MDs who extra-bill could face charges
Province takes aim at private clinics
Doctors and private clinics that break tough laws meant to stop private billing at surgery and diagnostic imaging clinics could be prosecuted, perhaps even hit with criminal fraud charges.
The NDP cabinet is activating changes to the Medicare Protection Act on Oct. 1. The amendments, passed in 2003 under the Liberals but not brought into force, allow fines of up to $20,000 when doctors and clinics extra bill patients for expedited care.
Extra billing is the term government uses when a patient is directly charged for a procedure normally covered by medicare, often at a higher rate than the Medical Services Plan pays doctors.
Private clinic doctors warned Wednesday the result could be longer waiting lists unless hospitals get more funding to staff idle operating rooms, post-surgery recovery beds and ward beds.
Five to 10 per cent of surgeries in B.C. (60,000 a year) are done in private clinics, either through private pay arrangements or through contracting out by health authorities. Health minister Adrian Dix said health authorities contract out about $15 million in surgical cases to private centres each year and he’s not against that. But he is opposed to patients being charged for medically necessary care.
There are more than 80,000 adult patients waiting for scheduled, non-emergency surgery, a historical high. When they can no longer opt for private surgery to jump the queue to get faster care, they may have to choose the option that many used before private clinics existed — leave Canada as medical tourists.
The provincial Medicare Protection Act already forbids extra billing but Dix said clinics have been ignoring the law.
Under the Canada Health Act, provinces are penalized for allowing extra billing. Dix said the B.C. government had its annual transfer payment reduced by $16 million last month.
Under the new laws, doctors who supplement public hospital duties with private clinic work and extra bill patients could, if convicted, be forced to repay the patient, be fined up to $20,000, and even be de-enrolled from the Medical Services Plan, which means they could no longer work in the public system.
“If the (Health Ministry’s) special investigation
unit believes that there is sufficient concern to point to fraud, in addition to the extra billing covered under the Medicare Protection Act, then it would be referred on to Crown counsel who would determine whether or not criminal charges were warranted,” said ministry spokeswoman Laura Heinze.
Dr. Mark Godley, the anesthesiologist who founded the False Creek Surgical Centre, warned the legislation could have serious ramifications.
“The consequences of this legislation are unimaginable, but let’s start with an exodus of some of the greatest doctors in B.C., the inability to recruit new specialists and even longer wait lists for patients.”
Dr. Brian Day, co-owner of the Cambie Surgery Centre, said he will instruct his lawyers to seek an injunction to block the legislation from coming into force.
Day said he is “astounded” the government would take such “draconian” action when he’s in the midst of a trial centred on the very issue of whether the Canadian Charter of Rights and Freedoms gives patients the right to seek and pay for care in private clinics.
Dix said there are 56 private surgical clinics and 17 private clinics offering MRI scans. He said Health Canada officials raised concerns about extra billing in B.C. in 2017, so B.C. agreed to do more audits of private clinics which pegged extra billing at about $16 million a year.
“What kind of a democracy is this? Clinics will close. Many are already operating on thin margins,” said Day.