Direct Payment to CNESST and IVAC

Direct Payment to CNESST and IVAC

Retirement and Benefits

Issue 19-15
Wed, 08/21/2019 - 00:00

The Régie de l'assurance maladie du Québec (RAMQ) has recently informed pharmacists that, following an agreement with la Commission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST), individuals compensated by CNESST and l’Indemnisation des victimes d’actes criminels (IVAC) will soon be able to send their payment request for pharmacy drugs and services directly through a pharmacy. The transmission of data for payment claims will be the same as that currently in place for people compensated by le Régime public d’assurance automobile de la Société d’assurance automobile du Québec (SAAQ). 

This development is good news for private plan policyholders. The vast majority of private drug plans currently have a direct payment option, which allows policyholders to pay at the point of sale only the portion of the cost that is not reimbursed by their private plan. In comparison, individuals compensated by the CNESST or the IVAC do not currently have access to this option. These compensated persons must therefore pay in full the costs of their eligible prescriptions and, subsequently, make the reimbursement request to the organization in question. Given the current administrative process, which is less efficient and quick to obtain reimbursement of drugs by CNESST and IVAC and the required cash advances before obtaining the reimbursement, it became much simpler for the compensated person to have their medecine reimboursed through their private plan by direct payment. 

The impact on cost for private prescription drug insurance plans will vary for each policyholder and will depend on the number of people compensated by CNESST and IVAC as well as their current practice regarding the reimbursement of their eligible drugs. 

According to the information available on the Government of Quebec’s website, completion date for the dashboard of this computer project is scheduled for December 31, 2019. The transmission of interactive data between pharmacies, CNESST and IVAC should so be operational by 2020. We will follow the progress for our clients and we will inform you of future developments. 

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