Hospital Insurance Act

Hospital Insurance Act 204 1996 712470149/96204/tlc96204_f E3tlc96204 Definitions 1 In this Act: beneficiary means a beneficiary as defined in section 1 of the Medicare Protection Act ; benefits means the general hospital services authorized under this Act; hospital means, except in sections 24 and 29 (2) (a), a a hospital as defined by section 1 of the Hospital Act that has been designated under this Act by the Lieutenant Governor in Council as a hospital required to provide the general hospital services provided under this Act, b a private hospital as defined by section 5 of the Hospital Act with which the government has entered into an agreement requiring the hospital to provide the general hospital services provided under this Act, c a hospital owned and operated by Canada that has been designated under this Act a "federal hospital", d an agency or establishment that i provides a service to hospitals or a health service and ii has been designated as a hospital facility by the Lieutenant Governor in Council, or e an establishment in which outpatient services are available that has been designated a diagnostic and treatment centre by the Lieutenant Governor in Council for providing outpatient benefits to beneficiaries in accordance with this Act and the regulations; PHSA means the Provincial Health Services Authority, a society under the Societies Act ; regional health board means a board as defined in section 1 of the Health Authorities Act ; resident means a resident as defined in section 1 of the Medicare Protection Act . Repealed 2 [Repealed 2002-16-2.] Beneficiaries 3 1 Subject to this Act and the regulations, every beneficiary is entitled to receive the general hospital services provided under this Act. 2 [Repealed 2002-16-3.] Benefits for beneficiaries only 4 No person other than a beneficiary is entitled to the benefits provided by this Act. Benefits 5 1 Except as provided in subsection (2), the general hospital services provided under this Act are the following: a for beneficiaries requiring treatment for acute illness or injury, the public ward accommodation, necessary operating and case room facilities, diagnostic or therapeutic X-ray procedures, anesthetics, prescriptions, drugs, dressings, cast materials and other services prescribed by regulation; b for beneficiaries requiring active treatment for chronic illness or disability, the public ward accommodation, physiotherapy and occupational therapy, minor operating room and diagnostic X-ray services, prescriptions, drugs, dressings, cast materials and other services prescribed by regulation; c for beneficiaries requiring treatment or diagnostic services as outpatients, the outpatient treatment or diagnostic services prescribed by regulation. 2 General hospital services under this Act do not include the following: a transportation to or from hospital; b services or treatment that the minister, or a person designated by the minister, determines, on a review of the medical evidence, the beneficiary does not require; c services or treatment for an illness or condition excluded by regulation of the Lieutenant Governor in Council; d laboratory services that are benefits within the meaning of the Laboratory Services Act . 3 For the purposes of subsection (1) (c), the regulations may authorize the minister to define categories of outpatient care and specify the treatment or diagnostic services to be provided for those categories. 4 No person is entitled to receive any of the benefits under this Act unless a it has been certified in the manner provided in the regulations that the person requires the services, and b it is proved to the satisfaction of the minister that the person is a beneficiary. 5 [Repealed 2002-16-5.] 6 If a person does not obtain certification as provided in subsection (4), the person has no claim against the government for general hospital services provided to the person. 7 Subject to the approval of the Lieutenant Governor in Council, the right of a beneficiary to receive the benefits under this Act may be made subject to the payment by or on behalf of the beneficiary of a portion of the cost of providing any treatment or services rendered to the beneficiary by a hospital, and the government must pay, on behalf of any person who is certified by the minister charged by order of the Lieutenant Governor in Council with the administration of the Employment and Assistance Act to be a person entitled to health services, a charge levied under this subsection against that person. Payment for organ donor not a beneficiary 6 Despite this Act, if a beneficiary requires an organ transplant from a donor who is not a beneficiary, the cost of diagnosis, services and treatment rendered to the donor by the hospital must be paid to the hospital in a manner and amount the minister directs. Necessary information to be supplied on request 7 1 The minister or an officer of the minister's ministry or of a hospital may require a person to provide, by means of a signed statement or otherwise, information regarding the person or the members of the person's family thought necessary by the minister or an officer for the proper administration of this Act. 2 A person who does any of the following commits an offence: a makes a false statement of fact in a signed statement or other statement required under this Act; b fails or refuses to make a signed statement or other statement at once on being required to do so; c withholds or misrepresents information regarding a matter connected with this Act. 3 A person who commits an offence under subsection (2) is liable on conviction to a penalty of not less than $100 or to imprisonment for not less than 10 days, or both. Hospitals to provide services for beneficiaries 8 1 Every hospital must provide for beneficiaries those public ward facilities, including necessary operating and case room facilities, X-ray diagnostic and therapeutic procedures, anesthetics, and other services, dressings and drugs the Lieutenant Governor in Council requires or provides for under regulations. 2 Every hospital must provide for beneficiaries those laboratory services that are benefits within the meaning of the Laboratory Services Act . Payment to a regional health board, the Nisg̱a'a Nation or the PHSA 9 1 There must be paid annually to a each regional health board, b the Nisg̱a'a Nation, and c the PHSA for the hospitals it funds an amount determined by the minister to cover all or part of the cost to the regional health board, the Nisg̱a'a Nation or the PHSA for the provision to beneficiaries of those general hospital services authorized by this Act that the hospitals are required by the minister to provide for beneficiaries admitted for treatment, excluding those amounts payable for those hospitals under section 5 (7) and section 14. 2 The fiscal year of a hospital begins April 1. Nonbeneficiaries 10 1 The government is not liable for payment of the cost of providing any hospital service or treatment rendered to a person who is not a beneficiary. 2 [Repealed 2003-33-6.] 3 Despite a contract or any other Act, payment for hospital services or treatment rendered to a person who is not a beneficiary must be made to the hospital by the person or on the person's behalf. 4 For the purposes of subsection (3), a the hospital must compute the amount owing by or on behalf of that person in a manner approved by the minister, and b each computation must be based on the rate or charge approved by the minister. 5 If a patient is not a beneficiary, the hospital has a cause of action against the patient or the person legally liable to pay for the hospital services or treatment rendered to the patient for the amount owing in respect of them as determined under this section. 6 For the purposes of subsection (5), if the patient claims to be entitled to benefits under this Act, the burden of proving that the patient is a beneficiary is on that person. 7 If a person receives hospital services or treatment other than services or treatment authorized under this Act, payment of a sum computed by the hospital must be made to the hospital by or on behalf of that person for the cost of the other special services or treatment, in addition to the payment of other sums to which the hospital is entitled for any general hospital care which the hospital has rendered to that person. Persons who may be excluded from benefits 11 The Lieutenant Governor in Council may by regulation exclude, in whole or in part, from the benefits provided under this Act a a person who is entitled to receive hospital care or treatment under an Act of Canada or of British Columbia specified in an agreement entered into between British Columbia and Canada, or b a person who is entitled to receive hospital care or treatment from a government other than the government of British Columbia or of Canada. A regional health board, the Nisg̱a'a Nation or the PHSA must not seek additional payment 12 If a regional health board, the Nisg̱a'a Nation or the PHSA has been paid by the government for general hospital services provided under this Act, the payment, subject to section 5 (7) or 14, is deemed to be payment in full for the services, and the regional health board, the Nisg̱a'a Nation, the PHSA or a hospital must not seek to recover additional payment from any other person for the services. Offence to bill beneficiary for insured services 13 1 A person wilfully rendering an account or causing an account to be rendered to a beneficiary for hospital services that are provided, and to which the beneficiary is entitled under this Act, commits an offence. 2 A person who commits an offence under subsection (1) is liable on conviction to a fine of not more than $500. Other than public ward accommodation 14 1 If a person entitled to the benefits provided by this Act requests and receives care in addition to public ward care, or if additional care is provided for a patient on the order of the patient's physician, a the hospital must be paid on the basis of public ward care as provided in this Act, and b the hospital may collect from the patient and retain the difference in rates between the public ward care and the actual care provided. 2 A proportion of all sums collected and retained by the hospitals under subsection (1) must be applied toward the cost of providing care in addition to public ward care. 3 The proportion of the sums referred to in subsection (2) to be applied under that subsection must be in accordance with the directions issued by the minister. Repealed 15 [Repealed RS1996 (Supp)-204-6.] Accounting 16 The minister must keep accounts of the money received and expended under this Act. Agreement with other governments 17 The minister may enter into an agreement with any other province a to bring about a high degree of liaison and cooperation between the provinces concerning hospital insurance matters, and b to make arrangements under which a beneficiary may move the beneficiary's home from one province to the other without ceasing to be entitled to benefits. Other agreements 18 The minister may enter into agreements with other agencies, associations, societies or companies for taking over commitments made by agencies providing for hospital care of certain individuals or groups resident in British Columbia. Workers' Compensation Board 19 The Lieutenant Governor in Council may make regulations a for coordinating the benefits available under the Workers Compensation Act with the general hospital services provided under this Act, b for preventing duplication and difficulties in administration, and c authorizing both the minister and the Workers' Compensation Board to enter into an agreement regulating their respective responsibilities and financial obligations. Acquisition of hospitals and health facilities 20 With the approval of the Lieutenant Governor in Council, the minister may a acquire, including acquisition by expropriation, hospitals and health facilities, and land, buildings and equipment to be used for hospital or health facility purposes, and lease or transfer them to nonprofit agencies or corporations to be used as or for hospitals or health facilities, and b enter into agreements for the purposes of paragraph (a). Special services 21 1 The Lieutenant Governor in Council may provide for special or emergency aid in making available hospital services for particular parts or areas of British Columbia. 2 [Repealed RS1996 (Supp)-204-8.] Dispute as to whether services required 22 1 If a dispute arises between a beneficiary and the minister as to whether the beneficiary requires hospital services, the beneficiary, if required by the minister, must submit to an examination by a medical practitioner appointed by the minister. 2 If the beneficiary does not submit to an examination when required by the minister or if the beneficiary in any way obstructs an examination by the medical practitioner, a the beneficiary's rights under this Act are suspended until the examination has taken place, and b the beneficiary is personally liable for any hospital service received by the beneficiary during the suspension. Physician's report 23 1 The minister must secure reports the minister thinks necessary from the attending physician in a specific case and may make payment to physicians for the reports. 2 A physician commits an offence if the physician, having received notice by registered mail from the minister of information required by the physician, fails to comply with the notice. 3 A physician who fails to make a report required under this Act, unless excused by the minister, commits an offence. 4 A person who commits an offence under subsection (2) or (3) is liable on conviction to a fine of not more than $50. Hospital services outside British Columbia 24 Subject to this Act and the regulations, the minister must pay for hospital services rendered outside British Columbia to beneficiaries by a hospitals, and b other institutions approved by the minister. Repealed 25 [Repealed 2008-27-26.] Service of notices 26 1 Notice required to be given under this Act a must be in writing, and b may be served by mailing it by prepaid post to the person named in it at the person's last known address. 2 A person served with notice under subsection (1) is deemed to have received it on the day on which it would reach the person in the ordinary course of mail. Penalties 27 If this Act, or regulations, rules or orders made under it by the Lieutenant Governor in Council are contravened, and no other penalty is provided for, the person guilty of the contravention is liable on conviction to a penalty of not more than $100 for each offence. Limitation period for laying charges 28 An information for an offence against this Act must be laid within 6 years from the time when the matter of the information arose. Power to make regulations 29 1 The Lieutenant Governor in Council may make regulations referred to in section 41 of the Interpretation Act . 2 Without limiting this section, the Lieutenant Governor in Council may make regulations for the following: a the amount and method of payment to hospitals and other institutions referred to in section 24 for hospital services rendered outside British Columbia to beneficiaries under this Act and the number of days of care for which payment will be made to those hospitals and other institutions; b the facilities and services that a regional health board, the Nisg̱a'a Nation or the PHSA must provide for beneficiaries under this Act in order to qualify them for payment by the government, and the amount of the payment to regional health boards, the Nisg̱a'a Nation or the PHSA; c [Repealed 2002-16-8.] d the manner and form in which reports must be made and accounts rendered to the minister, and all other matters and procedures concerned with payment of accounts or their compilation and presentation; e inquiries to determine the correctness of accounts rendered by hospitals, regional health boards, the Nisg̱a'a Nation or the PHSA; f the treatment and services referred to in section 5; g the kind of information to be obtained under this Act; h the presentation by the board of management of a hospital of satisfactory medical certification to show clearly the need of any patient for hospital care and treatment; i the length of stay in a hospital for which payment may be made by the government on behalf of a beneficiary; j the acquisition or use of land as sites for hospitals, and the creation, establishment, construction, alteration, equipment, maintenance and repair of hospitals; k the provision of any special or other type of service for any particular area that the Lieutenant Governor in Council may provide; l the classification, grades and standards of hospitals; m the inspection, control, government, management, conduct, operation and use of hospitals; n the exclusion of persons, in whole or in part, from the benefits provided under this Act; o the admission, treatment, conduct, discipline and discharge of patients; p the records, books, accounting systems, audits, reports and returns to be made and kept by hospitals; q morbidity reporting by hospitals; r communicable diseases, tuberculosis and maternity patients; s the equipment and use of X-ray, operating and case rooms; t the records, books, accounting systems, audits, reports and returns to be made and kept by the minister; u [Repealed RS1996 (Supp)-204-11.] v the kind of information that must be considered confidential and need not be divulged; w financial aid to institutions approved under the Hospital Act ; x certification of requirements for admission to hospital; x.1 the verification of the identity and enrolment, under the Medicare Protection Act , of a person requesting benefits under this Act; y the information that associations, companies or other agencies engaged in providing hospital insurance must provide to the minister; z definitions of expressions not defined elsewhere in this Act. 3 Without limiting this section, the Lieutenant Governor in Council may make regulations for the following: a provision for the payment by or on behalf of a beneficiary of a portion of the cost of providing any treatment or services rendered to the beneficiary by a hospital and the manner in which the payment is to be calculated and made; a.1 in respect of payments referred to in paragraph (a), prescribing different rates for different classes of beneficiaries, including classes based on the date on which beneficiaries were approved to receive, or did receive, treatment or services; b the exemption of persons or classes of persons from making payments referred to in paragraph (a); b.1 authorizing the minister to waive, in respect of a beneficiary or class of beneficiary, all or part of a payment referred to in paragraph (a); c [Repealed 2008-27-27.] d securing information from persons living in British Columbia thought necessary by the minister for the administration of this Act, the prescribing of forms by the minister for this purpose, and prescribing rules for the use of the forms; e the establishment of advisory committees and boards with objects and powers that appear advisable, and the appointment and remuneration of the members.