A-29.01, r. 4 - Regulation respecting the basic prescription drug insurance plan

Section 14 Disposition versions

2017-12-21

14. In addition to the information specified in section 8.1.1 of the Act respecting prescription drug insurance (chapter A-29.01), the itemized invoice given by the pharmacist must indicate the following:

(1)  with respect to the cost:

(a)  the amount insured by the Board, by a group insurance contract or an employee benefit plan, which amount corresponds to the sum of the pharmacist’s professional fees for each service provided and, if applicable, to the cost of each medication or supply as well as the wholesaler’s profit margin;

(b)  the amount representing the surplus between the cost of a medication and the maximum payment amount covered by the basic plan, where applicable;

(c)  the amount of the prescription, which corresponds to the sum of the amounts referred to in paragraphs a and b of subparagraph 1;

(2)  with respect to the contribution required from a person when paying for the cost of pharmaceutical services, medications or supplies:

(a)  the deductible amount;

(b)  the coinsurance amount;

(c)  the total contribution amount, which corresponds to the sum of the amounts referred to in paragraphs a and b of subparagraph 2;

(3)  the amount paid by the Board, by a group insurance contract or an employee benefit plan;

(4)  the total amount required of the person from whom is claimed the payment of pharmaceutical services, medications or supplies provided to him;

(5)  with respect to the total amount of the maximum contribution per reference period borne by a person, beyond which the cost of pharmaceutical services, medications and supplies is fully covered by the Board, by a group insurance contract or an employee benefit plan, as the case may be:

(a)  the amount of the contributions paid to date;

(b)  the remaining amount of the maximum contribution to which this person is subject;

(6)  the reference number assigned by the Board, by a group insurance contract or an employee benefit plan.

In the case of information from a group insurance contract or an employee benefit plan, mention of the information listed in subparagraphs 2, 3, 5 and 6 of the first paragraph is required insofar as the pharmacist has this information.

O.C. 1519-96, s. 14; O.C. 1137-2017, s. 1.

2012-09-01

14. A pharmacist shall remit to any beneficiary to whom he has provided pharmaceutical services and medications the coverage of which is paid by the Board, a receipt indicating, in particular, the following information with respect to each medication thus provided:

(1)  with respect to the cost;

(a)  the cost of the prescription;

(b)  the amount insured; and

(c)  the uninsured surplus that may be required from the beneficiary, where applicable;

(2)  with respect to the contribution to the payment of the cost of pharmaceutical services and medications exigible from the beneficiary:

(a)  the deductible amount;

(b)  the 25% coinsurance amount;

(3)  the amount paid by the Board;

(4)  with respect to the state of the beneficiary’s maximum contribution for the reference period:

(a)  the amount of the contributions paid to date;

(b)  the remaining amount of the maximum contribution he must pay;

(5)  the reference number awarded by the Board.

O.C. 1519-96, s. 14.