Extra-billing fines delayed as doctors, ministry agree to 1-month extension

B.C.'s ministry of health is extending, until the end of June, the time before fines and other penalties are levied on doctors who are still providing for-pay services.

The province says extra-billing practices in B.C. have cost the province$32-million in lost federal health-care transferpayments that arewithheld by Ottawa, because some doctors and clinics continue to charge for medical care privately.

InNovember, B.C. Supreme Court Madame Justice Janet Winteringham set a deadline of June 1 for the provisions andpenalties of B.C.'s new health-care act to kick in.

She stopped the province from immediately enacting the new provisions of the Medicare Protection Act, because of an ongoing constitutional challenge, as well asconcerns aroundthe impact penalizing doctors mighthave on patients.

This weekend, both the province and thedoctors involved in challenging the law agreed to extend the deadline by amonth.

"The Province and Plaintiffs have agreed to a brief extension of a more limited form of the injunction, limited to the Bill 92 enforcement provisions that were introduced last October, to the end of June," said the ministry in an emailed statement.

The province has long said it would move torecover some $15.9 million in fines incurred under the Canada Health Act for extra billing byprivate surgical clinics.

In October 2018, the ministry introduced Bill 92 to do just that. It alsorequired B.C. doctors who were providing services at private clinics that had contracts with health authoritiesto sign what some doctors describe as "compliance letters."

They were told tosign to confirm that they understoodthe law relating to extra billing and would not engage in for-pay medical practices at those private clinics.

But about 100 doctors challenged those letters in B.C. Supreme Court as a violation of their rights.

A May 30 ruling on the challenge stipulated the doctors wouldhave to file a new legal application if they plannedto keep challenging theletters.The legal team for Cambie Surgeries Corp. says it's reviewing itsnext move.

Province wants us to run out of money

Cambie Surgeries Corporation's Dr. Brian Day, who spearheaded the challenges,said he doubts it will happen.

He says the main focus is the constitutional challenge of the provincial legislation which doesn't allow for a mix of private-public medical care options he believes would cut wait-times and better serve patients. He says aside action over the letters would just cost too much time and money.

"One of the strategies of the government is to make us run out of money," Day told CBC.

It's unclear what will happen after the30-day extension ends.

Provincial officials saythey are reviewing a B.C. Supreme Court ruling handed down last week to determine next steps.

B.C. officials say extra billing is resulting in a loss of federal health transfer dollars that could reduce wait-times for patients by increasing surgery hours.

The province says federal funding to B.C. was reduced in 2018 by $16-million because some practitioners and clinics were extra billing patients.

This year,B.C. says itlost a further $16-million in health transfer payments money, it says, could be used to improve public health care.

Health Minister Adrian Dix has said a crackdown isneeded to prevent clinics that have ignored the rules for decades.

The constitutional challenge case is expected to wrap up this fall with a decision probably not until 2020. Somepredict that the judge maykeep extending the order until that trial is over.

In Winteringham's 74-page decision last November, the B.C. Supreme Court justice said that tough penalties on doctors would force clinic closures and cut limited services, causing more delays in a system already beset with long line-ups for surgery.

In the meantime, Day complains the province is moving to pull public contracts from surgeriesand surgeons who are refusing to comply with the new act, and he says that's making waits even longer for patients looking for these specialized surgeons' services.