed.
BENEFITS
Formulary
28(1)A request under subsection 29(4) of the Act shall be made on a form provided by the Minister and signed by a provider or medical practitioner.
28(2)For the purposes of subsection 29(4) of the Act, the information to be provided is as follows:
(a) the name, dosage form, strength and treatment schedule of the drug;
(b) whether the request is for an approval of a brand name product when a pharmaceutical equivalent or a pharmaceutical alternative is available;
(c) clinical information that outlines the request of the member of the Plan;
(d) outcome measures to support continued use and to stop treatment;
(e) supporting laboratory tests and objective clinical measures;
(f) details of previous treatment with other therapies or products, if applicable;
(g) details of availability of the drug to the member of the Plan from other sources; and
(h) supporting published data and evidence for use.
2020, c.1, s.3
List of prices
29(1)The list established under subsection 30(1) of the Act shall be published by the Minister on the Department of Health website.
29(2)The Minister may vary the unit price of a drug that is an entitled service if the proposed price is not higher than the price in another Canadian jurisdiction and one or more of the following conditions exists:
(a) the manufacturer provides documentation indicating that a different unit price should be established;
(b) the manufacturer’s list price for the original product has changed;
(c) the original product is no longer marketed in Canada or another product with similar ingredients, strength and dosage form has received a notice of compliance;
(d) it is justified having regard to market conditions; or
(e) it is justified in the public interest having regard to the safety of members of the Plan, access to the drug or costs to the Plan.
2020, c.1, s.3
Entitlement to benefits
30For the purposes of subsection 31(2) of the Act, a member of the Plan may be entitled to a benefit if entitled services as defined in the Medical Services Payment Act are authorized under subsection 2(2) or 2(3) of that Act.
Exceptions
31For the purposes of paragraph 32(c) of the Act, a benefit shall not be provided
(a) in a nursing home as defined in the Nursing Homes Act from the limited supply of drugs referred to in paragraphs 21(h) or (i) of the General Regulation under that Act, or
(b) in a correctional institution as defined in the Corrections Act.
Evidence of membership
32For the purposes of subsection 33(1) of the Act, a member of the Plan shall provide his or her valid identification card issued by the Director as evidence of membership in the Plan.
Reimbursement for entitled services
33For the purposes of subsection 34(1) of the Act, a member of the Plan shall make a request for reimbursement within one year after the date an entitled service was provided to the member.
2020, c.1, s.3
Restrictions
34For the purposes of section 35 of the Act, the Director may limit the maximum number of providers or the quantity of benefits that may be provided to a member of the Plan in the following circumstances:
(a) there is documentation indicating that the member filled prescriptions from more than one prescriber for duplicate therapy;
(b) there is documentation indicating that the member has filled prescriptions at more than one provider for duplicate therapy;
(c) in the opinion of the member’s attending physician, the member is abusing or misusing a drug resulting in danger to the health of the member or unnecessary cost to the Plan; or
(d) there is documentation indicating that the member has filled prescriptions for amounts of a drug that are not within recommended dosing for the drug.
FUNDING
Repealed: 2015-8
2015-8
Premiums
Repealed: 2015-8
2015-8
35Repealed: 2015-8
2015-8
MINIMUM REQUIREMENTS
Repealed: 2015-8
2015-8
Private group drug insurance
Repealed: 2015-8
2015-8
36Repealed: 2015-8
2015-8
Certificate of private group drug insurance
Repealed: 2015-8
2015-8
37Repealed: 2015-8
2015-8
Information provided by the insurer
Repealed: 2015-8
2015-8
38Repealed: 2015-8
2015-8
Cancellation of an insurance contract
Repealed: 2015-8
2015-8
39Repealed: 2015-8
2015-8
REVIEW COMMITTEE
2020, c.1, s.3
Review Committee
2020, c.1, s.3
39.1(1)The Review Committee shall be composed of the following four members appointed by the Lieutenant-Governor in Council:
(a) a chartered professional accountant, to serve as chair; and
(b) three pharmacists who are not employees of the Department of Health.
39.1(2)Members of the Review Committee shall be appointed for a term of up to three years and are eligible for reappointment for one additional term.
39.1(3)Despite the expiration of his or her term, a member shall continue to be a member until he or she is replaced.
39.1(4)If a member is unable or unwilling to perform his or her duties due to incapacity, incompetence, absence or for any other reason, that member may be removed as a member by the Lieutenant-Governor in Council and another shall be appointed in his or her place.
39.1(5)A vacancy on the Review Committee does not impair the capacity of the Review Committee to act.
39.1(6)A member of the Review Committee is entitled to be reimbursed for accommodation, meal and travel expenses reasonably incurred in connection with his or her duties in accordance with the Treasury Board travel policy guidelines, as amended.
2020, c.1, s.3
Meetings and quorum
2020, c.1, s.3
39.2(1)The Review Committee shall meet as required at the call of the chair at the date, time and place designated by the chair.
39.2(2)Three members of the Review Committee constitute a quorum with at least one member being the chair.
39.2(3)All matters of decision shall be decided by majority vote and the chair shall not vote except to have a casting vote in the event of a tie.
39.2(4)Matters reviewed by the Review Committee and the deliberations of the Review Committee shall be held in confidence and, when possible, the Minister shall provide the Review Committee only with information that does not identify the participating provider.
2020, c.1, s.3
ENFORCEMENT
Notice of non-compliance
40(1)For the purposes of subsection 50(2) of the Act, the Minister shall serve the notice of non-compliance
(a) in the manner in which personal service may be made under the Rules of Court, or
(b) by registered mail to the person’s latest known address.
40(2)Service by registered mail shall be deemed to have been effected five days after the date the notice of non-compliance is deposited in the mail.
40(3)For the purposes of subsection 50(3) of the Act, the notice of non-compliance shall include the following information:
(a) the name of the person who has violated or failed to comply with a provision of the Act or regulations;
(b) the provision of the Act or regulations and the date on which the violation or failure to comply occurred;
(c) the amount of the administrative penalty that may be imposed; and
(d) information with respect to the person’s right to make written submissions.
Notice of administrative penalty
41(1)For the purposes of subsection 53(2) of the Act, the Minister shall serve the notice of administrative penalty
(a) in the manner in which personal service may be made under the Rules of Court, or
(b) by registered mail to the person’s latest known address.
41(2)Service by registered mail shall be deemed to have been effected five days after the date the notice of administrative penalty is deposited in the mail.
41(3)For the purposes of subsection 53(3) of the Act, the notice of administrative penalty shall include the following information:
(a) the name of the person required to pay the administrative penalty;
(b) the provision of the Act or regulations and the date on which the violation or failure to comply occurred;
(c) the amount of the administrative penalty;
(d) when and how the administrative penalty shall be paid; and
(e) information with respect to the person’s right to request a review of the Minister’s decision.
Maximum amount of administrative penalty
42The maximum amount of an administrative penalty is $500.
APPEALS
Repealed: 2015-8
2015-8
Appeal Committee
Repealed: 2015-8
2015-8
43Repealed: 2015-8
2015-8
Notice of appeal and information
Repealed: 2015-8
2015-8
44Repealed: 2015-8
2015-8
Grounds of appeal
Repealed: 2015-8
2015-8
45Repealed: 2015-8
2015-8
Notice of hearing
Repealed: 2015-8
2015-8
46Repealed: 2015-8
2015-8
Conduct of hearings
Repealed: 2015-8
2015-8
47Repealed: 2015-8
2015-8
Decisions of the Appeal Committee
Repealed: 2015-8
2015-8
48Repealed: 2015-8
2015-8
Conflict of interest of a member of a hearing panel
Repealed: 2015-8
2015-8
49Repealed: 2015-8
2015-8
Remuneration and compensation
Repealed: 2015-8
2015-8
50Repealed: 2015-8
2015-8
COMMENCEMENT
Commencement
51(1)Subject to subsection (1.1), this Regulation comes into force on April 1, 2014.
51(1.1)Paragraph 20(g.1), subparagraphs 20(h)(i), (iii) and (iv), paragraph 21(1)(g.1) and subparagraphs 21(1)(i)(i) and (iii) come into force on November 1, 2014.
51(2)Repealed: 2015-8
2014-62; 2015-8
SCHEDULE A
Gross Income Levels
Annual Premium
Single individual
Single individual with children/couple with or without children
 
$18,307 or less
$  36,615 or less
$
     66
$18,308 to $19,297
$  36,616 to $  38,287
$
   133
$19,298 to $20,228
$  38,288 to $  39,862
$
   266
$20,229 to $21,217
$  39,863 to $  41,535
$
   399
$21,218 to $22,206
$  41,536 to $  43,209
$
   532
$22,207 to $23,195
$  43,210 to $  44,882
$
   665
$23,196 to $24,126
$  44,883 to $  46,456
 $
   798
$24,127 to $25,116
$  46,457 to $  48,129
 $
   931
$25,117 to $26,105
$  48,130 to $  49,802
 $
1,064
$26,106 to $27,095
$  49,803 to $  51,475
 $
1,197
$27,096 to $28,026
$  51,476 to $  53,050
 $
1,330
$28,027 to $29,015
$  53,051 to $  54,723
 $
1,463
$29,016 to $30,004
$  54,724 to $  56,397
 $
1,596
$30,005 to $30,993
$  56,398 to $  58,069
 $
1,729
$30,994 to $40,791
$  58,070 to $  73,746
 $
1,862
$40,792 to $50,589
$  73,747 to $  89,422
 $
1,995
$50,590 to $60,387
$  89,423 to $105,098
 $
2,128
$60,388 to $70,185
$105,099 to $120,775
 $
2,261
$70,186 to $79,982
$120,776 to $136,451
 $
2,394
$79,983 to $89,779
$136,452 to $152,127
 $
2,527
Over $89,779
Over $152,127
 $
2,660
2015-8; 2022-67; 2023-54
SCHEDULE B
Gross Income Levels
Maximum
Co-payment
Single individual
Single individual with children/couple with or without children
 
$18,307 or less
$  36,615 or less
$
  4.00
$18,308 to $19,297
$  36,616 to $  38,287
$
  5.35
$19,298 to $20,228
$  38,288 to $  39,862
$
  6.70
$20,229 to $21,217
$  39,863 to $  41,535
$
  8.25
$21,218 to $22,206
$  41,536 to $  43,209
$
11.00
$22,207 to $23,195
$  43,210 to $  44,882
$
12.40
$23,196 to $24,126
$  44,883 to $  46,456
 $
13.75
$24,127 to $25,116
$  46,457 to $  48,129
 $
15.15
$25,117 to $26,105
$  48,130 to $  49,802
 $
16.50
$26,106 to $27,095
$  49,803 to $  51,475
 $
17.90
$27,096 to $28,026
$  51,476 to $  53,050
 $
19.25
$28,027 to $29,015
$  53,051 to $  54,723
 $
20.65
$29,016 to $30,004
$  54,724 to $  56,397
 $
22.00
$30,005 to $30,993
$  56,398 to $  58,069
 $
23.40
$30,994 to $40,791
$  58,070 to $  73,746
 $
24.75
$40,792 to $50,589
$  73,747 to $  89,422
 $
26.15
$50,590 to $60,387
$  89,423 to $105,098
 $
27.55
$60,388 to $70,185
$105,099 to $120,775
 $
28.90
$70,186 to $79,982
$120,776 to $136,451
 $
30.30
$79,983 to $89,779
$136,452 to $152,127
 $
31.65
Over $89,779
Over $152,127
 $
33.05
2015-8; 2022-67; 2023-54
N.B. This Regulation is consolidated to November 1, 2023.