Measures to protect patients in British Columbia from extra billing for medically necessary treatments under Bill 92 will come into force Oct. 1, 2018.
Under this bill, provisions applicable to diagnostic services will come into effect April 1, 2019, following a six-month extension.
Similar to measures in place in other provinces, the provisions coming into force next month mean patients who were extra-billed will have the option to be refunded by the Medical Services Commission. In addition, it also establishes fines for those clinics and practitioners who act in contravention of the Medicare Protection Act. Extra billing occurs when a patient or a person acting on behalf of a patient, is asked to pay more, or in addition, to what the Medical Services Plan would pay for medically necessary treatments.
In addition, the provisions, which are unproclaimed parts of Bill 92 that were passed unanimously in 2003, position the Province to recover $15.9 million in fines incurred under the Canada Health Act for extra billing by private surgical clinics.
The six-month extension for the section of Bill 92 applicable to diagnostic services takes into consideration the government’s commitment to dramatically increase publicly funded MRI exams through new capacity, while making sure that public investments are used to their full capacity to decrease wait lists. For many years, publicly funded MRI units sat idle during periods of the day, with the number of scans per capita in B.C. being well under the national average.
Under the government’s new diagnostics strategy, eight machines are operating 24 hours a day/seven day a week, up from just one machine a year ago. More are scheduled to begin running non-stop in the coming months.
“The problem of MRI wait times didn’t appear overnight, and we are making important progress toward reducing them,” said Adrian Dix, Minister of Health. “To this end, we are ramping up new capacity in the system that is going to be sustained going forward. Our strategy to dramatically increase the number of MRI procedures will make sure that they are available to patients, and that our public health-care system is on track. We are ahead of our MRI target of 225,000 for this fiscal year, which is 37,000 more when compared to last year.”
“We are also working with private clinics regarding this provision, and the next six months will help provide them with more time to meet its requirements,” said Dix.
The federal government continues to require reporting of extra billing by the provinces and territories, and will act to deduct Canada Health Transfer funds where extra billing takes place.
With respect to such fines, the federal government’s policy is that provinces and territories will be eligible to be reimbursed for theses deductions when they demonstrate that they have taken action against extra billing for medically necessary treatments.
Sections of Bill 92 coming into effect Oct. 1, 2018, position B.C. to recover the $15.9 million fine it has incurred due to extra billing for medically necessary surgeries.
The federal government has noted that it may take time in some jurisdictions to align systems for diagnostic services and has provided provinces and territories until April 1, 2020, to come into alignment. By enforcing the provisions of Bill 92 that relate to diagnostic services beginning April 1, 2019, B.C. will be well positioned to avoid any deductions related to these services.
- Total MRI volumes are expected to increase to 225,000 MRI exams completed in 2018-19, up from 188,000 in 2017-18.
- To meet these ambitious targets, $11 million is being made available in the public health-care system to add resources and capacity.
- Achievements to date include:
- MRI machines throughout the province are operating more than 800 additional hours per week;
- 33.5% more MRI scans were completed in the most-recent reporting period over the previous year;
- centralized scheduling is being implemented at the regional levels that will reduce duplicate referrals and repeat scans to prevent wasted operating time, while also offering patients the earliest appointment available in a region, as appropriate; and
- in addition to increasing capacity, the Ministry of Health is working with health authorities to find ways to make sure referrals for MRI are the most appropriate diagnostic choice and that the quality of exams is consistently high to ensure patient safety and reduce the need to repeat them and take up more valuable time.
- MRI is one of the tools that may be used to diagnose medical conditions, including abnormalities of the brain, as well as tumours, cysts and soft-tissue injuries in other parts of the body. An early diagnosis can lead to early treatment, which can positively impact people’s quality of life and return them to being contributing members of their communities and the economy.