The amendment to the Drug Cost Assistance Program Regulations, designated as EC2024-796, was approved by the Lieutenant Governor in Council of Prince Edward Island on August 27, 2024. This update, pursuant to section 21 of the Drug Cost Assistance Act, R.S.P.E.I. 1988, Cap. D14.1, includes several changes aimed at improving the efficiency of the Drug Cost Assistance Program and clarifying the eligibility criteria for applicants.

The first major amendment involves the revocation of section 2 of the Drug Cost Assistance Program Regulations (EC367/14), which has been replaced with a new requirement that eligible persons must submit claims for benefits to their third-party insurers or administrators of prescribed benefit plans before seeking assistance under the Drug Cost Assistance Program. This change aims to ensure that all potential coverage options are explored before utilizing government resources, thereby maximizing the efficiency of the program and reducing unnecessary expenditures.

In the second amendment, clauses 37(2)(a) and (3)(a) have been revoked to eliminate age-related eligibility criteria regarding the Insulin Pump Program. This change reflects a commitment to inclusivity, allowing individuals of varying ages who require insulin pumps to access the program without age-based limitations, thereby broadening eligibility and ensuring that more patients can receive necessary medical support.

The third amendment addresses section 47 of the regulations, which outlines how applicants can establish a separation from their spouse. The revised regulations now permit an applicant to prove that they are separated by submitting a statutory declaration approved by the Minister. This declaration must confirm that there has been a breakdown of the marriage as defined by the Divorce Act (Canada) or that the spouses are no longer cohabiting in a conjugal relationship. Additionally, subsections 47(2), (3), and (4) have been amended to replace the phrase “living separate and apart” with the term “separated,” which simplifies the language and clarifies the requirements for applicants.

The revision of subsection 47(5) further clarifies the effect of separation on program enrollment. It states that if the Administrator determines that the applicant is indeed separated from their spouse, the spouse’s income will not be considered when assessing the applicant’s enrollment or the terms of enrollment in the program. This change ensures that individuals who are financially independent due to separation are not disadvantaged in their access to drug cost assistance.

The amendments to the Drug Cost Assistance Program Regulations represent significant updates designed to improve the program’s accessibility, efficiency, and responsiveness to the needs of eligible residents. These changes will streamline the claims process, broaden eligibility, and clarify requirements for applicants, reinforcing the commitment of the provincial government to support the health and well-being of its citizens.

Prince Edward Island (EC2024-796) August 31, 2024