It is understood that additional work may be required by the pharmacist when a client is seen for the first time. In order to receive payment for the emergency dispense, the provider must contact the Drug Exception Centre on the next business day for a back-dated approval. If you have any questions about Google™ Translate, please visit: Google™ Translate FAQs. These drugs include opioids, benzodiazepines and methadone. The agreement also contains a list of two-month and 100-day supply drugs. These include certain drug therapies for particular conditions which fall outside of the NIHB mandate and are not provided as benefits under the NIHB program. The following policies affect the benefits under which the NIHB program will reimburse pharmacy goods and services provided to eligible clients. This prescriber may become the sole prescriber for 1 or for more of these classes of drugs. One (1) full dispensing fee will be paid per 30-day dispense (or less, if prescribed in a smaller quantity). A prescription with the direction of 'dispense daily' or 'daily dispense' is not a sufficient rationale for the program to reimburse differently than as described in the NIHB short-term dispensing policy. Providers should follow the usual process for prior approval of pharmacy benefits and contact the Drug Exception Centre to submit requests. Any changes will be communicated via updates to the NIHB Drug benefit list as well as in the quarterly NIHB provider newsletters. When the Drug Exception Centre is informed that a client requires end-of-life care, an end-of-life care formulary application form will be generated and faxed to the prescriber. DF = usual and customary dispensing fee, up to the regional maximum approved by NIHB. Providers should be aware that a representative from the Drug Exception Centre may call them directly to discuss the request or to collect any necessary information. If a client seeks information about the appeal process, pharmacy providers may direct them to the online appeal procedures, or to the appropriate First Nations and Inuit Health Branch regional office. For additional information on Coordination of Benefits, please refer to the Pharmacy Claims Submission Kit. The NIHB program has specific requirements for drug cost, mark-up, and dispensing fees when billing methadone for the treatment of opioid use disorder. For more information, please contact Indigenous Services Canada’s Access to Information and Privacy (ATIP) Coordinator at (819) 997-8277 or aadnc.atiprequest-airprpdemande.aandc@canada. The NIHB program has established a formulary in order to streamline access to adjunctive (non-chemotherapy) medications frequently used by clients undergoing active cancer treatment. When approval is granted, a confirmation letter with the applicable dates and prior approval details will be faxed or mailed to the provider. In these instances, the Drug Exception Centre will require details about the prescription, the prescriber, the client and the pharmacy. Limited use benefits and the criteria for their coverage are identified in the Drug benefit list. Please ensure the name indicated on the prescription matches the identity of the Status Card presented at the time of dispense. It is the NIHB program's policy that claims are submitted appropriately on the date of service and not in advance. The drugs must also demonstrate evidence of therapeutic efficacy, safety, and incremental benefit in proportion to the incremental cost. References to or the use of 'dispensing fee', 'usual and customary dispensing fee', or any variation thereof are subject to reimbursement up to the regional maximum of the program. The Drug Exception Centre will fax the pharmacy a NIHB-CSP package to give to the client. Provider manual claims and client reimbursement will not be permitted for these drugs. To be eligible for payment of services rendered, pharmacy providers must adhere to the terms and conditions of the NIHB program. Once the client has been placed in the NIHB-CSP, the next time the client attempts to fill a prescription for benzodiazepines, opioids, stimulants, gabapentin, pregabalin or nabilone, the pharmacy will receive a rejection message and must call the Drug Exception Centre. A number of pages on the Government of Saskatchewan's website have been professionally translated in French. The pharmacist may charge one dispensing fee for each prescription for most drugs listed in the Saskatchewan Formulary. Dispensing Fees: Ready-prepared. The prescription or client profile at the pharmacy must contain specific documentation citing the reason why the prescription was refilled early. If rejected, the provider may resubmit the claim electronically to have the prior approval request reviewed by the Drug Exception Centre. Pharmacy providers in Quebec should refer to the agreement between Indigenous Services Canada (formerly Health Canada) and l'Association québécoise des pharmaciens propriétaires (AQPP) for reimbursement details. You also have the right to file a complaint with the Privacy Commissioner of Canada if you think your personal information has been handled improperly. More detailed information about client eligibility is included in section 4.1 of the Pharmacy Claims Submission Kit. Providers must follow the usual prior approval process to dispense the balance of the prescription. For refills for medications requiring a shorter term dispensing less than 28 days due to compliance concerns, the short-term dispensing policy applies. Dispensers are encouraged to provide most ODB recipients with a 100 days’ supply of most chronic-use medications to ensure that they receive a dispensing fee for each dispensing event. The Health Information and Claims Processing Services (HICPS) contractor performs this audit function by verifying paid claims against pharmacy records to confirm that the claims have been billed in compliance with the terms and conditions of the NIHB program.

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