BILL 12
An Act Respecting the Management of Prescriptions and Recovery Authority
Her Majesty, by and with the advice and consent of the Legislative Assembly of New Brunswick, enacts as follows:
Prescription and Catastrophic Drug Insurance Act
1( 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)
1( 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”.
1( 3) The heading “Claims to the Director” preceding section 27 of the Act is amended by striking out “Director” and substituting “Plan Administrator”.
1( 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”.
1( 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;
cby repealing paragraph c) and substituting the following:
cdonner l’ordre d’annuler sa participation au régime.
1( 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.
1( 7) Subsection 43(3) of the Act is repealed.
1( 8) Section 44 of the Act is repealed and the following is substituted: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.
1( 9) Subsection 47(2) of the Act is repealed.
1( 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) A 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 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.
Review of results
47.2( 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.
47.2( 2) On receiving a request for review, the Director shall send the request without delay to the Review Committee.
47.2( 3) The Review Committee shall send its decision to the participating provider within 60 days after receiving the request for review.
47.2( 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.
47.2( 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 Queen’s Bench of New Brunswick.
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.
1( 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.
60.1( 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.
60.1( 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.
60.1( 4) The Review Committee may adopt the rules and procedures that it considers advisable.
1( 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.1providing 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;
Prescription Drug Payment Act
2( 1) Section 1 of the Prescription Drug Payment Act, chapter P-15.01 of the Acts of New Brunswick, 1975, is amended
aby repealing the definition “Minister” and substituting the following:
“Minister” means the Minister of Health and includes any person designated by the Minister to act on the Minister’s behalf; (ministre)
bin paragraph c) of the French version of the definition « bénéficiaire » by striking out “Ministre” wherever it appears and substituting “ministre”;
cin the French version of the definition « régime » by striking out “établi” and substituting “institué”;
din the English version of the definition “resident” by striking out the period at the end of the definition and substituting a semicolon;
ein the French version of the definition « service assuré » by striking out “Ministre” and substituting “ministre”;
fby adding the following definition in alphabetical order:
“Review Committee” means the Inspection Review Committee established under section 3.8; (Comité d’examen)
2( 2) The Act is amended by adding after section 1 the following:
Establishment of programme
1.1 There 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.
2( 3) The heading “Powers of Minister” preceding section 2 of the Act is repealed.
2( 4) Section 2 of the Act is repealed.
2( 5) The Act is amended by adding before section 2.01 the following:
Appointment of Director
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.
Appointment of Programme Administrator
2.002 The Minister shall appoint a Programme Administrator to exercise the powers and perform the duties as provided for under this Act and the regulations.
Agreements
2.003 The 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.
Policies and guidelines
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).
2( 6) Subsection 2.01(1) of the French version of the Act is amended by striking out “Ministre” and substituting “ministre”.
2( 7) Section 2.1 of the Act is amended
aby repealing subsection (1) and substituting the following:
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.
bin paragraph (1.1)b) of the French version by striking out “Ministre” and substituting “ministre”;
cin subsection (1.2) of the French version by striking out “Ministre” and substituting “ministre”;
din subsection (1.3) of the French version in the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”;
ein subsection (2) of the French version by striking out “Ministre” wherever it appears and substituting “ministre”;
fin subsection (3) of the French version
( i) in the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”;
( ii) in paragraph a) by striking out “Ministre” and substituting “ministre”;
gin subsection (4) of the French version by striking out “Ministre” and substituting “ministre”;
hin subsection (5) of the French version by striking out “Ministre” and substituting “ministre”;
iin subsection (6) of the French version by striking out “Ministre” wherever it appears and substituting “ministre”.
2( 8) Section 2.11 of the Act is amended
ain subsection (1) of the French version
( i) in the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”;
( ii) in paragraph a) by striking out “Ministre” and substituting “ministre”;
( iii) in paragraph b) by striking out “Ministre” wherever it appears and substituting “ministre”;
bin subsection (2) of the French version by striking out “Ministre” wherever it appears and substituting “ministre”;
cin subsection (3) of the French version
( i) in the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”;
( ii) in paragraph a) by striking out “Ministre” wherever it appears and substituting “ministre”;
( iii) in paragraph b) by striking out “Ministre” wherever it appears and substituting “ministre”;
( iv) in paragraph c) by striking out “Ministre” wherever it appears and substituting “ministre”;
dby adding after subsection (3) the following:
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.
ein subsection (4) of the French version
( i) in the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”;
( ii) in paragraph a) by striking out “Ministre” wherever it appears and substituting “ministre”;
( iii) in paragraph b) by striking out “Ministre” wherever it appears and substituting “ministre”;
( iv) in paragraph c) by striking out “Ministre” wherever it appears and substituting “ministre”.
2( 9) Section 2.2 of the French version of the Act is amended by striking out “Ministre” and substituting “ministre”.
2( 10) Section 2.3 of the French version of the Act is amended by striking out “Ministre” and substituting “ministre”.
2( 11) Section 2.4 of the French version of the Act is amended
ain subsection (1) by striking out “Ministre” and substituting “ministre”;
bin subsection (2) in the portion following paragraph b) by striking out “Ministre” and substituting “ministre”;
cin subsection (3) by striking out “Ministre” and substituting “ministre”;
din subsection (4) by striking out “Ministre” and substituting “ministre”;
ein subsection (5) by striking out “Ministre” and substituting “ministre”.
2( 12) The heading “Le Ministre peut fixer la somme disponible pour le bénéficiaire” preceding section 2.5 of the French version of the Act is amended by striking out “Ministre” and substituting “ministre”.
2( 13) Section 2.5 of the French version of the Act is amended
ain subsection (1) in the portion preceding the definition « classe ou classes de médicaments » by striking out “règlement” and substituting “article”;
bin subsection (2) by striking out “Ministre” wherever it appears and substituting “ministre”;
cin subsection (3)
( i) in the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”;
( ii) in paragraph c) by striking out “Ministre” and substituting “ministre”;
din subsection (4) in the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”;
ein subsection (6) by striking out “Ministre” and substituting “ministre”.
2( 14) The heading “Accord entre le Ministre et le dispensateur participant” preceding section 3 of the French version of the Act is amended by striking out “Ministre” and substituting “ministre”.
2( 15) Section 3 of the French version of the Act is amended
ain the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”;
bin paragraph a) by striking out “Ministre” and substituting “ministre”;
cin paragraph c) by striking out “Ministre” and substituting “ministre”;
din paragraph d) by striking out “Ministre” and substituting “ministre”.
2( 16) The Act is amended by adding after section 3 the following:
Claims
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.
Non-compliance
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
aissue a warning letter to the provider or beneficiary,
bmake an order suspending the participation of the provider or beneficiary in the programme for the period specified in the order, and
cmake 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.
Inspectors
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.
Inspections
3.21( 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.
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.
Confidentiality of information
3.3 A 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.
Obstruction of inspector
3.4 No person shall obstruct or interfere with an inspector who is carrying out or attempting to carry out an inspection under section 3.21.
Powers of the Minister
3.5 After an inspection has been conducted, the Minister may order, in writing, the participating provider to pay an amount owing to the Minister.
Results of inspection
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.
Review of results
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 Queen’s Bench of New Brunswick.
Inspection Review Committee
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.
Overpayments
3.9 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 3.21.
2( 17) The heading “Records and related requirements” preceding section 4 of the Act is repealed.
2( 18) Section 4 of the Act is repealed.
2( 19) The heading “Communication de renseignements par le Ministre” preceding section 4.1 of the French version of the Act is amended by striking out “Ministre” and substituting “ministre”.
2( 20) Section 4.1 of the Act is amended
ain the portion preceding paragraph a) of the French version by striking out “Ministre” and substituting “ministre”;
bin paragraph (b) by striking out “a programme established under this Act” and substituting “the programme”;
cin the portion following paragraph b) of the French version by striking out “Ministre” and substituting “ministre”.
2( 21) Section 5 of the Act is amended
ain subsection (1)
( i) in the French version in the portion preceding paragraph a) by striking out “, quiconque” and substituting “quiconque :”;
( ii) in paragraph (a) by striking out “application” and substituting “application or a claim”;
( iii) by adding after paragraph (a.2) the following:
a.3who knowingly fails to provide any information, document or record;
( iv) by repealing paragraph (b) and substituting the following:
bwho 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;
bby repealing subsection (2);
cby repealing subsection (3) and substituting the following:
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.
dby adding after subsection (3) the following:
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.
2( 22) The Act is amended by adding after section 5 the following:
Continuing offence
5.1 If an offence under this Act or the regulations continues for more than one day,
athe 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
bthe 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.
2( 23) The heading “Certificat du Ministre comme preuve” preceding section 6 of the French version of the Act is amended by striking out “Ministre” and substituting “ministre”.
2( 24) Section 6 of the French version of the Act is amended by striking out “Ministre” and substituting “ministre”.
2( 25) Section 6.1 of the Act is amended in the portion preceding paragraph (a) by striking out “a programme established under this Act” and substituting “the programme”.
2( 26) The Act is amended by adding after section 6.1 the following:
Debt due to the Province
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 Queen’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.
Immunity
6.3 No 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:
athe Minister;
bthe Director;
cthe Programme Administrator; or
da person acting under or who has acted under the authority of this Act or the regulations.
2( 27) Section 7 of the Act is amended
ain paragraph a.1) of the French version by striking out “Ministre” and substituting “ministre”;
bin paragraph e.5) of the French version by striking out “Ministre” and substituting “ministre”;
cin paragraph e.6) of the French version by striking out “Ministre” and substituting “ministre”;
din paragraph f.3) of the French version by striking out “Ministre” and substituting “ministre”;
ein paragraph g) of the French version by striking out “comptes” and substituting “réclamations”;
fin paragraph h) of the French version by striking out “comptes relatifs” and substituting “réclamations relatives”;
gin paragraph (l) by striking out “remuneration and”;
hby adding after paragraph (l) the following:
l.1setting out the powers and duties of the Director and the Programme Administrator;
l.2conferring additional powers and duties to inspectors;
l.3providing 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.4prescribing information to be provided to the Programme Administrator by a participating provider for the purposes of subsection 3.1(1);
l.5prescribing the time within which the participating provider shall submit a claim for the purposes of subsection 3.1(1);
l.6prescribing 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;
iin paragraph m.1) of the French version by striking out “définir” and substituting “définissant”;
jby adding after paragraph (m.1) the following:
m.2prescribing, in respect of offences under the regulations, categories of offences for the purposes of Part 2 of the Provincial Offences Procedure Act;
m.3setting an interest rate for the purposes of subsection 6.2(5);
General Regulation under the Prescription and Catastrophic Drug Insurance Act
3( 1) Section 3 of the French version of New Brunswick Regulation 2014-27 under the Prescription and Catastrophic Drug Insurance Act is amended
ain the definition « équivalent pharmaceutique » by striking out “forme dosifiée” and substituting “forme pharmaceutique”;
bin the definition « produit de marque » by striking out “forme dosifiée” and substituting “forme pharmaceutique”;
cin paragraph b) of the definition « substitut pharmaceutique » by striking out “formes dosifiées” and substituting “formes pharmaceutiques”.
3( 2) Section 6 of the Regulation is amended
ain paragraph (b) by striking out “claims” and substituting “claims and requests”;
bby adding after paragraph (f) the following:
f.1recover overpayments in accordance with the results of an inspection;
3( 3) Subsection 14(6) of the English version of the Regulation is amended by striking out “apply for a reimbursement” and substituting “make a request for reimbursement”.
3( 4) Paragraph 20(d) of the Regulation is amended by striking out “form” and substituting “dosage form”.
3( 5) Paragraph 21(1)(d) of the Regulation is amended by striking out “form” and substituting “dosage form”.
3( 6) Subsection 23(1) of the Regulation is amended by striking out “Director” and substituting “Plan Administrator”.
3( 7) Paragraph 28(2)(a) of the Regulation is amended by striking out “form” and substituting “dosage form”.
3( 8) Paragraph 29(2)(c) of the Regulation is amended by striking out “form” and substituting “dosage form”.
3( 9) Section 33 of the English version of the Regulation is amended by striking out “submit a claim” and substituting “make a request”.
3( 10) The Regulation is amended by adding before section 40 the following:
REVIEW COMMITTEE
Review Committee
39.1( 1) The Review Committee shall be composed of the following four members appointed by the Lieutenant-Governor in Council:
aa chartered professional accountant, to serve as chair; and
bthree 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.
Meetings and quorum
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.
Prescription Drug Regulation under the Prescription Drug Payment Act
4( 1) Section 2 of New Brunswick Regulation 84-170 under the Prescription Drug Payment Act is amended
aby repealing the following definitions:
“Committee”;
“Corporation”;
“Director”;
bin the definition “original product” by striking out “form” and substituting “dosage form”;
cin the French version of the definition « médecin désigné » by striking out “Ministre” and substituting “ministre”;
din the French version of the definition « médecin pro-pharmacien » by striking out “Directeur” and substituting “directeur”.
4( 2) Section 3 of the Regulation is repealed.
4( 3) Paragraph 4(2)e) of the French version of the Regulation is amended by striking out “Ministre” and substituting “ministre”.
4( 4) Paragraph 6b) of the French version of the Regulation is amended by striking out “Directeur” wherever it appears and substituting “directeur”.
4( 5) Section 7 of the French version of the Regulation is amended
ain subparagraph (1)b)(i) by striking out “Directeur” and substituting “directeur”;
bin subsection (2) by striking out “Directeur” and substituting “directeur”;
cin subsection (3) by striking out “Directeur” and substituting “directeur”.
4( 6) Section 7.1 of the French version of the Regulation is amended by striking out “Directeur” and substituting “directeur”.
4( 7) Section 7.2 of the French version of the Regulation is amended
ain subsection (1) by striking out “Directeur” wherever it appears and substituting “directeur”;
bin subsection (2) by striking out “Directeur” wherever it appears and substituting “directeur”.
4( 8) Section 8 of the French version of the Regulation is amended
ain subsection (10) by striking out “Ministre” and substituting “ministre”;
bin subsection (12) by striking out “Régime” and substituting “régime”.
4( 9) Section 8.1 of the French version of the Regulation is amended
ain subsection (1) by striking out “Ministre” and substituting “ministre”;
bin subsection (2) by striking out “Ministre” and substituting “ministre”.
4( 10) Section 9 of the English version of the Regulation is amended by striking out “as defined in this Regulation” and substituting “within the meaning of this Regulation”.
4( 11) The Regulation is amended by adding after section 9 the following:
9.1 For the purposes of section 2.002 of the Act, the Programme Administrator shall perform the following duties:
aprocess claims; and
brecover overpayments in accordance with the results of an inspection.
4( 12) Section 10 of the French version of the Regulation is amended by striking out “aux fins” and substituting “aux fins d’application”.
4( 13) Section 12 of the French version of the Regulation is amended
ain subsection (2) by striking out “Directeur” and substituting “directeur”;
bin subsection (4) by striking out “Ministre” and substituting “ministre”.
4( 14) Section 12.1 of the French version of the Regulation is amended
ain subsection (1) by striking out “Ministre” and substituting “ministre”;
bin subsection (2) by striking out “Ministre” and substituting “ministre”.
4( 15) Subsection 12.2(2) of the French version of the Regulation is amended in the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”.
4( 16) Paragraph 12.3(b) of the Regulation is amended by striking out “dosage” and substituting “dosage form”.
4( 17) Section 13 of the Regulation is amended
aby repealing the portion preceding paragraph (a) and substituting the following:
13 When a participating provider provides an entitled service to a beneficiary, the participating provider shall submit a claim to the Programme Administrator accompanied by the following information:
bin paragraph f) of the French version by striking out “au programme” and substituting “facturé au régime”.
4( 18) Section 14 of the Regulation is amended
ain subsection (1) of the English version by striking out “claim against the programme” and substituting “request for reimbursement under the programme”;
bin paragraph (2)h) of the French version by striking out “dosage” and substituting “concentration”;
cin subsection (4) of the English version by striking out “submit a claim against the programme” and substituting “make a request for reimbursement under the programme”;
din subsection (5) of the French version by striking out “Directeur” and substituting “directeur;
ein subsection (6) by striking out “an account for reimbursement” and substituting “a request for reimbursement”;
fin subsection (7) of the French version by striking out “Directeur” and substituting “directeur.
4( 19) Section 15 of the Regulation is amended
ain subsection (2) of the English version by striking out “claim against the programme” and substituting “request for reimbursement under the programme”;
bin subsection (3) of the French version by striking out “Directeur” and substituting “directeur;
cin subsection (3.1) of the French version by striking out “Directeur” and substituting “directeur;
din subsection (3.2) of the French version by striking out “Directeur” and substituting “directeur.
4( 20) Subsection 15.001(3) of the French version of the Regulation is amended by striking out “Directeur” and substituting “directeur”.
4( 21) Section 16 of the French version of the Regulation is amended
ain subsection (3) in the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”;
bin paragraph (4)a) by striking out “Ministre” and substituting “ministre”;
cin paragraph (5)b)
( i) in subparagraph (i) by striking out “Directeur” and substituting “directeur”;
( ii) in subparagraph (ii) by striking out “Ministre” and substituting “ministre”;
din subsection (6)
( i) in the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”;
( ii) in paragraph c) by striking out “Directeur” and substituting “directeur”.
4( 22) Section 19 of the Regulation is repealed.
4( 23) Section 20 of the French version of the Regulation is amended by striking out “un compte” and “à tout ou partie dudit compte” and substituting “une réclamation” and “à toute ou partie de cette réclamation” respectively.
4( 24) Section 21 of the French version of the Regulation is amended by striking out “Directeur” and substituting “directeur”.
4( 25) Section 22 of the French version of the Regulation is amended
ain subsection (3) in the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”;
bin paragraph (5)b) by striking out “Directeur” and substituting “directeur”;
cin subsection (6)
( i) in the portion preceding paragraph a) by striking out “Ministre” and substituting “ministre”;
( ii) in paragraph c) by striking out “Directeur” and substituting “directeur”.
4( 26) The Regulation is amended by adding after section 23 the following:
23.01( 1) For the purposes of subsection 3.1(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.
23.01( 2) A participating provider shall submit a claim under section 13 in electronic format within three months after the date an entitled service was provided to a beneficiary or in non-electronic format within one year after the date an entitled service was provided to a beneficiary.
23.02( 1) A participating provider may request a reassessment of a claim by resubmitting the claim in electronic format within three months after the date the entitled service was provided to the beneficiary or in non-electronic format within one year after the date an entitled service was provided to the beneficiary.
23.02( 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.
4( 27) Section 23.1 of the French version of the Regulation is amended by striking out “Ministre” and substituting “ministre”.
4( 28) Section 23.2 of the Regulation is amended
ain the portion preceding paragraph a) of the French version by striking out “Ministre” and substituting “ministre”;
bby repealing paragraph (a) and substituting the following:
aas a debt due to the Province, in the manner set out in section 6.2 of the Act, or
cin the portion following paragraph b) of the French version by striking out “Ministre” and substituting “ministre”.
4( 29) Section 23.3 of the Regulation is repealed.
4( 30) Section 24 of the Regulation is repealed.
4( 31) Section 25 of the Regulation is repealed.
4( 32) Subsection 26(1) of the Regulation is repealed and the following is substituted:
26( 1) The following definitions apply in this section.
“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)
“narcotic” means a narcotic as defined in the Narcotic Control Regulations under the Controlled Drugs and Substances Act (Canada). (stupéfiant)
4( 33) Subsection 27(1) of the Regulation is amended in the portion preceding paragraph (a) by striking out “reimbursement is requested” and substituting “a claim is submitted”.
4( 34) Section 29 of the Regulation is amended
ain subsection (1) of the French version by striking out “Ministre” and substituting “ministre”;
bin subsection (2) of the French version by striking out “Ministre” and substituting “ministre”;
cin subsection (3)
( i) in paragraph (a) by striking out “of accounts” and substituting “of claims”;
( ii) in the portion following paragraph (b) by striking out “individual account” and substituting “individual claim”;
din subsection (4) of the French version by striking out “Directeur” wherever it appears and substituting “directeur”;
ein subsection (5) of the French version by striking out “Ministre” and substituting “ministre”;
fin subsection (6) of the French version by striking out “Ministre” and substituting “ministre”.
4( 35) The Regulation is amended by adding before section 32.1 the following:
32.01( 1) The Review Committee shall be composed of the following four members appointed by the Lieutenant-Governor in Council:
aa chartered professional accountant, to serve as chair; and
bthree pharmacists who are not employees of the Department of Health.
32.01( 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.
32.01( 3) Despite the expiration of his or her term, a member shall continue to be a member until he or she is replaced.
32.01( 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.
32.01( 5) A vacancy on the Review Committee does not impair the capacity of the Review Committee to act.
32.01( 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.
32.02( 1) The Review Committee shall meet as required at the call of the chair at the date, time and place designated by the chair.
32.02( 2) Three members of the Review Committee constitute a quorum with at least one member being the chair.
32.02( 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.
32.02( 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.
4( 36) Section 32.1 of the Regulation is repealed.
4( 37) Section 32.2 of the Regulation is repealed.
4( 38) Section 32.3 of the Regulation is repealed.
4( 39) Section 32.4 of the Regulation is repealed.
4( 40) Section 32.5 of the Regulation is repealed.
4( 41) Section 32.6 of the Regulation is repealed.
4( 42) Schedule 1 of the Regulation is amended by repealing paragraph 2(b) and substituting the following:
bBlind Workers’ Compensation Act, chapter 101, Revised Statutes of New Brunswick, 2014;