British Columbia

B.C. to crack down on extra fees billed by health-care providers

The B.C. government is planning to fine doctors who charge extra user fees and reimburse patients who are improperly billed, Health Minister Adrian Dix announced Wednesday.

Ministry of Health says there will be repercussions for physicians who levy improper charges

The B.C. Ministry of Health says patients who have been charged improper fees will be reimbursed without having to initiate legal action. (Shutterstock/Bright097)

The B.C. government is planning to fine doctors who charge extra user fees and reimburse patients who are improperly billed, Health Minister Adrian Dix announced Wednesday.

The province will make it an offence to charge extra fees for publicly insured services, and introduce fines of up to $10,000 for a first offence and $20,000 for a second offence for anyone convicted, Dix told reporters.

"Our public healthcare system is meant to provide high quality healthcare to everyone, based on need, regardless of where they live or their ability to pay," he said.

The news comes after a Health Canada audit of three private clinics in B.C. Based on that audit, the federal government estimates that $15.9 million in extra fees were charged to British Columbians in the 2015-2016 fiscal year.

This year, federal health-care funding to B.C. was reduced by the same amount. The Canada Health Act specifically forbids patient payments for "medically necessary" services covered by the public health-care system.

In response, Dix says the province will bring into force the full Medicare Protection Amendment Act, which was passed by the legislature in 2003 but not fully implemented. The full act would have given government the authority to take action against clinics and doctors charging illegal fees.

"We've had this system of don't ask, don't tell, ever since," Dix said.

Patients to be reimbursed

Right now, the Medical Services Commission only has the power to audit and ask for court injunctions against providers who are found to have billed improperly.

The health ministry says that when the full act is brought into force in October, patients will not be liable for any extra fees they have been charged.

Practitioners who have charged those extra fees will be required to reimburse them, and if they refuse to do so, the Medical Services Commission will provide the refund.

Apart from fines, doctors and clinics who charge illegally could also be delisted from the Medical Services Plan.

"We are taking strong action today and will be asking the federal government to restore funding to B.C. in the coming year as a result," Dix said.

He added that the changes will not prevent patients from seeking private treatment for services that aren't covered under MSP, or end the practice of public funding for procedures provided through private clinics.

Federal Health Minister Ginette Petitpas Taylor said she was delighted by the news from B.C., but it was too early to say whether the province would be reimbursed for the funding that was clawed back this year.

"In no way do we want to take money away from provinces, just the opposite, but we certainly want to make sure that the extra billing fees and user fees stop," she told CBC News.

B.C. has high rate of improper billing

Edith MacHattie, co-chair of the B.C. Health Coalition, welcomed the changes and described them as long overdue.

"We at the B.C. Health Coalition do hear often from patients who have been extra-billed and who are facing real hardships from these for-profit clinics that are profiting off of their illness and their need for treatment," she told CBC News.

There are six audits of private clinics planned for this year, and three are already underway, according to the province.

Last year, a study from the Ontario Health Coalition found that B.C. had one of the highest rates of improper billing in the country. 

For example, the researchers found that some private B.C. clinics had billed patients between $650 and $995 for MRI scans and more than $8,000 for knee surgery to repair a torn ACL — services that are covered through MSP.

In a few cases, those clinics also asked people for their health cards, suggesting that both MSP and patients were being billed for the same services.


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