Guide for Pharmacy Benefits_ Non-insured Health Benefits – housing benefit number tameside

A prescription from an NIHB recognized licensed prescriber is required for any listed drug to be processed as a benefit under the NIHB program. The prescriber must be in good standing with the appropriate governing body, province or territory in which they practice, and the prescription must be written in accordance with the applicable provincial or territorial prescriber guidelines. Prescribers include, but are not limited to, medical doctors, medical specialists, dentists, pharmacists, and nurse practitioners corresponding to respective provincial or territorial legislation and policies.

The NIHB program has introduced a wide range of client safety measures to prevent and respond to potential misuses of prescription drugs to ensure that first nations and inuit clients can get the medications they need without being put at risk.Housing benefit number tameside

these monitored drugs include: opioids, benzodiazepines, gabapentin and stimulants. The program has introduced several strategies to monitor these medications which include: gradually reducing dose limits, the prescription monitoring program (as described above), and reviewing the utilization of medications prescribed and dispensed for our clients.

The NIHB policy to reimburse the best price alternative product also applies to generic products not deemed interchangeable by the province or generic products not listed on the provincial formulary. For these drugs, the NIHB program will only reimburse up to the best price (lowest cost) generic product available in the provincial formulary. If the pharmacist chooses a generic that is covered by the NIHB program, but is not listed on the provincial formulary or interchangeability list, the claim will be reimbursed to the maximum of the provincially listed LCE price and the higher costs will not be reimbursed.Housing benefit number tameside

The NIHB program has a maximum allowable cost (MAC) pricing model for select OTC medications. Pricing for medications will be determined through assessments of product accessibility and package sizing by province and territory which will ensure fairness to NIHB service providers while providing unit cost consistency. For example, all dins for acetaminophen 500 mg are subject to the same MAC price. The OTC MAC pricing will be reviewed and updated regularly. Only oral tablets, capsules and caplets are included in the OTC MAC pricing model. The products that have a defined OTC MAC include: acetaminophen (tylenol), acetylsalicylic acid (aspirin), loratadine (claritin), cetirizine (reactine), and ibuprofen (advil).

Drugs of potential abuse require close monitoring by health care providers, such as prescribers and pharmacists, to maximize safety and effectiveness and minimize the risk of harm, abuse and diversion.Housing benefit number tameside in order for the program to provide coverage for these medications appropriately, information about drug claims must be received in an accurate and timely manner. The adjudication system for the NIHB program, health information and claims processing services (HICPS) ensures this by adjudicating claims in real time. In order to ensure client safety and program integrity, all claims for methadone, suboxone, opioids, benzodiazepines or stimulants must be adjudicated at the point of sale. Provider manual claims and client reimbursement will not be permitted for these drugs.

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