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ECKLER GROUPNEWS > JUNE 2013 > PAGE 1
Legal & Legislative Update Federal: Portions of the Helping Families in Need Act (Bill C-44) Effective June 9, 2013 The federal government has announced that certain sections of ook effect on June 9, 2013. These sections amend the Canada Labour Code to provide unpaid leave to an eligible federally regulated employee whose child is critically ill, and also amend the Employment Insurance Act to create a new employment insurance benefit for eligible parents of critically ill children (PCIC). The PCIC benefit provides up to 35 weeks of temporary income supplement support for eligible claimants who take time away from work to provide care or support for one or more critically ill children under 18 years of age. For more information on Bill C-44, please refer to the .
Relat also took effect June 9, 2013. These regulations enable the implementation of the PCIC benefit by clarifying eligibility requirements and ensuring that the new benefit is consistent with other EI special benefits (maternity, parental, sickness and compassionate care). Specifically, they:
• add definitions of “care,” “critically ill child,” “parent,” “specialist medical doctor” and
• add references to PCIC benefits wherever other EI special benefits are mentioned; and
• specify the benefit allocation process for situations where claimants sharing PCIC benefits
cannot agree on how they are to be divided. Nova Scotia: Children’s Dental Program Expanded On May 30, 2013, the Nova Scotia Department of Health and Wellness that the province would cover the cost of dental care for non-insured children aged 13 and younger effective immediately. Coverage was previously only offered for children aged nine and younger. Nova Scotia: Expansion of Pharmacists’ Role On May 28, 2013, the Nova Scotia Department of Health and Wellnested ts the authority to administer drugs by injection (e.g. flu shots), and to order and interpret lab tests to help manage patients’ drug therapy. According to the announcement, once the standards are in place, pharmacists wishing to provide these new services will be provided proper training. Ontario: Changes to Access and Coverage for Physiotherapy Non-hospital physiotherapy services will no longer be covered by the Ontario Health Insurance Plan (OHIP) effective August 1, 2013. The change is in response to a number of recent recommendations, including those in the ommission on the Reform of Ontario’s Public Services.
Funding for physiotherapy services will now be provided by the following:
• Community Care Access Centres (CCACs);
• Community based, contract physiotherapy providers;
• Local Health Integration Networks (LHINs); and
• Family health care settings (e.g. Family Health Teams, Community Health Centres, Nurse
Complete details on this change, including a backgrounder and press release, are available on
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Saskatchewan: Changes to Seniors Income Plan (SIP) Benefits Effective July 1, 2013 (Regulation), which was filed May 30, 2013, amends the Seniors Income Plan Regulations, effective July 1, 2013. As a result of the amendments, the maximum monthly benefits payable under the SIP will increase as shown in the table below. Beneficiary Category Maximum Monthly SIP Benefit: Maximum Monthly SIP Benefit: July 1, 2013
Provincial residents are eligible to receive SIP benefits if they:
• are permanent residents of the province;
• receive full or partial Old Age Security and Guaranteed Income Supplement benefits; and
• have income below a specified threshold.
The Regulation also increases the rate at which benefits are reduced, by reason of other income, for SIP recipients who receive less than the maximum monthly benefit. Drug News New Brunswick Regulation Addresses Generic Drug Costs and Dispensing Fees egulation), which amends the province’s as filed May 30, 2013. The Regulation amends the PDR to change the dispensing fees charged by pharmacists and to make minor changes to previously-announced generic drug cost-control measures.
Prior to the Regulation, the price paid for a prescription drug was up to 100% of the drug’s actual cost plus a dispensing fee based on the price of the dispensed drug, as set out in Schedule 3 to the PDR. The fees in the Schedule ranged from $10.40 to $163.00. The Regulation provides that, effective June 1, 2013, the price paid for a prescription drug will generally be up to 100% of the manufacturer’s list price of the dispensed drug, plus a dispensing fee of up to $10.50 and an amount up to 8% of the manufacturer’s list price.
The same pricing model applies to interchangeable pharmaceutical products, although references to the manufacturer’s list price are replaced by references to the maximum allowable price (MAP). In the case of prescription medications used to treat opioid dependencies (i.e., Methadone), the maximum fee that can be charged is 100% of the MAP plus a dispensing fee of up to $9.50. Different fee rules apply for prepared prescriptions. The Regulation also sets out the conditions under which the province will authorize the payment of the listed dispensing fees to pharmacists.
The Regulation also contains some clarifications to the province’s ongoing efforts to address rising generic drug costs. As noted in the , the province previously capped the maximum allowable price pharmacies can charge for generics at 40% of the name-brand price, effective June 1, 2012, with a further reduction to 35% of the name-brand price (or 25% of the name-brand price for generics sold in oral dosage form) on December 1, 2012. These caps were in relation to the list price of the original product as of April 11, 2011, while the Regulation uses the list price in effect on January 1, 2010.
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Research Conference Board of Canada Survey on Workplace Smoking Cessation Programs The Conference Board of Canada’s surve(Survey) marks the first time that Canadian employers have provided detailed information on workplace programs and policies in place to help their employees quit smoking. Conducted in January 2013, the Survey was sent to senior-level human resources practitioners from primarily medium- and large-sized Canadian organizations. A total of 129 organizations responded.
Most employers provide psychological or counselling sessions through an Employee Assistance Program (78%) and coverage of prescription smoking cessation medications such as Champix or Zyban (73%). However, prescription drug plans often have yearly (16%) or lifetime (48%) maximums. Alternative therapies such as hypnosis or acupuncture and psychological sessions/counselling are also covered by approximately 40% of organizations. In many cases, these treatments are covered only if the employer/benefits provider indicates that it is an eligible paramedical expense.
The Survey found access to group benefits plans to vary greatly based on an employee’s type of employment. While almost all permanent full-time employees (98%) working for survey respondents are covered by a group benefits plan, coverage is less common for permanent part-time employees (74%) and non-permanent employees (23%), such as those on contract or term.
The Survey concludes that, while smoking cessation programs can be a critical component in improving employee health and wellness, only about half of organizations take the important first step of offering a Health Risk Assessment to determine if smoking is a significant health risk for their employee population. Most employers’ smoking cessation programs are not well coordinated with other benefits and are not typically part of a broader health and wellness strategy. More work also needs to be done to educate employees on what resources are offered and to ensure they are comfortable accessing and participating in these programs at work. Health Council of Canada Report Examines Progress in Key Areas of Health Care The Health Council of Canada r(Report) on May 23, 2013. The Report – the third installment in a series looking at key health care topics relating to the 2003/2004 accords – highlights progress by governments in five key areas: wait times; primary health care and electronic health records; pharmaceuticals management; disease prevention/health promotion; and Aboriginal health. The authors find that reform is not happening fast enough to keep pace with Canadians’ changing health care needs, and that access to services varies across the country. This is affecting Canadians’ ability to get the care they need in a timely manner, and to access medications at reasonable costs.
The Report lists a number of recommendations, including that governments should:
• continue working together to advance health care innovation, access and affordability, as
premiers have done recently through initiatives such as the joint pricing of prescription drugs;
• share innovative practices, to avoid duplication and speed progress;
• renew their focus on ensuring Canadians have 24/7 access to primary health care, and
mandate the use of electronic health and medical records across the country;
• commit to a national pharmaceuticals strategy, to ensure all Canadians enjoy the same drug
coverage and pharmacists’ services; and
• close the gap in health coverage and outcomes between Aboriginal and non-Aboriginal
Canadians, through collaborative partnerships between governments and Aboriginal communities.
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Wait Time Alliance Report Finds Canadians Still Waiting Too Long for Medical Care The Wait Time Alliance released its eighth report card, (Report Card) on June 11, 2013. The Report Card finds that Canadians are waiting as long, if not longer, for medical care as they have in previous years. It focuses specifically on the length of time between the point where a patient and his or her specialist decide on a course of treatment, and the start of that treatment. Wait periods to see family physicians and specialists aren’t measured, though the authors note that, taken together, these various wait periods can add up to long waits for Canadians.
The Report Card indicates that the number of “alternate levels of care” patients – those who are in hospital but could ideally receive care elsewhere, such as a rehabilitative facility or at home – threaten to overwhelm the health care system by restricting access for patients who need emergency care or elective surgery. One positive development noted in the report is that all provinces have established – and continue to improve – websites dedicated to reporting wait times. However, the authors suggest that provinces need to increase the number of medical procedures for which they report wait times. They also recommend a number of structural changes that could help to improve timely health care access for Canadians. All GroupNews issues are avo view or download any of these issues, yNewsletters from the Eckler main page, and choose GroupNews when you are directed to the Thought Leadership page. The Eckler website has a robust search engine, which you can use to locate all GroupNews issues containing a specific term or word.This notice has been prepared by the GroupNews editorial board for general information only and does not constitute professional advice. Current editorial board members are: Karen DeBortoli, Andrew Tsoi-A-Sue and Charlene Milton. Should you require professional advice in respect of the content of this notice, please contact any of the following members of your Eckler group benefits consulting team: Andrew Tsoi-A-Sue aon athelan a, Michael J. Sanford a, Anne Thomas at, Cissy Kwok at , Tamar Pilavdjian at , Laura Cabral at t yana Srinath a, Doreen Sue a, Ama Nibaze at or Kwame Smart at . Our general switchboard number is 416.429.3330.
ECKLER GROUPNEWS > JUNE 2013 > PAGE 5
Balancing Point Center for Wellness WOMEN’S FERTILITY QUESTIONNAIRE Name: ___________________________________________ Date: _______________________ 1.Basic Information a. Address: ____________________________________________________________________________________________ 2. Menstrual History 3. Gynecologic History a. At what age did you begin your menses? ________a. D