Law & Governance

Law & Governance November -0001 : 0-0

Bill 8, the Commitment to the Future of Medicare Act, 2003


Bill 8 was introduced into the Ontario Legislature on November 27th, by Minister of Health and Long-Term Care, George Smitherman. Bill 8 has only passed first reading in the Legislature and still requires second and third reading and Royal Assent before passing into law.

The Content of the Bill

The Bill is divided into five parts:

Part Iestablishes the Ontario Health Quality Council, which has the mandate to monitor the health care system and report to the people of Ontario on its state, including access to publicly funded health services. Any person who is on the board or senior staff of a health system organization cannot serve on the Council. The Council must report annually to the Minister on the state of the health system.

Part II prohibits physicians and designated practitioners from charging or accepting "unauthorized payments" for insured services provided to insured persons. An unauthorized payment is a payment for an insured service rendered to an insured person which is not made under OHIP or pursuant to an agreement with the Ministry under section 2(2) of the Health Insurance Act. Once there is a determination that an unauthorized payment has been made, the General Manager of OHIP is authorized to reimburse the individual who made the payment, creating a debt to OHIP on the part of the party who received the unauthorized payment.

Part II also prohibits physicians, other designated practitioners, and hospitals from charging more than OHIP pays for an insured service. Similarly, payment cannot be accepted for the purpose of "queue jumping" - e.g., providing preferential access to an insured health service. In terms of uninsured services, Bill 8 prohibits the charging of block or annual fees by physicians, practitioners or hospitals for uninsured services, unless permitted by the regulations. The contravention of Part II will be a provincial offence, and conviction can result in an order for fines, compensation or restitution for loss, as well as court costs.

Part III is entitled "Accountability" and allows the Minister to require health resources providers to:

  • Enter into an accountability agreement with the Minister; and
  • Comply with directives issued by the Minister.

If a health resources provider meets or exceeds the terms of the accountability agreement, the Minister may recognize that provider in ways set out in the regulations. However, if a health resources provider fails to comply with the terms of the accountability agreement, the Minister can subject the provider to measures set out in the regulations.

Part IV amends the Health Insurance Act, including prohibiting the past practice that allowed physicians to bill patients directly for insured services and the patient to recover such payments from OHIP.

Part V repeals the Health Care Accessibility Act, and provides for the commencement and short title of the Bill.

Next Steps

About the Author(s)

Michael Watts, Kathy O'Brien and Patricia North


© 2003 Cassels Brock & Blackwell LLP


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