Hon. Alice Wong, P.C.

As a result of a recent news article, we are posting the following information on the Canada Health Act, specifically with respect to extra billing and user charges. You can read the entire Canada Health Act by clicking here.

Under section 18 to 21 (Extra Billing and User Charges), the Act states (emphasis added on Section 20):

Extra-billing
18. In order that a province may qualify for a full cash contribution referred to in section 5 for a fiscal year, no payments may be permitted by the province for that fiscal year under the health care insurance plan of the province in respect of insured health services that have been subject to extra-billing by medical practitioners or dentists.

User charges
19. (1) In order that a province may qualify for a full cash contribution referred to in section 5 for a fiscal year, user charges must not be permitted by the province for that fiscal year under the health care insurance plan of the province.

Limitation
     (2) Subsection (1) does not apply in respect of user charges for accommodation or meals provided to an in-patient who, in the opinion of the attending physician, requires chronic care and is more or less permanently resident in a hospital or other institution.

Deduction for extra-billing
20. (1) Where a province fails to comply with the condition set out in section 18, there shall be deducted from the cash contribution to the province for a fiscal year an amount that the Minister, on the basis of information provided in accordance with the regulations, determines to have been charged through extra-billing by medical practitioners or dentists in the province in that fiscal year or, where information is not provided in accordance with the regulations, an amount that the Minister estimates to have been so charged.

Deduction for user charges
     (2) Where a province fails to comply with the condition set out in section 19, there shall be deducted from the cash contribution to the province for a fiscal year an amount that the Minister, on the basis of information provided in accordance with the regulations, determines to have been charged in the province in respect of user charges to which section 19 applies in that fiscal year or, where information is not provided in accordance with the regulations, an amount that the Minister estimates to have been so charged.

The Minister of Health makes the determination whether there has been user charges or extra billing that has occurred in respect to insured health services.

Also, the phrase “cash contribution” in the above legislative text is commonly referred to in the media as “transfer payments”, or sometimes “health transfers”.

Filed under: Commentary