Debates of June 2, 2006 (day 4)
Member’s Statement On Process Issues With GNWT Health Insurance Provider
Thank you, Mr. Speaker. Mr. Speaker, I want to speak again today to something that has been raised in the House numerous times before. As we are all aware, the Government of the Northwest Territories, its boards and agencies, are one of the largest employers in the Northwest Territories. As such, the GNWT’s public service health care plan, as administered by Sun Life Financial and paying 80 percent of prescription’s cost, is probably the second largest defined benefit health care program in the NWT, after the aboriginal non-insured health benefit plan administered by the federal government. The problem, Mr. Speaker, is that the Sun Life plan this government participates in does not allow NWT pharmacies online real time access to Sun Life for approvals and confirmation of receipt of the bill for the filled prescriptions. The majority of other health insurance providers allow for this type of online access and issue cheques to pharmacies every two weeks. By batching two weeks of prescription onto one cheque, the administrative burden on pharmacies is lightened. When the pharmacist receives a cheque and batch information from one of the other health insurance providers, it is a simple matter for the pharmacy to check against their transaction records. In contrast, Mr. Speaker, under the Sun Life plan, each prescription is submitted separately and each transaction has its own cheque issued by Sun Life. The pharmacist also does not know whether the prescription is approved for payment until they get the cheque.
So for a small pharmacy, like the one in my community with about 800 government employee prescriptions on file, they could easily be looking at 1,000 cheques and prescriptions they must reconcile each month as opposed to the two cheques and batch lists that other health insurance providers supply.
Mr. Speaker, I had correspondence with the Minister of Human Resources on this issue before. The response that I received seems to indicate that there are no problems with pharmacies billing Sun Life directly on behalf of government employees and that this is just a simple matter of the employees signing over their billing rights to the pharmacy. Mr. Speaker, it is not that simple. It is a matter that needs to be resolved. I will have questions for the Minister at the appropriate time today. Thank you, Mr. Speaker.
---Applause