MSP Member Update Vol. 8 No. 31
Sept. 4th, 2009
In This Issue:
- NIHB - ESI Standard Pharmacy Agreement
- Confirmation of Professional Fees
- MTS Centre Presents the Wiggles
- NIHB – ESI Standard Pharmacy Agreement
Earlier this week MSP was requested to assist ESI with informing MSP members that “the registration process with ESI Canada for the Non-Insured Health Benefit (NIHB) Program is now underway”. For the MSP Members benefit this letter can be accessed at http://www.msp.mb.ca/files/events/esi_letter_for_members.pdf.
In addition MSP has enclosed below a copy of previous Communication Plus related to the ESI Standard Agreement on July 8th, 2009. Members should be aware that a copy of a related Briefing Note and Legal Opinion are also included below.
NIHB - ESI Standard Pharmacy Agreement - recently Manitoba pharmacies received a standard contract from ESI with respect to the Non Insured Health Benefits Agreement. The Manitoba Society of Pharmacists along with other Provincial Pharmacy Organizations across Canada, CPhA and CACDS were involved with ensuring some changes were made to the standard agreement before it was circulated to pharmacy providers. The legal document pharmacies have received is the best document possible given the circumstances. However, with any agreement there various obligations and undertakings.
MSP decided to provide all members with a background package which we encourage pharmacy owners’/ managers to review before deciding on whether to sign the standard agreement. The enclosed package includes a briefing note and an independent legal opinion on the standard agreement from the law firm D'Arcy and Deacon, and is intended to provide members with an improved understanding.
Click Here to access the Briefing Note
Click Here to access the Legal Opinion
- Confirmation of Professional Fees
All community pharmacies should have received a package of documents from Manitoba Health (MB Health) with respect to Confirmation of Professional Fees. This initiative is related to a Manitoba Auditor General Report which identified a need for a more formalized process for MB Health to verify pharmacy professional fees.
With any new initiative a variety of questions need to be addressed and MSP has dialogued with MB Health and provided advice. You likely also have questions and we have attempted to provide you with some additional insight on this initiative. Please take a few minutes to review the Question and Answer document which was prepared by MSP with the consultation of MB Health (see below).
Question & Answer
Question 1) - Why does MB Health require this information?
Answer: There was a need to establish a more formalized and consistent process for MB Health to verify pharmacy professional fees. In December, 2008, the Office of the Auditor General (OAG) Manitoba reviewed the Pharmacare Program and made the following observations:
There is need for “monitoring performed of Pharmacare claims to ensure that professional fees charged were the same for Pharmacare and non-Pharmacare clients.”
Manitoba Health is responding to the findings of the OAG. OAG reports need to be addressed and in this case the OAG identified a need for improvement to validate fees.
Question 2) - Doesn’t MB Health have this information already in DPIN?
Answer: MB Health already has most of this information. This initiative is to establish a more formalized and comprehensive validation process.
Question 3) - Once I provide MB Health with my fee structure can my pharmacy make changes in the future?
Answer: Yes. MB Health has provided pharmacies with a form which must be submitted to the Department when there changes to professional fees are implemented.
Question 4) - Can I be assured that my fee structure is maintained in a confidential manner; after all I do not want it widely circulated?
Answer: This matter has been discussed and MB Health in correspondence to all Manitoba community pharmacies has referenced section 18(1) of the Freedom of Information and Protection of Privacy Act which addresses “Disclosure harmful to a third party’s business interests”.
Question 5) - Why is MB Health requiring this information now, when it wasn’t required in the past?
Answer: Some pharmacies have regularly updated MB Health anytime fee changes are made. This initiative is to establish a more formalized and comprehensive validation process.
Question 6) – As the pharmacy manager for a chain drug store, I do not have the authority to determine fees; is there someone else at my company that can sign and submit the Confirmation of Professional Fee Notification?
Answer: MB Health is aware this may be an issue for some pharmacies and are prepared to work with pharmacy managers, head offices, and pharmacy owners should this be needed.
Question 7) – My pharmacy has many different fees; which ones do I need to include in the Confirmation of Professional Fees Notification?
Answer: Include all your professional fees. MB Health is aware that pharmacies often have sophisticated fee structures with a variety of fees such as: birth control, blister packaging, compounding fee, diabetic supplies, usual and customary fee for oral medications, days supply, professional fee as a percentage of product costs for expensive meds, inhalers, and narcotics professional fee. If you have any questions you can also contact MB Health (as outlined in their correspondence).
Question 8) – There is not enough space provided for me to insert all of the different fees charged by my pharmacy. What should I do?
Answer: Send in additional Confirmation of Professional Fees Notification.
Question 9) – How do I address exceptions (whether more or less than standard fees) and do I need to report each one to MB Health?
Answer: Note the reason for the exceptions in your records so that your pharmacy is able to respond should a review of your records occur.
Question 10) – What has MSP done with respect to this new requirement?
Answer: MSP has had a number of discussions with MB Health about this requirement. MSP worked with MB Health to develop the forms and establish a streamlined process. For most pharmacies the Confirmation of Professional Fees Notification form can be completed within ½ hour.
Question 11) – I object to providing MB Health with this information and refuse to comply. What, if anything will MB Health do?
Answer: MSP has asked this question and a definite response has not been provided. It has been suggested that should a pharmacy not provide the requested information, MB Health can obtain this information through an on-site audit.
Question 12) – Is Manitoba Health attempting to replace the fee structure by requesting this information?
Answer: MB Health is aware that the Competition Bureau noted that a market driven fee structure such as the one in place in Manitoba is preferable to a capped fee which is employed in other jurisdictions. This initiative is intended only to validate professional fees paid through the Pharmacare program.
- MTS Centre – The Wiggles Go Bananas
The most beloved family entertainment band in the world, The Wiggles, are setting out on their wildest adventure to date. The fab four from down under are back with a brand new live show! This spectacular musical extravaganza will showcase old favorites as well as their hit “Monkey Man” featuring Australian pop sensation Kylie Minogue from “The Wiggles Go Bananas” album. The Wiggles, Captain Feathersword, Dorothy the Dinosaur, Henry the Octopus, Wags the Dog and all the Wiggly Dancers invite their fans to join them as they “Go Bananas Live!” in Winnipeg, MB.
For more information go to http://www.msp.mb.ca/files/events/the_wiggles.pdf
To order tickets contact Derek Kuzina @ 926-5516 or dkuzina@truenorth.mb.ca
Order deadline is Oct. 1, 2009
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