BILL 24

An Act to Amend the Prescription and Catastrophic Drug Insurance Act

Her Majesty, by and with the advice and consent of the Legislative Assembly of New Brunswick, enacts as follows:

1 Section 1 of the Prescription and Catastrophic Drug Insurance Act, chapter 4 of the Acts of New Brunswick, 2014, is amended by adding the following definition in alphabetical order:

“Review Committee”  means the Inspection Review Committee established under section 60.1. (Comité d’examen)

2 Subsection 15(2) of the English version of the Act is amended by striking out “applies for a reimbursement” and substituting “makes a request for reimbursement”.

3 The heading “Claims to the Director” preceding section 27 of the Act is amended by striking out “Director” and substituting “Plan Administrator”.

4 Section 27 of the Act is amended

ain subsection (1) by striking out “Director” and substituting “Plan Administrator”;

bin subsection (5) by striking out “Director” and substituting “Plan Administrator”.

5 Subsection 28(1) of the French version of the Act is amended

ain the portion preceding paragraph a) by striking out “des règlements” and substituting “de ses règlements”;

bby repealing paragraph b) and substituting the following: 

bdonner l’ordre de suspendre sa participation au régime pendant la période indiquée dans l’ordre;

6 Section 34 of the Act is amended

ain subsection (1) of the English version by striking out “submit a claim” and substituting “make a request”;

bin subsection (2) of the English version by striking out “claim under subsection (1) and, if the claim” and substituting “request under subsection (1) and, if the request”;

cby repealing subsection (3) and substituting the following:

34( 3) If a request is denied under subsection (2), the member of the Plan may request that the Director reconsider his or her decision.

7 Subsection 43(3) of the Act is repealed.

8 Section 44 of the Act is repealed and the following is substituted:

44( 1) An inspector may

arequire to be produced any record or document or copies or extracts of any record or document, and

bmake those examinations and inquiries of any person that the inspector considers necessary to ensure compliance with the provisions of this Act and the regulations.

44( 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.

44( 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.

44( 4) An inspector who enters and inspects premises under subsection (3) shall produce his or her certificate of appointment on request.

44( 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.

9 Subsection 47(2) of the Act is repealed.

10 The Act is amended by adding after section 47 the following:

Results of inspection

47.1( 1) An inspector shall report the results of an inspection in writing to the participating provider who is the subject of the inspection.

47.1( 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.

47.1( 3) The request under subsection (2) shall indicate the reasons for which the request is made and include additional relevant information, if any.

47.1( 4) Within 30 days after receiving the 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 the results of the inspection.

Review of results

47.2( 1) Within 30 days after receiving the results of a reconsideration, the participating provider may make a request to the Director that the Review Committee review the results of the inspection.

47.2( 2) On receiving a request for review, the Director shall send the request without delay to the Review Committee and the Review Committee shall make its recommendations to the Minister within 30 days after receiving the request.

47.2( 3) The Minister may affirm or vary the results of the inspection based on the recommendations of the Review Committee.

47.2( 4) Within 30 days after receiving the recommendations of the Review Committee, the Minister shall send its decision to the participating provider.

47.2( 5) A decision by the Minister is final and may not be questioned or reviewed in any court.

Overpayments

47.3 The 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 44.

11 The Act is amended by adding before PART 11 the following:

PART 10.1

INSPECTION REVIEW COMMITTEE

Inspection Review Committee

60.1( 1) There is established the Inspection Review Committee consisting of members appointed by the Lieutenant-Governor in Council.

60.1( 2) 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.

60.1( 3) The Review Committee may adopt the rules and procedures that it considers advisable.

12 Section 63 of the Act is amended

ain paragraph (k) of the English version

( i) in subparagraph (iii) by striking out “an application for a reimbursement” and substituting “a request for reimbursement”;

( ii) in subparagraph (v) by striking out “submit a claim” and substituting “make a request for reimbursement”;

bin subparagraph (q)(v) of the English version by striking out “deny a claim” and substituting “deny a request”;

cby adding after paragraph (oo) the following:

oo.1respecting 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;

13 This Act or any provision of it comes into force on a day or days to be fixed by proclamation.