Regulation - LGIC

Alignment of ODB Program Days Supply for Ontario Works Recipients 25 years of age and older.

Regulation Number(s):
O. Reg. 201/96
Bill or Act:
Ontario Drug Benefit Act (ODBA)
Summary of Proposal:
The proposed amendments would align the maximum days supply of a prescription dispensed for OW recipients, regardless of age.

OW recipients 24 years and under are, in most cases, able to receive 100-days supply under the Ontario Drug Benefit (ODB) program as part of the implementation of OHIP+, effective January 1, 2018.

All other ODB program recipients (e.g. those who have OHIP coverage and who are 65 years of age and older, long-term care home residents, Ontario Disability Support Program recipients, etc.) also receive up to 100 days supply for their prescriptions in most cases. This leaves only OW recipients who are 25 years of age or older (and who do not qualify through another eligibility stream) at 35-days maximum days supply.

This proposed amendment would ensure that, in most cases, persons who are eligible for the ODB program could receive up to a 100-day supply of medication, regardless of their eligibility stream.

A consequential regulatory amendment is also proposed to ensure that pharmacy claims for payment submitted in respect of OW recipients are subject to the 5-dispensing-fees-per-year rule for certain chronic medications in subsection 18(11.1) of Ontario Regulation 201/96, to reflect the 100 maximum days supply for OW recipients.

The ministry is proposing that the proposed amendments, if approved, would come into effect on April 1, 2018.
Analysis of Regulatory Impact:
Final Analysis to be provided with approved regulation.
Further Information:
Proposal Number:
Posting Date:
January 16, 2018
Comments Due Date:
February 14, 2018
Contact Address:
Ministry of Health & Long-Term Care
Ontario Public Drug Programs
5700 Yonge St., 3rd Floor
Toronto ON M2M 4K5