PharmaCare cracks down on problem pharmacies, about 46 will not be re-enrolled

PHARMACARE has informed a number of Lower Mainland pharmacies that it no longer intends to do business with them, as the result of a new regulation that allows the Ministry of Health to better enforce the rules around billing PharmaCare.

The ministry has notified the pharmacies of its intent to refuse to enrol pharmacies for a variety of reasons:

* Some have a past history of billing issues with PharmaCare, including audits that have recovered hundreds of thousands of dollars.

* Others have improperly filed drug information into patient records in PharmaNet, the provincewide network that tracks all prescriptions, thereby putting patient’s health at risk.

* Still others have apparently given false information on their enrolment applications.

The Ministry of Health intends to refuse re-enrolment as providers to PharmaCare to about 46 pharmacies in the Lower Mainland, as of June 1. The rest of the more than 1,280 pharmacies in B.C. will be re-enrolled as providers to the public drug plan in good standing on the same day.

The ministry has sent letters to the affected pharmacies, to inform them of the intent to refuse enrolment and the specific reasons behind the decision. Each pharmacy has 21 days to respond as to why enrolment should be allowed; the ministry will consider each pharmacy’s response and decide whether to refuse or allow enrolment.

“The Ministry of Health takes its responsibility to protect vulnerable patients and health care dollars seriously,” said Minister of Health Terry Lake on Thursday. “Until now, it could be hard for the ministry to cancel the enrolment of a pharmacy taking advantage of patients or breaking PharmaCare’s billing rules. Now we can act decisively to protect patients and taxpayers, as well as the good name of the vast majority of pharmacists.”

Once a final decision is made to refuse enrolment, the ministry will contact patients who use the affected pharmacies to let them know and give them time to transfer their prescriptions to nearby pharmacies. All of the affected pharmacies are in areas with several other pharmacy options for patients nearby.

“The college’s main priority is to ensure continuity of care and that pharmacies have the necessary information to facilitate any transfers of patient care,” said Suzanne Solven, Deputy Registrar of the College of Pharmacists of BC. “We are confident that pharmacy professionals will be able to provide a smooth transition for patients that move from one pharmacy to another.”

The ministry is taking these actions under its new provider regulation, which is part of the Pharmaceutical Services Act. The regulation now allows the ministry to refuse to do business with people and pharmacies that have a past history of problematic business and billing practices with PharmaCare and other public drug plans. It came into effect in December 2014.

The provider regulation sets out the roles and responsibilities for pharmacy owners, directors and managers who bill the PharmaCare program.

“We were pleased to have contributed to the development of these new regulations,” said Geraldine Vance, CEO of the BC Pharmacy Association. “We support the minister’s efforts to protect the interests of taxpayers and patients.”

The new regulation requires all pharmacies to re-enrol with PharmaCare under a new process by May 31, 2015. Under the new enrolment process, all pharmacies in B.C. will have to disclose ownership and management, and their track record as pharmacy providers.

PharmaCare spends about $1.1 billion a year; most of the money is paid to B.C. pharmacies as reimbursement for drugs and services. There are more than 65 million pharmacy transactions recorded in PharmaNet, the provincewide network that tracks every prescription dispensed in British Columbia.

PharmaCare is the province’s public drug plan; every British Columbian is eligible to apply. While pharmacies do not need to be enrolled in PharmaCare to operate, only enrolled pharmacies can charge medication costs and services to the public drug plan on behalf of PharmaCare clients.