May 31, 2012

1922970521/370494221/1885370804

E4tlc12022

Definitions

Definitions

In this Act:

alternate payee means a person prescribed to receive

payment under

section 17 (2) [payments] ;

beneficiary means a person who is enrolled in a drug

plan;

benefit , subject to subsection (2), means a drug,

device or substance listed on a formulary, or a related service listed on a related

services list, for which full or partial payment may be made by the minister under this

Act;

claim means a claim made under this Act for payment in

respect of a benefit;

co-payment means an amount a beneficiary must pay toward

the cost of a benefit for which partial payment is being made by the minister under this

Act;

data stewardship committee means the data stewardship

committee established under the E-Health (Personal

Health Information Access and Protection of Privacy)

Act ;

deductible means an amount a beneficiary must pay toward

the cost of benefits before the minister may make a payment, under this Act, in respect

of the beneficiary;

device means an article, instrument or apparatus

used

to prevent, diagnose, treat or mitigate a disease, a disorder or an abnormal

physical or mental state or a symptom of any of them,

to restore, correct or modify organic functions,

to diagnose pregnancy, or

to administer a drug;

drug plan means a prescribed plan that authorizes payment,

by the minister under this Act, for benefits received by a class of

beneficiaries;

enforcement action means any of the following:

the making of an order made under

section 46 [enforcement orders] ;

the imposition of an administrative penalty under

section 48 [imposing administrative penalties] ;

the prosecution of an offence under

section 51 [offences] ;

formulary means a list of drugs, devices and substances

that are benefits for the purposes of a drug plan;

franchisor means a franchisor of a provider's pharmacy,

facility or other place where drugs, devices, substances or related services are

provided to persons;

health authority means

a regional health board designated under the Health Authorities

Act , and

the Provincial Health Services Authority;

incentive includes money, gifts, discounts, rebates,

refunds, customer loyalty schemes, coupons, goods, rewards and other prescribed

things;

inspector means a person appointed or retained as an

inspector under

section 34 [appointment of inspectors] ;

personal information means recorded information about an

identifiable individual;

prescribed information management technology means any of

the following prescribed things:

an information management system;

a technological application;

an integrated set of databases;

protective word means a word or phrase attached, under

section

28 [attaching and removing protective words] , to a person's personal

information in prescribed information management technology;

provider means a person who is enrolled under

section 11 [enrolment of providers] for the purpose of receiving payment for

providing benefits;

regulatory college has the same meaning as in the Health Professions and Occupations Act ;

related service means care, a service or an activity

related to the provision, distribution, sale, purchase or use of a drug, device or

substance;

related services list means a list of related services that

are benefits for the purposes of a drug plan.

The definition of benefit in subsection (1) does not

apply

for the purposes of

section 32 [whistle-blower protection] or 56 [no benefit from

offence or contravention] , or

in the context of benefits and services provided

under an enactment other than this Act, or

through a program of Canada, a provincial or territorial government of

Canada or a health authority for the purposes of

section 60 (a) [regulations respecting beneficiaries] .

In this Act, the terms child and

spouse have the same meaning as in the Medicare Protection

Act .

In this Act, the terms dispense , drug ,

pharmacist , pharmacy ,

practitioner and prescription have the same

meaning as in the Pharmacy Operations and Drug Scheduling

Act .

Provincial Drug Program

Provincial Drug Program

Provincial drug program established

The provincial drug program known as BC PharmaCare is established, consisting

of the benefits

provided through the drug plans established under this Act, and

provided, under this Act, outside of a drug plan.

The minister is responsible for the administration of the provincial drug

program.

Establishing and maintaining formularies

Subject to the regulations, the minister must establish and maintain one

formulary for each drug plan.

The minister may do anything the minister considers necessary or appropriate

for the purposes of establishing and maintaining formularies, including doing one or

more of the following:

considering all published and unpublished information respecting the

clinical efficacy, effectiveness and safety of a drug, device or

substance;

considering the price and cost-effectiveness of a drug, device or

substance;

requesting information respecting a drug, device or substance from its

manufacturer or a supplier;

undertaking, or requiring a manufacturer or supplier to provide for, an

independent review of the clinical efficacy, safety and cost-effectiveness of a

review;

considering the advice of a committee established under

section

31 [advisory committees] ;

if 2 or more drugs, devices or substances have different compositions or

means of administration or use but have essentially the same therapeutic objectives,

treating the drugs, devices or substances differently;

determining, on any basis, including following a process involving the

solicitation of competitive proposals, which drugs, devices or substances to list on

a formulary;

setting conditions that must be met for a drug, device or substance to be

listed on a formulary;

changing a formulary, including cancelling the listing of a drug, device or

substance from the formulary.

A change under subsection (2) (

i) may be made at any time without

notice to anyone or an opportunity to be heard.

Subsection (3) does not relieve the minister of any notice requirement

set out in an agreement made under this Act.

The minister may designate a drug, device or substance listed on a formulary

as a drug, device or substance that will be a benefit only

for beneficiaries meeting criteria set by the minister, and

if the drug, device or substance is the subject of an application made under

section

6 [special payments] .

Establishing and maintaining related services lists

Subject to the regulations, the minister must establish and maintain one

related services list for each drug plan.

The minister may do anything the minister considers necessary or appropriate

for the purposes of establishing and maintaining related services lists, including

doing one or more of the following:

considering all published and unpublished information respecting the

clinical efficacy, effectiveness and safety of a related service;

considering the price and cost-effectiveness of a related

service;

considering the advice of a committee established under

section

31 [advisory committees] ;

determining which related services to list on a related services

list;

setting conditions that must be met for a related service to be listed on a

related services list;

changing a related services list, including cancelling the listing of a

related service from the related services list.

A change under subsection (2) (

f) may be made at any time without

notice to anyone or an opportunity to be heard.

Subsection (3) does not relieve the minister of any notice requirement

set out in an agreement made under this Act.

The minister may designate a related service listed on a related services list

that will be a benefit only

for beneficiaries meeting criteria set by the minister, and

if the related service is the subject of an application made under

section 6 [special payments] .

Publishing formularies and related services lists

The minister must publish the formularies and related services lists that

apply to each drug plan.

The minister may publish information respecting one or more drugs, devices or

substances listed on a formulary or one or more related services listed on a related

services list, including information respecting one or more of the

following:

the clinical efficacy, effectiveness and safety of the drug, device,

substance or related service;

the price and cost-effectiveness of the drug, device, substance or related

service;

the process by which the decision was made to list the drug, device,

substance or related service.

Special payments

This

section applies despite any provision of this Act or a regulation made

under it, including a limit or condition imposed under another provision of this

Act.

On application made by one or more providers or practitioners, the minister

may authorize payment under this Act for all or part of a drug, device, substance or

related service provided to a person or class of persons, including a person who is

not a beneficiary, or a class of persons who are not beneficiaries, even if

the drug, device or substance is not listed on a formulary or the related

service is not listed on a related services list,

the person is not otherwise eligible to have the drug, device, substance or

related service provided as a benefit, or

the person would otherwise receive only partial payment.

On application made by one or more providers or practitioners, the minister

may authorize payment under this Act for all or part of a benefit designated under

section 3

(5) [establishing and maintaining formularies] or 4

(5) [establishing and maintaining related services lists] provided

to a person meeting the criteria set under

section 3 (5) or 4 (5), as

applicable.

On application made by a beneficiary, the minister may authorize payment under

this Act for all or part of

a drug, device, substance or related service provided to the beneficiary

and, for this purpose, subsection (2) (

a) to (

c) applies, or

a benefit designated under

section 3 (5) or 4 (5), if

the beneficiary meets the criteria set under

section 3 (5) or 4 (5), as

applicable.

The minister, as the minister considers appropriate, may do one or more of the

following:

establish classes of persons, including classes of providers or

practitioners, for the purposes of this section;

authorize payments based on the class of provider or practitioner to which

the applicant belongs;

set limits or conditions on the making of payments, including setting

different limits or conditions on the making of payments based on the class of

provider or practitioner to which the applicant belongs;

without giving notice or an opportunity to be heard,

change the limits or conditions set under this subsection, or

cancel an authorization made under subsection (2), (3)

(4).

Subject to any limits or conditions set under subsection (5) of this

section, if the minister authorizes a payment under subsection (2) or (4) (

a) of

this section,

the drug, device, substance or related service is deemed to be a benefit in

respect of the recipient for the purposes of sections 9, 16 to

18, 20, 37, 38, 42 and 51 and a regulation made in respect of one or

more of those provisions,

if the recipient is not a beneficiary, the recipient is deemed to be a

beneficiary for the purposes of sections 17, 42 and

51 and a regulation made in respect of one or more of those

provisions, and

the minister may give binding directions respecting the application of a

provision of this Act or a regulation made under it in respect of the deemed

benefit, if applicable, the deemed beneficiary, and its provision by a provider to a

person.

Confidential information

Despite the Freedom of Information and Protection of Privacy

Act or any other enactment that would require the disclosure of

information, the minister may refuse to make public information respecting the

deliberations and recommendations, by an advisory committee or by employees of the

ministry of the minister, respecting the following:

the listing of a drug, device or substance on a formulary;

the listing of a related service on a related services list;

the authorization of payments under

section 6 [special payments] .

Beneficiaries

Enrolment of beneficiaries

A person may enrol, in accordance with the regulations, in one or more drug

plans for which the person is eligible.

For the purposes of determining a person's eligibility to enrol in a drug

plan, the minister may require a person to provide information, including personal

information, additional to that required under

section 59 (c) [regulations respecting provincial drug program] .

Entitlement to benefits

Subject to this Act and the regulations made under it, a beneficiary is

entitled to the benefits provided for by each drug plan in which the beneficiary is

enrolled.

Subject to the regulations, the minister may impose limits and conditions on a

beneficiary's entitlement to benefits.

Despite subsection (1) but subject to the

regulations,

the provincial drug program must be considered insurance of last resort,

and

a beneficiary is not entitled to payment under this Act for any part of a

benefit for which the beneficiary is eligible for payment under a

prescribed

enactment, or

program, including a program of Canada, a provincial or territorial

Cancelling beneficiary enrolment

Subject to the regulations, the minister may cancel a beneficiary's enrolment

in one or more drug plans.

The minister may impose limits and conditions on the re-enrolment as a

beneficiary of a person whose enrolment has been cancelled.

Providers, Suppliers and Manufacturers

Enrolment of providers

An owner of a pharmacy, facility or other place where drugs, devices,

substances or related services are provided to persons, other than on a wholesale

basis, may apply to the minister to be enrolled as a provider.

An owner of more than one pharmacy, facility or other place described in

subsection

(1) must apply for enrolment in respect of each pharmacy, facility or

other place.

Despite subsection (1), the minister may permit a person who

is connected to a place referred to in subsection (1), but is not an

owner of the place, to apply for enrolment.

If satisfied that the applicant meets prescribed criteria, the

minister

may enrol the applicant as a provider, unless the minister is of the

opinion that it would not be in the public interest to do so,

may designate the provider as a member of a class of providers established

by the minister, and

may impose limits and conditions on the provider's enrolment.

Duties

This

section applies to

a provider, a supplier, a manufacturer, a franchisor and an alternate

payee,

a former provider, supplier, manufacturer, franchisor and alternate

payee,

a person prescribed for the purposes of

section 21 [incentives] or subsection (3) of this

section, and

a person who is an employee or agent of a person referred to in any of

paragraphs (

a) to (c).

A person referred to in subsection (1) must comply with

this Act and the regulations made under it,

a limit or condition that is imposed under this Act, and

a limit or condition that is identified in an agreement made under this Act

as a limit or condition to which this

section applies.

A person referred to in subsection (1), and a prescribed person,

must

keep prescribed records in the manner required by the minister,

and

produce those records on request of the minister and within the time

requested.

Changing or cancelling provider enrolment

A provider may cancel the provider's enrolment as a provider by giving 30 days'

written notice to the minister.

Subject to the regulations and after giving the provider 30 days' notice and

an opportunity to be heard, the minister may

change or cancel a designation made under

section 11 (4) (b) [enrolment of providers] , or

cancel a provider's enrolment.

The minister may change or add limits and conditions on a provider's enrolment

on giving 30 days' notice but without giving an opportunity to be heard, or

following a hearing in relation to the proposed cancellation of a provider's enrolment.

Providing and Receiving Benefits

Limits or conditions on provision

A provider must comply with all prescribed limits and conditions in respect of

the prescription, dispensation, sale, purchase or use of a drug, device, substance or

related service.

Identity numbers

A person must not knowingly use, in order to obtain benefits, an identity

number other than the one issued to the person by the Medical Services Commission

under the Medicare Protection Act .

A person prescribed for the purposes of this

section must promptly report to

the minister, in the form and manner required by the minister, if the prescribed

person has reason to believe that another person has contravened subsection

(1).

No legal proceeding for damages lies or may be commenced or maintained against

a person who makes a report, in good faith, under subsection (2).

Claims for benefits

A person may claim payment for a benefit by making the claim in the form and

manner required by the minister.

For the purposes of assessing a claim, the minister may require a person to

provide

information to support the claim, including personal information,

and

written consent to the release, by another person, of personal information

of the person.

Payments

The minister may pay a claim in accordance with the beneficiary's entitlement

to benefits under this Act.

The minister may make all of a payment under subsection (1) directly to the

beneficiary, the provider or a prescribed person, or part of the payment to each of

them.

A person is not entitled to payment under subsection (1) if, in

providing the benefit or making the claim, the person acts contrary to

this Act, the

Health Professions and Occupations Act , the

Pharmacy Operations and Drug Scheduling Act or a

prescribed enactment of British Columbia or Canada, or

the regulations made, or a limit or condition imposed, under any of

them.

The minister may enter into agreements respecting the payment of claims with

providers and persons prescribed for the purposes of subsection (2).

Reassessments

The minister may reassess a claim if the minister is of the opinion that any

of the following has occurred:

an error or an accidental or inadvertent omission has been made in respect

of making or paying the claim;

within the calendar year in which the benefit to which the claim relates was

provided, the beneficiary's

eligibility for enrolment in a drug plan changed, or

entitlement to benefits changed.

On reassessment of a claim, the minister may adjust the determination of the

amount to which a person is entitled as payment of the claim and, after

adjustment,

make a further payment under

section 17 [payments] , or

require a person to repay amounts to which the person was not entitled under

this Act or an agreement made under this Act.

An amount that a person is liable to repay under subsection (2) (b), and any

interest payable on the amount, is a debt due to the government and may be

deducted from any subsequent payment that may be made to the person under

this Act, including under an agreement made under this Act, or

recovered in a court of competent jurisdiction.

Emergency Circumstances

Emergency circumstances

If there is an emergency within the meaning of

section 51 of the Public Health Act and the minister is of the opinion

that it is necessary for the purposes of preventing, controlling or eradicating a

health hazard, the minister may order that a person, whether or not the person is a

beneficiary, is entitled to receive

a designated drug, device or substance, whether or not the drug, device or

substance is listed on a formulary, or

a designated related service, whether or not the related service is listed

on a related services list.

For the purposes of this Act,

a drug, device, substance or related service designated under subsection

(1) is deemed to be a benefit in respect of the recipient for the purposes of sections

9, 16 to 18, 20, 37, 38, 42 and 51

and a regulation made in respect of one or more of those provisions, and

if the recipient is not a beneficiary, the recipient is deemed to be a

beneficiary for the purposes of sections 17, 42 and

51 and a regulation made in respect of one or more of those

provisions.

Price Regulation

Price regulation

Without limiting

section 3 (2) (h) [establishing and maintaining formularies] but subject to any limit

or condition prescribed under

section 62 (1) (a) [regulations respecting price regulation] , the minister may set

limits or conditions on the amount that will be paid, by the minister under this Act,

for a particular drug, device, substance or related service that is a

benefit.

Subject to any limit or condition prescribed under

section 62 (1) (b), the minister

may enter into agreements with any person respecting prices of, or amounts that may be

charged for, drugs, devices, substances or related services, including setting

conditions that must be met for

a drug, device or substance to be listed, or to continue to be listed, on a

formulary, or

a related service to be listed, or to continue to be listed, on a related

services list.

The conditions that may be set under subsection (2) include, without

limitation, conditions respecting the amounts charged and the use, or prohibition of the

use, of incentives.

Incentives

A provider, a franchisor and a prescribed person, and a person who is an

employee or agent of any of these, must not accept any incentive prohibited by the

regulations.

A supplier, a manufacturer and a prescribed person, and a person who is an

employee or agent of any of these, must not provide an incentive that is prohibited by

the regulations to

a person described in subsection (1), or

a person within a prescribed class of persons.

On request of the minister, a provider, franchisor, supplier, manufacturer and

prescribed person must report to the minister information respecting all of the

following:

amounts received or provided for

drugs, devices and substances listed on a formulary,

related services listed on a related services list, and

iii

drugs, devices, substances and related services for which payment is

authorized under

section 6 [special payments] ;

the nature and value of any incentive received or provided in relation

drugs, devices and substances listed on a formulary,

related services listed on a related services list, and

iii

drugs, devices, substances and related services for which payment is

authorized under

section 6.

Administration

Information Management

Collection, use and disclosure of personal

information

The minister may collect personal information under this Act for one or more

of the following purposes:

to provide health services, or facilitate care, in relation to drugs,

devices, substances and related services;

to administer this Act;

for a prescribed purpose.

The minister may use and disclose, inside Canada, personal information

collected under subsection (1) for one or more of the following

purposes:

to administer this Act or another enactment for which the minister is

responsible;

to identify an individual who needs or is receiving health

services;

to provide health services to, or facilitate the care of, an

individual;

to identify a person who is providing health services;

to prevent or manage chronic conditions, at the individual or population

level;

to facilitate health insurance and health service billing, including for the

purposes of

a payment in respect of health services or drugs, devices, substances or

related services to be made to or by the government of British Columbia or a

public body,

authorizing, administering, processing, verifying or cancelling such a

payment,

iii

resolving an issue regarding such a payment, or

an audit by a federal or provincial government payment agency that makes

reimbursement for the cost of health services, drugs, devices, substances or

related services;

to assess and address public health needs;

to engage in health system planning, management, evaluation or improvement,

including

health service development, management, delivery, monitoring and

evaluation,

the compilation of statistical information,

iii

public health surveillance, and

the assessment of the safety and effectiveness of drugs, devices,

substances and related services;

to conduct or facilitate research into health issues;

to assess and address threats to public health;

for a prescribed purpose.

The minister may disclose, outside Canada, personal information collected

under subsection (1) for one or both of the following purposes:

to conduct or facilitate research into health issues;

to assess and address threats to public health.

Disclosure of personal information

The minister may disclose, inside Canada, personal information under this Act

for one or more of the following purposes:

for a purpose described in

section 33 (2) (

s) or (3) (

d) of the Freedom of Information and Protection of Privacy

Act only;

to investigate or discipline

a licensee under the Health Professions and Occupations Act , or

a person who practises in another jurisdiction a health profession within the meaning of that Act;

for the monitoring of

the practice of a designated health profession within the meaning of the Health Professions and Occupations Act , or

the practice in another jurisdiction of a health profession within the meaning of that Act;

for a purpose to which the person who is the subject of the personal

information has consented.

The minister may disclose personal information under this Act inside or

outside Canada for one or more of the following purposes:

for a purpose described in

section 33 (2) (a), (e), (h), (l), (m), (o), (p), (t), (

u) or (v), (3) (a), (

b) or (c), (8) or (9) of the Freedom of

Information and Protection of Privacy Act only;

for a purpose to which the person who is the subject of the personal

information has consented in writing.

Further use and disclosure of personal information

A person to whom the minister discloses personal information under this Act

must not use or disclose the personal information for any purpose other than the

purpose for which it was disclosed to the person, except

in respect of the person's own personal information,

in accordance with this Act or a regulation made under it,

for the purposes of court proceedings, or

for the purposes of enabling a regulatory college that is responsible, under the

Health Professions and Occupations Act , for governing a designated health profession, a committee of the regulatory college or a person acting for the regulatory college to exercise powers or perform duties under

the

Health Professions and Occupations Act , or

the bylaws of the regulatory college.

A person to whom the minister discloses personal information under this Act

must comply with any limits or conditions set, in writing, by the minister.

No market research

This

section applies despite

Part 2 of the Freedom of Information and Protection of Privacy Act

and any provision of this Act or a regulation made under it.

The minister must not disclose, for the purpose of market research, any of the

following information collected under this Act:

the personal information of any person;

information related to a practitioner.

A person to whom the minister discloses, under this Act, information described

in subsection

(2) must not use or disclose the information for the purpose of market

research.

Disclosure for other research purposes

A person may request that personal information collected under this Act be

disclosed to the person for the purpose of conducting or facilitating research into

health issues only by submitting the request, in the form and manner required by the

data stewardship committee, to the data stewardship committee.

Despite subsection (1), that subsection does not apply to a

person who is

an officer or employee of the ministry of the minister, or

a service provider to the ministry of the minister.

Section 14 [disclosure for health research purposes] of the E-Health (Personal Health Information Access and Protection of Privacy)

Act applies to a request made under subsection

(1) of this

section in the same manner as if the personal information

were contained in a ministry database under that Act.

Information management technology

Subject to subsections (2) to (4), a person other than the

minister must not access or record information in prescribed information management

technology.

Subject to the regulations, a pharmacist and a prescribed person may access

information contained in prescribed information management technology.

A pharmacist working in a community pharmacy who dispenses a drug, device or

substance or provides a related service, and a prescribed person, must record in

prescribed information management technology all personal information and other

information relevant to the drug, device, substance or related service, including its

prescription and dispensation.

Subject to the regulations and without limiting subsection (3), a prescribed

person may record information described in subsection (3) in prescribed

information management technology.

A person may access and record information in prescribed information

management technology only in the form and manner required by the minister.

A practitioner may issue electronically a prescription for a drug, device,

substance or related service, but only through prescribed information management

technology.

Attaching and removing protective words

Subject to the regulations, a person may attach a protective word to the

person's personal information recorded in prescribed information management

technology, or remove an attached protective word,

in the manner set out in the regulations, or

by requesting, in the form and manner required by the minister, that a

pharmacist attach or remove a protective word.

A pharmacist who receives a request under subsection (1) must comply

with the request in the manner set out in the regulations.

Until the contrary is demonstrated, a person is presumed to be capable of

understanding

the nature of a protective word, and

the consequences of attaching or removing a protective word.

A protective word takes effect when activated in the prescribed information

management technology.

A reference to a person in this section,

section 29 [effect of protective words] or

section 63 (4) [regulations respecting information] in relation to the

attachment or removal of a protective word includes the person's personal

representative when acting in the course of the personal representative's duties.

Effect of protective words

A person within a prescribed class of persons who is otherwise permitted under

this Act to collect, use or disclose personal information from prescribed information

management technology must not do so if a protective word is attached to the personal

information, except as follows:

to notify a person that a protective word applies to personal information

that would otherwise be available to the person;

for a purpose described in

section 33 (2) (

e) of the Freedom of Information and Protection of Privacy

Act ;

with the express consent of the person to whose personal information the

protective word applies;

section 12 of the Health Care

(Consent) and Care Facility (Admission) Act applies and a

health care provider acting under that

section reasonably believes that the personal

information may be required to provide health care in accordance with that

section.

For the purposes of subsection (1) (

d) of this section, a reference in

section

12 of the Health Care (Consent) and Care Facility (Admission)

Act to an adult is to be read as a reference to a person to

whose personal information a protective word applies.

A person must not disclose to a person within a prescribed class of persons

personal information to which a protective word is attached, except in a circumstance

described in subsection (1).

Administrative Matters

Applications, notices, hearings, information or

reports

The minister may make forms for the purposes of this Act and the regulations

made under it, other than a form for the purposes of

section 49 (3) [recovery of administrative penalties] .

Unless the minister provides otherwise, use of a form made under subsection

(1) is compulsory.

The minister may specify the manner in which applications or reports may be

made, or notices or information must be given, under this Act.

An application or a report made under this Act must provide all information

requested by the minister.

If the minister is required under this Act to give a person notice and an

opportunity to be heard, the giving of notice and of the opportunity to be heard must

be done in accordance with the regulations.

Advisory committees

The minister may establish committees for the purpose of advising the minister

respecting any matter under this Act, including in relation to the listing

drugs, devices or substances on a formulary, and

related services on a related services list.

The minister may designate the chair and vice chair of a committee established

under subsection (1).

Members of a committee established under subsection (1) may be

paid

remuneration set by the minister, and

reasonable and necessary travel and out-of-pocket expenses incurred in

carrying out the work of the committee.

Whistle-blower protection

A person must not dismiss, suspend, demote, discipline, harass or otherwise

disadvantage another person, or deny another person a benefit, because

the other person, acting in good faith and on the basis of reasonable belief,

has notified the minister, a provider, the chief data steward under the E-Health (Personal Health Information Access and Protection of Privacy)

Act , a regulatory college , or the commissioner under the Freedom of Information and Protection of Privacy Act ,

that a person has contravened or is about to contravene this Act,

the other person, acting in good faith and on the basis of reasonable belief,

has done or stated an intention of doing anything that is required to be done in order

to avoid having any person contravene this Act,

the other person, acting in good faith and on the basis of reasonable belief,

has refused to do or stated an intention of refusing to do anything that is in

contravention of this Act, or

the person believes that the other person will do anything described in any of

paragraphs

(

a) to

(c).

Immunity from legal proceedings

This

section applies to the following persons:

a member of a committee under

section 31 [advisory committees] , other than a member who

is employed in the ministry of the minister, or

sits on the board of a health authority;

an inspector retained under

section 34 (2) [appointment of inspectors] ;

a person acting under the order or direction of any person referred to in

paragraph

(

a) or (

b) of this subsection.

Subject to subsection (3), no legal proceeding for damages lies

or may be commenced or maintained against a person referred to in subsection

(1) because of anything done or omitted

in the exercise or intended exercise of a power under this Act,

in the performance or intended performance of a duty under this

Act.

Subsection (2) does not apply to a person referred to in that subsection

in relation to anything done or omitted in bad faith.

Subsection (2) does not absolve the government from vicarious liability

arising out of anything done or omitted by a person referred to in that subsection for

which the government would be vicariously liable if this

section were not in

force.

Enforcement

Audits and Inspections

Appointment of inspectors

The minister may appoint one or more persons, employed under the Public Service Act , to exercise the powers and

perform the duties of an inspector under this Act.

Despite subsection (1), the minister may retain persons as

necessary to be inspectors, and, for this purpose, delegate to those persons any power

or duty of an inspector.

A person retained under subsection (2) may be paid

remuneration set by the minister, and

reasonable and necessary travel and out-of-pocket expenses incurred in

carrying out the work of an inspector.

The Public Service Act does not apply

to a person retained under subsection (2).

Audits and inspections

The minister may appoint inspectors to conduct audits and inspections for the

following purposes:

to determine compliance with this Act;

to fulfill a prescribed purpose.

An inspector may audit or inspect the matters set out in subsection

(3) in respect of

a provider, a manufacturer, a supplier, a franchisor or an alternate

payee,

a former provider, manufacturer, supplier, franchisor or alternate

payee,

a person prescribed for the purposes of

section 21 [incentives] , or

a person who was formerly a person prescribed for the purposes of

section 21.

The following matters may be the subject of an audit or inspection:

a claim;

the billing and business practices of a person referred to in subsection

(2);

prescribed matters.

Powers and duties of inspectors

An inspector must conduct an audit or inspection in conformity with the

practices and procedures set by the minister.

An inspector, at any reasonable time and for the purposes of an audit or

inspection, may

enter any premises, and

inspect the premises and the records found in the premises.

An inspector must not enter a private dwelling under subsection (2) of this

section without either the consent of the occupier or a warrant under

section 40 [warrants] .

General records

Without limiting

section 36 (2) [powers and duties of inspectors] , the records that may be

inspected under that

section include the following:

records that an inspector considers relevant to

the provision of benefits,

the making of claims and the payment of appropriate amounts for benefits,

iii

billing and business practices;

records that would aid the minister in determining whether to take action

under

section 13 (2) or (3) [changing or cancelling provider

enrolment] ;

records relevant to a matter prescribed for the purposes of

section 35 (3)

(c) [audits and inspections] ;

records that would indicate whether a person is in compliance with this

Act.

Practitioner records

An inspector may require the production of or electronic access to any record

that is

in the possession or control of a practitioner, and

relevant to the provision of a benefit by a provider or former provider who

is the subject of an audit or inspection.

A practitioner must comply with a requirement made under subsection

(1).

Duties during audit and inspection

A person who is the subject of an audit or inspection must do all of the

following on the request of an inspector:

produce or provide electronic access to, and permit inspection of, the

records referred to in

section 36 (2) (b) [powers and duties of inspectors] ;

supply copies of or extracts from the records;

answer all questions of the inspector respecting any matter relating to the

records or to the audit or inspection generally.

If required by an inspector, a person must produce, or provide electronic

access to, all books of account and other records that the inspector considers

necessary for the purposes of an audit or inspection.

If records that may be required under this

section are not located on the

premises of a person referred to in subsection (1), a person who

has possession of those records, on the request of an inspector, must produce and

permit inspection of those records by the inspector.

Warrants

Without notice to any person, the minister may apply to a justice of the peace

for an order under this section.

A justice of the peace may issue a warrant authorizing a person to enter and

search a place, including a private dwelling, and take any necessary action if

satisfied by evidence on oath or affirmation that it is necessary for the purposes

taking an action authorized under this Act, or

determining whether an action authorized under this Act should be

taken.

Results of audit

The minister must report the results of an audit to the person who is the

subject of the audit.

On receiving a report under subsection (1), the recipient

may request the minister to reconsider the results by submitting to the minister,

within 30 days after receiving the report, a request in the form and manner required

by the minister.

After considering a request for reconsideration, the minister may

affirm or vary the results of the audit, or

send notice to the person who is the subject of the audit that no action

will be taken under this Act.

Nothing in this

section prevents the minister from taking any action available

to the minister under this Act.

Recovery of non-entitled amounts

An amount is a non-entitled amount if the amount is paid by the minister to a

provider or an alternate payee, or a former provider or alternate payee, who, under

this Act, is not entitled to the amount, including any amount paid

for a drug, device, substance or related service provided to a person who

was not a beneficiary,

for a drug, device, substance or related service that was not a

benefit,

in respect of a claim for payment

for a benefit that was not provided, or

that is not supported by the records kept or produced under this

Act,

after relying on a representation of fact that was untrue, or

by mistake.

Without limiting any action the minister could take under

section 46 [enforcement orders] , if the minister determines that the

minister has paid a non-entitled amount to a provider or an alternate payee, or a

former provider or alternate payee, the minister may require the provider or alternate

payee, or former provider or alternate payee, to

repay the non-entitled amount,

pay a prescribed surcharge, and

pay interest on the amounts owing under paragraphs (

a) and

(b).

The total amount that a person is liable to pay under subsection

(2) is a debt due to the government and may be

deducted from any subsequent payment that may be made to the person under

this Act, including under an agreement made under this Act, or

recovered in a court of competent jurisdiction.

Sharing information for compliance purposes

In this section:

health care body means

the ministry of the minister,

a health care body as defined in the Freedom of

Information and Protection of Privacy Act ,

the Provincial Health Services Authority, and

a society that reports to the Provincial Health Services

Authority;

private insurer means a private body operating in any

jurisdiction in Canada that provides funding in the nature of a health insurance

scheme in respect of a health service;

public insurer means a public body of any jurisdiction in

Canada that provides funding in the nature of a public health insurance scheme in

respect of a health service.

Without limiting

section 22 [collection, use and disclosure of personal information] or 23

[disclosure of personal information] ,

a regulatory college , health care body, public insurer and private insurer may disclose

personal information to the minister for the purposes of determining any person's

compliance with this Act, and

a regulatory college , health care body and public insurer may collect and use personal

information from the minister for the purposes of determining any person's

compliance with an enactment that governs the regulatory college , health care body or public

insurer, as applicable.

Without limiting

section 22 or 23, the minister may

collect and use personal information from a regulatory college , health care body,

public insurer and private insurer for the purposes of determining any person's

compliance with this Act, and

disclose personal information to a regulatory college , health care body and public

insurer for the purposes of determining any person's compliance with an enactment

that governs the regulatory college , health care body or public insurer, as

applicable.

Enforcement and Penalties

Use of evidence and inferences

This

section applies to

an inspector, for the purpose of conducting an audit or inspection,

including determining whether to conduct an audit or inspection and determining the

results of the audit or inspection, and

the minister, for the purpose of making an order or a determination under

this Act.

For a purpose set out in subsection (1), an inspector or the minister, as

applicable, may do any of the following:

subject to subsection (4), consider, and base a determination

or an order on, any relevant source of information, including a source

created

on a statistical basis, including information derived from sampling,

by a comparison between benefits provided by a provider and corresponding

benefits provided by other providers;

draw an adverse inference from any failure to produce sufficient information

in relation to the matter that is the subject of a determination or an order

a person in respect of whom an audit or inspection is conducted or the

determination is to be made, or

a person against whom the order is proposed to be made.

It is not necessary for an inspector or the minister to consider, under

subsection

(2) (a), any particular benefit that was provided by a

provider.

The minister may make orders respecting the use or application of, or reliance

on, statistical methodologies for the purposes of subsection (2) (a).

The minister must publish an order made under subsection (4).

Suspension of payments

The minister, without giving notice or an opportunity to be heard, may suspend

payments owing under this Act by the government to a provider or an alternate payee,

or a former provider or alternate payee, if the minister has reason to believe

that

the provider or alternate payee, or former provider or alternate

payee,

has engaged in conduct that could be the subject of enforcement action,

has been convicted of a prescribed offence under an enactment of British

Columbia or Canada,

prescribed circumstances exist, or

it would be in the public interest to suspend payment.

As soon as reasonably practicable after suspending payments under subsection

(1), the minister must give notice of the suspension and an opportunity

to be heard.

The minister must resume payments and pay any amounts owing during the

suspension period if the minister suspends payments on the grounds set out

subsection (1) (a) (

i) and enforcement action is not commenced within

3 months of the suspension, or

subsection (1) (a), (

b) or (

c) and, following a hearing, the minister

determines that

the grounds for suspending the payments no longer exist, or

suspension of payments is unnecessary for any reason, or is not required

to protect the public interest.

If a provider or an alternate payee, or a former provider or alternate payee,

does not respond within 21 days after notice is given under subsection

(2) or if the minister does not resume payments after giving an

opportunity to be heard under that subsection,

the minister, if applicable, may cancel the enrolment of the provider

without giving further notice or an opportunity to be heard under

section 13 (2)

(b) [changing or cancelling provider enrolment] , and

despite any provision of this Act or a regulation or an agreement made under

it,

no further amounts are owing to the provider or alternate payee, or former

provider or alternate payee, and

any agreement with the provider or alternate payee, or former provider or

alternate payee, is terminated without notice or compensation of any

kind.

The minister may designate a person to exercise the powers and perform the

duties of the minister under this section.

Enforcement orders

This

section applies if the minister is satisfied that a person has

contravened this Act, or

committed an offence under

section 51 [offences] .

In the circumstances set out in subsection (1), the minister

may

order a person to do anything that, in the opinion of the minister, is

necessary to bring the person into compliance, and

attach limits and conditions to the order, including requiring proof, at the

cost of the person against whom the order is made, that the order has been complied

with.

A person against whom an order is made must comply with the order.

Injunctions

Without notice to any person, the minister may apply to a judge of the Supreme

Court for an order under this section.

If satisfied by evidence on oath or affirmation that there has been or will be

a contravention of this Act or an order made under

section 46 [enforcement orders] , a judge of the Supreme Court may grant an

injunction restraining a person from contravening, or requiring a person to comply

with, this Act or the order.

If satisfied by evidence on oath or affirmation that a person is interfering

with or obstructing, or will likely interfere with or obstruct, a person who is

exercising powers or performing duties under this Act, a judge of the Supreme Court

may order the first person to do or refrain from doing those things the judge

considers necessary.

A judge of the Supreme Court may grant an interim injunction or order until

the outcome of an application commenced under this section.

Imposing administrative penalties

Subject to subsection (3) of this section, the minister, after

giving 30 days' notice and an opportunity to be heard, may impose an administrative

penalty if satisfied on a balance of probabilities that a person has

contravened this Act,

without limiting paragraph (

a) of this subsection, contravened an order made

under

section 46 [enforcement orders] , or

committed an offence under

section 51 [offences] .

If a person is subject to an administrative penalty, the person must pay the

administrative penalty within 30 days following the imposition of that administrative

penalty.

An administrative penalty imposed under subsection (1) must not be

greater than

$5 000, in respect of an administrative penalty imposed on an individual,

$50 000, in respect of an administrative penalty imposed on a person other

than an individual.

The minister may designate a person to exercise the powers and perform the

duties of the minister under this section.

Recovery of administrative penalties

If a person is liable to pay an administrative penalty under this Act, the

administrative penalty may be recovered

as a debt due to the government, or

by deducting the amount of the administrative penalty from any subsequent

payment that may be made to the person under this Act, including under an agreement

made under this Act.

If a person fails to pay an administrative penalty as required, the minister

may file a certificate in a court of competent jurisdiction and, on filing, the

certificate has the same force and effect, and all proceedings may be taken on it, as

if it were a judgment of the court with which it is filed.

A certificate under subsection (2) must be in the prescribed form, be

signed by the minister and contain

the name of the person who is liable for the administrative

penalty,

the contravention or failure in relation to which the administrative penalty

is imposed, and

the amount of the administrative penalty.

Offence Act application

Sections 4 and 5 of the Offence

Act do not apply in respect of this Act or the regulations made

under it.

Offences

A person who does any of the following commits an offence:

contravenes

section 12 (3) [duties] , 15 (1) [identity numbers] , 21

[incentives] , 25 [no market research] ,

32 [whistle-blower protection] or 39 [duties during

audit and inspection] ;

knowingly provides false or misleading information

to a person who is exercising a power or performing a duty under this Act,

or a person acting under the order or direction of that person, or

for the purposes of receiving a benefit;

wilfully interferes with or obstructs a person who is exercising a power or

performing a duty under this Act, or a person acting under the order or direction of

that person;

collects, uses or discloses personal information other than as permitted

under this Act.

A person commits an offence if the person offers an incentive

to a beneficiary, as an inducement for the beneficiary to receive a benefit

from a particular provider, or

to any person, as an inducement to refer a beneficiary for the purposes of

the beneficiary receiving a benefit from a particular provider.

Subsection (2) does not apply to a drug, device, substance or related

service for which the minister does not make a payment, in respect of the recipient of

the drug, device, substance or related service, under the Act.

Fines and incarceration

A person who commits an offence listed in

section 51 (1) or (2)

[offences] , or established under the regulations and identified

as an offence to which this

section applies, is liable on conviction to a fine not

exceeding $200 000 or to imprisonment for a term not exceeding 6 months, or to

both.

General Provisions

Person not to be charged with both administrative penalty and

offence

A person subject to an administrative penalty must not be prosecuted for an

offence in respect of the same incident that gave rise to the administrative

penalty.

A person charged with an offence must not be subject to an administrative

penalty in respect of the same incident that gave rise to the charge.

Actions by corporation or employee

If a corporation contravenes

this Act, or

without limiting paragraph (

a) of this subsection, an order made under

section

46 [enforcement orders] ,

an officer, a director, an employee or an agent of the corporation who

authorized, permitted or acquiesced in the contravention is also liable to an

administrative penalty under

section 48 [imposing administrative penalties] even though the corporation

is liable for or pays the administrative penalty.

If a corporation commits an offence under

section 51 [offences] , an officer, a director, an employee or an agent of

the corporation who authorized, permitted or acquiesced in the offence commits the

offence whether or not the corporation is convicted.

If an employee commits an offence under

section 51, an employer who

authorized, permitted or acquiesced in the offence commits the offence whether or not

the employee is identified or convicted.

Continuing contraventions or offences

If a person

contravenes

this Act, or

without limiting subparagraph (

i) of this paragraph, an order made under

section

46 [enforcement orders] , or

commits an offence under

section 51 [offences] ,

and continues to contravene the Act or order, or to commit the offence, separate

penalties may be imposed in respect of the contravention or offence for each day the

original contravention or offence continues.

No benefit from contravention or offence

This

section applies if a person gains a benefit in

contravening

this Act, or

without limiting subparagraph (

i) of this paragraph, an order made under

section

46 [enforcement orders] , or

committing an offence under

section 51 [offences] .

In any of the circumstances set out in subsection (1) of this

section

but subject to subsection (3) of this section,

the minister may impose, in addition to any administrative penalty imposed

under

section 48 [imposing administrative penalties] , an administrative penalty

in an amount not exceeding the amount of the benefit, or

the person is liable on conviction, in addition to any fine imposed under

this Act, to a fine in an amount not exceeding the amount of the benefit.

Subsection (2) of this

section does not apply in respect of any amount

recovered under

section 42 [recovery of non-entitled amounts] .

Limitation period

A proceeding for

an administrative penalty under

section 48 [imposing administrative penalties] may not be commenced under

this Act, and

an offence under

section 51 [offences] may not be commenced in any court

more than 3 years after the facts on which the proceeding is based first come to

the knowledge of the minister.

Publication of orders and offences

The minister may publish information, including personal information, respecting

the following:

a change to a designation made under

section 13 (2) (a) [changing or cancelling provider enrolment] ;

a cancellation of a provider's enrolment under

section 13 (2) (

b) or 45 (4)

[suspension of payments] ;

enforcement action taken under this Act.

Regulations

Regulations respecting provincial drug program

The Lieutenant Governor in Council may make regulations respecting the provincial

drug program as follows:

establishing one or more drug plans and providing that a drug plan need not have

either a formulary or a related services list established for the drug plan;

respecting eligibility for enrolment as a beneficiary in one or more drug

plans, including respecting assessments for eligibility;

respecting requirements for enrolment as a beneficiary in a drug plan,

including respecting proof of eligibility for enrolment;

if a beneficiary is enrolled in more than one drug plan, establishing rules for

the purpose of determining which drug plan applies to the beneficiary in relation to a

particular benefit;

respecting deductibles and co-payments, including requiring a beneficiary or

authorizing the minister to make full payment for the cost of receiving

benefits;

respecting limits and conditions for the purposes of paragraph

(e).

Regulations respecting beneficiaries

The Lieutenant Governor in Council may make regulations respecting beneficiaries

as follows:

for the purposes of

section 9 [entitlement to benefits] ,

respecting co-ordination of the assessment of claims and payment of benefits

with insurers and other reimbursement programs,

respecting reciprocal arrangements for the provision of benefits with Canada

iii

prohibiting beneficiaries from receiving payment for benefits under this Act

that are provided for through insurers and other reimbursement programs,

and

prescribing enactments and programs for the purposes of subsection (3) of

that section;

respecting limits and conditions on a beneficiary's entitlement to

benefits;

respecting verification of the identity and enrolment, under the Medicare Protection Act , of a person requesting

benefits under this Act;

respecting the cancellation of a beneficiary's enrolment in one or more drug

plans, including requiring the minister to give notice of the cancellation.

Regulations respecting providers and others

The Lieutenant Governor in Council may make regulations respecting persons

described in

section 12 [duties] as follows:

respecting the information that must be supplied by a person applying to be

enrolled as a provider;

respecting the criteria a person must meet to be enrolled as a provider, or to

continue enrolment;

respecting records that must be kept and the period of time for which they

must be kept;

respecting changes to a provider's designation and the cancellation of a

provider's designation or enrolment;

prohibiting providers from charging beneficiaries for drugs, devices,

substances or related services for which the provider receives payment from the

minister under this Act;

requiring providers to make certain information available to the

public.

A regulation made under subsection (1) (

c) may adopt by reference, in whole or

in part and with any changes the Lieutenant Governor in Council considers appropriate, a bylaw of the regulatory college that is responsible, under the Health Professions and Occupations Act , for governing the designated health profession of pharmacy .

Unless otherwise stated, a bylaw referred to in subsection (2) is adopted as

amended from time to time.

The Lieutenant Governor in Council, for the purposes of

section 14 [limits or conditions on provision] , may make regulations setting

limits and conditions in respect of the prescription, dispensation, sale, purchase or

use of drugs, devices, substances or related services.

The Lieutenant Governor in Council may make regulations prescribing persons, by

class, for the purposes of sections 12, 15 [identity numbers] and 17

[payments] .

The Lieutenant Governor in Council may make regulations prescribing enactments

for the purposes of

section 17.

Regulations respecting price regulation

The Lieutenant Governor in Council may make regulations for the purposes of

regulating the price of drugs, devices, substances and related services as

follows:

setting limits and conditions on the amount that will be paid under this Act

in respect of a class of drugs, devices, substances or related services;

setting limits and conditions on the price of, or amount charged for, a class

of drugs, devices, substances or related services, and for this purpose, the

Lieutenant Governor in Council may specify that a limit or condition applies in

respect of one or more classes of beneficiaries and persons who are not

beneficiaries;

requiring the minister not to list, or to discontinue listing, a drug, device

or substance on a formulary, or a related service on a related services

list,

if prescribed limits or conditions are not met, or

in prescribed circumstances.

An amount for the purposes of subsection (1) may be expressed

in any form, including

as a formula, or

in relation to other classes of drugs, devices, substances or related

services,

a percentage of the price of them, or

amounts that may be paid or charged for them.

The Lieutenant Governor in Council may make regulations respecting incentives as

follows:

prescribing persons, by class, for the purposes of

section 21 [incentives] ;

respecting the means of determining the value of incentives;

prohibiting the receipt or offer of an incentive;

providing that the prohibition set out in

section 21 does not apply to

specified matters that are the subject of ordinary commercial terms.

Regulations respecting information

In making a regulation under this Part, the Lieutenant Governor in Council may

make regulations requiring a person to provide either or both of the

following:

personal information;

written consent to the release, by another person, of personal

information.

The Lieutenant Governor in Council may make regulations respecting the

management of information as follows:

prescribing additional purposes for which personal information may be

collected, used and disclosed, or further used or disclosed, under this

Act;

if the disclosure of personal information is authorized under this

Act,

clarifying or limiting the purposes for which further use or disclosure is

authorized, and

setting limits and conditions, in addition to any limits or conditions

already provided for under this Act, on that further use or disclosure;

defining "health services" and "health system" for the purposes of Division 1 [Information Management] of

Part 4;

prescribing information management technology for the purposes of the

definition of "prescribed information management technology" in

section 1;

d.1

prescribing activities or circumstances that do or do not comprise market research for the purpose of

section 25 [no market research] ;

prescribing persons, by class, for the purposes of

section 27 (2), (3) and

(4) [information management technology] ;

respecting access to and recording in prescribed information management

technology, including prohibiting access to and setting limits or conditions on access

or recording;

respecting the recording of personal information in prescribed information

management technology by a person authorized, under the terms of a designation order,

to collect or have disclosed to the person information from a health information

bank;

respecting the disclosure of personal information from prescribed information

management technology to a person authorized, under the terms of a designation order,

to collect information into a health information bank;

respecting fees that may be charged for access to information in the custody

of the minister, but not including fees for access, by a person, to personal

information of the person.

In subsection (2) (

g) and (h), "designation order" and "health information

bank" have the same meaning as in the E-Health (Personal

Health Information Access and Protection of Privacy)

Act .

The Lieutenant Governor in Council may make regulations respecting protective

words as follows:

limiting or prohibiting classes of persons from attaching protective

words;

respecting conditions that apply to the attachment or removal of a protective

word, including requiring the submission of records to a person;

respecting the manner in which a protective word may be attached or

removed;

prescribing classes of persons for the purposes of

section 29 [effect of protective words] .

Regulations respecting administration and enforcement

The Lieutenant Governor in Council may make regulations as follows:

respecting the service of a notice or an order under this Act, including

providing for the waiver of notice if service is not reasonably practicable;

respecting hearings under this Act and providing for the manner and form of the

hearing, including by written submissions;

prescribing purposes for which an audit may be conducted;

prescribing matters that may be the subject of an audit;

prescribing surcharges that must be paid on non-entitled amounts;

prescribing, for the purposes of

section 45 [suspension of payments] ,

offences, and

circumstances that may be grounds for suspending payments;

respecting administrative penalties that may be imposed, including providing

factors to be considered in the determination of the appropriate penalty;

respecting the form of a certificate under

section 49 [recovery of administrative penalties] ;

respecting any other matter for which regulations are contemplated by this

Act.

General regulation-making powers

The Lieutenant Governor in Council may make regulations referred to in

section 41

of the

Interpretation Act .

A person must not read any

section of this Part as limiting the general powers

to make regulations described in subsection (1) of this section.

The Lieutenant Governor in Council may

make regulations establishing classes of persons, drug plans, drugs, devices,

substances or related services, and

make different regulations for different classes, including limiting the

application of a regulation made under this Part to one or more classes.

The Lieutenant Governor in Council may make regulations

exempting a person, drug, device, substance or related service, or a class of

any of them, from one or more provisions of this Act or a regulation made under it,

authorizing the minister to waive or modify one or more requirements, limits

or conditions of a regulation made under this

Part in respect of a person, drug,

device, substance or related service, or a class of any of them, including a class

established by the minister.

Without limiting subsection (4) (

b) of this section, a regulation made

under this Part may confer a discretion on the minister.

Transitional Provisions and Consequential Amendments

Transitional Provisions

Transition

definitions

In this Part:

corresponding drug plan means a drug plan, deemed to be

established under this Act by

section 67 (2) (a) [transition PharmaCare plans] ,

that

corresponds to a PharmaCare plan, and

has the same name as the PharmaCare plan to which the drug plan

corresponds;

PharmaCare formulary means a list of drugs, devices and

substances that, under the terms of a PharmaCare plan, are benefits for the purposes

of that plan;

PharmaCare manual means the policy manual of the ministry

of the minister entitled "PharmaCare Policy Manual Version 1.0", dated March 2012, as

amended from time to time;

PharmaCare plan means a plan within the PharmaCare

program;

PharmaCare program means the collection of Plans B, C, D,

F, G, I, M, P, S and X established under

section 2 of the

Schedule to

the Continuing Care Programs Regulation, B.C. Reg. 146/95, as it read on the date this

section comes into force;

PharmaCare related services list means a list of related

services that, under the terms of a PharmaCare plan, are benefits for the purposes of

that plan.

Transition PharmaCare plans

In this section, PharmaCare benefit means

a drug, device or substance that is listed on a PharmaCare formulary,

and

a related service that is listed on a PharmaCare related services

list.

On the date this

section comes into force,

each PharmaCare plan, for the purposes of this Act, is deemed to be a drug

plan established under this Act, having the same name,

PharmaCare benefits for a PharmaCare plan are deemed to be benefits for the

purposes of the corresponding drug plan, subject to

any changes to benefits made under

section 3 [establishing and maintaining formularies] or 4

[establishing and maintaining related services lists] ,

a regulation made under

section 59 [regulations respecting provincial drug program] ,

a person who is registered in a PharmaCare plan is deemed to be enrolled as

a beneficiary under this Act in the corresponding drug plan, and

the requirements, prohibitions, limits and conditions in respect of

entitlement to PharmaCare benefits under a PharmaCare plan, as described in the

PharmaCare manual, apply for the purposes of paragraphs (a), (

b) and

(

c) of this subsection.

This

section ceases to have effect in respect of a PharmaCare plan that is

deemed to be a drug plan on the earliest of

the making of a regulation under this Act that establishes the PharmaCare

plan's corresponding drug plan, and

3 years after the date this

section comes into force.

Despite subsection (3) (a), the Lieutenant Governor in

Council may provide, in a regulation made under this Act that establishes a

corresponding drug plan, that a requirement, prohibition, limit or condition in

respect of entitlement to PharmaCare benefits described in the PharmaCare manual

continues to apply to the corresponding drug plan for up to 3 years after the date

this

section comes into force.

If there is a conflict or an inconsistency between a regulation made under

this Act and the PharmaCare manual, subsection (4) does not apply

and the regulation prevails.

Transition PharmaCare formularies and related

services lists

A PharmaCare formulary that applies to a PharmaCare plan continues in effect

and is deemed to be the formulary that applies to the corresponding drug

plan.

A PharmaCare related services list that applies to a PharmaCare plan continues

in effect and is deemed to be the related services list that applies to the

corresponding drug plan.

Transition agreements

This

section applies to an agreement made

before the date this

section comes into force between a manufacturer or a

supplier and Her Majesty the Queen in Right of British Columbia, as represented by

the Minister of Health, and

in respect of

the listing of a drug, device or substance on a PharmaCare formulary,

a drug, device or substance for which the minister is making a

payment.

An agreement described in subsection (1) continues for the purposes of this

Act as if the agreement were made under this Act.

Despite any provision of an agreement to the contrary, if an agreement does

not provide for termination of the agreement by the government, on notice and without

cause, the minister may terminate the agreement without cause on giving 60 days'

notice to the other party or parties to the agreement.

Despite any other enactment or law to the contrary,

no damages or compensation of any kind is payable by the government,

and

no proceedings in which damages or compensation is claimed may be commenced

or maintained against the government,

arising from the exercise of a power or the performance of a duty under this

Act in relation to an agreement described in subsection (1), the

termination of an agreement described in subsection (1) or the

operation of this section.

Transition special payments

If, on the date this

section comes into force,

there is a subsisting authorization, by the minister, for payment for a

drug, device, substance or related service, or a benefit, and

the authorization is in the nature of an authorization that may be granted

under

section 6 [special payments] ,

the authorization is deemed to be an authorization granted under that

section.

An authorization under subsection (1) of this

section continues, subject to

any limits and conditions applicable as of the date this

section comes into force,

until changed or cancelled under

section 6 (5) (d).

Transition providers

This

section applies to a person who, on the date this

section comes into

force, is a party to any of the following agreements with Her Majesty the Queen in

Right of British Columbia, as represented by the Minister of Health:

a PharmaCare Enrolment Agreement;

a Pharmacy Participation Agreement;

a British Columbia PharmaCare Non-Pharmaceutical Supplier Participation

Agreement;

a British Columbia PharmaCare Pharmacy Participation Agreement for the

Provision of PharmaCare Services to Long Term Care Facilities;

a Methadone Maintenance Payment Program Addendum to a Pharmacy Participation

Agreement.

On the date this

section comes into force, a person described in subsection

(1) is deemed to be a provider subject to

any designation made and any limits or conditions imposed under subsection

(3) of this section,

the requirements, prohibitions, limits or conditions in respect of the

provision of PharmaCare benefits described in the PharmaCare manual,

the terms of an agreement described in subsection (1) to which the

provider is subject, and

a change to or the cancellation of the person's enrolment under

section

13 [changing or cancelling provider enrolment] .

The minister may

designate a deemed provider as a member of a class of providers established

by the minister, and

impose limits and conditions on the deemed provider's enrolment.

An agreement described in subsection (1) of this

section in respect of a

deemed provider, along with that provider's deemed enrolment under subsection

(2) of this section, is terminated on the earlier of

the agreement's termination in accordance with the terms of the agreement,

and

180 days after the making of a regulation under

section 61 (1) (

a) and (b)

[regulations respecting providers and others] .

If the minister enrols a deemed provider who, within 180 days after the

making of a regulation under

section 61 (1) (

a) and (b), applied for enrolment, the

minister may specify that the person is enrolled as of a particular date, including

the date on which the person's deemed enrolment is terminated under subsection (4)

(

b) of this section.

Subsection (2) (

b) ceases to have effect 3 years after the date this

section

comes into force, unless the Lieutenant Governor in Council, on making a regulation

under

section

61, provides that subsection (2) (

b) of this

section ceases to have

effect on an earlier date.

Despite any other enactment or law to the contrary,

no damages or compensation of any kind is payable by the government,

and

no proceedings in which damages or compensation is claimed may be commenced

or maintained against the government,

arising from the exercise of a power or the performance of a duty under this

Act in relation to an agreement described in subsection (1), the

termination of an agreement described in subsection (1) or the

operation of this section.

Transition immunity

No legal proceeding for damages lies or may be commenced or maintained against

the minister or an employee of the government because of anything done or

omitted

in the exercise or intended exercise of a power under

section 69 [transition agreements] or 71

[transition providers] , or

in the performance or intended performance of a duty under

section 69

or 71.

Transition incentives

This

section applies to a person who is a party to an agreement that provides

for incentives to be received or provided in relation to drugs, devices and substances

listed on a formulary or in relation to related services listed on a related services

list.

Despite any other enactment or law to the contrary,

no damages or compensation of any kind is payable by the government,

and

no proceedings in which damages or compensation is claimed may be commenced

or maintained against the government,

arising from the contravention or termination, by a party, of an agreement

referred to in subsection (1) of this

section or the operation of

section 21 [incentives] .

Transition PharmaNet

In this

section and in

section 78 (1) [transition regulations] ,

PharmaNet and PharmaNet stewardship

committee have the same meaning as they had in

section 1 of

the Pharmacy Operations and Drug Scheduling Act before

those

definitions were repealed by this Act.

The provincial computerized networks and associated databases, collectively

known as PharmaNet, are continued under this Act and are deemed to be prescribed

information management technology for the purposes of this Act until a regulation is

made under

section 63 (2) (d) [regulations respecting information] .

The rules, policies and procedures of the PharmaNet stewardship committee as

they existed immediately before the repeal of

section 14 of the Pharmacy Operations and Drug Scheduling Act by this

Act

in respect of data that relate to drugs, devices, substances or related

services continue to apply, and

in respect of any other matter are the rules, policies and procedures of the

data stewardship committee under the E-Health (Personal

Health Information Access and Protection of Privacy)

Act ,

except to the extent the rules, policies and procedures are repealed or

amended by the data stewardship committee.

If personal health information was being disclosed under

section 16

of the Pharmacy Operations and Drug Scheduling

Act immediately before the repeal of that

section by this Act,

the disclosure may continue in accordance with the terms under which the disclosure

was authorized under that section.

A reference, in a bylaw made under the authority of

section 21

of the Pharmacy Operations and Drug Scheduling

Act and in force immediately before the amendment of that

section by this Act,

to PharmaNet is to be read as a reference to prescribed information

management technology under

section 27 [information management technology] of this Act, and

to the PharmaNet stewardship committee is to be read as a reference to the

data stewardship committee under the E-Health (Personal

Health Information Access and Protection of Privacy)

Act .

The Access to PharmaNet Regulation, B.C. Reg. 117/2009, whether or not

consistent with or authorized to be made under this Act, is deemed to be validly made

under this Act and is given effect until the earliest of

the regulation's repeal by regulation of the Lieutenant Governor in

Council,

the regulation's amendment in accordance with this Act, and

3 years from the date this

section comes into force.

Transition advisory

committees

This

section applies to the committees, established by the minister, that

advise the minister respecting one or more of the following:

drugs, devices, substances and related services;

clinical matters in relation to drugs, devices, substances and related

services;

adjudication in relation to matters under the PharmaCare program.

The committees referred to in subsection (1) are continued as advisory

committees for the purposes of

section 31 [advisory committees] .

A person who, on the date this

section comes into force, is a member of a

committee referred to in subsection

(1) continues to be a member of the committee, and

is subject to the limits and conditions of the person's appointment to the

committee, until the minister changes or rescinds that person's

appointment.

Transition new applicants to be

beneficiaries

If a person applies to be a beneficiary after the date this

section comes into

force but before a regulation is made under

section 59 (b), (

c) or (d)

[regulations respecting provincial drug program] , the

requirements, prohibitions, limits and conditions described in the PharmaCare manual

in respect of entitlement to PharmaCare benefits apply for the purposes of

making the application, and

determining the person's eligibility, and continued eligibility, to receive

benefits.

If an applicant under subsection (1) is eligible to receive benefits under

a corresponding drug plan, the applicant is deemed to be a beneficiary enrolled in

that corresponding drug plan, subject to

any limits or conditions imposed under

section 9 (2) [entitlement to benefits] ,

the requirements, prohibitions, limits or conditions in respect of

entitlement to PharmaCare benefits described in the PharmaCare manual,

and

the cancellation of the person's enrolment under

section

11 [cancelling beneficiary enrolment] .

Subsections (1) and (2) (

b) of this

section cease to have effect on the

earliest of

the making of a regulation under

section 59 (b), (

c) or (d), and

3 years after the date this

section comes into force.

Despite subsection (3) (

a) of this section, the Lieutenant Governor in Council

may provide, in a regulation made under

section 59 (b), (

c) or (d), that a

requirement, prohibition, limit or condition in respect of entitlement to PharmaCare

benefits described in the PharmaCare manual continues to apply for up to 3 years after

the date this

section comes into force.

If there is a conflict or an inconsistency between a regulation made under

this Act and the PharmaCare manual, subsection (4) does not apply

and the regulation prevails.

Transition new applicants to be

providers

If a person applies to be a provider after the date this

section comes into

force but before a regulation is made under

section 61 (1) (

a) or (b)

[regulations respecting providers and others] , the

requirements, prohibitions, limits and conditions in respect of the provision of

PharmaCare benefits described in the PharmaCare manual apply for the purposes

making the application, and

determining the person's eligibility, and continued eligibility, to provide

benefits.

If an applicant under subsection (1) is eligible to provide benefits, the

person is deemed to be enrolled as a provider subject to

any designation made and any limits or conditions imposed under subsection

(3) of this section,

the requirements, prohibitions, limits or conditions in respect of the

provision of PharmaCare benefits described in the PharmaCare manual, and

a change to or the cancellation of the person's enrolment under

section

13 [changing or cancelling provider enrolment] .

The minister may

designate a deemed provider as a member of a class of providers established

by the minister, and

impose limits and conditions on the deemed provider's enrolment.

A provider's deemed enrolment under subsection (2) of this

section is

terminated 180 days after the making of a regulation under

section 61 (1) (

a) or

(b).

Subsections (1) and (3) of this

section cease to have effect on the

earliest of

the making of a regulation under

section 61 (1) (

a) or (b), and

3 years after the date this

section comes into force.

Despite subsection (5) (

a) of this section, the Lieutenant Governor in Council

may provide, in a regulation made under

section 61 (1) (

a) or (b), that a requirement,

prohibition, limit or condition in respect of the provision of PharmaCare benefits

described in the PharmaCare manual continues to apply for up to 3 years after the date

this

section comes into force.

If there is a conflict or an inconsistency between a regulation made under

this Act and the PharmaCare manual, subsection (6) does not apply

and the regulation prevails.

Subsection (2) (

b) of this

section ceases to have effect 3 years after the

date this

section comes into force, unless the Lieutenant Governor in Council, on

making a regulation under

section 61, provides that subsection (2) (

b) of this

section ceases to have effect on an earlier date.

Transition regulations

The Lieutenant Governor in Council may make regulations the Lieutenant

Governor in Council considers necessary or advisable for the orderly

transition

from the Pharmacy Operations and Drug Scheduling

Act to this Act in respect of PharmaNet and the PharmaNet

stewardship committee under that Act, and

from the PharmaCare program to the provincial drug program under this

Act.

The authority to make or amend a regulation made under subsection

(1), but not the authority to repeal a regulation made under subsection

(1), ends 3 years after the date subsection (1) comes into

force.

Consequential Amendments

79-105

[Note: See Table of Legislative Changes for the status of sections 79 to 105.]

Section(

s) Affected Act

79-92

E-Health (Personal Health Information Access and Protection of Privacy)

Act

Freedom of Information and Protection of Privacy Act

Health Care Costs Recovery Act

95-96

Health Statutes Amendment Act, 2007

97-98

Medicare Protection Act

99-100

Ministry of Health Act

101-104

Pharmacy Operations and Drug Scheduling Act

Public Health Act

Commencement

This Act comes into force on the date of Royal Assent.