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Low Income Pharmacare for Children Regulations

made under subsections 6(2), 7(1) and 31(1) of the

Fair Drug Pricing Act

S.N.S. 2011, c. 7

O.I.C. 2011-428 (December 20, 2011), N.S. Reg. 324/2011


Citation

1     These regulations may be cited as the Low Income Pharmacare for Children Regulations.


Definitions

2     In these regulations

 

“Act” means the Fair Drug Pricing Act;

 

“eligible individual” means a person who is eligible for the Nova Scotia Child Benefit and has the same meaning as in clause 2(e) of the Nova Scotia Child Benefit Regulations made under the Income Tax Act;

 

“Nova Scotia Child Benefit” means the benefit provided for in the Nova Scotia Child Benefit Regulations made under the Income Tax Act;

 

“Program” means the Low Income Pharmacare for Children Program;

 

“qualified dependant” means a qualified dependant as defined in clause 2(h) of the Nova Scotia Child Benefit Regulations made under the Income Tax Act.


Program coverage

3     (1)    An eligible individual is entitled to coverage under the Program for benefits for a qualified dependant in accordance with these regulations.

 

       (2)    Coverage under the Program is insurance of last resort and no amount may be paid under these regulations for benefits supplied to any qualified dependant if

 

                (a)    coverage in respect of the benefits has been paid under any contract or plan of insurance that applies to the qualified dependant; or

 

                (b)    coverage in respect of the benefits would be payable if claimed under any contract or plan of insurance that applies to the qualified dependant.


Authorization for release of information

4     (1)    To verify information obtained from an individual for the administration and enforcement of the Program, a person applying for coverage under the Program or, when requested, a beneficiary, must provide authorization for the release of information about their eligibility for the Nova Scotia Child Benefit in a form acceptable to the administrator of the Program.

 

       (2)    If a person refuses to provide the authorization required by subsection (1), the administrator of the Program must refuse their application for the Program or cancel their coverage under the Program.


Benefits purchased before date of coverage

5     A beneficiary must not be reimbursed for benefits they purchased for a qualified dependant before the date the coverage for the qualified dependant begins under the Program.


Copayments

6     A beneficiary must pay a copayment of $5.00, or such other amount set by the Program, directly to the provider at the time of purchase.