[Ontario] Update to: Paperless Drug Cards

Some updates to the Paperless Drug Card initiative (Ontario), from Ministry of Health and Ontario Pharmacists Association.

​Our original post can be found here: 
http://www.behindthecounter.ca/opinion/understanding-paperless-drug-cards-ontario

New Updates to the Paperless Drug Card Iniative

Quote from Ontario Pharmacists Association:
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• Social assistance clients will now present their Ontario health card to the pharmacy in lieu of the monthly paper drug card.  The pharmacist will use the health card number to adjudicate the claim.
• If a claim is accepted, eligibility has been verified and there is no need to further validate coverage. 
• If the claim is rejected, the pharmacist should ensure the correct information has been entered, including the eligibility end date and that only plan codes C or D are being used.  Plan codes M, N and Y should be entered as plan code D.  If the claim is still rejected, only then should the pharmacist verify patient eligibility with the Social Assistance Verification Line to establish coverage.
• As of December 1, 2016, the Social Assistance Verification Line will be available from 7 a.m. to 7 p.m. and will have a higher call capacity than the current system with the goal of addressing calls in a timely fashion.  We recognize that in the event that coverage cannot be verified after hours, and where a patient has an immediate need for the medication, there remains some uncertainty regarding the use of the Good Faith override code.  The Ontario Pharmacists Association continues to work with the MCSS and the Ministry of Health and Long-Term Care to get clarity on this matter and we will provide further guidance as it is available. 
• For the month of December, pharmacists can accept the paper drug eligibility card issued for November 2016 as verification of eligibility for ALL December claims.  As an example, should pharmacists encounter a situation in which they are not able to verify eligibility and the patient has immediate need for a medication, the November paper card can be accepted as proof of coverage and eligibility.
  
  

Source: Ontario Pharmacists Association 

​Thanks to OPA for their work with the Ministry of Health