Regulation - LGIC
Amendments to Ontario Regulation 201/96 made under the Ontario Drug Benefit Act
Regulation Number(s):
Instrument Type:
Regulation - LGIC
Bill or Act:
Ontario Drug Benefit Act
Summary of Decision:
• The government amended Ontario Regulation 201/96 under the Ontario Drug Benefit Act to establish and implement OHIP+: Children and Youth Pharmacare ("OHIP+").
• OHIP+ provides eligible children and youth with publicly funded access to all drug products and professional pharmacy services currently covered through the Ontario Drug Benefit (ODB) program with no co-payments or deductibles. This includes more than 4,400 drug products listed on the ODB Formulary and additional drugs eligible for funding through the Exceptional Access Program.
• The regulatory amendments:
1. prescribe persons who have OHIP coverage and are aged 24 or under as a class of "eligible persons" for the purposes of the ODB program;
2. specify that no co-payment may be charged to ODB-eligible persons who are aged 24 and under;
3. prescribe the implementation of OHIP+: Children and Youth Pharmacare as a purpose for which the Ministry of Health and Long-Term Care may collect, use and disclose personal information under section 13 of the ODBA; and
4. ensure that Ontario Works recipients under 25 who obtain drug coverage through OHIP+ or through their social assistance status could receive up to a 100 day supply of medication.
The effective date for amendments 1, 2, and 4 above was January 1, 2018. The effective date for amendment 3 above was August 31, 2017
• OHIP+ provides eligible children and youth with publicly funded access to all drug products and professional pharmacy services currently covered through the Ontario Drug Benefit (ODB) program with no co-payments or deductibles. This includes more than 4,400 drug products listed on the ODB Formulary and additional drugs eligible for funding through the Exceptional Access Program.
• The regulatory amendments:
1. prescribe persons who have OHIP coverage and are aged 24 or under as a class of "eligible persons" for the purposes of the ODB program;
2. specify that no co-payment may be charged to ODB-eligible persons who are aged 24 and under;
3. prescribe the implementation of OHIP+: Children and Youth Pharmacare as a purpose for which the Ministry of Health and Long-Term Care may collect, use and disclose personal information under section 13 of the ODBA; and
4. ensure that Ontario Works recipients under 25 who obtain drug coverage through OHIP+ or through their social assistance status could receive up to a 100 day supply of medication.
The effective date for amendments 1, 2, and 4 above was January 1, 2018. The effective date for amendment 3 above was August 31, 2017
Further Information:
DRAFT REGULATION FOR PUBLIC CONSULTATION
Proposal Number:
17-HLTC032
Posting Date:
July 10, 2017
Summary of Proposal:
As part of the 2017 Budget and the government's ongoing commitment to provide better and faster access to high-quality health services, Ontario is proposing to create OHIP+: Children and Youth Pharmacare Program.
Under the program, the province would, as of January 1, 2018, provide drug coverage for children and youth who are covered by OHIP and aged 24 or under, regardless of family income. Enrollment in OHIP+ would be automatic based on age and OHIP coverage, and eligible drug products would be available at no cost. There would be no applications necessary to join the program and no upfront costs to acquire eligible medications at a pharmacy. Those who are eligible for the program would only need to have their health card number and a valid prescription starting January 1st, 2018.
The program would cover all drugs currently covered through the Ontario Drug Benefit (ODB) program. This includes more than 4,400 drug products listed on the ODB Formulary/Comparative Drug Index and additional drugs eligible for funding through the Exceptional Access Program (EAP).
Covering the cost of eligible prescription medication for children and youth is part of Ontario's Patients First: Action Plan for Health Care, which is increasing access to care, reducing wait times and improving the patient experience.
Amendments to O. Reg. 201/96 made under the Ontario Drug Benefit Act (ODBA) are required to create and implement the program. The proposed regulatory amendments would:
- prescribe persons who have OHIP coverage and are aged 24 or under as a class of "eligible persons" for the purposes of the ODB Program;
- specify that no co-payment may be charged to ODB-eligible persons who are under 25; and
- prescribe the implementation of OHIP+: Children and Youth Pharmacare Program as a purpose for which the Ministry of Health and Long-Term Care may collect, use and disclose personal information under section 13 of the ODBA.
Under the program, the province would, as of January 1, 2018, provide drug coverage for children and youth who are covered by OHIP and aged 24 or under, regardless of family income. Enrollment in OHIP+ would be automatic based on age and OHIP coverage, and eligible drug products would be available at no cost. There would be no applications necessary to join the program and no upfront costs to acquire eligible medications at a pharmacy. Those who are eligible for the program would only need to have their health card number and a valid prescription starting January 1st, 2018.
The program would cover all drugs currently covered through the Ontario Drug Benefit (ODB) program. This includes more than 4,400 drug products listed on the ODB Formulary/Comparative Drug Index and additional drugs eligible for funding through the Exceptional Access Program (EAP).
Covering the cost of eligible prescription medication for children and youth is part of Ontario's Patients First: Action Plan for Health Care, which is increasing access to care, reducing wait times and improving the patient experience.
Amendments to O. Reg. 201/96 made under the Ontario Drug Benefit Act (ODBA) are required to create and implement the program. The proposed regulatory amendments would:
- prescribe persons who have OHIP coverage and are aged 24 or under as a class of "eligible persons" for the purposes of the ODB Program;
- specify that no co-payment may be charged to ODB-eligible persons who are under 25; and
- prescribe the implementation of OHIP+: Children and Youth Pharmacare Program as a purpose for which the Ministry of Health and Long-Term Care may collect, use and disclose personal information under section 13 of the ODBA.
Contact Address:
Executive Officer, Ontario Public Drug Programs
Ministry of Health and Long-Term Care
80 Grosvenor St., 9th Floor
Hepburn Block, Queen's Park
Toronto, ON M7A 1R3
Fax: 416-325-6647
Ministry of Health and Long-Term Care
80 Grosvenor St., 9th Floor
Hepburn Block, Queen's Park
Toronto, ON M7A 1R3
Fax: 416-325-6647
Effective Date:
August 31, 2017
Decision:
Approved