1995 Legislative Session: 4th Session, 35th Parliament
THIRD READING
The following electronic version is for informational purposes only.
The printed version remains the official version.
Certified correct as passed Third Reading on the
12th day of June, 1995
Ian D. Izard, Law Clerk
HONOURABLE PAUL RAMSEY
MINISTER OF HEALTH AND
MINISTER
RESPONSIBLE FOR SENIORS
HER MAJESTY, by and with the advice and consent of the Legislative Assembly of the Province of British Columbia, enacts as follows:
1 The Medical and Health Care Services Act, S.B.C. 1992, c. 76, is amended
(a) by repealing the title and substituting the following:
MEDICARE PROTECTION ACT , and
(b) by adding the following preamble:
WHEREAS the people and government of British Columbia believe that medicare is one of the defining features of Canadian nationhood and are committed to its preservation for future generations;
WHEREAS the people and government of British Columbia wish to confirm and entrench universality, comprehensiveness, accessibility, portability and public administration as the guiding principles of the health care system of British Columbia and are committed to the preservation of these principles in perpetuity;
WHEREAS the people and government of British Columbia recognize a responsibility for the judicious use of medical services in order to maintain a fiscally sustainable health care system for future generations;
AND WHEREAS the people and government of British Columbia believe it to be fundamental that an individual's access to necessary medical care be solely based on need and not on the individual's ability to pay; .
2 Section 1 is amended by repealing the definition of "rendered by" and substituting the following:
"render" means perform personally by or under the personal supervision of the person to whom reference is being made and "personal supervision" in this context means
(a) in the case of a practitioner, personal supervision authorized by the commission in the circumstances, and
(b) in the case of a medical practitioner or health care practitioner who is not enrolled, personal supervision acceptable to the appropriate disciplinary body for the medical practitioner or health care practitioner; .
3 The following section is added:
1.1 The purpose of this Act is to preserve a publicly managed and fiscally sustainable health care system for British Columbia in which access to necessary medical care is based on need and not an individual's ability to pay.
4 Section 12 is amended by adding the following subsection:
(9) A medical practitioner whose enrollment is cancelled under subsection (8) may not apply for enrollment under subsection (1) within 12 months of the date of the cancellation unless the commission, because it considers this to be in the public interest, allows the application.
5 Section 13 (9), (10) and (11) is repealed and the following substituted:
(9) As soon as practicable after rendering a benefit, a practitioner who has made an election under subsection (1) must give the beneficiary a claim form that is completed by the practitioner in the manner required by the commission.
6 Section 14 (1) (d) is amended by striking out "section 16," and substituting "section 17.1, 17.2 or 17.3," .
7 Sections 15 and 16 are repealed.
8 The following Part is added:
Part 3.1 -- Limits on Billing
17.1 (1) Except as specified in this Act or the regulations or by the commission under this Act, a person must not charge a beneficiary
(a) for a benefit, or
(b) for materials, consultations, procedures, use of an office, clinic or other place or for any other matters that relate to the rendering of a benefit.
(2) Subsection (1) does not apply:
(a) if, at the time a service was rendered, the person receiving the service was not enrolled as a beneficiary;
(b) if, at the time the service was rendered, the service was not considered by the commission to be a benefit;
(c) if the service was rendered by a practitioner who
(i) has made an election under section 13 (1), or
(ii) is subject to an order under section 14 (2) (b);
(d) if the service was rendered by a medical practitioner who is not enrolled.
17.2 (1) If a medical practitioner who is not enrolled renders a service to a beneficiary and the service would be a benefit if rendered by an enrolled medical practitioner, the medical practitioner must not charge the person for, or in relation to, the service an amount that, in total, is greater than
(a) the amount that would be payable under this Act, by the commission, for the service if rendered by an enrolled medical practitioner, or
(b) if a payment schedule or regulation permits or requires an additional charge by an enrolled medical practitioner, the total of the amount referred to in paragraph (a) and the additional charge.
(2) Subsection (1) applies only to a service rendered in
(a) a hospital as defined in section 1 of the Hospital Act,
(b) a community care facility as defined in section 1 of the Community Care Facility Act, or
(c) other circumstances specified by regulation by the Lieutenant Governor in Council.
(3) If a medical practitioner described in section 17.1 (2) (c) renders a benefit to a beneficiary, the medical practitioner must not charge the beneficiary for, or in relation to, the service an amount that, in total, is greater than
(a) the amount that would be payable under this Act, by the commission, for the service, or
(b) if a payment schedule or regulation permits or requires an additional charge, the total of the amount referred to in paragraph (a) and the additional charge.
17.3 (1) Before a beneficiary is rendered a service that would be a benefit if rendered by a practitioner, the person who intends to require the beneficiary to pay all or a portion of the costs of the service must advise the beneficiary, in a manner the beneficiary can understand, of the following:
(a) that the person proposes to collect the amount directly from the beneficiary;
(b) how much the person will charge for the service;
(c) how much, if anything, the person reasonably expects that the commission will reimburse the beneficiary for the rendering of the service.
(2) Subsection (1) does not apply if the medical condition or incapacity of the beneficiary makes compliance with that subsection impractical but, if the service would be a benefit if rendered by a practitioner, the beneficiary must not be charged for the service an amount that, in total, is greater than
(a) the amount that would be payable under this Act, by the commission, for the service, or
(b) if a payment schedule or regulation permits or requires an additional charge, the total of the amount referred to in paragraph (a) and the additional charge.
(3) If a beneficiary is not advised, as required by subsection (1), the beneficiary is not liable to pay for the service unless the service was rendered in an emergency situation that made it impractical to comply with that subsection.
17.4 (1) If a beneficiary pays for a service described in section 17.2, the person who charged for, or in relation to, the service must refund to the beneficiary any amount paid for the service that is in excess of the amount allowed for that service by section 17.2.
(2) If a beneficiary pays for a service but was not liable to pay for it because of section 17.3 (3), the person who charged for, or in relation to, the service must refund to the beneficiary the amount paid for the service.
17.5 An amount that is to be refunded under this Part is a debt due to the person who paid the amount, recoverable by action in any court of competent jurisdiction.
17.6 The minister, or a person designated by the minister for the purpose, may enter into an agreement to pay an amount to offset all or part of the cost for materials, consultations, use of an office, clinic or other place or for any other matter that relates to the rendering of a benefit.
9 Sections 11 (1) (a) and 12 (2) (a) of the Guaranteed Available Income for Need Act, R.S.B.C. 1979, c. 158, are amended by striking out "under the Medical and Health Care Services Act;" and substituting "under the Medicare Protection Act;".
10 The Hospital Act, R.S.B.C. 1979, c. 176, is amended by adding the following section:
4.1 A hospital must take all reasonable measures to ensure that the limits on direct or extra billing established by Part 3.1 of the Medicare Protection Act are complied with in respect of a service rendered to a beneficiary, as defined in section 1 of the Medicare Protection Act, by a medical practitioner at the hospital.
11 Sections 1 and 3 of the Medical and Health Care Services Special Account Act, S.B.C. 1994, c. 10, are amended by striking out "Medical and Health Care Services Act" wherever it appears and substituting "Medicare Protection Act".
12 Section 1 (3) (c) of the Social Service Tax Act, R.S.B.C. 1979, c. 388, is amended by striking out "Medical and Health Care Services Act." and substituting "Medicare Protection Act."
13 This Act may be cited as the Medical and Health Care Services Amendment Act, 1995.
14 This Act comes into force by regulation of the Lieutenant Governor in Council.
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