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Drug Plan Regulations
made under subsections 6(2) and (4), 17(2) and 31(2) and (4) of the
Fair Drug Pricing Act
S.N.S. 2011, c. 7
O.I.C. 2011-234 (June 30, 2011, effective July 1, 2011), N.S. Reg. 222/2011
as amended by O.I.C. 2013-237 (July 9, 2013, effective August 6, 2013), N.S. Reg. 255/2013
Citation
1 These regulations may be cited as the Drug Plan Regulations.
Definitions for the Act and regulations
2 (1) In the Act and these regulations,
(a) “benefit” is further defined to mean a drug, device or service described in clause 2(c) of the Act for which a prescription has been issued;
(b) “provider” is further defined to include a pharmacy licensed under the Pharmacy Act that has entered into an agreement with the Minister respecting the tariff and has been designated as a provider, or in a class of providers.
(2) In these regulations,
“Act” means the Fair Drug Pricing Act;
“health card” means identification with a person’s health card number and issued by the Minister;
“health card number” means a unique identification number assigned by the Minister to individuals insured under the Health Services and Insurance Act;
“hospital” has the same meaning as in the Hospitals Act;
“product” means a drug or a combination of drugs in a single dosage form;
“similar active ingredients” means active drug ingredients, such as different salts, esters, complexes or solvates, of the same therapeutic moiety.
Conditions for designating provider not licensed under Pharmacy Act
3 A supplier of drugs, devices or services that is not licensed as a pharmacy under the Pharmacy Act must meet one of the following to be designated as a provider under Section 17 of the Act:
(a) the supplier is designated as a provider before the effective date of these regulations;
(b) the supplier is a hospital and has entered into an agreement with the Province regarding payment for any drugs, devices and services supplied.
Information on provider receipts for beneficiaries
4 Effective July 1, 2012, a provider must give a beneficiary a receipt containing all of the following information for any benefit the provider claims:
(a) the cost of the drug, device, or service and the mark-up on the cost of the drug;
(b) the dispensing fee;
(c) the total prescription price.
Proof of enrolment
5 When requested by a provider, a beneficiary must show their health card to the provider, so that the provider can verify proof of their eligibility for any benefits being received.
Reasons for restricting, refusing, suspending, varying or discontinuing payment of benefits
6 The following are the circumstances under which the Minister may restrict, refuse, suspend, vary or discontinue payment of benefits to or on behalf of a beneficiary or other person under subsection 8(4) of the Act:
(a) the beneficiary or other person fraudulently claims for benefits under the Plan;
(b) the beneficiary or other person habitually claims for unnecessary benefits under the Plan;
(c) the beneficiary or other person has outstanding unpaid premiums, deductibles or copayments under the Plan.
Sufficient supply of drug condition of designation
7 (1) The Minister must be satisfied that a manufacturer can supply a drug in sufficient quantity for residents before designating the drug as a benefit.
(2) If a manufacturer is unable to supply a drug designated as a benefit for any of the following time periods, it may result in cancellation of the designation under subsection 9(2) of the Act:
(a) a 30-day period;
(b) more frequently than 4 times in a 12-month period.
Conditions for designating product as interchangeable
8 To be designated as interchangeable with another product under subsection 9(1) of the Act and dispensed in accordance with Section 37 of the Pharmacy Act, a product in a particular strength identified by a specific product name or manufacturer must meet all criteria imposed by the Minister and set out in the benefits list under subsection 11(2) of the Act, and 1 of the following criteria:
(a) the product must contain the drug or drugs in the same amounts as the other product;
(b) the product must contain the same or similar active ingredients in the same or similar form as the other product.
Section 8 amended: O.I.C. 2013-237, N.S. Reg. 255/2013.
Correcting errors in designations
9 (1) The Minister may amend a designation or a modification or cancellation of a designation of a drug, device or service as a benefit to correct any of the following errors:
(a) a clerical or typographical error;
(b) an accidental or inadvertent error, omission or similar mistake;
(c) an error in computation.
(2) An amendment under subsection (1) is effective as of the date of the original designation, modification or cancellation unless a later date is specified by the Minister in the amendment.
Committees
10 (1) Before a person appointed to a committee begins their duties, the Minister may require the person to take an oath to the effect that the person will not divulge any information received by the person in the course of their duties as a member of the committee, unless authorized by the Minister.
(3)[(2)] Subject to the powers, duties and functions conferred on it, a committee may make rules respecting any matter it requires, including:
(a) governing the calling of its meetings;
(b) the procedure to be used at its meetings;
(c) the conduct of business at its meetings;
(d) reporting on its business carried out.