First Nations Inuit Health Branch (FNIHB) Service Outage

NIHB Service Outage -- What To Do
(please pass this on to other pharmacists):

NIHB is reporting ongoing system problems with the national claims processor since late Sunday night. The complete system is currently non-functional and pharmacists will not be able to file claims to NIHB for affected patients. In the interim, NIHB is encouraging pharmacists to provide medications under the emergency supply policy outlined below. NIHB appreciates your support in ensuring that clients get required therapies during this period of service interruption.
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Emergency Supply Policy
When a drug requiring PA is needed on an emergency basis, and access to the NIHB DEC is not possible (e.g., statutory holidays and after hours of operation only), a pharmacist may dispense an initial course of treatment (maximum of four-day supply). It is important that the pharmacist contact the NIHB DEC as soon as possible for an approval to be back-dated to cover the emergency supply. This approval number must be included when submitting the four-day emergency supply claim. Additional dispensing of the balance of the prescription must follow the usual PA process. If a PA is granted, the pharmacist is provided with a PA number and the details of the approved benefit by fax.

The PA number must be included on any subsequent claim submitted for the requested approved drug benefit. Claims submitted to the Program as Emergency Supply within the hours of operation of the NIHB DEC will be subject to audit.

If the item is eligible for auto PA, but did not meet the criteria, the provider may resubmit the rejected claim with applicable intervention code to initiate the PA process as soon as possible so that the NIHB DEC can review the request for NIHB emergency supply coverage. Refer to the Pharmacy Claims Submission Kit for information on how to re-submit a request.