Transforming Health Benefits for First Nations in B.C.

As of September 16, 2019, Pacific Blue Cross will become the new third-party administrator of medical supplies and equipment and supplementary drug benefits for clients of the First Nations Health Authority (FNHA). This engaging session will introduce pharmacies to the new plan for FNHA clients and provide practical information to prepare for changes to claiming procedures as of September 16th.

The First Nations Health Authority (FNHA) is the first province-wide health authority of its kind in Canada. The FNHA is the health and wellness partner to more than 200 diverse First Nations communities and approximately 144,000 citizens across BC. In 2013, the FNHA began a new era in First Nations health governance and health care delivery in BC by taking responsibility for the programs and services formerly delivered by Health Canada. Since then the FNHA has been working to address service gaps through new partnerships, closer collaboration, health systems innovation, and the reform and re-design of health programs and services for individuals, families, communities and Nations.

Pacific Blue Cross (PBC) is BC’s number one health benefits provider and a not-for-profit organization, providing health, dental, life, disability, and travel coverage to one in three British Columbians. Rooted right here in BC, Pacific Blue Cross has over 75 years of experience in the local health landscape and proudly provides benefits and a claims services infrastructure tailored to the needs of our community. Pacific Blue Cross offers a proactive approach to wellness, driven by a mission to improve health and wellbeing for British Columbians.

On September 16, 2019, Pacific Blue Cross will become the new third-party administrator of the following benefits for clients of the First Nations Health Authority (FNHA):

• Select Medical Supplies & Equipment (MS&E)
• FNHA’s supplementary drug benefits (in addition to Plan W benefits)
• Drug benefits for clients who are not yet enrolled in Plan W

In collaboration with BCPhA, representatives from FNHA and PBC will present on:

• An overview of the transition
• New plan and claiming procedures
• Supporting First Nations clients through the change
• Troubleshooting and resources

1. Increase awareness of the upcoming changes on to the FNHA Health Benefits Program
2. Understand the changes to benefit coverage and claiming procedures
3. Understand challenges and opportunities to continuously improve health and wellness for First Nations in BC
4. Understand how to minimize disruptions in patient care for First Nations in BC
5. Understand how to troubleshoot coverage and claims issues for First Nations in BC

Cindy Preston, BSc (Pharm), RPh, Pharmacist, FNHA

Cindy Preston is a pharmacist working with FNHA Health Benefits and Nursing Services on issues related to pharmacy services, regulatory issues, and practice standards.  She is passionately working on FNHA’s Healthy Medication Use initiative, an initiative that promotes safe use of appropriate drug therapies and to support community awareness of importance of safe prescription drug use.  She grew up in on Vancouver Island and now resides the Lower Mainland with her husband and two young children.

Connie Chong, Manager of Provider Relations, FNHA

Connie Chong is the Manager for Provider Relations at the First Nations Health Authority (Health Benefits), working to build a network of culturally safe health service providers for BC First Nations. She has experience leading healthcare nonprofit, association, and professional regulatory organizations. On behalf of the College of Opticians of British Columbia in 2017, she signed the Declaration for Cultural Safety and Humility between the BC Health Regulators and the First Nations Health Authority. Connie holds a Master of Health Administration from the University of British Columbia and a BA in International Relations from the University of Calgary.

Carlos Sorensen, Manager, Claims Services, PBC

Carlos Sorensen is a native of Costa Rica and has lived in Vancouver, British Columbia since 1984. Shortly after graduating from the Langley Fine Arts School, Carlos moved back to Central America where he spent a total of 8 years in both Costa Rica and Panama. It was during this time that Carlos worked on developing his leadership, managerial and operational skills in off shore call centers. Upon returning to Canada, Carlos spent 4 years with TELUS in the Tele -Communications industry before joining Pacific Blue Cross in 2010. Carlos is an active member with the Canadian Life and Health Insurance Association which monitors, studies and makes recommendations on all matters relating to group insurance including the administration of Dental, Health and Drug benefits coverage.

Laura Dale, Manager, Claims Policy and Standards, PBC

Laura Dale is the Manager of Claims Policy and Standards at Pacific Blue Cross, located in Burnaby British Columbia. Her portfolio includes fostering strong relationships with provider communities and implementing evidence-based policies to improve health outcomes of Pacific Blue Cross member’s and clients. She has a Masters’ of Science in Population and Public Health from the University of British Columbia, and a Bachelors’ of Arts in Health from Queen’s University. When Laura isn’t working, she can be found exploring the city and spending time outdoors.

Riva Pickering, Pharmacy Services Analyst, PBC

Riva Pickering is a Pharmacy Services Analyst at Pacific Blue Cross, located in Burnaby British Columbia. She has extensive experience in pharmacy practice in the province of BC.  She started out with the Provincial Health Services Authority as a pharmacy technician at the Vancouver Cancer Centre Pharmacy and the BC Cancer Agency’s Provincial Pharmacy before moving on to supporting community pharmacy practice with the BC Pharmacy Association.  Most recently, Riva has spent the past 5 years supporting the health and well-being of British Columbians through drug plan management and analysis with the Pharmacy Services team at Pacific Blue Cross.

Wendy Watkins, Senior Manager of Operational Solutions, PBC