1997 Legislative Session: 2nd Session, 36th Parliament
FIRST READING
The following electronic version is for informational purposes only.
The printed version remains the official version.
HONOURABLE JOY K. MacPHAIL
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 Section 7 of the Medicare Protection Act, R.S.B.C. 1996, c. 286, is amended
(a) by repealing subsection (1) and substituting the following:
(1) A resident must apply to the commission in the manner required by the commission
(a) for enrollment as a beneficiary if not already enrolled,
(b) for enrollment of the resident's spouse as a beneficiary if the spouse
(i) is not living separate and apart from the resident,
(ii) is not enrolled or applying for enrollment as a beneficiary, and
(iii) has not submitted a statement under subsection (1.1),
(c) for enrollment of each of the resident's children as a beneficiary if the child
(i) is a resident,
(ii) is not living independently from the resident, and
(iii) is not enrolled or applying for enrollment as a beneficiary.
(1.1) Subsection (1) (a) does not apply to a resident who submits a statement to the commission in the manner required by the commission stating that the resident does not want to be enrolled as a beneficiary.
(1.2) A statement under subsection (1.1) may not be submitted for the purpose of requesting that a child described by subsection (1) (c) not be enrolled. ,
(b) by repealing subsection (7) and substituting the following:
(7) The commission may cancel the enrollment of a beneficiary effective
(a) on application by the beneficiary, effective on a date subsequent to the date of the application,
(b) on the date the commission determines to have been the date that the beneficiary ceased to be a resident, or
(c) on the date of enrollment as a beneficiary, if the commission determines that the beneficiary was not eligible for enrollment on that date.
(7.1) Subsection (7) (a) does not apply for the purpose of requesting that the enrollment of a child described by subsection (1) (c) be cancelled. ,
(c) in subsection (8) by striking out "who paid them." and substituting "who paid them unless the commission determines that the person would be unjustly enriched by the refund.", and
(d) by adding the following subsection:
(9) A beneficiary must, within 14 days of the change, provide the commission with
(a) the beneficiary's former and new addresses, if there is a change in these addresses, or
(b) the beneficiary's former and new names, if there is a change in the beneficiary's name.
2 The following sections are added:
7.1 The commission must not enroll a person as a beneficiary for a prescribed period from the date that the commission
(a) receives a statement under section 7 (1.1) from the person, or
(b) cancels the enrollment of the person under section 7 (7) (a),
the commission must not enroll a person as a beneficiary.
7.2 The commission may cancel the enrollment of a beneficiary if the commission believes the beneficiary has ceased to be a resident.
8.1 If payments under section 7 (5) are not made in the prescribed manner and within the prescribed time, the person liable to make these payments is also liable to pay the commission interest at the prescribed rate on these payments.
8.2 (1) If a person defaults in the payment of part or all of the premiums, including any interest on premiums, payable under this Act, the commission may issue a certificate in the prescribed form stating
(a) that payment is in default,
(b) the amount remaining unpaid, including interest, and
(c) the name of the person by whom it is payable.
(2) The commission may file the certificate with a court of competent jurisdiction 30 days after the commission has served the person in default with
(a) a copy of the certificate, and
(b) a notice stating the location of the court where the certificate will be filed.
(3) The documents referred to in subsection (2) (a) and (b) sent by registered mail to the last known address of the person in default are conclusively deemed to be served on the person to whom they are addressed on the earlier of
(a) the 14th day after these documents were deposited with Canada Post, or
(b) the date on which these documents were actually received by the person, whether by mail or otherwise.
(4) An appeal from a certificate filed under subsection (2) lies to the court at the location where the certificate is filed and, if an appeal is commenced, the application of subsection (7) is not stayed unless the court orders otherwise pending the outcome of the appeal.
(5) No appeal referred to in subsection (4) shall be instituted later than 45 days after the filing of the certificate under subsection (2).
(6) An appeal referred to in subsection (4) shall be a trial de novo and the court may make any order it considers just, including an order that the commission amend its certificate.
(7) On being filed, the certificate, including any amendment made under subsection (6), has the same force and effect, and all proceedings may be taken on it, as if it were a judgment in favour of the government of the court for the recovery of a debt for the amount stated in the certificate against the person named in it.
(8) Section 32 (2) to (4) applies to the amount referred to in subsection (1) (b) stated in a certificate as though that amount were the premiums referred to in section 32 (2) collected under an agreement referred to in section 32 (1).
3 Section 9 is repealed and the following substituted:
9 Subject to sections 10 (1), 11, 14 and 15, a beneficiary is entitled to have payment made in accordance with amounts in a payment schedule for a benefit that the beneficiary has received and this payment will be
(a) at a reduced rate, if applicable, as provided for under this Act, and
(b) less any applicable patient visit charge.
4 Section 11 (4) is amended by striking out "cancellation under section 7 (7) (b)," and substituting "cancellation under section 7 (7) (b) or (c),".
5 Section 13 is amended by adding the following subsections:
(3.1) The commission may establish one or more formulae under which
(a) one or more categories of medical practitioners are specified by
(i) the lengths of their periods of enrollment or practice as medical practitioners,
(ii) the benefits to which this regulation applies, and
(iii) the area of British Columbia where this regulation applies, and
(b) the rate or rates at which medical practitioners in a category established under paragraph (a) are eligible to be paid, less any reduction made under section 24 (2), for rendering benefits specified under paragraph (a) (ii) in the area specified under paragraph (a) (iii).
(3.2) Despite subsection (3), a medical practitioner in a category established under subsection (3.1) (a) who renders a benefit specified under subsection (3.1) (a) (ii) to a beneficiary in an area specified under subsection (3.1) (a) (iii) is, if this Act and the regulations made under it are complied with, eligible to be paid for his or her services in accordance with the applicable rate established under subsection (3.1) (b), less any reduction made under section 24 (2), rather than as provided for under the applicable payment schedule.
6 The following section is added:
13.1 (1) Despite section 13 (2), no person may be enrolled as a medical practitioner if the person is 75 years of age or older.
(2) The enrollment of a medical practitioner is cancelled on December 31 of the calendar year in which the medical practitioner becomes 75 years of age.
(3) Despite subsection (2), in the calendar year in which this section comes into force, the enrollment of a medical practitioner is cancelled on December 31 of that calendar year if the medical practitioner is 75 years of age or older.
(4) Despite subsections (1) to (3), if the commission is satisfied that beneficiaries may be denied access to necessary benefits if subsections (1) to (3) were to apply to a person, the commission may suspend the application of subsections (1) to (3) to the person on the terms and conditions the commission considers appropriate.
7 Section 15 (2) is amended by striking out "or" at the end of paragraph (a) and by adding the following paragraph:
(a.1) order that the practitioner, for a period fixed by the commission, be paid for rendering benefits at a rate specified by the commission that is less than the rate under the applicable payment schedule, or .
8 Section 18 is amended
(a) in subsection (1) by striking out "the medical practitioner must not charge the person" and substituting "a person must not charge the beneficiary", and
(b) in subsection (3) by striking out "the medical practitioner" and substituting "a person".
9 The following section is added:
20.1 (1) A person requesting a benefit for a beneficiary must not be charged for the benefit in place of the beneficiary if this Part requires that the beneficiary not be charged for the benefit.
(2) A person requesting a benefit for a beneficiary must receive advice concerning a requirement to pay for the benefit if this Part requires that the beneficiary receive advice concerning the requirement to pay for the benefit.
10 Section 32 is amended
(a) by adding the following subsection:
(1.1) If the payment of another person's premiums referred to in subsection (1) (a) is in arrears, including arrears arising before the making of an agreement referred to in subsection (1) respecting the other person, the person making the agreement, if requested by the commission, must collect and remit the arrears, including applicable interest on these arrears, by payment to the commission as specified by the commission under subsection (1). , and
(b) in subsection (2) by striking out "subsection (1)" and substituting "subsection (1) and arrears collected under subsection (1.1)".
11 Section 36 is amended
(a) in subsection (1) by adding the following definition:
"prescribed agency" means a body that is prescribed for the purposes of this Part. , and
(b) by adding the following subsections:
(2.1) If the commission, on behalf of a prescribed agency, pays a practitioner, an owner of a diagnostic facility or a representative of a professional corporation for services rendered, or claimed to have been rendered, this Part applies to the services as though these services were benefits.
(2.2) The claims and patterns of practice or billing concerning a prescribed agency
(a) need not be under this Act, and
(b) can have arisen at any time since July 24, 1992.
12 Section 37 (1) is amended
(a) in paragraph (b) by striking out "by a practitioner", and
(b) in paragraph (c) by striking out "by the practitioner".
13 Section 43 is repealed and the following substituted:
43 (1) A practitioner, an owner of a diagnostic facility or a representative of a professional corporation in respect of whom an order was made under section 15 (2) or 37 (1) may appeal the order to the Supreme Court not more than 30 days after the date of the order or cancellation.
(2) An appeal from a decision of the Supreme Court on appeal under subsection (1) lies to the Court of Appeal with leave of a justice of the Court of Appeal.
(3) An appeal under this section does not operate to stay the order appealed from unless the court to which the appeal is made otherwise orders.
14 Section 51 (2) is amended by adding the following paragraphs:
(c.1) prescribing the period for the purposes of section 7.1;
(c.2) establishing the manner and time for the making of payments of premiums;
(c.3) prescribing the rate for the purposes of section 8.1;
(c.4) prescribing the form of certificate under section 8.2;
(h.1) prescribing bodies for the purposes the definition of prescribed agencies in Part 7; .
15 This Act comes into force by regulation of the Lieutenant Governor in Council.
[This Bill amends the Revised Statutes of British Columbia, 1996. The Revised Statutes of British Columbia, 1996 came into force on April 21, 1997.]
SECTION 1: [Medicare Protection Act, amends section 7]
requires all residents as defined in the Act to enroll as beneficiaries unless they elect not to be enrolled by submitting a statement to the commission;
provides that an election not to be enrolled can not be made by or on behalf of a dependent child;
requires beneficiaries to keep the commission advised of their current names and addresses;
clarifies that a beneficiary will not qualify for a refund of premiums through voluntary cancellation of enrollment if this would result in an unjust enrichment of the beneficiary.
SECTION 2: [Medicare Protection Act, enacts sections 7.1, 7.2, 8.1 and 8.2]
creates a waiting period for enrollment as a beneficiary for persons who voluntarily cancel their enrollments, or elect not to be enrolled, as beneficiaries;
allows the commission to cancel the enrollment of a beneficiary if the commission believes the beneficiary has ceased to be a resident;
allows interest to be charged at a prescribed rate on overdue premium payments;
allows the commission to file with a court a certificate setting out the amount owed by a beneficiary in arrears and to enforce payment of this amount through that court as though the court had issued a judgment for that amount.
SECTION 3: [Medicare Protection Act, re-enacts section 9] is only to make this similar to other Bills consequential to the amendments made to section 13 of the Act by section 5 of this Bill.
SECTION 4: [Medicare Protection Act, amends section 11 (4)] is a consequential amendment to the amendments made to section 7 (7) of the Act by this Bill.
SECTION 5: [Medicare Protection Act, adds section 13 (3.1) and (3.2)] allows the commission to establish formulae for increasing or decreasing its payments to specified medical practitioners from those established by payment schedules established under Part 5 of the Act for rendering specified benefits. The increase or decrease would be based on the area of British Columbia where the benefit is rendered and the length of time of enrollment of the medical practitioner.
SECTION 6: [Medicare Protection Act, enacts section 13.1] disqualifies persons 75 years of age or older from being, or remaining, enrolled under the Act as medical practitioners except in special cases where the commission is satisfied that beneficiaries may otherwise be denied access to necessary benefits.
SECTION 7: [Medicare Protection Act, amends section 15 (2)] allows the commission, as a penalty for contravention of the rules governing the plan, to reduce for a time the rate at which a practitioner can bill for benefits rendered.
SECTION 8: [Medicare Protection Act, amends section 18] clarifies that the prohibition on extra billing applies not only to medical practitioners but also to any person billing on behalf of a medical practitioner.
SECTION 9: [Medicare Protection Act, enacts section 20.1] clarifies that a relative or other person aiding a benefit to obtain a beneficiary can not be billed for charges that the Act specifies can not be billed directly to or on behalf of the beneficiary.
SECTION 10: [Medicare Protection Act, amends section 32] facilitates the collection under section 32 of premiums in arrears.
SECTION 11: [Medicare Protection Act, amends section 36] allows Part 7 of the Act, which provides for the inspection and audit of claims by a practitioner, an owner of a diagnostic facility or a representative of a professional corporation for payments under the plan, to be applied for the inspection and audit of claims for payments from the commission acting as a payments agent on behalf of the prescribed agencies.
SECTION 12: [Medicare Protection Act, amends section 37 (1)] clarifies the intent of section 37 (1) of the Act which is that the section apply generally to the actions of a practitioner, owner of a diagnostic facility or a representative of a professional corporation. The amendments to section 36 of the Act extend the application of section 37 to corresponding actions of those acting for prescribed agencies.
SECTION 13: [Medicare Protection Act, re-enacts section 43] allows a practitioner, an owner of a diagnostic facility or a representative of a professional corporation to appeal directly to the Supreme Court in circumstances where, under the current section 43, the appeal would be to the Medical and Health Care Services Appeal Board.
SECTION 14: [Medicare Protection Act, amends section 51 (2)] allows regulations to be made to prescribe matters that this Bill requires be prescribed.
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