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Physician Services InfoBulletins

Keeping Health Care Providers informed of payment, policy or program changes

To: Physician Services

Published by:Strategy Execution Branch, Ontario Public Drug Programs, Ministry of Health and Long-Term Care

Date Issued: October 13, 2017

Bulletin Number: 4701

Re:EAP Streamlined Request Submission Process for OHIP+– How to Make a Request

Posted Electronically Only

PDF Version Portable Document Format | 1 Mb


For OHIP+ recipients who require an Exceptional Access Program (EAP) request, the ministry has developed a shorter EAP form to reduce the administrative burden.

The streamlined EAP request submission process is only applicable for children and youth who will become eligible for benefits under the Ontario Drug Benefit (ODB) program starting January 1, 2018.

The purpose of the streamlined process is to minimize EAP assessment delays for patients who have been stabilized on certain medications that require an EAP approval.  This process cannot be used for children and youth who are starting a new drug therapy (i.e. after January 1, 2018) that requires an EAP assessment.

Children and youth who already have an approved EAP request for a particular drug product will be fully covered for the cost of that drug, and an additional application will not be required.

Streamlined EAP request forms have been developed for the medications listed below.

  • Alcohol Addiction Therapy (acamprosate, naltrexone)
  • Alfacalcidol (drops)
  • Atomoxetine
  • Betahistine
  • Buspirone
  • Hormone Therapy (conjugated estrogen, estradiol, progesterone, testosterone)
  • Modafinil
  • Oxcarbazepine
  • Phytonadione & Multivitamin (injections)
  • Tranexamic acid
  • Valacyclovir
  • Vigabatrin (sachet)

Additional drugs may be added to the list of eligible drugs for the streamlined process in the future.

Prescribers are encouraged to submit EAP requests for children/youth before January 1, 2018. EAP streamlined forms can be accessed at:
www.forms.ssb.gov.on.ca/

Form Number: 014-5067-87E

Title: OHIP+ Eligible Recipient Request for an Unlisted Drug - Exceptional Access Program

The EAP streamlined forms can be filled out electronically and then printed and faxed to
1-844-227-6590.

Prescribers can also select a drug from the form’s drop down menu, and complete the form by hand. Once the form is completed, fax it to
1-844-227-6590.

EAP streamlined forms can also be mailed to Ontario Public Drug Programs at:
Ontario Public Drug Programs
Drug Programs Delivery Branch
3rd Floor, 5700 Yonge Street
Toronto, ON  M2M 4K5

For drugs not available under the streamlined submission process, the ministry is encouraging prescribers to submit full EAP requests for eligible patients as soon as possible.

Please fax full EAP requests to 1-844-227-6590.

Full EAP request forms can be found at:
health.gov.on.ca/en/pro/programs/drugs/eap_mn.aspx#3

Additional information on Ontario’s Exceptional Access Program can be found at:
health.gov.on.ca/en/pro/programs/drugs/eap_mn.aspx

For additional questions or comments: OHIPplus@ontario.ca.



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