Non-Insured Health Benefits (NIHB) Newsletter
First Canadian Health
NEWS AND INFORMATION FOR OUR NIHB PROVIDERS
NIHB TOLL-FREE INQUIRY CENTRE: 1-888-511-4666
For our Pharmacy Providers
Spring 2005
News and Views
Welcome to the spring 2005 edition of the Non-Insured Health Benefits (NIHB) quarterly newsletter. First Canadian Health (FCH) is now in its seventh year of operations as the claims processor for the NIHB Program of the First Nations and Inuit Health Branch (FNIHB) of Health Canada.
Again, FCH would like to thank you for your support as you continue to provide quality health services to First Nations and Inuit clients of the NIHB Program.
As always, your comments and questions are welcome. Please contact the FCH NIHB Toll-Free Inquiry Centre at 1-888-511-4666, or send your correspondence to:
FCH Provider Relations
3080 Yonge Street, Suite 3002
Toronto, ON M4N 3N1
Spring 2005 NIHB Drug Benefit List Update
Please find attached the Spring 2005 updates, which list all changes made to the NIHB Drug Benefit List (DBL) since the last update for Winter 2004-2005. These updates include the addition and replacement of Drug Identification Numbers (DIN), limited use benefits, drugs removed from the Canadian market and drugs discontinued by the manufacturer effective April 1, 2005.
These updates are reflected in the most recent electronic version
of the NIHB DBL. Please refer to the website at the following
URL address:
www.hc-sc.gc.ca/fnihb/nihb/pharmacy
To be added to the distribution list for a hard copy of the April
1, 2004 reprint of the NIHB DBL, a request must be submitted
using the form below. Please fax the entire page to (613)
941–6249 no later than June 1, 2004. After that time,
hard copies of
the April 1, 2004 reprint of the NIHB DBL will not be provided.
Name:
Provider Number:
Street Address:
City:
Prov. / Postal Code:
Should you have any questions, please contact the FCH NIHB Toll-Free
Inquiry Centre at 1-888-511-4666.
Frequency Limit for Disposable Diapers and Briefs
As of January 1, 2005, the frequency limit for disposable diapers and briefs is a maximum of 450 diapers/briefs per three-month period. This frequency limit applies to the following item codes:
- 99400436 -- Pant, briefs, disposable
- 99400440 -- Diaper disposable, medium, adult
- 99400750 -- Diaper disposable, small, youth, adult
- 99400751-- Diaper disposable, large adult
- 99400752 -- Diaper disposable, child over 2 years of age
- 99400753 -- Diaper disposable, large/extra large, child over 2 years of age
For a list of the disposable diapers and briefs covered by the NIHB Program, please refer to Sections 10B.2.5 and 10B.8 of the NIHB Pharmacy/Medical Supplies and Equipment (MS&E) Provider Information Kit.
Quantity Limitations for MS&E Items
MS&E items that have an annual quantity limitation must be provided and claimed for no more than a three-month period at a time. This applies to items with or without a prior approval number.
Items must be claimed in individual units, not packages or boxes, unless otherwise indicated (e.g. gloves) in the recommended replacement guidelines column of the MS&E benefit lists in the NIHB Pharmacy/MS&E Provider Information Kit. For example:
- Irrigation Syringes (item code 99400320): The quantity limitation is 24 syringes per year, therefore a maximum of 6 syringes can be provided and claimed per three-month period.
- Batteries for left hearing aids (item code 99400259): A maximum of 12 individual batteries can be claimed every 3 months.
Claims for MS&E items that are submitted with quantities in excess of the amount allowed during the three-month period are subject to reversal or recovery through the audit program.
Providers can download a current version of the NIHB Pharmacy/Medical Supplies and Equipment Provider Information Kit from the NIHB website.
Providers without internet access can contact the FCH NIHB Toll-Free Inquiry Centre at 1-888-511-4666 .
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