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Ministry of Health

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Sections of the Medicare Protection Act, 2003, coming into force

In 2003, Bill 92 was passed by the legislative assembly as a series of amendments intended to fortify the Medicare Protection Act (MPA) by clarifying and strengthening the prohibitions against extra billing. It was intended to ensure the Province was in compliance with the principles of the Canada Health Act.

At the time, only the portion of Bill 92 that provided the Medical Services Commission additional powers of audit and inspection, and the right to apply for court injunctions, were brought into force. The remaining provisions of the act were not proclaimed.

Outstanding sections of the act that are coming into force include the following:

  • Making it an offence to extra bill and create offences for extra billing along with significant fines (s. 46(5.1)(5.2));
  • Clarifying that selling priority access to medically necessary care is extra billing (s. 17(1.1));
  • Providing new protections for beneficiaries and establishing that they are not liable to pay for extra billing charges (s. 17(1.2), 18(4), 18.1(3), 19(4), 20, 21);
  • Creating consequences for practitioners, or others, such as privately owned medical clinics, who have extra-billed beneficiaries (such as requiring them to refund the amounts paid) (s. 20); and
  • Ensuring that all diagnostic facilities, including non-approved diagnostic facilities, cannot charge beneficiaries for diagnostic services if the services would be covered under MSP (s. 18.1).

Extra billing involves charging a MSP beneficiary for a service that is covered under MSP, or is covered under the Hospital Insurance Act, unless otherwise permitted under the Medicare Protection Act or by the Medical Services Commission. Under Section 18, a practitioner who is not enrolled in MSP is not permitted to charge more than they could if they were enrolled, if the service is provided in a hospital, a continuing-care facility, publicly funded community-care facilities, assisted living residences or a health authority.