Government of New Brunswick

Prescription Renewals by Pharmacists

Overview


Prescription renewals by a pharmacist may be eligible for coverage by the Department of Health effective October 1, 2021. Each patient is eligible for a maximum of four (4) prescription renewal services per one-year period.

This program does not cover drugs, or the costs associated with dispensing or administering drugs.

Eligibility

Prescription renewal services may be eligible for coverage provided all the following criteria are met:

Patient

  • The patient must be:
    • Without a primary care provider or have barriers to access their current provider due to absence or leave; or
    • In an urgent situation for which the patient or the patient’s pharmacist is not able to obtain a prescription from the patient’s primary care provider. It is intended for those who would otherwise be required to visit a walk-in clinic or emergency room to obtain a prescription renewal. The pharmacist should inform the patient that this service is for urgent situations only and is not intended to replace an appointment with their primary care provider.
  • The patient must have a valid Medicare card, and not reside in a nursing home or a correctional facility
  • A maximum of four (4) prescription renewal service PINs of any combination per patient within the past 12 months.

Pharmacist

  • The service is conducted in person by a pharmacist licensed with the NB College of Pharmacists (NBCP).
  • The pharmacist must comply with all applicable NBCP requirements and standards.
  • The pharmacist must determine when completing the patient assessment if there are likely to be other prescriptions that will require renewal within a reasonable time frame and provide those renewals at the same time, understanding the patient has a maximum number of renewal services that can be billed per year.

Prescription

  • The prescription(s) is for Schedule 1 drugs, insulin, epinephrine or nitroglycerin.
  • At least one of the prescriptions must be dispensed on the same day as the service is submitted for payment and dispensed from the pharmacy submitting the assessment; unless the patient chooses to fill the prescription at another pharmacy, however this must be documented in the patient record.
  • The days supply of the prescription renewal is not less than the patient’s usual duration of therapy. Usual duration will include usual days’ supply dispensed plus authorized refills. Exceptions may be granted if, in the professional judgement of the pharmacist, it would be unsafe or unwise to do so, and the specific rationale is documented in the patient record.
  • Please note: Prescription renewals to bridge the patient to their next appointment with their primary care provider are not eligible.

Eligible Services and Fees


The Department of Health will pay participating providers for each claim billed for eligible patients in New Brunswick. The participating provider is not permitted to charge additional fees to the patient for prescription renewals which have been paid for by the Department of Health. The applicable service fees are outlined below:

Table 1

Service

Number of Prescriptions Renewed

 PIN

Fee

Patient has no primary care provider or has barriers to access their primary care provider due to absence or leave

2 or less

22224000

$10

3

22224001

$15

4 or more

22224002

$20

Patient in an urgent situation

2 or less

22224003

$10

3

22224004

$15

4 or more

22224005

$20

Documentation Requirements


Pharmacists must document how the patient meets the eligibility criteria for this policy, and which prescriptions were renewed.

Claim Submission


Manual claims will not be accepted. Claims must be submitted online and include the following information:

Field

Information Required

Carrier ID

NB

Group Number or Code

M

Client ID

Patient’s NB Medicare number.  (Note: this also applies to New Brunswick Drug Plans beneficiaries.)

Patient Code

Leave Blank

Patient Name

Patient’s first and last name

Patient DOB

Patient’s date of birth

Prescriber ID

New Brunswick College of Pharmacists Licence Number of the prescribing pharmacist.

Prescriber ID Reference Code

46

DIN / PIN

Refer to Table 1

Quantity

1

Days Supply

1

Drug Cost / Product Value

Zero

Cost Upcharge

Zero

Professional Fee

Refer to Table 1

Pharmacy Audits


All claims submitted by participating providers for reimbursement are subject to audit and recovery.

Service Exclusions


Claims for service fees for the following types of prescription renewals are excluded:

  • Prescriptions for less than the usual duration of therapy, to bridge the patient to their next appointment.
  • Prescriptions filled outside of New Brunswick.
  • Prescriptions for vaccines, and blood products or derivatives
  • Prescriptions for a non-prescription product, including but not limited to:
    • nutritional supplements and food products
    • natural health products (e.g., nicotine replacement therapies, vitamins and minerals, herbal remedies, probiotics, homeopathic medicines, traditional medicines)
    • soaps, cleansers,shampoos, antiseptics, or disinfectants
    • medical supplies, devices and equipment (e.g., prostheses, first aid supplies, wound care products, ostomy supplies, diabetes test strips and syringes, etc.)
    • products for esthetic or cosmetic purposes
  • Prescription accessories, convalescent aids or similar non-drug items