Medical Marijuana. Coverage under Extended Health Care Plans. Valerie Dixon

Transcription

1 Medical Marijuana Coverage under Extended Health Care Plans Valerie Dixon

2 Regulation of Medical Marijuana Medical marijuana has been legal in Canada for approximately 15 years - 40,000 authorized users. Regulation of distribution and use similar to regulation of other prescription drugs. Medical marijuana generally not covered by group drug benefit plans. Group insurance plans only cover drugs which have a drug identification number. Health Canada refuses to issue a drug identification number for medical marijuana.

3 Regulation of Medical Marijuana (cont.) The Corporation of the City of Hamilton and Hamilton Professional Firefighters Association (Ont. Lrb. Arb.) First decision on whether worker entitled to reimbursement for medical marijuana under group health plan. Grievor claimed reimbursement from benefit plan for medical marijuana use by spouse. Spouse had medical authorization for use of medical marijuana.

4 Regulation of Medical Marijuana (cont.) Relevant provisions in the collective agreement: The employer shall pay the full cost of the premiums of the Canada Life extended medical plan, including semiprivate coverage and drugs, for all employees Drug claims must indicate the prescription number, name, strength and quantity of the drug plus the drug identification number. Drugs Formulary 2 mandatory generic plan: drugs, serums, injectables and insulin (needles, syringes and test tapes for use by diabetics) purchased on the prescription of a medical doctor.

5 Arbitrator s Decision No coverage Medical authorization similar to a prescription but is not a prescription Purchased on the prescription of a medical doctor Most important factor: the union and the employer specifically agreed that the drug benefit plan would only reimburse employees for drugs which have a drug identification number

6 Lessons From City Of Hamilton Decision provides reassurance that arbitrators will not necessarily read-in medical marijuana coverage into group health plans But collective agreement language unusual Some collective agreements include broad enough language to include medical marijuana in coverage Employers should review their collective agreements and related documents carefully

7 Trends in Coverage Some providers are covering medical marijuana if employer or plan sponsor expressly asks provider to cover University of Waterloo Sun Life agreed to cover medical marijuana for student covered under student plan - student union advocated for coverage because of specific medical condition Some providers may also allow coverage through health spending accounts Is considered an eligible medical expense for purposes of CRA

8 Miller Thomson Labour & Employment Group Nicole Byres, QC Partner Ashley Mitchell Associate Valerie Dixon Partner Eric Ito Associate Follow us... Miller Thomson LLP, All Rights Reserved. All Intellectual Property Rights including copyright in this presentation are owned by Miller Thomson LLP. This presentation may be reproduced and distributed in its entirety provided no alterations are made to the form or content. Any other form of reproduction or distribution requires the prior written consent of Miller Thomson LLP which may be requested from the presenter(s). This presentation is provided as an information service and is a summary of current legal issues. This information is not meant as legal opinion and viewers are cautioned not to act on information provided in this publication without seeking specific legal advice with respect to their unique circumstances.