24

 

 

First Session, 48th General Assembly

65 Elizabeth II, 2016

BILL 24

AN ACT RESPECTING INSURED MEDICAL AND HOSPITAL SERVICES IN THE PROVINCE

Received and Read the First Time................................................................

Second Reading............................................................................................

Committee.....................................................................................................

Third Reading...............................................................................................

Royal Assent.................................................................................................

HONOURABLE JOHN HAGGIE

Minister of Health and Community Services

Ordered to be printed by the Honourable House of Assembly

 

EXPLANATORY NOTES

This Bill would enact the Medical Care and Hospital Insurance Act and repeal the Medical Care Insurance Act, 1999 and the Hospital Insurance Agreement Act.

The Bill would

·         continue the medical care and hospital insurance plans for the residents of the province;

·         provide for the payment to medical and dental practitioners for insured services provided by them to beneficiaries of the medical care insurance plan;

·         prohibit medical and dental practitioners in the province from billing a beneficiary of the medical care insurance plan for more than the rate at which the medical care insurance plan will pay for those services;

·         continue the levy paid by motor vehicle insurers to recover the cost of insured services resulting from injuries caused by motor vehicle accidents; and

·         allow the minister to recover the cost of insured services resulting from injuries caused by persons who are not insured by a policy to which the levy applies.

A BILL

AN ACT RESPECTING INSURED MEDICAL AND HOSPITAL SERVICES IN THE PROVINCE

Analysis


        1.   Short title

        2.   Definitions

              PART I
RIGHTS AND CONFIDENTIALITY

        3.   Rights

        4.   Confidentiality of information

              PART II
PLANS

        5.   Medical care and hospital insurance plans

        6.   Duty of residents to register

              PART III
ACCOUNTS AND PAYMENTS

        7.   Extra billing

        8.   Enrollment and election

        9.   Accounts

      10.   Time to submit account

      11.   Payments generally

      12.   Payment to participating practitioner

      13.   Payments to beneficiaries

      14.   Right not to be assigned or attached

      15.   Residents of other jurisdictions

      16.   Exception for emergencies

      17.   Professional corporation

      18.   Non-application of Act

      19.   Penalties for false statements

              PART IV
AUDITS

      20.   Definition

      21.   Audits

      22.   Powers and duties

      23.   Notice to practitioner

      24.   Withholding of payments

      25.   Overpayments

      26.   Review

      27.   Review board

      28.   Panel

      29.   Orders

      30.   Interest

      31.   Joint and individual liability

      32.   Appeal

      33.   Advisory committee

      34.   Alternative dispute resolution

              PART V
LEVY

      35.   Levy generally

      36.   Calculation and payment

      37.   Report and adjustment

      38.   Interest

      39.   Unpaid levy

      40.   Effect on licence

              PART VI
RECOVERY OF COSTS FOR SERVICES

      41.   Recovery by injured person generally

      42.   Claim for recovery

      43.   Proof of amount

      44.   Settlement of claim

      45.   Fees

              PART VII
GENERAL

      46.   Consultation with associations

      47.   Regulations

      48.   Regulations by minister

      49.   Offence and penalty

      50.   Date and effect of regulations

      51.   Offence

      52.   Actions barred

      53.   Non-liability

      54.   Practitioner liability

              PART VIII
TRANSITIONAL, CONSEQUENTIAL, REPEAL AND COMMENCEMENT

      55.   Transitional

      56.   RSNL1990 cA-22 Amdt.

      57.   SNL2004 cC-5.1 Amdt.

      58.   RSNL1990 cI-10 Amdt.

      59.   SNL1991 c16 Amdt.

      60.   SNL2008 cP-7.01 Amdt.

      61.   SNL1992 cR-17 Amdt.

      62.   SNL2001 cT-4.2 Amdt.

      63.   Repeal

      64.   Commencement


Be it enacted by the Lieutenant-Governor and House of Assembly in Legislative Session convened, as follows:

Short title

        1. This Act may be cited as the Medical Care and Hospital Insurance Act.

Definitions

        2. In this Act

             (a)  "beneficiary" means a person who is so defined under the regulations but does not include

                      (i)  a member of the Canadian Forces,

                     (ii)  a person serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada), or

                    (iii)  a resident for whom the required waiting period prescribed by the regulations has not elapsed;

             (b)  "dental association" means the Newfoundland and Labrador Dental Association continued under the Dental Act, 2008;

             (c)  "department" means the department presided over by the minister;

             (d)  "documentation" includes correspondence, health records, notes, charts, documents, material and other information;

             (e)  "earned vehicles" means the aggregate exposure, in car years, for automobile liability coverage derived from all statistical experience reported and accepted by the Superintendent of Insurance under all types of business other than type 3, miscellaneous and fleets on an earnings, receipts or payroll basis, for those vehicle types exhibited annually in the Actual Loss Ratio Exhibits covering the general categories of private passenger, farmers, commercial, motor cycles, snow vehicles and interurban trucks;

             (f)  "hospital" means an institution operated by the Crown or an agent of the Crown for the care of diseased, injured or sick people;

             (g)  "hospital insurance plan" means the hospital insurance plan referred to in section 5;

             (h)  "hospital service" means a service so defined under the regulations;

              (i)  "injury" includes a disability;

              (j)  "insured service" means the medical services and hospital services so defined under the regulations;

             (k)  "levy year" means a calendar year in which a levy is due from insurance companies with respect to automobile insurance business transacted in the province;

              (l)  "medical association" means the Newfoundland and Labrador Medical Association continued under the Medical Act, 2011;

           (m)  "medical care insurance plan" means the medical care insurance plan referred to in section 5;

             (n)  "medical service" means a service so defined under the regulations;

             (o)  "minister" means the minister appointed under the Executive Council Act to administer this Act;

             (p)  "participating practitioner" means a practitioner who is enrolled with the medical care insurance plan as a practitioner and for whom an election under section 8 is not in effect;

             (q)  "practitioner" means a person who is

                      (i)  lawfully entitled to practise medicine or dentistry in the province, or

                     (ii)  entitled under the regulations to provide insured services;

              (r)  "professional corporation" means a corporation

                      (i)  permitted under the Medical Act, 2011 to provide the services of a medical practitioner,

                     (ii)  permitted under the Dental Act, 2008 to provide the services of a dentist, or

                    (iii)  permitted under another statute to provide the services of a practitioner referred to in subparagraph (q)(ii);

             (s)  "resident" means a person who

                      (i)  is lawfully entitled to be or to remain in Canada,

                     (ii)  makes his or her home in the province, and

                    (iii)  is ordinarily present in the province,

but does not include a tourist, transient or visitor to the province; and

              (t)  "Superintendent of Insurance" means the Superintendent of Insurance appointed under the Insurance Companies Act.

PART I
RIGHTS AND CONFIDENTIALITY

Rights

        3. Nothing in this Act or the regulations shall

             (a)  interfere with or restrict the right of a beneficiary to select the practitioner, or other person providing services, from whom he or she will receive insured services;

             (b)  interfere with or restrict the right of a practitioner, or other person providing services, to accept or refuse to accept a patient who is a beneficiary; or

             (c)  interfere with or restrict the right of a practitioner, or other person providing services, to charge for insured services provided to a patient who is not a beneficiary.

Confidentiality of information

        4. (1) A person employed in the administration of this Act shall maintain confidentiality with respect to all matters that come to his or her knowledge in the course of that person's employment and shall not communicate the matters to another person, including an employee of the government, except

             (a)  to a person to whom an insured service is provided about that insured service;

             (b)  to a practitioner for a purpose relating to insured services that the practitioner has provided;

             (c)  to a professional corporation and its directors, officers and employees for a purpose relating to insured services that were provided through the corporation;

             (d)  for the purpose of the administration of this Act;

             (e)  for the purpose of consultation between the minister and the medical association or the dental association;

             (f)  to a person employed by the government to enforce support orders under the Support Orders Enforcement Act, 2006;

             (g)  to a professional regulatory or licensing body for the purpose of making an allegation;

             (h)  to a peace officer for the purpose of reporting a suspected offence;

              (i)  to a person who is empowered by a statute which requires disclosure of information;

              (j)  for the purpose of releasing information, including personal  health information as defined in the Personal Health Information Act, to the Newfoundland and Labrador Centre for Health Information in accordance with the Centre for Health Information Act and regulations made under that Act; or

             (k)  in other circumstances that may be established by the Lieutenant-Governor in Council.

             (2)  The Crown is not liable for damages caused to a person as a result of the release of information under subsection (1).

             (3)  An action for defamation against the minister or an employee of the department shall not be founded on the disclosure of information released under subsection (1).

PART II
PLANS

Medical care and hospital insurance plans

        5. (1) The minister shall administer a medical care insurance plan and a hospital insurance plan for the residents of the province.

             (2)  Each plan shall be administered and operated on a non-profit basis.

Duty of residents to register

        6. (1) Every resident shall register in accordance with the regulations.

             (2)  A resident who wilfully gives false information or withholds information necessary for the purpose of registration is guilty of an offence and liable on summary conviction to a fine of not more than $10,000.

PART III
ACCOUNTS AND PAYMENTS

Extra billing

        7. (1) A practitioner who provides insured services, whether or not he or she has made an election under section 8 which is in effect, shall not charge or collect from a beneficiary a fee for those insured services in excess of the amount payable under this Act and the regulations.

             (2)  A practitioner or other person who contravenes subsection (1) is guilty of an offence and liable on summary conviction to a fine of not more than $20,000 for each contravention.

Enrollment and election

        8. (1) A practitioner who wishes to submit accounts and collect payments directly from the medical care insurance plan for insured services provided to beneficiaries shall enroll with that plan as a participating practitioner in accordance with the regulations.

             (2)  The minister may refuse, suspend or cancel the enrollment of a practitioner as a participating practitioner under the medical care insurance plan in the circumstances prescribed by the regulations.

             (3)  A practitioner may, in writing, notify the minister of his or her election to collect payments in respect of insured services provided by the practitioner to beneficiaries otherwise than from the minister.

             (4)  An election under subsection (3) shall have effect from the first day of the first month beginning after the expiration of 60 days after the date on which the minister receives the notice of election.

             (5)  A practitioner who has made an election under subsection (3) may revoke the election by written notice to the minister.

             (6)  A revocation of election under subsection (5) shall have effect from the first day of the first month beginning after the expiration of 60 days after the date on which the minister receives the notice of revocation.

             (7)  Notwithstanding subsections (4) and (6), the minister may waive the time periods in those subsections where, in his or her opinion, it is reasonable to do so.

Accounts

        9. (1) In order to receive payment for an insured service provided to a beneficiary, a participating practitioner shall submit an account for the service to the minister together with the information that is required to substantiate the claim for payment in the form prescribed by the minister.

             (2)  In order to receive payment for an insured service provided to a beneficiary by a practitioner who is not a participating practitioner, the beneficiary shall submit an account to the minister together with the information that is required to substantiate the claim for payment in the form prescribed by the minister.

             (3)  Participating practitioners and beneficiaries shall supply further information where the minister requires it to clarify or substantiate his or her claim for payment.

Time to submit account

      10. (1) A participating practitioner shall submit an account for an insured service no later than 90 days after the practitioner provides the insured service.

             (2)  A beneficiary shall submit an account no later than 2 years after the insured service is provided to him or her. 

             (3)  Notwithstanding subsections (1) and (2), the minister may extend the time for submitting an account where, in his or her opinion, good cause for the extension is shown.

Payments generally

      11. The minister shall not pay for an insured service where the account for the service is not in accordance with this Act and the regulations.

Payment to participating practitioner

      12. (1) The minister shall, under this Act and the regulations, make payment to a participating practitioner for providing an insured service to a beneficiary according to the terms, conditions and rates prescribed by the minister.

             (2)  Where a participating practitioner provides an insured service to a beneficiary, he or she shall accept payment from the minister in respect of that insured service, and the participating practitioner shall accept the payment as payment in full for that service.

             (3)  Notwithstanding subsection (1), where a participating practitioner performs professional services for a public authority or body that has received the prior approval of the minister in addition to the provision of insured services to beneficiaries, the minister may, upon being satisfied that the participating practitioner is receiving remuneration for the provision of those professional services, enter into an arrangement with the public authority or body providing for the payment to it for the insured services provided to beneficiaries, and the minister shall make the payment in accordance with the arrangements made.

             (4)  A practitioner shall not receive payment from the minister for an insured service provided to a beneficiary unless the practitioner was a participating practitioner when the insured service was provided.

Payments to beneficiaries

      13. (1) Where an insured service is provided in the province to a beneficiary by a practitioner other than a participating practitioner, the minister shall, under this Act and the regulations, make payment to the beneficiary in respect of that insured service according to the terms, conditions and rates prescribed by the minister.

             (2)  Where an insured service is provided outside the province to a beneficiary, the minister shall make payment in accordance with this Act and the regulations.

             (3)  The right of the beneficiary to receive payment from the minister for insured services provided under subsection (1) is a contractual right and the beneficiary is entitled to receive payment from the minister in respect of those services in an amount equal to the amount that would be payable to a participating practitioner by the minister under this Act and the regulations.

Right not to be assigned or attached

      14. The right of a beneficiary to receive payment from the minister in respect of insured services provided to the beneficiary shall not be assigned, and an amount owing in respect of the right shall not be charged or attached, and a transaction purporting to assign the right or to charge or attach the amount is void.

Residents of other jurisdictions

      15. Where an insured service is provided in the province to a person who is an insured person of another jurisdiction in Canada by other than a participating practitioner, the responsibility for payment will not rest with the medical care insurance plan or the hospital insurance plan.

Exception for emergencies

      16. Notwithstanding subsection 12(4), where an insured service is provided in the province to a beneficiary in an emergency, the minister may make payment to a practitioner for that insured service even though the practitioner was not a participating practitioner when the service was provided.

Professional corporation

      17. (1) Notwithstanding any other provision of this Act or the regulations, a professional corporation may submit accounts and be paid by the minister in respect of insured services provided by a participating practitioner through the professional corporation to a beneficiary.

             (2)  A professional corporation submitting accounts shall comply with sections 9, 10 and 12 of this Act as if it were a participating practitioner.

             (3)  Where a professional corporation submits an account for insured services, every participating practitioner whose services are included in that account is considered to have certified that the information provided about his or her services is true.

Non-application of Act

      18. (1) Where a practitioner providing insured services is not a participating practitioner and the practitioner provides an insured service to a beneficiary, the practitioner is not subject to this Act or the regulations relating to the provision of insured services to beneficiaries or the payment to be made for the services except that he or she shall

             (a)  provide the beneficiary to whom the practitioner has provided the insured service with the information required by the minister to enable payment to be made under this Act to the beneficiary in respect of the insured service; and

             (b)  not charge or collect from a beneficiary in respect of an insured service an amount in excess of the amount which would be payable to a participating practitioner by the minister under this Act or the regulations.

             (2)  Where a practitioner who is not a participating practitioner provides insured services through a professional corporation, the professional corporation is not, in relation to those services, subject to this Act or the regulations relating to the provision of insured services to beneficiaries or the payment to be made for the services except that the professional corporation and the practitioner providing the insured services shall comply with paragraphs (1)(a) and (b).

             (3)  Notwithstanding subsections (1) and (2), a practitioner providing insured services who is not a participating practitioner and a professional corporation through which a practitioner who is not a participating practitioner provides insured services are subject to Part IV of this Act.

Penalties for false statements

      19. (1) A practitioner providing insured services to a beneficiary who wilfully gives false information or wilfully makes a false statement in a report, form or return required to enable a payment to be made under this Act or the regulations is guilty of an offence and liable on summary conviction to a fine of not less than $10,000 and not more than $20,000.

             (2)  A person, other than a practitioner providing insured services to a beneficiary, who wilfully gives false information or wilfully makes a false statement in a report, form or return prescribed by or required for the purpose of this Act or the regulations is guilty of an offence and liable on summary conviction to a fine of not less than $10,000 and not more than $20,000.

             (3)  A professional corporation that wilfully gives false information or wilfully makes a false statement in a report, form or return required to enable a payment to be made under this Act or the regulations is guilty of an offence and liable on summary conviction to a fine of not less than $15,000 and not more than $25,000.

             (4)  The liability of a practitioner under subsection (1) is not affected because the practitioner provides services through a professional corporation.

PART IV
AUDITS

Definition

      20. In this Part, "practitioner" includes

             (a)  a participating practitioner;

             (b)  a person who was formerly a participating practitioner under this Act or a participating physician under the Medical Care Insurance Act, 1999; and

             (c)  a person who was formerly a practitioner.

Audits

      21. (1) The minister may appoint auditors under this Act to audit accounts and claims for payment by practitioners and the patterns of practice or billing followed by practitioners including

             (a)  accounts and claims without proper documentation;

             (b)  accounts and claims for services which are not insured services;

             (c)  accounts and claims for insured services which contain billing errors for services provided;

             (d)  accounts and claims for insured services which are not medically necessary;

             (e)  accounts and claims in violation of this Act or the regulations; and

             (f)  patterns of practice or billing that do not follow the average pattern of practice or billing.

             (2)  An audit may be performed in respect of accounts and claims for payment made and patterns of practice or billing followed by practitioners before this Act came into force.

             (3)  Audits performed under this Act shall be performed according to generally accepted auditing standards including statistical sampling, estimation, extrapolation or those techniques prescribed by the regulations.

             (4)  The minister may prepare guidelines and criteria for the guidance of practitioners that may be applied to the patterns of practice or billing followed by practitioners.

Powers and duties

      22. (1) An auditor performing an audit may, at reasonable times and for reasonable purposes of the audit,

             (a)  without a warrant, enter and inspect premises where insured services are provided or where documentation required for the purpose of this Act is stored;

             (b)  examine documentation and make copies of it;

             (c)  interview or question a practitioner and his or her employees on matters that relate to the provision of insured services;

             (d)  interview or question persons employed in a hospital, clinic or other premises in which insured services are provided on matters that relate to the provision of insured services; and

             (e)  interview or question a person on matters that may be relevant to an audit.

             (2)  An examination of documentation referred to in paragraph (1)(b) includes an examination of electronic records and an auditor may make a copy of that documentation, including electronic records, in the manner that, in his or her opinion, is necessary, including photocopying, scanning and electronic copying of data.

             (3)  Notwithstanding paragraph (1)(a), an auditor performing an audit shall not enter a dwelling-house without the consent of the occupant except under the authority of a warrant.

             (4)  A person shall, on the request of an auditor,

             (a)  produce documentation and permit examination of it;

             (b)  provide information required and answer all questions of the auditor relating to the documentation; and

             (c)  supply copies of or extracts from the documentation.

             (5)  The minister may set time periods for producing and examining documentation, providing information, answering questions or supplying copies or extracts under subsection (4).

             (6)  Notwithstanding subsection (5), where the auditor and the person agree, the time periods set by the minister under subsection (5) may be extended.

             (7)  A person shall not hinder, obstruct or interfere with an auditor doing anything that the auditor is authorized to do under this section or prevent or attempt to prevent the auditor from doing any such thing.

             (8)  A person shall not knowingly make a false or misleading statement, either orally or in writing, or provide or produce false documentation to an auditor who is carrying out duties and functions under this Act.

             (9)  An action shall not lie against a person for providing documentation under this section.

          (10)  Paragraphs (1)(b) to (e) and subsection (4) apply notwithstanding a provision of any other Act.

Notice to practitioner

      23. (1) Upon completion of the audit, the auditor shall notify the practitioner in writing of the findings of the audit and advise the practitioner of the right to alternative dispute resolution, a review of the audit under section 26 or both.

             (2)  Notice under this section shall be sent by registered mail.

             (3)  Notice of the findings of an audit sent by registered mail in accordance with subsection (2) shall be considered to be received on the fifth day following the day the notice is sent by registered mail, unless the person to whom it is sent establishes that, acting in good faith, the person did not receive the notice or did not receive it until a later date.

             (4)  Within 30 days of the auditor notifying the practitioner of the findings of the audit under subsection (1), the minister shall refer the findings of the audit in writing to the medical association or the dental association which shall, where appropriate, make submissions to the minister relating to the findings within 14 days of the referral.

             (5)  The practitioner may respond to the findings of the audit in writing to the minister no more than 30 days from the receipt of the notice of the findings of the audit under subsection (1).

             (6)  After reviewing the practitioner's response, the minister may revoke one or more of the findings of the audit and notify the practitioner accordingly.

Withholding of payments

      24. Where an auditor notifies a practitioner of the findings of an audit under subsection 23(1), the minister may withhold from payments which would, apart from findings of the audit to the contrary, be due to be paid to a participating practitioner or professional corporation under section 12 for the provision of insured services, up to the amount which, in the opinion of the minister, constitutes the value of the subject matter raised by the audit, but only until the matter has been finally determined, subject always to the right of permanent retention or withholding for the purpose of compliance with an order made under section 29 or an agreement made under paragraph 25(1)(a).

Overpayments

      25. (1) Where the findings of an audit indicate that there has been an overpayment to the practitioner or the professional corporation, the minister may recover all or part of the amount of the overpayment plus interest under

             (a)  an agreement between the minister and the practitioner or the professional corporation; or

             (b)  an order of the minister made under section 29.

             (2)  Where there is an agreement under paragraph (1)(a), the minister shall not make an order under section 29 unless the practitioner or professional corporation does not comply with the agreement.

Review

      26. (1) A practitioner, either personally or through another person acting on his or her behalf with his or her written consent, may request a review by a review board of the findings of an audit performed under this Act.

             (2)  A request for a review under this section shall be made in writing to the minister no more than 30 days from the receipt of the notice of the findings of the audit provided under subsection 23(1).

             (3)  A request for review may be included in a response submitted under subsection 23(5).

             (4)  A review board shall be appointed within 60 days of receipt of the request for a review.

             (5)  The review board shall conduct a hearing within 60 days of its appointment.

             (6)  The review board shall make a written report of its findings and recommendations to the minister within 30 days of the completion of the hearing.

             (7)  Notwithstanding subsections (2), (4), (5) and (6), where the parties to the hearing agree, the time periods referred to in those sections may be extended.

             (8)  The parties to the hearing are the practitioner, the professional corporation and the minister.

             (9)  A practitioner shall not request a review of an amount identified as owing under an audit conducted in accordance with this Act by reason only that the amount was determined from a random sample of the practitioner's accounts or claims for payment and by the application of statistical methodology to the account or claim for payment from which the sample was drawn as opposed to a case by case examination of the accounts and claims for payment in respect of which the audit is made.

          (10)  Only non-identifying personal health information shall be disclosed in written or oral representations to the review board.

Review board

      27. (1) A review board appointed under subsection 26(4) shall consist of the following persons, all of whom shall first be appointed to the panel established under section 28:

             (a)  one member appointed by the minister;

             (b)  one member appointed by the practitioner or professional corporation; and

             (c)  one member appointed jointly by the minister and the practitioner or professional corporation.

             (2)  Where an appointment to the review board under paragraph (1)(b) is not made within 30 days of the request to review, the minister shall appoint a member to the review board on behalf of the practitioner or professional corporation from the panel established under section 28.

             (3)  Where the minister and the practitioner or professional corporation are not able to agree on the appointment of a member under paragraph (1)(c), the members appointed under paragraphs (1)(a) and (b) shall appoint the third member of the review board.

             (4)  Where the members appointed under paragraphs (1)(a) and (b) are not able to agree on the appointment of the third member under subsection (3), the minister or the practitioner or professional corporation may apply to the Trial Division for an order appointing the third member of the review board.

             (5)  The review board shall determine the procedure for the hearing.

             (6)  Notwithstanding subsection (5), the procedure adopted for the hearing shall permit the parties to be represented by a solicitor or other person, to lead evidence from witnesses and to produce documents.

             (7)  For the purpose of this Act, the review board has the powers that are or may be conferred on a commission under the Public Inquiries Act, 2006.

Panel

      28. (1) The Lieutenant-Governor in Council shall appoint a panel of not more than 15 persons to act as members of review boards and

             (a)  at least 5 of those persons shall be medical practitioners selected from a list of nominees provided by the medical association; and

             (b)  at least 2 of those persons shall be dentists selected from a list of nominees provided by the dental association.

             (2)  The members of the panel shall be appointed for a term of up to 3 years and are eligible for reappointment.

             (3)  Where the term of a member of the panel expires, he or she continues to be a member until reappointed or replaced.

Orders

      29. (1) The minister may make a written order after reviewing

             (a)  the audit findings;

             (b)  the submissions made by the medical association or the dental association, where the association made submissions under subsection 23(4);

             (c)  the practitioner's response, where the practitioner responded to the audit findings under subsection 23(5);

             (d)  the report of the review board, where a hearing is held by a review board appointed under subsection 26(4); and

             (e)  the advice of the advisory committee, where the minister referred the matter to a committee under subsection 33(1).

             (2)  In an order under subsection (1), the minister may do one or more of the following:

             (a)  order the practitioner or the professional corporation to pay to the minister, within the time period specified in the order, an amount determined to have been overpaid to the practitioner or the professional corporation and where the minister makes such an order, he or she shall also order the practitioner or professional corporation to pay interest on the amount of the overpayment;

             (b)  where the minister makes an order under paragraph (a), also order that all or part of the amount of the overpayment and interest be deducted from an amount payable to the practitioner or the professional corporation under the medical care insurance plan;

             (c)  order the practitioner or the professional corporation to adopt an appropriate pattern of practice or billing, as specified by the minister in the order;

             (d)  order the practitioner or professional corporation to pay a penalty totalling an amount not greater than the amount estimated to be the loss sustained by the Crown because of a payment to the practitioner, professional corporation or beneficiary for insured services which relate to the subject of the audit plus 10% of that amount and, for the purpose of this paragraph, the estimated amount shall, subject to proof to the contrary or appeal in accordance with section 32, be considered to be the loss sustained;

             (e)  strike the name of the practitioner from the list of participating practitioners under the medical care insurance plan for the time period specified in the order;

             (f)  reduce an amount payable to a practitioner or professional corporation under the medical care insurance plan by a percentage for the time period specified in the order; or

             (g)  order the practitioner or professional corporation to pay all or part of the costs of either or both of the audit or the review board hearing.

             (3)  The minister may base an order on any relevant source of information, including a source created on a statistical basis or by a comparison between insured services provided by the practitioner and corresponding insured services provided by other practitioners, but the minister is not required to review a particular insured service the practitioner provided.

             (4)  Notwithstanding subsection 27(5) or (6), the minister may make an order where the practitioner or professional corporation does not appear at the review board hearing after having been given written notice of the review board hearing.

             (5)  The minister shall provide a copy of an order made under this section to

             (a)  the practitioner or the professional corporation; and

             (b)  the medical association or the dental association.

             (6)  Where the minister makes an order, he or she may advise the appropriate professional regulatory or licensing body that an order has been made respecting the practitioner or the professional corporation.

             (7)  An order made by the minister may be filed with the Trial Division and, upon filing, is enforceable in the same manner as an order or a judgment of that court.

Interest

      30. Interest ordered to be paid to the minister under paragraph 29(2)(a) or agreed to be paid under an agreement under paragraph 25(1)(a) shall be calculated in accordance with the regulations.

Joint and individual liability

      31. Where an order is made under section 29 against a professional corporation, a practitioner who provided services which are, or are related to, the subject of the audit in respect of which the order was made, is jointly and individually liable with the professional corporation for the order imposed on the professional corporation.

Appeal

      32. (1) A practitioner or professional corporation aggrieved by an order of the minister under section 29 may, within 60 days from the date of the order, appeal against the order to a judge of the Trial Division by filing a notice of appeal with the court, and by serving a copy of the notice of appeal on the minister.

             (2)  Notwithstanding a rule or practice to the contrary, the notice of appeal shall

             (a)  set out in detail the allegations of the appellant and the grounds upon which the order is appealed; and

             (b)  be signed by the appellant or his or her solicitor.

             (3)  The appellant shall, within 14 days after serving the notice of appeal on the minister under this section, apply to a judge for the appointment of a day for the hearing of the appeal and shall, not less than 30 days before the hearing, serve upon the minister a written notice of the day appointed for the hearing of the appeal.

             (4)  The minister shall produce to the judge hearing the appeal all papers and documents in his or her possession relevant to the subject matter of the appeal.

             (5)  The judge shall hear the appeal and the evidence presented by the appellant and the minister in a summary manner and, after reviewing all aspects which the judge, in his or her discretion believes to be appropriate in the interests of justice, equity and fairness, decide the appeal by

             (a)  upholding, amending or revoking the order; or

             (b)  making another order or decision which he or she believes to be appropriate in the circumstances.

             (6)  The judge may order costs for or against the appellant or the Crown and fix the amount.

             (7)  An appeal may be taken from an order or decision of the judge to the Court of Appeal upon a point of law raised on the hearing of the appeal, and the rules governing appeals to that court from an order or decision of a judge of the Trial Division apply to appeals under this subsection.

             (8)  The filing of a notice of appeal under this section or the appeal itself shall not affect the order of the minister which shall remain in force pending the outcome of the appeal.

Advisory committee

      33. (1) The minister may, in accordance with the regulations, appoint a committee to review and advise upon matters relating to audits performed under this Act that are referred to it by the minister.

             (2)  The minister shall, by regulation, prescribe the terms of reference for the committee, the composition of the committee and the duties of the committee. 

Alternative dispute resolution

      34. Notwithstanding any other provision of this Part, the minister may employ alternative dispute resolution mechanisms in resolving the matters related to audit reviews and appeals in the manner prescribed by the regulations.

PART V
LEVY

Levy generally

      35. (1) This Part applies where insured services are provided with respect to an injury and the injury is caused by, or contributed to by, or results from, a motor vehicle accident in which the person, whose negligence, act or omission caused, contributed to or resulted in the injury, is insured at the date of the accident by a policy of insurance through a licensed insurer on whom a levy was imposed under this Act for the levy year in which the accident occurred.

             (2)  The minister shall impose a levy to be paid by every licensed motor vehicle insurer with respect to each vehicle insured by that insurer for the purpose of recovering the cost of insured services received by beneficiaries as a result of injuries where the injuries were caused by, or contributed to by, or result from, motor vehicle accidents.

Calculation and payment

      36. (1) Every licensed insurer who carries on the business of automobile insurance in the province shall, in respect of each levy year, pay to the minister a levy determined by multiplying the base rate per vehicle by the number of earned vehicles at the end of each levy year.

             (2)  Every licensed insurer liable to pay a levy under subsection (1) shall before the last day of March, June, September and December in each levy year pay one quarter of the levy estimated to be payable as calculated by the minister or his or her representative by reference to the number of earned vehicles and the base rate per vehicle for the immediately preceding levy year.

             (3)  Where a licensed insurer provides the minister with satisfactory proof that the actual earned vehicle count will vary significantly from the previous year on which the estimated levy is based, the minister may adjust the estimated levy.

Report and adjustment

      37. (1) The Superintendent of Insurance shall provide annually to the minister a report detailing actual automobile experience including the number of earned vehicles and the number of claims for every licensed insurer as provided under the Insurance Companies Act.

             (2)  Based on the report in subsection (1), the minister shall issue an adjustment invoice or credit as applicable to licensed insurers in respect of the immediately preceding levy year payable or refundable within 30 days of issuance.

Interest

      38. Where the levy is not paid in full on the due date, the licensed insurer shall pay to the minister interest on the unpaid portion from the due date at an annual rate equal to the sum of the prime lending rate of the bank holding the province's general revenue fund plus 4 percentage points.

Unpaid levy

      39. An amount payable under sections 35 to 38 constitutes a debt due the Crown and the minister may bring an action for its recovery in a court in the province.

Effect on licence

      40. The insurer shall pay a levy payable under sections 35 to 38 before the issuance or renewal of a licence under the Insurance Companies Act.

PART VI
RECOVERY OF COSTS FOR SERVICES

Recovery by injured person generally

      41. (1) This Part applies where insured services are provided with respect to an injury and the injury is caused by, contributed to by or results from

             (a)  the negligence, act or omission of a person; or

             (b)  a motor vehicle accident in which the person whose negligence, act or omission caused, contributed to or resulted in the injury is not insured at the date of the accident by a policy of insurance through a licensed insurer liable to pay a levy under this Act.

             (2)  For the purpose of this Part,

             (a)  the amount paid for insured hospital services that are received by a beneficiary shall be an amount equal to the charges of the hospital in which the services were provided, calculated in accordance with this Act and the regulations, that the beneficiary would have been required to pay if he or she was not entitled to receive the services as insured hospital services under this Act; and

             (b)  the cost of insured medical services provided is the cost as established in this Act and the regulations.

             (3)  In this Part, "insured services" includes any services for which an amount has been or may in the future be paid by the minister in relation to negligence or an act or omission including medical and hospital services and any services prescribed by the regulations as insured services for the purpose of this Part.

Claim for recovery

      42. (1) Where a beneficiary suffers an injury caused by, contributed to by or resulting from the negligence, act or omission of a person for which the beneficiary received insured services, including the costs of future insured services, the beneficiary

             (a)  has the same right to recover the amount paid for the insured services against the person whose negligence, act or omission caused, contributed to or resulted in the injury as the beneficiary would have had if the beneficiary had been required to pay for the insured services; and

             (b)  shall claim and seek to recover the costs of the insured services if the beneficiary makes a claim for the injury suffered against the person whose negligence, act or omission caused, contributed to or resulted in the injury.

             (2)  Where a beneficiary recovers an amount in respect of insured services under subsection (1), he or she shall without delay pay the amount recovered to the minister. 

             (3)  Where a beneficiary does not pay the amount to the minister under subsection (2) within a reasonable time, the minister may recover the amount from the beneficiary as a debt due the Crown.

             (4)  The minister shall be subrogated to the rights of a beneficiary under this section to recover any amount paid by the minister for insured services provided to that beneficiary and an action may be brought by the minister, either in his or her name or in the name of the beneficiary, for the recovery of that amount.

             (5)  It is not a defence to an action brought by the minister under subsection (4) that a claim for damages has been adjudicated upon unless the claim included a claim for the amount paid for insured services and it is not a defence to an action for damages for an injury brought by a beneficiary who has received insured services that an action taken by the minister under subsection (4) has been adjudicated upon.

             (6)  Where an action has not been brought by or on behalf of that beneficiary under subsection (1) for the recovery of damages arising out of the injury, the minister upon service of notice on the beneficiary may bring an action in his or her own name or in the name of the beneficiary for the recovery of the cost of the insured services, and before trial of the action that beneficiary may join in the action another claim arising out of the same occurrence upon the conditions as to costs or otherwise that to the court may seem just and may in that case effect settlement of that claim.

             (7)  A beneficiary and the minister shall share in proportion to their respective losses in any recovery in accordance with the terms and conditions prescribed by the regulations where, as a result of a claim under this section,

             (a)  the claim is settled or a judgment is obtained; and

             (b)  insufficient funds are available to provide complete recovery to the beneficiary for his or her losses and injuries and to pay the costs of the insured services referred to in section 41,

but nothing in this subsection prevents the minister from waiving in whole or in part the minister's share of an amount recovered where, in the opinion of the minister, the circumstances warrant.

             (8)  Where a person whose negligence, act or omission caused, contributed to or resulted in injury to a beneficiary is insured by a liability insurer, the liability insurer may pay to the minister any amount referable to a claim for recovery of the cost of insured services that would otherwise be paid to the beneficiary and payment of that amount to the minister discharges the liability of the insurer to pay that amount to the beneficiary or to any person claiming on behalf of the beneficiary.

Proof of amount

      43. In an action under section 42, a certificate of a person designated by the minister as to the amount paid for or cost of insured services provided to a beneficiary is admissible in evidence and is, in the absence of evidence to the contrary, proof of that amount.

Settlement of claim

      44. (1) A release or settlement of a claim or judgment based upon a cause of action for damages for an injury where the beneficiary has received insured services shall not be binding upon the Crown unless the minister has approved the release or settlement in writing.

             (2)  A beneficiary acting on his or her own behalf or a person acting on behalf of a beneficiary shall not make a settlement of a claim based upon a cause of action for damages for an injury where the beneficiary has received insured services without the approval of the minister in writing.

             (3)  Notwithstanding anything in this section, the approval of the minister in writing is required under subsections (1) and (2) even where the beneficiary or a person acting on his or her behalf has not made a claim.

Fees

      45. Notwithstanding any other provision of this Act, the minister may, in accordance with the regulations, authorize the payment of a fee to a barrister or solicitor who makes a claim and recovers an amount in respect of the cost of insured services that are received by the beneficiary.

PART VII
GENERAL

Consultation with associations

      46. The medical association and the dental association shall be consulted by the minister with reference to the rates of payments to be made under this Act in respect of insured services provided to beneficiaries by practitioners, the manner and form in which the payments to practitioners shall be made and changes in connection with payments and, where in the opinion of the minister it is necessary, with reference to general questions of principle concerning the practices of medicine and dentistry.

Regulations

      47. The Lieutenant-Governor in Council may make regulations

             (a)  prescribing which services are insured services for the purpose of this Act;

             (b)  prescribing which services are not insured services for the purpose of this Act;

             (c)  prescribing the facilities in which insured services may be provided;

             (d)  prescribing which services are hospital services for the purpose of this Act;

             (e)  prescribing which services are medical services for the purpose of this Act;

             (f)  prescribing to what extent and under what circumstances insured services shall be paid for by the minister where the insured services are received by beneficiaries while they are out of the province;

             (g)  prescribing a procedure for reviewing decisions relating to whether, under this Act and the regulations,

                      (i)  a person is a resident,

                     (ii)  a person is a beneficiary, and

                    (iii)  a beneficiary is entitled to payment;

             (h)  respecting the techniques that may be used during an audit;

              (i)  respecting the calculation of interest for the purpose of section 30;

              (j)  defining the term "policy of insurance" for the purpose of subsections 35(1) and 41(1);

             (k)  prescribing the fees that may be paid to barristers or solicitors in accordance with section 45 and any terms and conditions respecting the payment of those fees;

              (l)  providing for the investigation of complaints of violations of this Act or regulations or of an order made under this Act or the regulations;

           (m)  providing for the holding of inquiries into a complaint referred to in paragraph (l) or into the operation of this Act or into a charge or complaint that a person has contravened this Act or the regulations, or has wilfully made a false statement in a form, return, account or statement required to be completed or made under this Act, or into another matter arising in the administration of this Act, and providing that the person holding the inquiry shall have the powers that may be conferred upon a commission under the Public Inquiries Act, 2006 including the power to take evidence under oath or affirmation;

             (n)  notwithstanding any other provision of this Act, adapting, modifying, qualifying or altering the provisions of this Act to meet the requirements of the Canada Health Act for the purpose of rendering the medical care insurance plan one in respect of which a contribution is payable by Canada under the Canada Health Act;

             (o)  defining a word or phrase used but not defined in this Act; and

             (p)  generally, to give effect to the purpose of this Act.

Regulations by minister

      48. (1) The minister may make regulations

             (a)  to prevent unnecessary use or abuse of insured services;

             (b)  prescribing the waiting period that is required to elapse before a resident becomes a beneficiary and the other conditions to be observed by a resident in order that he or she may qualify as a beneficiary;

             (c)  prescribing the conditions to be observed by a resident to continue to qualify as a beneficiary;

             (d)  respecting the registration of residents for the purpose of this Act, including the information required and the form of proof of that information;

             (e)  respecting the expiry of registration of residents;

             (f)  defining which residents are beneficiaries for the purpose of this Act;

             (g)  respecting the manner in which persons may be identified as beneficiaries including the use, return, replacement or destruction of identification issued by the minister;

             (h)  defining

                      (i)  the terms and conditions relating to the provision of dental and other health related services, and

                     (ii)  to what extent and under what circumstances dental and other health related services shall be paid for by the minister;

              (i)  prescribing for the purpose of subparagraph 2(q)(ii) which persons are entitled to provide insured services;

              (j)  establishing the procedure by which practitioners enroll as participating practitioners;

             (k)  following consultation with the medical association and the dental association, prescribing the circumstances under which the minister may refuse, suspend or cancel the enrollment of a practitioner as a participating practitioner under the medical care insurance plan;

              (l)  respecting the manner and form in which accounts and claims for payment shall be submitted;

           (m)  respecting the information that shall be submitted with accounts and claims for payment including the manner and form of that information;

             (n)  prescribing, by reference to professional or other scales of fees, the rates of payments to be made under this Act in respect of insured services provided to beneficiaries by practitioners;

             (o)  respecting the manner and form in which payments to practitioners, professional corporations and other persons shall be made under this Act;

             (p)  governing the method of assessing accounts and claims for payment submitted by practitioners, professional corporations and other persons;

             (q)  prescribing the manner in which alternative dispute resolution mechanisms may be employed in resolving matters related to audits including reviews and appeals of audits;

              (r)  respecting the application of this Act to a professional corporation;

             (s)  following consultation with the medical association and the dental association, prescribing a formula for the determination of the average pattern of practice for the whole or an area of the province and defining the words "pattern of practice" for the purpose of sections 21 and 29;

              (t)  establishing an advisory committee under section 33;

             (u)  establishing a formula for the determination of the base rate for each vehicle under section 36;

             (v)  prescribing the terms and conditions with respect to the minister and a beneficiary sharing in proportion their respective losses under subsection 42(7);

            (w)  for the provision by hospitals of insured services upon uniform terms and conditions to beneficiaries of the province under the conditions specified in the Canada Health Act and regulations made under that Act;

             (x)  for the payment of amounts to hospitals from funds voted by the Legislature in respect of the cost of insured services, and the payment of those amounts that may be specified in an agreement when insured services are provided to beneficiaries of the province, who are eligible for them and entitled to them by hospitals that are owned or operated by Canada or are situated outside the province;

             (y)  providing for the furnishing to the Minister of Health for Canada of the information and at the times that the minister may require for the purpose of the Canada Health Act;

             (z)  defining a word or phrase used but not defined in this Act; and

          (aa)  generally, to give effect to the purpose of this Act.

             (2)  Regulations made under paragraph (1)(n) do not constitute subordinate legislation for the purpose of the Statutes and Subordinate Legislation Act.

Offence and penalty

      49. The Lieutenant-Governor in Council may, in regulations made under section 47, and the minister may, in regulations made under section 48, provide that a person who contravenes a specified provision of the regulations is guilty of an offence and may prescribe penalties to which the person is liable, on summary conviction, for failing to comply with or otherwise contravening the provisions of the regulations.

Date and effect of regulations

      50. Regulations made under section 47 or 48 may be made with retroactive effect.

Offence

      51. (1) Unless otherwise provided, a person who contravenes this Act or the regulations, except those regulations made under paragraph 48(1)(n), is guilty of an offence and where no penalty is specifically provided in this Act or the regulations, liable on summary conviction in the case of a first conviction to a fine not more than $10,000 and in the case of a second or subsequent conviction for a similar offence to a fine not more than $20,000.

             (2)  For the purpose of subsection (1) a conviction is not a second or subsequent conviction unless it is in respect of an offence committed within 12 months after a prior offence.

Actions barred

      52. An action shall not lie against practitioners or professional corporations providing insured services, or an employee of those practitioners and professional corporations, relating to information provided to the minister with respect to an insured service provided to a beneficiary.

Non-liability

      53. (1) An action relating to providing insured services under this Act shall not lie against the minister or a person employed in the department with respect to the negligence, act or omission of a practitioner, professional corporation or other person providing the services or of an employee or a person acting on behalf of a practitioner, professional corporation or other person.

             (2)  An action shall not lie against a member of a medical or other committee serving the minister in a consultative or advisory capacity in respect of anything done or omitted to be done in good faith in the performance of the duties of the member.

Practitioner liability

      54. It is not a defence to a prosecution of a practitioner for an offence under this Act that insured services were provided through a professional corporation or that a claim for payment in respect of services provided by that practitioner was submitted by a professional corporation.

PART VIII
TRANSITIONAL, CONSEQUENTIAL, REPEAL AND COMMENCEMENT

Transitional

      55. (1) Where a person is registered with the medical care insurance plan in relation to the Medical Care Insurance Act, 1999 or the hospital insurance plan in relation to the Hospital Insurance Agreement Act immediately before the coming into force of this Act, he or she is considered to be registered in the equivalent plan under this Act.

             (2)  Where a practitioner is enrolled with the medical care insurance plan in relation to the Medical Care Insurance Act, 1999 or the hospital insurance plan in relation to the Hospital Insurance Agreement Act immediately before the coming into force of this Act, he or she is considered to be enrolled in the equivalent plan under this Act.

             (3)  Where an election of a practitioner to collect payments in respect of insured services provided by the practitioner to beneficiaries other than from the minister is in effect immediately before the coming into force of this Act, that election is considered to be an election under section 8 of this Act and continues to be in effect.

             (4)  Where an account for an insured service was submitted to the minister for payment but had not yet been paid immediately before the coming into force of this Act, that account is considered to be an account submitted under this Act.

             (5)  Where an arrangement under subsection 10(2) of the Medical Care Insurance Act, 1999 is in effect immediately before the coming into force of this Act, that arrangement is considered to be an arrangement made under subsection 12(3) of this Act.

             (6)  Where a notice under subsection 15(1) of the Medical Care Insurance Act, 1999 was sent in relation to an audit, investigation or inquiry under that Act before the coming into force of this Act, the Medical Care Insurance Act, 1999 shall apply to the audit, investigation or inquiry as though that Act were still in force.

             (7)  Notwithstanding subsection (6), subsections 27(2) and 29(4) of this Act shall apply to all audits, investigations and inquiries regardless of when and whether a notice under subsection 15(1) of the Medical Care Insurance Act, 1999 has been sent.

             (8)  Where a notice under subsection 15(1) of the Medical Care Insurance Act, 1999 was not sent in relation to an audit, investigation or inquiry under that Act before the coming into force of this Act and the audit, investigation or inquiry is ongoing on the coming into force of this Act, this Act shall apply to the audit, investigation or inquiry.

             (9)  Persons who are members of a review board appointed under subsection 15(5) of the Medical Care Insurance Act, 1999 immediately before the coming into force of this Act shall continue to be members of that review board.

          (10)  Persons who are members of the panel referred to in subsection 15(7) of the Medical Care Insurance Act, 1999 immediately before the coming into force of this Act shall continue to be members of the panel referred to in section 28 of this Act.

          (11)  Orders made under section 15 of the Medical Care Insurance Act, 1999 and agreements between the minister and a physician after an audit, investigation or inquiry which are in effect immediately before the coming into force of this Act continue to be in effect as though they were orders and agreements made under this Act.

          (12)  Where a retainer agreement or contingency fee agreement signed by the minister was in effect immediately before the coming into force of this Act, the provisions of that agreement relating to the minister's claim for recovery under the Medical Care Insurance Act, 1999 continue to be in effect and shall not be subject to this Act but shall be subject to the Medical Care Insurance Act, 1999 as though that Act were still in force.

          (13)  A person shall only claim for the cost of future insured services under this Act where the cause of action on which the claim is based arises after this Act comes into force.

          (14)  Persons who are members of the Medical Consultants’ Committee under section 15 of the Physicians and Fees Regulations under the Medical Care Insurance Act, 1999 immediately before the coming into force of this Act shall continue to be members of that committee for the purposes of this Act.

RSNL1990 cA-22 Amdt.

      56. (1) Subsection 45.1(8) of the Automobile Insurance Act is repealed and the following substituted:

             (8)  For the purpose of this section a person shall not be considered to have insurance coverage or inadequate insurance coverage only because he or she receives or is entitled to receive compensation or benefits under the Medical Care and Hospital Insurance Act, the Income and Employment Support Act or the Workers' Compensation Act for injuries or damages arising out of an accident involving an automobile.

             (2)  Subsection 45.20(2) of the Act is repealed and the following substituted:

             (2)  Subsection (1) shall not apply to applications under the Medical Care and Hospital Insurance Act, the Income and Employment Support Act or the Workers' Compensation Act.

SNL2004 cC-5.1 Amdt.

      57. Subparagraph 16(d)(iv) of the Centre for Health Information Act is repealed and the following substituted:

                    (iv)  the Medical Care and Hospital Insurance Act,

RSNL1990 cI-10 Amdt.

      58. Subsection 14(10) of the Insurance Companies Act is repealed and the following substituted:

          (10)  Effective July 1, 1994, after notification by the Department of Health to the superintendent of any unpaid levy due under the Medical Care and Hospital Insurance Act, the superintendent shall prohibit the insurer from entering into new contracts of insurance or renewing existing contracts of insurance until the levy is paid.

SNL1991 c16 Amdt.

      59. Paragraph 11(4)(c) of the Jury Act, 1991 is repealed and the following substituted:

             (c)  the names, addresses and dates of birth of beneficiaries under the Medical Care and Hospital Insurance Act, but no other information respecting beneficiaries shall be provided; and

SNL2008 cP-7.01 Amdt.

      60. Paragraph 2(1)(m) of the Personal Health Information Act is repealed and the following substituted:

           (m)  "MCP" means the Newfoundland and Labrador Medical Care Plan administered under the Medical Care and Hospital Insurance Act;

SNL1992 cR-17 Amdt.

      61. Subsection 59(3) of the Royal Newfoundland Constabulary Act, 1992 is repealed and the following substituted:

             (3)  Paragraph (1)(b) does not apply to expenses for which provision is made for recovery by the minister under sections 41 to 45 of the Medical Care and Hospital Insurance Act.

SNL2001 cT-4.2 Amdt.

      62. Subparagraph 2(d)(ii) of the Tobacco Health Care Costs Recovery Act is repealed and the following substituted:

                     (ii)  insured services as defined under the Medical Care and Hospital Insurance Act, and

Repeal

      63. (1) The following Acts are repealed:

             (a)  Hospital Insurance Agreement Act; and

             (b)  Medical Care Insurance Act, 1999.

             (2)  The Medical Care Insurance Release of Information Order, Newfoundland and Labrador Regulation 132/97, published under the Medical Care Insurance Act, 1999, is repealed.

Commencement

      64. This Act comes into force on October 1, 2016.