A-29.01 - Act respecting prescription drug insurance

Full text
78. In addition to the regulatory powers otherwise conferred on it by this Act, the Government may, after consulting the Board, make regulations to
(1)  determine, for the purposes of section 6, the classes of persons who are otherwise entitled to coverage equivalent to basic plan coverage;
(1.1)  determine, for the purposes of the second paragraph of section 5, classes of persons eligible for the basic plan as well as the conditions those persons must meet to be eligible;
(1.2)  determine, for the purposes of section 8, the services required for pharmaceutical reasons and provided by a pharmacist that are covered by the basic prescription drug insurance plan and determine, among those whose cost is paid by the Board, the services that must relate to a medication on the list of medications drawn up by the Minister under section 60;
(1.3)  determine, for the purposes of section 8.1, the cases in and conditions on which an owner pharmacist may claim fees for a pharmaceutical service provided to a person covered by a group insurance contract or an employee benefit plan;
(1.4)  determine, for the purposes of section 11, the pharmaceutical services for which no contribution is payable; those services may vary according to whether the insurance coverage is provided by the Board or by a group insurance contract or an employee benefit plan;
(2)  determine, for the purposes of section 22, the other services required for pharmaceutical reasons and provided by a pharmacist whose cost is borne by the Board, and prescribe the frequency with which certain services described in that section must be provided to remain covered; the frequency may vary in the cases and on the conditions it determines;
(2.0.1)  determine, for the purposes of section 22, the other pharmaceutical services that must relate to a medication that is on the list of medications drawn up by the Minister under section 60;
(2.1)  determine the other information the itemized invoice referred to in section 8.1.1 must contain, which may vary according to whether the insurance coverage is provided by the Board or by a group insurance contract or an employee benefit plan;
(3)  (subparagraph repealed);
(4)  determine the cases in which and conditions on which the medications determined by the Government, that are provided as part of the services provided by an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) or the Act respecting health services and social services for Cree Native persons (chapter S-5) or by any other institution recognized for that purpose by the Minister that is situated outside Québec in a region bordering on Québec, are covered for the classes of persons it determines;
(5)  prescribe the cases in which and conditions on which eligible persons who remain outside Québec during the entire year, and who retain their status as persons resident in Québec under the Health Insurance Act (chapter A-29) despite their absence from Québec, may be exempted from payment of the premium for that calendar year;
(6)  list the types of impairment which constitute functional impairment for the purposes of section 17 and the cases in which and conditions on which a person suffering from a functional impairment is deemed to attend an educational institution on a full-time basis;
(7)  determine, for the purposes of sections 13.1 and 28.1, the rules pursuant to which rates of adjustment are to be fixed annually and specify the class of persons to which each rate is applicable, where that is the case;
(8)  (subparagraph repealed);
(9)  prescribe, for the purposes of section 40, the information that the Board may require from an insurer transacting group insurance or the administrator of an employee benefit plan, and prescribe the manner in which such information may be communicated;
(9.1)  determine any conditions or circumstances considered to be distinctive characteristics of group insurance in addition to those set out in the second paragraph of section 42.2;
(9.2)  prescribe, for the purposes of sections 70.1 to 70.3, the procedure for communicating lists of group insurance contracts and employee benefit plans, group insurance contracts and employee benefit plans, and information on any amendments to those contracts and plans causing eligible persons to be transferred to the public plan, as well as the intervals at which they must be communicated and the information the lists must contain;
(10)  determine, for the purposes of section 43, the terms and conditions on which the risks arising from the basic plan coverage must be pooled, and the period during which they are to apply;
(11)  determine the provisions of a regulation the contravention of which constitutes an offence.
A regulation made under this section shall have effect, with respect to health care professionals bound by a valid agreement and despite any contrary stipulation contained in the agreement, on the date or dates fixed in the regulation.
1996, c. 32, s. 78; 1999, c. 37, s. 6; 2000, c. 23, s. 2; 2002, c. 27, s. 28; 2005, c. 40, s. 26; 2015, c. 8, s. 192; 2016, c. 28, s. 47; 2021, c. 23, s. 8.
78. In addition to the regulatory powers otherwise conferred on it by this Act, the Government may, after consulting the Board, make regulations to
(1)  determine, for the purposes of section 6, the classes of persons who are otherwise entitled to coverage equivalent to basic plan coverage;
(1.1)  determine classes of persons eligible for the basic plan other than those determined in this Act, and the conditions those persons must meet;
(1.2)  determine, for the purposes of section 8, the services required for pharmaceutical reasons and provided by a pharmacist that are covered by the basic prescription drug insurance plan and determine, among those whose cost is paid by the Board, the services that must relate to a medication on the list of medications drawn up by the Minister under section 60;
(1.3)  determine, for the purposes of section 8.1, the cases in and conditions on which an owner pharmacist may claim fees for a pharmaceutical service provided to a person covered by a group insurance contract or an employee benefit plan;
(1.4)  determine, for the purposes of section 11, the pharmaceutical services for which no contribution is payable; those services may vary according to whether the insurance coverage is provided by the Board or by a group insurance contract or an employee benefit plan;
(2)  determine, for the purposes of section 22, the other services required for pharmaceutical reasons and provided by a pharmacist whose cost is borne by the Board, and prescribe the frequency with which certain services described in that section must be provided to remain covered; the frequency may vary in the cases and on the conditions it determines;
(2.0.1)  determine, for the purposes of section 22, the other pharmaceutical services that must relate to a medication that is on the list of medications drawn up by the Minister under section 60;
(2.1)  determine the other information the itemized invoice referred to in section 8.1.1 must contain, which may vary according to whether the insurance coverage is provided by the Board or by a group insurance contract or an employee benefit plan;
(3)  (subparagraph repealed);
(4)  determine the cases in which and conditions on which the medications determined by the Government, that are provided as part of the services provided by an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) or the Act respecting health services and social services for Cree Native persons (chapter S-5) or by any other institution recognized for that purpose by the Minister that is situated outside Québec in a region bordering on Québec, are covered for the classes of persons it determines;
(5)  prescribe the cases in which and conditions on which eligible persons who remain outside Québec during the entire year, and who retain their status as persons resident in Québec under the Health Insurance Act (chapter A-29) despite their absence from Québec, may be exempted from payment of the premium for that calendar year;
(6)  list the types of impairment which constitute functional impairment for the purposes of section 17 and the cases in which and conditions on which a person suffering from a functional impairment is deemed to attend an educational institution on a full-time basis;
(7)  determine, for the purposes of sections 13.1 and 28.1, the rules pursuant to which rates of adjustment are to be fixed annually and specify the class of persons to which each rate is applicable, where that is the case;
(8)  (subparagraph repealed);
(9)  prescribe, for the purposes of section 40, the information that the Board may require from an insurer transacting group insurance or the administrator of an employee benefit plan, and prescribe the manner in which such information may be communicated;
(9.1)  determine any conditions or circumstances considered to be distinctive characteristics of group insurance in addition to those set out in the second paragraph of section 42.2;
(9.2)  prescribe, for the purposes of sections 70.1 to 70.3, the procedure for communicating lists of group insurance contracts and employee benefit plans, group insurance contracts and employee benefit plans, and information on any amendments to those contracts and plans causing eligible persons to be transferred to the public plan, as well as the intervals at which they must be communicated and the information the lists must contain;
(10)  determine, for the purposes of section 43, the terms and conditions on which the risks arising from the basic plan coverage must be pooled, and the period during which they are to apply;
(11)  determine the provisions of a regulation the contravention of which constitutes an offence.
A regulation made under this section shall have effect, with respect to health care professionals bound by a valid agreement and despite any contrary stipulation contained in the agreement, on the date or dates fixed in the regulation.
1996, c. 32, s. 78; 1999, c. 37, s. 6; 2000, c. 23, s. 2; 2002, c. 27, s. 28; 2005, c. 40, s. 26; 2015, c. 8, s. 192; 2016, c. 28, s. 47.
78. In addition to the regulatory powers otherwise conferred on it by this Act, the Government may, after consulting the Board, make regulations to
(1)  determine, for the purposes of section 6, the classes of persons who are otherwise entitled to coverage equivalent to basic plan coverage;
(1.1)  determine classes of persons eligible for the basic plan other than those determined in this Act, and the conditions those persons must meet;
(1.2)  determine, for the purposes of section 8, the services required for pharmaceutical reasons and provided by a pharmacist that are covered by the basic prescription drug insurance plan and determine, among those whose cost is paid by the Board, the services that must relate to a medication on the list of medications drawn up by the Minister under section 60;
(1.3)  determine, for the purposes of section 8.1, the cases in and conditions on which an owner pharmacist may claim fees for a pharmaceutical service provided to a person covered by a group insurance contract or an employee benefit plan;
(1.4)  determine, for the purposes of section 11, the pharmaceutical services for which no contribution is payable; those services may vary according to whether the insurance coverage is provided by the Board or by a group insurance contract or an employee benefit plan;
(2)  determine, for the purposes of section 22, the other services required for pharmaceutical reasons and provided by a pharmacist whose cost is borne by the Board, and prescribe the frequency with which certain services described in that section must be provided to remain covered; the frequency may vary in the cases and on the conditions it determines;
(2.0.1)  determine, for the purposes of section 22, the other pharmaceutical services that must relate to a medication that is on the list of medications drawn up by the Minister under section 60;
(2.1)  determine what information on the medications provided must be given by a pharmacist when providing pharmaceutical services and medications covered by the Board to an eligible person;
(3)  (subparagraph repealed);
(4)  determine the cases in which and conditions on which the medications determined by the Government, that are provided as part of the services provided by an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) or the Act respecting health services and social services for Cree Native persons (chapter S-5) or by any other institution recognized for that purpose by the Minister that is situated outside Québec in a region bordering on Québec, are covered for the classes of persons it determines;
(5)  prescribe the cases in which and conditions on which eligible persons who remain outside Québec during the entire year, and who retain their status as persons resident in Québec under the Health Insurance Act (chapter A-29) despite their absence from Québec, may be exempted from payment of the premium for that calendar year;
(6)  list the types of impairment which constitute functional impairment for the purposes of section 17 and the cases in which and conditions on which a person suffering from a functional impairment is deemed to attend an educational institution on a full-time basis;
(7)  determine, for the purposes of sections 13.1 and 28.1, the rules pursuant to which rates of adjustment are to be fixed annually and specify the class of persons to which each rate is applicable, where that is the case;
(8)  (subparagraph repealed);
(9)  prescribe, for the purposes of section 40, the information that the Board may require from an insurer transacting group insurance or the administrator of an employee benefit plan, and prescribe the manner in which such information may be communicated;
(9.1)  determine any conditions or circumstances considered to be distinctive characteristics of group insurance in addition to those set out in the second paragraph of section 42.2;
(9.2)  prescribe, for the purposes of sections 70.1 to 70.3, the procedure for communicating lists of group insurance contracts and employee benefit plans, group insurance contracts and employee benefit plans, and information on any amendments to those contracts and plans causing eligible persons to be transferred to the public plan, as well as the intervals at which they must be communicated and the information the lists must contain;
(10)  determine, for the purposes of section 43, the terms and conditions on which the risks arising from the basic plan coverage must be pooled, and the period during which they are to apply;
(11)  determine the provisions of a regulation the contravention of which constitutes an offence.
A regulation made under this section shall have effect, with respect to health care professionals bound by a valid agreement and despite any contrary stipulation contained in the agreement, on the date or dates fixed in the regulation.
1996, c. 32, s. 78; 1999, c. 37, s. 6; 2000, c. 23, s. 2; 2002, c. 27, s. 28; 2005, c. 40, s. 26; 2015, c. 8, s. 192.
78. In addition to the regulatory powers otherwise conferred on it by this Act, the Government may, after consulting the Board, make regulations to
(1)  determine, for the purposes of section 6, the classes of persons who are otherwise entitled to coverage equivalent to basic plan coverage;
(1.1)  determine classes of persons eligible for the basic plan other than those determined in this Act, and the conditions those persons must meet;
(2)  determine, for the purposes of section 22, the services required for pharmaceutical reasons and provided by a pharmacist that are covered by the basic prescription drug insurance plan provided by the Board, and prescribe the frequency with which certain services must be provided to remain covered; the frequency may vary in the cases and on the conditions it determines;
(2.1)  determine what information on the medications provided must be given by a pharmacist when providing pharmaceutical services and medications covered by the Board to an eligible person;
(3)  (subparagraph repealed);
(4)  determine the cases in which and conditions on which the medications determined by the Government, that are provided as part of the services provided by an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) or the Act respecting health services and social services for Cree Native persons (chapter S-5) or by any other institution recognized for that purpose by the Minister that is situated outside Québec in a region bordering on Québec, are covered for the classes of persons it determines;
(5)  prescribe the cases in which and conditions on which eligible persons who remain outside Québec during the entire year, and who retain their status as persons resident in Québec under the Health Insurance Act (chapter A-29) despite their absence from Québec, may be exempted from payment of the premium for that calendar year;
(6)  list the types of impairment which constitute functional impairment for the purposes of section 17 and the cases in which and conditions on which a person suffering from a functional impairment is deemed to attend an educational institution on a full-time basis;
(7)  determine, for the purposes of sections 13.1 and 28.1, the rules pursuant to which rates of adjustment are to be fixed annually and specify the class of persons to which each rate is applicable, where that is the case;
(8)  (subparagraph repealed);
(9)  prescribe, for the purposes of section 40, the information that the Board may require from an insurer transacting group insurance or the administrator of an employee benefit plan, and prescribe the manner in which such information may be communicated;
(9.1)  determine any conditions or circumstances considered to be distinctive characteristics of group insurance in addition to those set out in the second paragraph of section 42.2;
(9.2)  prescribe, for the purposes of sections 70.1 to 70.3, the procedure for communicating lists of group insurance contracts and employee benefit plans, group insurance contracts and employee benefit plans, and information on any amendments to those contracts and plans causing eligible persons to be transferred to the public plan, as well as the intervals at which they must be communicated and the information the lists must contain;
(10)  determine, for the purposes of section 43, the terms and conditions on which the risks arising from the basic plan coverage must be pooled, and the period during which they are to apply;
(11)  determine the provisions of a regulation the contravention of which constitutes an offence.
A regulation made under this section shall have effect, with respect to health care professionals bound by a valid agreement and despite any contrary stipulation contained in the agreement, on the date or dates fixed in the regulation.
1996, c. 32, s. 78; 1999, c. 37, s. 6; 2000, c. 23, s. 2; 2002, c. 27, s. 28; 2005, c. 40, s. 26.
78. In addition to the regulatory powers otherwise conferred on it by this Act, the Government may, after consulting the Board, make regulations to
(1)  determine, for the purposes of section 6, the classes of persons who are otherwise entitled to coverage equivalent to basic plan coverage;
(2)  determine, for the purposes of section 22, the services required for pharmaceutical reasons and provided by a pharmacist that are covered by the basic prescription drug insurance plan provided by the Board, and prescribe the frequency with which certain services must be provided to remain covered; the frequency may vary in the cases and on the conditions it determines;
(3)  (subparagraph repealed);
(4)  determine the cases in which and conditions on which the medications determined by the Government, that are provided as part of the services provided by an institution within the meaning of the Act respecting health services and social services (chapter S‐4.2) or the Act respecting health services and social services for Cree Native persons (chapter S‐5) or by any other institution recognized for that purpose by the Minister that is situated outside Québec in a region bordering on Québec, are covered for the classes of persons it determines;
(5)  prescribe the cases in which and conditions on which eligible persons who remain outside Québec during the entire year, and who retain their status as persons resident in Québec under the Health Insurance Act (chapter A‐29) despite their absence from Québec, may be exempted from payment of the premium for that calendar year;
(6)  list the types of impairment which constitute functional impairment for the purposes of section 17;
(7)  determine, for the purposes of sections 13.1 and 28.1, the rules pursuant to which rates of adjustment are to be fixed annually and specify the class of persons to which each rate is applicable, where that is the case;
(8)  (subparagraph repealed);
(9)  prescribe, for the purposes of section 40, the information that the Board may require from an insurer transacting group insurance or the administrator of an employee benefit plan, and prescribe the manner in which such information may be communicated;
(10)  determine, for the purposes of section 43, the terms and conditions on which the risks arising from the basic plan coverage must be pooled, and the period during which they are to apply;
(11)  determine the provisions of a regulation the contravention of which constitutes an offence.
A regulation made under this section shall have effect, with respect to health care professionals bound by a valid agreement and despite any contrary stipulation contained in the agreement, on the date or dates fixed in the regulation.
1996, c. 32, s. 78; 1999, c. 37, s. 6; 2000, c. 23, s. 2; 2002, c. 27, s. 28.
78. In addition to the regulatory powers otherwise conferred on it by this Act, the Government may, after consulting the Board, make regulations to
(1)  determine, for the purposes of section 6, the classes of persons who are otherwise entitled to coverage equivalent to basic plan coverage;
(2)  determine, for the purposes of section 22, the services required for pharmaceutical reasons and provided by a pharmacist that are covered by the basic prescription drug insurance plan provided by the Board, and prescribe the frequency with which certain services must be provided to remain covered; the frequency may vary in the cases and on the conditions it determines;
(3)  (subparagraph repealed);
(4)  determine the cases in which and conditions on which the medications determined by the Government, that are provided as part of the services provided by an institution within the meaning of the Act respecting health services and social services (chapter S‐4.2) or the Act respecting health services and social services for Cree Native persons (chapter S‐5) or by any other institution recognized for that purpose by the Minister that is situated outside Québec in a region bordering on Québec, are covered for the classes of persons it determines;
(5)  prescribe the cases in which and conditions on which eligible persons who remain outside Québec during the entire year, and who retain their status as persons resident in Québec under the Health Insurance Act (chapter A‐29) despite their absence from Québec, may be exempted from payment of the premium for that calendar year;
(6)  list the types of impairment which constitute functional impairment for the purposes of section 17;
(7)  determine, for the purposes of section 23, the rules pursuant to which the rate of adjustment of the premium is fixed annually ;
(8)  revise the amount of the deductible amount provided for in section 26;
(9)  prescribe, for the purposes of section 40, the information that the Board may require from an insurer transacting group insurance or the administrator of an employee benefit plan, and prescribe the manner in which such information may be communicated;
(10)  determine, for the purposes of section 43, the terms and conditions on which the risks arising from the basic plan coverage must be pooled, and the period during which they are to apply;
(11)  determine the provisions of a regulation the contravention of which constitutes an offence.
A regulation made under this section shall have effect, with respect to health care professionals bound by a valid agreement and despite any contrary stipulation contained in the agreement, on the date or dates fixed in the regulation.
1996, c. 32, s. 78; 1999, c. 37, s. 6; 2000, c. 23, s. 2.
78. In addition to the regulatory powers otherwise conferred on it by this Act, the Government may, after consulting the Board, make regulations to
(1)  determine, for the purposes of section 6, the classes of persons who are otherwise entitled to coverage equivalent to basic plan coverage;
(2)  determine, for the purposes of section 22, the services required for pharmaceutical reasons and provided by a pharmacist that are covered by the basic prescription drug insurance plan provided by the Board, and prescribe the frequency with which certain services must be provided to remain covered; the frequency may vary in the cases and on the conditions it determines;
(3)  (subparagraph repealed);
(4)  determine the cases in which and conditions on which the medications determined by the Government, that are provided as part of the services provided by an institution within the meaning of the Act respecting health services and social services (chapter S‐4.2) or the Act respecting health services and social services for Cree Native persons (chapter S‐5) or by any other institution recognized for that purpose by the Minister that is situated outside Québec in a region bordering on Québec, are covered for the classes of persons it determines;
(5)  prescribe the cases in which and conditions on which eligible persons who remain outside Québec during the entire year, and who retain their status as persons resident in Québec under the Health Insurance Act (chapter A‐29) despite their absence from Québec, may be exempted from payment of the premium for that calendar year;
(6)  list the types of impairment which constitute functional impairment for the purposes of section 17;
(7)  revise the amount of the annual premium provided for in section 23;
(8)  revise the amount of the deductible amount provided for in section 26;
(9)  prescribe, for the purposes of section 40, the information that the Board may require from an insurer transacting group insurance or the administrator of an employee benefit plan, and prescribe the manner in which such information may be communicated;
(10)  determine, for the purposes of section 43, the terms and conditions on which the risks arising from the basic plan coverage must be pooled, and the period during which they are to apply;
(11)  determine the provisions of a regulation the contravention of which constitutes an offence.
A regulation made under this section shall have effect, with respect to health care professionals bound by a valid agreement and despite any contrary stipulation contained in the agreement, on the date or dates fixed in the regulation.
1996, c. 32, s. 78; 1999, c. 37, s. 6.
78. In addition to the regulatory powers otherwise conferred on it by this Act, the Government may, after consulting the Board, make regulations to
(1)  determine, for the purposes of section 6, the classes of persons who are otherwise entitled to coverage equivalent to basic plan coverage;
(2)  determine, for the purposes of section 22, the services required for pharmaceutical reasons and provided by a pharmacist that are covered by the basic prescription drug insurance plan provided by the Board, and prescribe the frequency with which certain services must be provided to remain covered; the frequency may vary in the cases and on the conditions it determines;
(3)  determine the cases, conditions and therapeutic indications in and for which the cost of certain medications included in the list drawn up by the Minister under section 60 is covered by the basic plan; the conditions may vary according to whether the coverage is provided by the Board or under a group insurance contract or an employee benefit plan;
(4)  determine the cases in which and conditions on which the medications determined by the Government, that are provided as part of the services provided by an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) or the Act respecting health services and social services for Cree Native persons (chapter S-5) or by any other institution recognized for that purpose by the Minister that is situated outside Québec in a region bordering on Québec, are covered for the classes of persons it determines;
(5)  prescribe the cases in which and conditions on which eligible persons who remain outside Québec during the entire year, and who retain their status as persons resident in Québec under the Health Insurance Act (chapter A-29) despite their absence from Québec, may be exempted from payment of the premium for that calendar year;
(6)  list the types of impairment which constitute functional impairment for the purposes of section 17;
(7)  revise the amount of the annual premium provided for in section 23;
(8)  revise the amount of the deductible amount provided for in section 26;
(9)  prescribe, for the purposes of section 40, the information that the Board may require from an insurer transacting group insurance or the administrator of an employee benefit plan, and prescribe the manner in which such information may be communicated;
(10)  determine, for the purposes of section 43, the terms and conditions on which the risks arising from the basic plan coverage must be pooled, and the period during which they are to apply;
(11)  determine the provisions of a regulation the contravention of which constitutes an offence.
A regulation made under this section shall have effect, with respect to health care professionals bound by a valid agreement and despite any contrary stipulation contained in the agreement, on the date or dates fixed in the regulation.
1996, c. 32, s. 78.