Provider Enrolment Guide
Updated: March 2021
The Provider Regulation (“the Regulation”) under the Pharmaceutical Services Act (“the Act”) came into force on December 1, 2014. The Regulation sets out enrolment criteria for pharmacies, facilities, and other places where drugs, devices, substances or related services are provided (“sites”). It also sets out the commercial terms for the Province of British Columbia’s relationship with enrolled providers. The PharmaCare Policy Manual, and frequent updates in the PharmaCare Newsletter, spell out how the legislation is applied.
- PharmaCare Provider Enrolment Guide (PDF, 312KB)
- PharmaCare Provider Enrolment Form (HLTH 5432) (PDF, 604KB)
- Schedule A (HLTH 5432A)—Owner Details (PDF, 513KB)
- Schedule B (HLTH 5432B)—Additional Sites (PDF, 513KB)
- Schedule C (HLTH 5432C)—Additional Information (PDF, 498KB)
- PharmaCare Provider Change form (HLTH 5433) (PDF, 735KB)
Table of Contents
- 5.1 Site information
- 5.2 Provider type
- 5.3 Sub-class eligibility
- 5.4 Software vendor
- 5.5 Owner information
- 5.6 Additional sites
- 5.7 Additional information
- 5.8 Signature of authorized representative of the applicant
On May 31, 2012, the Pharmaceutical Services Act (“the Act”) came into effect. Under section 11(2) of the Act, pharmacies, facilities or other places where drugs, devices, substances or related services are provided may apply for enrolment with the PharmaCare program.
The Provider Regulation (“the Regulation”), which came into effect on December 1, 2014, sets out the prescribed criteria for enrolment and the ongoing responsibilities of PharmaCare providers. Please bookmark or print the Regulation for your ongoing reference.
This guide gives step-by-step instructions on how to enroll as a PharmaCare provider.
- Please PRINT clearly when completing the forms.
- You may also fill out the forms online. Please note: Forms must be printed and faxed. Forms cannot be submitted online.
- Do not submit your enrolment form more than 3 months before your site’s projected opening date.
- Fill out all sections that apply at the time of enrolment.
Important: If information on your enrolment form changes before your enrolment is approved, you must resubmit the form. If your information changes after approval, submit a Provider Change Form (HLTH 5433).
Please see Notification Requirements for more information on required notifications of changes.
- We recommend that you print a copy of the Provider Regulation to refer to while reading this guide and completing the form.
- If completing the form online, please upgrade to the latest (free) version of Adobe Acrobat Reader.
Important: Providing false or inaccurate information in the enrolment process is a serious matter. You may wish to seek legal advice on completing the form(s).
The application should be completed by any site wishing to enroll as a provider with PharmaCare in order for:
- The site to receive payment for providing PharmaCare benefits to PharmaCare-eligible individuals
- PharmaCare-eligible individuals to receive payment for PharmaCare benefits provided by their site
|Billing privileges||The privilege of seeking payment from PharmaCare or another public insurer for providing benefits|
|Information or billing contravention||
As declared on the first page of the PharmaCare Enrolment Form (section 1e):
|Pharmacy enactment||The Pharmaceutical Services Act, Continuing Care Act, Medicare Protection Act, Pharmacy Operations and Drug Scheduling Act, Pharmacists, Pharmacy Operations and Drug Scheduling Act, or any regulation made under these acts|
|Provider||An entity that is enrolled in PharmaCare for the purpose of receiving payment|
|Public drug insurance program||The First Nations Health Authority program, the Non-Insured Health Benefits (NIHB) program or a drug and/or medical device program of a provincial or territorial government of Canada other than B.C. (e.g., Ontario Drug Benefit Program)|
|Public insurer||The First Nations Health Authority, the Government of Canada or a provincial or territorial government of Canada|
For example, relevant audit includes audits conducted by PharmaCare and NIHB but not audits conducted by municipal governments or the Canada Revenue Agency.
|Site ID||The unique identification code issued to the site by Health Insurance BC (e.g., A01), also known as the Pharmacy Code or PharmaCare Code/ID|
|Field ID||Field Name||Instructions|
The name of the site for which the applicant is seeking enrolment.Note: Pharmacies should provide the Operating Name as shown on their pharmacy licence; device providers should use the Operating Name as shown on their business licence. A copy of either the pharmacy licence or the business licence, as appropriate, must be submitted with the PharmaCare enrolment form.
|b||Site ID||The unique identification code issued to the site by Health Insurance BC (e.g., A01), also known as the Pharmacy Code or PharmaCare Code/ID|
The street address of the physical location where drugs, devices, substances or related services will be provided. This must be a street address, not a box number (e.g., 123 Main Street not P.O. Box 1234).
May not include a P.O. Box number (A P.O. Box number may be included in the mailing address – see [d] below).
The address where the applicant wishes to receive correspondence (required only if different from the Site Address).
Can be a P.O. Box number.
|e||Payment Remittance Address||
The address to which the applicant wishes payment advices to be sent (Required only if different from the Site Address).
Can be a P.O. Box number.
|f||Email Address||The email address at which you wish to be contacted about this application (e.g., email address of the site or of the manager).|
Full name of the current manager of the site.
Pharmacies: Enter the name of the pharmacy manager as it appears on their pharmacist licence and their College of Pharmacists of BC Registration ID (the 5-digit number, which may have a leading 0).Device providers: Leave the Registration ID field blank. Do not enter “TBD”/ “To be determined”.
|h||Proposed Opening Date||
The date the site is scheduled to be open for business.Must be within 3 months of the date you submit the form.
Please note that a provider can be in more than one class and/or sub-class as long as they meet the requirements for each of those classes or sub-classes.
- A community pharmacy that serves Plan B facilities and has a trained breast prosthesis fitter onsite should select the Community Pharmacy and Device classes as well as the Plan B Pharmacy and Breast Prosthesis Provider sub-classes
- A community pharmacy that dispenses ostomy supplies needs to select only the Community Pharmacy class
- A site that provides ostomy and/or diabetes supplies but is not a pharmacy should select the Device class and Other in the Device Sub-class section
- A recognized limb prosthetist would select the Device class and Limb Prosthesis Provider sub‑class
|Field ID||Field Name||Instructions|
Pharmacies may also enroll in the Opioid Agonist Treatment Provider and Plan B Pharmacy sub-classes.
Pharmacies that also provide general medical supplies (such as diabetes supplies, insulin pumps and supplies, blood glucose test strips and ostomy supplies) do not need to apply for enrolment in the Device class unless they wish to provide one or more of the following:
Effective January 1, 2019: All pharmacy managers, staff pharmacists, and relief pharmacists employed in a community pharmacy that provides pharmacy services related to buprenorphine/naloxone maintenance treatment, methadone maintenance treatment or slow release oral morphine maintenance treatment must:
Effective September 30, 2021: The CPBC MMT training program (2013) will not be available beyond September 30, 2021. Registrants will no longer be able to fulfill the College’s training requirements by completing that program, and must complete any applicable component(s) of the BCPhA OAT-CAMPP by September 30, 2021.
A pharmacy can enroll in the Plan B Pharmacy sub-class if the pharmacy or the facility being serviced provides a copy of the facility licence to Health Insurance BC once it is available.
Sites that provide medical supplies and devices may enroll in the Device class.If you are enrolling in the device class, please include a copy of your business licence (unless you are a pharmacy).
Answer only the questions that apply to your site as indicated in section 2 of the Enrolment Form.
If you answered No to any of the questions, attach a written explanation as to why PharmaCare should consider enrolling you in this sub-class. Please note that you cannot be enrolled unless you meet the requirements or the Ministry of Health determines that enrolling your site:
- Would not present a risk to the integrity of PharmaCare
- Would be in the public interest
If you use PharmaNet to submit claims, indicate your software vendor and software version.
Contact your software vendor for more information, if necessary.
Different information will need to be provided depending on the type of ownership structure of the site.
|a||Type of ownership||
Please indicate if the site is owned by a sole proprietorship, partnership, corporation, health authority or other.
|b||Registered or legal name of sole proprietor, partnership, corporation or name of health authority||
|c||Mailing address/contact information||The address where the sole proprietor/partnership/ corporation/health authority can be contacted, including the phone number, fax number and email address.|
|d||Owner documentation requirements||
Please ensure the Site ID is indicated on all documents submitted.
Provide all the following, as applicable. If you are unsure of the documentation to include, please consult your legal counsel.
Note: For subsidiary corporations that are not publicly traded and which have a parent corporation that is not publicly traded, you must also include—for the parent corporation—the names and contact information of all officers and directors on Schedule A: Owner Details and a copy of the shareholder’s register and any relevant provisions of any shareholder agreements with respect to the operation of the site.
- Other sites in B.C. (regardless of whether they are enrolled in PharmaCare)
- Sites outside B.C. that are enrolled in PharmaCare.
- If your site is a subsidiary corporation, you must provide information respecting the directors, officers and shareholders of the parent corporation if both the subsidiary corporation and the parent corporation are not publicly traded. If either the subsidiary corporation or the parent corporation is publicly traded, the requirement to provide information respecting directors, officers and shareholders of the parent corporation is waived.
- If an owner of your site owns or manages any site located outside of B.C. and no application for enrollment for that site is being made, the requirement to provide the operating name of that site is waived.
If you are an owner who is enrolling multiple sites at the same time, please attach a list that includes all sites with each application (i.e., complete Schedule B once and attach a copy to each application).
All applicants must answer questions 1-8. To enroll as both a device provider and a pharmacy, answer all questions in this section. To enroll as a pharmacy only, answer questions 9-11. If you are asking to enroll as a device provider only, skip questions 9-11 but answer question 12.
If you answer Yes to any of the questions in section 7 of the Enrolment Form, please provide the additional information requested below (as applicable) on Schedule C: Additional Information.
If you answer Yes to any of the questions, attach a written explanation as to why PharmaCare should consider enrolling you. Please note that if you answer Yes to any of the questions other than Questions 8, 11 or 12, you cannot be enrolled unless the Ministry of Health determines that enrolling your site:
- Would not present a risk to the integrity of PharmaCare
- Would be in the public interest
|Question||Information to include if you answered "yes'|
The applicant is the legal owner. For example, in the case of a site owned by a corporation, the “applicant” is the corporation.
|Signature||Signature of the authorized representative of the applicant|
|Name||Name of the authorized representative of the applicant|
|Title||Title of the authorized representative of the applicant|
|Date signed||Date the form was signed|
|Phone number||Phone number where the applicant’s authorized representative may be contacted|
Submit your application and related documents by mail or fax:
PharmaCare Information Support
Health Insurance BC
P.O. Box 9684 Stn Prov Govt
Victoria BC V8W 9P7
Fax: (250) 405-3599
As the owner of a site, you must notify PharmaCare, in advance, of changes to your business (such as changes of ownership, management etc.) and, if applicable, your PharmaNet connection.
Failure to abide by your duties and obligations may result in delay or suspension of payments. Please read the materials included in your Welcome Package thoroughly, to ensure you understand your duties and obligations as a PharmaCare provider.
Once you have submitted your application, notify the Ministry of Health (via form submitted to Health Insurance BC) of any of the following in accordance with the notification requirement specified below:
|Change in provider contact information||Minimum 7 days before change|
|Change of operating/business or corporate name||Minimum 7 days before change|
|Change in owner information||Minimum 7 days before change|
|Change of manager||Minimum 7 days before change|
|Change of location||Minimum 7 days before change|
|Changes to a Power of Attorney||Minimum 7 days before change|
|Cancellation of sub-class||
Opioid Agonist Treatment Provider—30 days before services will end
Plan B—No later than the last day of the month before the final full month in which service will be providedDevice Provider—as soon as reasonably practicable
|Request to add a sub-class||Recommended notification period: Submit the request at least 21 days in advance of requested effective date to allow for processing.|
|Notice of certain action or event(s)*||Immediately|
|Notice of disposition (sale) or closure||Minimum 30 days before change|
*Actions or events include: order, suspension and/or cancellation of billing privileges, judgment or conviction; suspension or cancellation of pharmacist’s registration and/or pharmacy licence; disciplinary action taken by a governing body or action or proceeding taken by the Canadian Board for Certification of Prosthetists and Orthotists; instances in which an owner of the site has been the director of a corporation that has declared or been petitioned into bankruptcy; and, a requirement to pay an amount to a public insurer, other than BC PharmaCare.
Notify PharmaCare Information Support of any of these changes using the PharmaCare Provider Change Form (HLTH 5433).
Please retain a copy of your Enrolment Form and all Change Forms. If you are required to notify the Ministry of Health of a change using the PharmaCare Provider Change Form (HLTH 5433), you must ensure that information on HLTH 5433 matches the corresponding information on your Enrolment Form, or the last Change Form you submitted.
If you have read the instructions and still have questions, contact PharmaCare Information Support via the PharmaNet Help Desk:
- Vancouver: (604) 682‐7120
- Elsewhere in BC: 1-800-554‐0225