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The Health Services Insurance Act
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This version is current as of May 27, 2016.
It has been in effect since November 5, 2015.

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C.C.S.M. c. H35

The Health Services Insurance Act

HER MAJESTY, by and with the advice and consent of the Legislative Assembly of Manitoba, enacts as follows:

Manitoba Health Services Insurance Plan

1(1)        The plan to be administered under this Act for insurance in respect of the costs of hospital services, medical services and other health services may be referred to, or shortly described, in Acts of the Legislature or regulations made thereunder, and otherwise as: "Manitoba Health Services Insurance Plan".

Continuation of previous plans

1(2)        The Manitoba Health Services Insurance Plan shall be, for all purposes, deemed to be a continuation of Manitoba Health Services Insurance Plan in effect immediately prior to the coming into force of this Act.

Definitions

2(1)        In this Act

"authorized charges" means the charges, determined in accordance with the regulations, that may be made directly to persons for hospital services, medical services, personal care and other health services under the plan but not including charges made by way of a premium or other amount not directly related to a specific service; (« frais admissibles »)

"benefits" means the benefits that are designated in the regulations as benefits to which an insured person is entitled under this Act; (« prestations »)

"board" means the Manitoba Health Appeal Board established under section 9; (« Conseil »)

"child" means a son or daughter, step-son or step-daughter, of any age and also includes the child of a child; (« enfant »)

"dependant" where used to refer to a dependant of a person, means, subject to subsections (3) and (5), a resident who is that person's spouse and, if that person has no spouse, a resident who is that person's dependent parent and includes any child of that person who is a resident and is dependent upon him for support and who is

(a) under the age of 18 years, or

(b) 18 years of age or older and mentally or physically incapacitated, or

(c) between 18 and 20 years of age, and is attending a university, secondary school or other educational institution, or is training at a school of nursing,

and also includes a resident who is the spouse or child of any such child to whom clause (a), (b) or (c) applies if the spouse or child of the child is dependent for support upon that person; (« personne à charge »)

"employee" means a resident who, for an employer, regularly performs services under a contract of hiring and service or apprenticeship, whether written or oral, express or implied, but does not include an independent contractor or a married person who is otherwise an insured person as the dependant of another insured person; (« employé »)

"employer" means, subject to subsection (4), a person having in his service under a contract of hiring and service or apprenticeship, written or oral, express or implied, three or more employees, and includes Her Majesty in right of the province and also includes municipal corporations and boards and commissions having the management and conduct of any work or service owned by, or operated for, a municipal corporation or by or for the government; (« employeur »)

"fund" means Manitoba Health Services Insurance Fund; (« Fonds »)

"health region" means a health region established or continued under The Regional Health Authorities Act; (« région sanitaire »)

"hospital", except in sections 57 to 60, means

(a) a hospital in Manitoba that is designated as a hospital by regulation under subsection 113(1), and

(b) a hospital or facility outside Manitoba that

(i) is approved by the minister for the purpose of this Act, and

(ii) is licensed or approved as a hospital by the governmental licensing authority in the jurisdiction in which the hospital is located; (« hôpital »)

"hospital services" means the services which an insured person is entitled to receive in hospitals without payment as described in section 46 and which are not excluded under section 47; (« services hospitaliers »)

"in-patient" means a person admitted to and assigned to a bed in a hospital on the order of a medical practitioner, registered nurse (extended practice) or midwife or, subject to the conditions prescribed in the regulations, on the order of a licensed dentist; (« malade hospitalisé »)

"in-patient services" means such services supplied to an in-patient as are specified in the regulations; (« soins en hôpital »)

"insured person" means a resident who is entitled to receive benefits under this Act and the regulations; (« assuré »)

"medical practitioner" means a person lawfully entitled to practice medicine in the place where he renders medical services; (« médecin »)

"medical review committee" means the medical review committee established under an agreement made under section 76; (« comité de révision médicale »)

"medical services" means all services rendered by a medical practitioner that are medically required but does not include those services excepted by the regulations; (« soins médicaux »)

"minister" means the member of the Executive Council charged by the Lieutenant Governor in Council with the administration of this Act; (« ministre »)

"other health services" means health services to which this Act applies by reason of an order made under section 71; (« autres services de santé »)

"out-patient" means a patient of a hospital or surgical facility who receives necessary diagnostic or treatment services, and, in the case of a hospital, excludes

(a) an in-patient, and

(b) any other person assigned to a bed other than an emergency or temporary holding bed; (« malade en consultation externe »)

"out-patient services" means such services supplied to an out-patient as are specified in the regulations; (« soins en consultation externe »)

"participating hospital province" means a province or territory of Canada that is party to an agreement with the Government of Canada under the Federal Provincial Fiscal Arrangements and Federal Post-Secondary Education and Health Contributions Act (Canada) or the Canada Health Act and that has established a hospital insurance plan pursuant to the law of that province or territory; (« province participant au régime d'assurance-hospitalisation »)

"participating medical province" means a province or territory of Canada in which there is in operation a medical care insurance plan in respect of which a contribution is payable by Canada pursuant to the Federal-Provincial Fiscal Arrangements and Federal Post-Secondary Education and Health Contributions Act (Canada); (« province participant au régime d'assurance-maladie »)

"personal care" means care in the nature of

(a) basic nursing care under the supervision of a registered nurse, or

(b) personal assistance in the activities of daily living, or

(c) supervision of activities of daily living,

together with goods and services that are specified in the regulations as goods and services that are provided as part of personal care; (« soins personnels »)

"personal care home" means a personal care home designated in the regulations; (« foyer de soins personnels »)

"plan" means Manitoba Health Services Insurance Plan; (« régime »)

"recipient of public assistance" means a person who is of a class or kind designated or described in the regulations as being recipients of public assistance; (« bénéficiaire de l'aide sociale »)

"regional health authority" means a regional health authority established or continued under The Regional Health Authorities Act; (« office régional de la santé »)

"resident" means a person who is legally entitled to be in Canada, makes his or her home in Manitoba, and is physically present in Manitoba for at least six months in a calendar year, and includes any other person classified as a resident in the regulations, but does not include

(a) a person who holds a temporary resident permit under the Immigration and Refugee Protection Act (Canada), unless the minister determines otherwise, or

(b) a visitor, transient or tourist; (« résident »)

"surgical facility" means a facility that provides surgical services outside of a hospital; (« établissement chirurgical »)

"surgical service" means the alteration of the human body manually or through the use of an instrument or the introduction of an instrument into the human body, when the procedure is carried out with the concurrent use of

(a) a drug to induce sedation, or

(b) local, regional or general anaesthesia,

to a degree that requires the monitoring of vital signs, but does not include a surgical procedure that is exempted in the regulations. (« soins chirurgicaux »)

2(2)        [Repealed] S.M. 2004, c. 42, s. 32.

Other dependants

2(3)        Where an insured person maintains, in his household, a person who, if he were a child of that insured person would be, under the definition "dependant" in subsection (1), his dependant, if the insured person satisfies the minister as to those facts and files with the minister a written request that the person so maintained be deemed to be his dependant, that person shall be deemed to be his dependant for the purposes of this Act until that insured person withdraws or revokes the request in writing or until the person so maintained ceases to be a person who, if a child of that insured person, would be his dependant.

Meaning of "employer"

2(4)        For the purposes of determining whether a person is an employer as defined in subsection (1),

(a) another person who would be that person's employee, as defined in subsection (1) shall be deemed to be that person's employee, notwithstanding that the other person is a married person to whom reference is made in the definition of employee, and

(b) a person, other than a corporation, who has employees in his or her service shall be included among them in computing the number of employees the person employs.

Determination of attendance at educational institution

2(5)        If doubt arises in any case as to whether a person is attending a university, secondary school, or other educational institution, or is training at a school of nursing, within the meaning of the definition "dependant" in subsection (1), the matter shall be decided by the minister and his decision thereon is final and conclusive.

S.M. 1990-91, c. 12, s. 10; S.M. 1991-92, c. 8, s. 2; S.M. 1992, c. 35, s. 2 and 3; S.M. 1996, c. 43, s. 2; S.M. 1996, c. 53, s. 82; S.M. 1996, c. 58, s. 454; S.M. 1998, c. 53, s. 2; S.M. 2001, c. 21, s. 2; S.M. 2004, c. 42, s. 32; S.M. 2005, c. 42, s. 20; S.M. 2013, c. 42, s. 2; S.M. 2015, c. 43, s. 20.

Minister responsible for administration of plan

3(1)        The minister is responsible for the administration and operation of the plan.

Powers of minister

3(2)        The minister has the power

(a) to provide insurance for residents of the province in respect of the costs of hospital services, medical services and other health services, and personal care;

(b) to plan, organize and develop throughout the province a balanced and integrated system of hospitals, personal care homes and related health facilities and services commensurate with the needs of the residents of the province;

(c) to ensure that adequate standards are maintained in hospitals, personal care homes and related health facilities, including standards respecting supervision, licensing, equipment and inspection, or to make such arrangements as the minister considers necessary to ensure that adequate standards are maintained;

(d) to provide a consulting service, exclusive of individual patient care, to hospitals and personal care homes in the province or to make such arrangements as the minister considers necessary to ensure that such a consulting service is provided;

(e) to require that the records of hospitals, personal care homes and related health facilities are audited annually and that the returns in respect of hospitals which are required by the Government of Canada are submitted; and

(f) in cases where residents do not have available medical services and other health services, to take such measures as are necessary to plan, organize and develop medical services and other health services commensurate with the needs of the residents.

Contracts and agreements

3(3)        The minister may enter into contracts and agreements with any person or group of persons that the minister considers necessary for the purposes of this Act.

Grants

3(4)        The minister may make grants to any person or group of persons for the purposes of this Act on such terms and conditions as the minister considers advisable.

Minister may delegate

3(5)        The minister may, in writing, delegate to any person any power, authority, duty or function conferred or imposed upon the minister under this Act or the regulations.

S.M. 1992, c. 35, s. 4.

Records

4           The minister shall ensure that full and accurate records of the proceedings, transactions and finances of the plan are prepared and maintained.

S.M. 1992, c. 35, s. 4.

Annual budget

5(1)        The minister shall ensure that an annual budget for the plan is prepared before the beginning of each fiscal year.

Fiscal year

5(2)        The fiscal year of the plan commences on April 1 of each year and ends on March 31 of the following year.

S.M. 1992, c. 35, s. 4.

Financial statements

6(1)        The minister shall, annually within four months after the end of the fiscal year of the plan, cause to be prepared audited financial statements of the plan showing separately the expenditures for hospital services, medical services and other health services.

Annual report

6(2)        The minister shall cause to be prepared an annual report which shall include the financial statements referred to in subsection (1), and the minister shall table a copy of the annual report before the Legislative Assembly within 15 days of receiving it if the Legislative Assembly is then in session, or if it is not then in session, within 15 days of the beginning of the next session.

S.M. 1991-92, c. 8, s. 3; S.M. 1992, c. 35, s. 4; S.M. 2004, c. 42, s. 32.

Audit

7           The Auditor General, or another auditor designated by the Auditor General, shall at least once annually examine and audit the accounts of the plan, prepare a report with respect to that audit and provide a copy of the report to the minister.

S.M. 1992, c. 35, s. 4; S.M. 2001, c. 39, s. 31.

Insurance Act does not apply

8           The Insurance Act does not apply to the plan or to insurance in respect of hospital services, medical services or other health services or personal care provided under this Act.

S.M. 1992, c. 35, s. 4.

Manitoba Health Appeal Board established

9(1)        The Manitoba Health Appeal Board is established consisting of not less than five members appointed by the Lieutenant Governor in Council.

Term of office

9(2)        A member shall be appointed to hold office for the term specified in the order by which he or she is appointed, and shall continue to hold office until the member is reappointed, a successor is appointed or the appointment is revoked.

Chairperson and vice-chairperson

9(3)        The Lieutenant Governor in Council shall designate one of the members to be chairperson of the board and another to be vice-chairperson.

Remuneration and expenses

9(4)        The members of the board shall be paid remuneration and receive reasonable expenses at rates determined by the Lieutenant Governor in Council.

Duties

9(5)        The board shall

(a) hear and determine appeals made under section 10;

(b) perform any other duties assigned by this or any other Act of the Legislature or any regulation; and

(c) perform any other duties assigned by the minister.

Quorum

9(6)        Except where provided otherwise in this or any other Act of the Legislature or any regulation respecting the board, any three members of the board constitute a quorum and are sufficient for the performance of all functions and duties of the board.

Panels

9(7)        The board may sit in panels of at least three members.

Reference to board

9(8)        A reference to the board in this or any other Act of the Legislature or any regulation respecting the board includes any panel of the board.

Decision of board

9(9)        A decision or action of the majority of the members of a panel or of the majority of the members of the board constituting a quorum is a decision or action of the board.

Procedure

9(10)       The board may establish its own rules of practice and procedure, including rules respecting meetings and hearings, not inconsistent with this or any other Act of the Legislature or any regulation respecting the board.

Administrative support

9(11)       The minister may provide such clerical and administrative support to the board as the minister may consider necessary to enable it to carry out its duties and functions.

9(12)       [Repealed] S.M. 1995, c. 26, s. 2.

S.M. 1992, c. 35, s. 4; S.M. 1995, c. 26, s. 2; S.M. 1998, c. 53, s. 3.

Right of appeal

10(1)       An appeal may be made to the board by a person

(a) who has been refused registration as an insured person under this Act or the regulations;

(b) who has been denied entitlement to a benefit under this Act or the regulations;

(c) who has been refused an approval to operate a laboratory or a specimen collection centre, on whose approval conditions have been imposed, or whose approval has been revoked under subsection 127(1);

(d) who has been refused a licence to operate a personal care home under section 118.2 or whose licence to operate a personal care home has been suspended, cancelled or not renewed under that section; or

(e) prescribed by the regulations as being entitled to appeal to the board.

Notice of appeal

10(2)       An appeal under this Act or the regulations shall be commenced by a notice of appeal, setting out the grounds for appeal, which must be mailed or delivered to the board not more than 30 days after the date on which the appellant receives notice of the decision that is appealed, or within such further time as the board permits.

Notice to person who made decision

10(3)       The board shall promptly provide a copy of the notice of appeal to the person who made the decision that is appealed.

Informal proceedings

10(4)       An appeal under this section shall be conducted on an informal basis, and the board is not bound by the rules of law respecting evidence applicable to judicial proceedings.

Powers of board on appeal

10(5)       On considering an appeal under this Act or the regulations, the board may

(a) confirm, set aside or vary the decision in accordance with the provisions of this Act and the regulations; or

(b) refer the matter back to the person authorized to make the decision for further consideration in accordance with the board's instructions.

Panels

10(6)       The board may appoint a panel of not less than three of its members for the purpose of considering an appeal under this section, and a decision of a majority of the panel is the decision of the board.

Continuation after loss of panel member

10(7)       If, after a panel has commenced considering an appeal under this section, a member of the panel dies, resigns, or otherwise becomes incapable of acting, the remaining members of the panel may complete the appeal and render a decision and the decision is valid as though the remaining members constituted a full panel.

S.M. 1992, c. 35, s. 4; S.M. 1998, c. 53, s. 4.

11 and 12   [Repealed]

S.M. 1992, c. 35, s. 4.

12.1        [Repealed]

S.M. 1991-92, c. 8, s. 4; S.M. 1992, c. 35, s. 4.

13 to 16    [Repealed]

S.M. 1992, c. 35, s. 4.

17          [Repealed]

S.M. 1991-92, c. 8, s. 5; S.M. 1992, c. 35, s. 4.

18          [Repealed]

S.M. 1992, c. 35, s. 4.

18.1        [Repealed]

S.M. 1991-92, c. 8, s. 6; S.M. 1992, c. 35, s. 4.

19 to 26    [Repealed]

S.M. 1992, c. 35, s. 4.

Disposal of moneys received from Canada

27          Despite The Financial Administration Act, moneys contributed by the Government of Canada for the purposes of this Act shall be deposited by the Minister of Finance in the Consolidated Fund; and, on the written requisition of the minister the Minister of Finance may pay over to the fund out of the moneys so contributed, credited, and remaining on deposit in the Consolidated Fund, such amount as may be stated in the requisition.

S.M. 1992, c. 35, s. 5; S.M. 1996, c. 59, s. 95.

Fund continued

28          The Manitoba Health Services Insurance Fund is continued.

S.M. 1990-91, c. 12, s. 10; S.M. 1992, c. 35, s. 6.

Credits to fund

29          Despite The Financial Administration Act, the following shall be placed to the credit of the fund when received for the purposes of this Act:

(a) the amount of all premiums, fees, or other charges made, levied, or collected in respect of benefits to be paid out of the fund;

(b) all sums contributed thereto by the Government of Manitoba from the Consolidated Fund;

(c) all sums paid over by the Minister of Finance to the minister, on the minister's requisition, out of moneys contributed for the purposes of this Act by the Government of Canada;

(d) the amount of interest received upon moneys from time to time at the credit of the fund; and

(e) all other amounts received by the minister under this Act.

S.M. 1992, c. 35, s. 7.

Payments from the fund

30          The minister shall pay from the fund such amounts as are required to be paid for the purposes of this Act.

S.M. 1992, c. 35, s. 8.

Banking

31(1)       Subject to subsection (2), the minister shall deposit and keep deposited in a bank, trust company, credit union or other similar financial institution all amounts credited to the fund.

Investment

31(2)       If at any time the balance at the credit of the fund is in excess of the amount that is required for the immediate purposes of this Act, the minister shall pay over any surplus funds to the Minister of Finance for investment for and on behalf of the fund.

Fund not part of Consolidated Fund

31(3)       Notwithstanding The Financial Administration Act or any other Act but subject to subsection (2), the moneys in the fund do not form part of the Consolidated Fund; and the fund is not a division or part of the Consolidated Fund; but the moneys therein are the property of Her Majesty in right of the province.

S.M. 1992, c. 35, s. 9.

Payments from Consolidated Fund

32(1)       From and out of the Consolidated Fund with moneys authorized by an Act of the Legislature to be paid and applied for the purposes of this Act the Minister of Finance may pay to the fund such amounts as may from time to time be requisitioned by the minister.

Special advances

32(2)       With no authority other than this subsection, and with the approval of the Lieutenant Governor in Council, the Minister of Finance may make advances to the fund from and out of the Consolidated Fund at such time and upon such terms and conditions as the Lieutenant Governor in Council may prescribe.

S.M. 1992, c. 35, s. 10.

Insured persons

33          Each resident is an insured person and entitled to benefits subject to such waiting period as may be prescribed in the regulations.

Benefits to persons insured in other provinces

33.1        A person who is not an insured person and who provides evidence to a regional health authority, medical practitioner, hospital or surgical facility that he or she is registered or enrolled in another jurisdiction under an Act, plan or scheme in respect of which Manitoba has made an agreement under section 68 relating to the provision of hospital services or medical services is, subject to the agreement, entitled to receive benefits under this Act as though the person were an insured person.

S.M. 1998, c. 53, s. 5.

Premium for groups

34          For the purpose of achieving uniformity in the provision of benefits in the application of this Act Lieutenant Governor in Council may make regulations requiring residents or groups of residents to pay premiums in respect of insurance under this Act and may, by order, provide for the remittance of all or part of the premiums so paid to the residents by whom or on whose behalf any premiums are paid.

Amendments of agreements on removal of premium

35          Where an agreement between an employer and an employee respecting employment in Manitoba contains, whether by reason of an amendment made in accordance with this Act as it was prior to the coming into force of this section, or otherwise, a provision for the payment by the employer for or on behalf of the employee of all or a part of a premium under this Act as it was prior to the coming into force of this section, the agreement shall be conclusively deemed to be amended to provide for the payment by the employer to the employee, as additional wages, the amount which immediately prior to the coming into force of this section the employer was required to pay as all or part of a premium under this Act.

Amendment of pension etc.

36          Where an agreement between an employer and a retired employee respecting payment of a pension, annuity or a superannuation allowance to the employee after retirement, or the provisions of a plan or scheme respecting the payment of pensions, annuities or superannuation allowances to retired employees that applies to the retired employee, contains a provision for the payment by the employer or from a fund operated for the purposes of paying the pensions, annuities or superannuation allowances, for or on behalf of the retired employee of all or a part of a premium under this Act as it was prior to the coming into force of this section, the agreement or the plan or scheme, as the case may be, shall be conclusively deemed to be amended to provide for payment by the employer or from the fund to the retired employee, as long as he remains a resident, as additional pension, annuity or superannuation allowance, the amount which immediately prior to the coming into force of this section was paid by the employer or from the fund as all or part of the premium under this Act.

Registration of residents

37          Subject to such exceptions as may be prescribed in the regulations, each resident other than a dependant shall register himself and his dependants, if any, with the person specified, and at the time prescribed, in the regulations; and the registration shall be in such form, and the resident shall in making the registration furnish such information and particulars, as may be required by the minister.

S.M. 1992, c. 35, s. 11.

Registration by employers

38          Each employer shall register as an employer with the minister at the time prescribed, in the regulations, and he shall, at such times as may be prescribed by the minister, furnish such information and particulars as may be required by the minister.

S.M. 1992, c. 35, s. 11.

Duty of Registrar

39          Every person who is required under the regulations to accept registrations made under this Act shall discharge the duties imposed upon him in respect of such registration under this Act or the regulations or by the minister.

S.M. 1992, c. 35, s. 11.

Issue of registration certificates

40          The minister, by such methods or through such agents, and at such time, and in such form, as may be approved by the minister, shall issue to each of such persons as are described in the regulations, a registration certificate.

S.M. 1992, c. 35, s. 12.

Presentation of registration certificate

41          When he is received by or admitted to a hospital as a patient or when he consults a medical practitioner, or a person authorized by law to provide other health services, or, in the case of an emergency, as soon as is reasonably possible thereafter, every insured person shall present his registration certificate for the inspection of the admitting official of the hospital or the medical practitioner or a member of his staff or the person providing the other health services or a member of his staff; but, in the case of a dependant, the person of whom he is a dependant shall, on behalf of the dependant and at the time aforesaid, present or cause to be presented the registration certificate issued to him.

General penalty

42          Every person who

(a) fails or refuses to comply with any provision of this Act or the regulations; or

(b) knowingly gives or makes to the minister or other person to whom any information is required to be given in a report or statement made under this Act or the regulations, any information, report or statement, that is wholly or partly false;

is guilty of an offence and if no other penalty is provided therefor herein is liable, on summary conviction, to a fine not exceeding $5,000., to which shall be added, in every case, as an additional fine an amount equal to any premium that is payable under the Act by the person convicted and that is due and unpaid.

S.M. 1991-92, c. 8, s. 7; S.M. 1992, c. 35, s. 13.

Prosecution within two years

42.1        A prosecution for any offence under this Act or the regulations may be commenced not later than two years after the later of

(a) the day on which the offence was committed; or

(b) the day on which evidence of the offence first came to the attention of the minister.

S.M. 1995, c. 26, s. 3.

Fraudulent production of registration certificate an offence

43          Any person who produces to an admitting official of a hospital, or to a medical practitioner or a member of his staff or to a person authorized by law to provide other health services or a member of his staff, a registration certificate,

(a) knowing that the person named therein is not, at the time of the production thereof, an insured person; or

(b) knowing that the person on behalf of whom, and to facilitate whose treatment it is produced, is not the person named therein or a dependant of that person;

is guilty of an offence and liable, on summary conviction, to a fine not exceeding $5,000.

S.M. 1991-92, c. 8, s. 7.

Disposal of additional fine

44          The amount of any additional fine imposed under section 42 and paid to the convicting court shall be remitted to the minister forthwith.

S.M. 1992, c. 35, s. 11; S.M. 2008, c. 42, s. 45.

45           [Repealed]

S.M. 1992, c. 35, s. 14.

Insured hospital and personal care services

46(1)       The services that an insured person is entitled under this Act to receive at any hospital, surgical facility or personal care home without payment except for any authorized charges that he may be liable to pay are

(a) in-patient services and out-patient services in a hospital and out-patient services in a surgical facility;

(b) such services in a hospital as may be specified in the regulations as being additional hospital services that an insured person is entitled to receive under this Act; and

(c) subject to any special waiting period in respect of personal care prescribed in the regulations, and subject to meeting the admission requirements for the personal care home personal care provided in premises designated as personal care homes for the purposes of this section.

Designation of personal care homes

46(2)       The minister may by regulation designate premises situated in Manitoba as personal care homes for the purposes of this section.

S.M. 1992, c. 35, s. 11 and 15; S.M. 1998, c. 53, s. 6.

Certain cases excluded

47          Where

(a) by virtue of any legislation enacted or made by Parliament or any Legislature in Canada or elsewhere, a person is receiving hospital care and treatment, the cost of providing which he is entitled to have paid from a fund established under, or otherwise pursuant to, that legislation; and

(b) under an agreement made with the Government of Canada under section 50, the Government of Canada does not contribute to the cost of that hospital care and treatment under the Federal Provincial Fiscal Arrangements and Federal Post-Secondary Education and Health Contributions Act (Canada) or the Canada Health Act;

those services are not hospital services to which this Act applies.

S.M. 1991-92, c. 8, s. 8.

Right to payment for hospital and out-patient services

48(1)       Subject to this Act and the regulations,

(a) an insured person who has received hospital services is entitled to have the minister pay the amounts due for those services to the regional health authority responsible for the services;

(b) an insured person who has received out-patient services in a surgical facility operated by a regional health authority is entitled to have the minister pay the amounts due for those services to the authority;

(c) an insured person who has received out-patient services in a surgical facility not operated by a regional health authority is entitled to have the minister pay the amounts due for those services to the operator of the facility, but only if the operator has an agreement with the minister under section 64.1.

No charge to insured person

48(2)       No hospital providing hospital services to an insured person and no regional health authority shall make any charge to an insured person for providing the hospital services, other than authorized charges.

No charge for out-patient services in a surgical facility

48(3)       No person shall make any charge to an insured person for or in relation to providing out-patient services to the person in a surgical facility.

No collection from others for out-patient services in a surgical facility

48(4)       Except pursuant to an agreement under section 64.1, no person shall accept a fee or other payment made on behalf of an insured person for or in relation to providing out-patient services to the insured person in a surgical facility.

S.M. 1992, c. 35, s. 11; S.M. 1996, c. 53, s. 82; S.M. 1997, c. 41, s. 20; S.M. 1998, c. 53, s. 7; S.M. 2001, c. 21, s. 3.

Terms of provision of hospital services

49          Hospitals shall provide hospital services to insured persons as prescribed herein and in the regulations, under uniform terms and conditions.

Agreements with Canada

50(1)       With the approval of the Lieutenant Governor in Council, the Government of Manitoba, represented by the minister, may enter into agreements with the Government of Canada under the Federal Provincial Fiscal Arrangements and Federal Post-Secondary Education and Health Contributions Act (Canada) or the Canada Health Act to provide for contributions under those Acts by the Government of Canada towards the cost of providing hospital services to insured persons.

Payment by minister of cost of hospital services to insured persons

50(2)       Subject to subsection (3) and in accordance with sections 60 and 64 and the regulations, the minister shall pay from the fund to the hospitals in Manitoba that are not owned or operated by the Government of Canada the amounts due to those hospitals in respect of the cost of providing the hospital services received therein by insured persons.

Payments to regional health authority

50(2.1)     Notwithstanding subsection 59(2) and subject to subsection 50(3.1) and section 64,

(a) where a hospital providing hospital services to an insured person is in a health region and the operator of the hospital is a regional health authority for the health region, the minister shall pay from the fund any amounts due under subsection (2) to the regional health authority; and

(b) where a hospital providing hospital services to an insured person is in a health region and a regional health authority is not the operator of the hospital, the minister shall pay from the fund any amounts due under subsection (2) to the regional health authority which has the responsibility to provide the hospital services in the health region, for payment to the hospital in accordance with any agreement reached between the regional health authority and the operator of the hospital under section 64.

Withholding of payments

50(3)       Where a hospital fails to keep the books or records, or make the returns required under this Act or the regulations, the minister may withhold payments due to it until the hospital complies with this Act and the regulations.

Withholding of payments where hospital is in a health region

50(3.1)     Notwithstanding subsection 50(3), where a hospital in a health region fails to keep the books or records or make the returns required under this Act or the regulations, the minister may,

(a) where the operator of the hospital is a regional health authority for the health region, withhold the payments due to the regional health authority until the regional health authority complies with this Act and the regulations; and

(b) where the operator of the hospital is not a regional health authority, withhold the payments due to the regional health authority for the health region, which has the responsibility to provide the hospital services, for payment to the hospital, and the regional health authority is not required to make payments to the hospital under clause 50(2.1)(b), until the hospital complies with this Act and the regulations.

S.M. 1988-89, c. 11, s. 11; S.M. 1990-91, c. 12, s. 10; S.M. 1991-92, c. 8, s. 9; S.M. 1992, c. 35, s. 11; S.M. 1996, c. 53, s. 82; S.M. 1997, c. 41, s. 20.

Effect of making payments

51(1)       Payments made under subsection 50(2) shall be accepted by the hospital as, and shall be conclusively deemed to be, payment in full for the hospital services provided to the insured persons for whom they are made, except for authorized charges.

Effect of making payments to regional health authority

51(2)       Payments made under subsection 50(2.1) shall be accepted by the hospital and the regional health authority, as, and shall be conclusively deemed to be, payment in full for the hospital services provided to the insured person for whom the payments are made, except for authorized charges.

S.M. 1996, c. 53, s. 82.

Payments to Canadian Government Hospitals

52          The minister shall, in accordance with an agreement made under subsection 50(1), pay from the fund to hospitals owned or operated by the Government of Canada the amounts due to the hospitals in respect of the cost of providing the hospital services received in those hospitals by insured persons.

S.M. 1992, c. 35, s. 11.

Payments in respect of hospitalization outside the province

53(1)       Subject to subsection (2) the minister shall

(a) pay from the fund to hospitals in any participating hospital province such amounts as are prescribed in the regulations and specified in an agreement made with that province in respect of the cost of providing services equivalent to hospital services received in those hospitals by insured persons; and

(b) reimburse any insured person who, because of accident or illness, requires admission to a hospital that is outside the province but not in a participating hospital province, for hospital charges thereby incurred by him in such amounts as may be provided for in the regulations.

Alternative payments for outside hospitalization

53(2)       In lieu of making payment as provided in subsection (1), the minister may

(a) pay an amount the payment of which is authorized under clause (1)(a), directly to the insured person in respect of whom or whose dependants the services were provided, if he has himself paid the cost of those services to the hospital by which they were provided; and

(b) pay an amount the payment of which is authorized under clause (1)(b), directly to the hospital to which the insured person is liable for the cost of services provided by it, if the insured person has not paid the charge for those services.

S.M. 1992, c. 35, s. 11.

Hospitalization in mental hospitals outside province

54(1)       Notwithstanding clause 47(b), and as provided in section 53, the minister may pay from the fund to hospitals or insured persons amounts due in respect of the cost of providing hospital services under the terms and conditions and in such amounts as may be provided under the regulations.

Definitions

54(2)       In this section

"hospital" includes a hospital as defined in this Act, and also includes a hospital or institution for the mentally ill or disabled that is outside the province and that is approved by the minister; (« hôpital »)

"hospital services" includes hospital services as defined in this Act, and also includes services which an insured person is entitled to receive in a hospital as defined in this subsection and for which payment is provided in subsection (1). (« services hospitaliers »)

S.M. 1992, c. 35, s. 11 and 16; S.M. 1993, c. 29, s. 184.

Recovery of overpayments

55          In making payments to a hospital which is not in a health region the minister may deduct therefrom amounts in reduction of any overpayments previously made to that hospital until the total of the amounts so deducted is equal to the amount of the overpayment.

S.M. 1992, c. 35, s. 11; S.M. 1996, c. 53, s. 82.

Designation of budget officer

56          The minister shall designate a budget officer or officers for the purposes of this Act.

S.M. 1991-92, c. 8, s. 10; S.M. 1992, c. 35, s. 17.

Definition of "hospital"

57(1)       In this section and in sections 58 to 60, "hospital" means

(a) a hospital in Manitoba that is designated as a hospital by regulation under subsection 113(1) and that is not in a health region; and

(b) an institution or organization that is not a hospital but that provides facilities or services in Manitoba for, or ancillary to, the treatment or diagnosis of disease, illness or injury and that is designated in the regulations as an institution or organization to which this section applies.

Duties of budget officer re hospital budgets

57(1.1)     Subject to the direction of the minister, a budget officer shall

(a) examine the budget of each hospital;

(b) subject to subsection (2), approve and recommend to the minister a budget for each hospital showing separately

(i) the budget for the provision of hospital services, and

(ii) the budget for such services and costs as are not included in an agreement but are designated in the regulations; and

(c) on the basis of that budget recommend to the minister the rates of payment that should be made in respect of each hospital and that should be approved by the minister, showing separately

(i) the rates for hospital services, and

(ii) the rates for such hospital services and costs as are not included in an agreement but are designated in the regulations.

Notification of hospital

57(2)       On examining the budget of a hospital and recommending rates in respect of the hospital as provided in subsection (1.1), the budget officer shall notify the hospital of the budget and rates to be recommended, and the hospital may, within 30 days of such notification, request that the budget officer change the budget and rates to be recommended.

Recommendation to minister

57(3)       If the hospital does not request changes, or if changes are requested and a decision is made respecting them, the budget officer shall provide a recommendation to the minister as to a budget and rates for the hospital and shall notify the hospital to that effect.

Hospital may request referral

57(4)       A hospital that is dissatisfied with the recommended budget or rates may, within 30 days after receiving notice under subsection (3), request that the minister refer the matter to the board.

Referral to the board

57(5)       If a hospital requests a referral under subsection (4), the minister shall refer the matter to the board and the board shall hear the matter and make a recommendation to the minister, but the minister is not bound by the board's recommendation.

S.M. 1991-92, c. 8, s. 11, 12 and 13; S.M. 1992, c. 35, s. 18 and 19; S.M. 1993, c. 30, s. 2; S.M. 1996, c. 53, s. 82.

Rates

58          On the expiration of the time for a hospital to request a referral to the board under subsection 57(4) or, if a referral has been made, on a recommendation being made by the board under subsection 57(5), the minister shall approve a budget for the hospital and establish a rate of payment in respect of that hospital.

S.M. 1992, c. 35, s. 20.

59          [Repealed]

S.M. 1992, c. 35, s. 20.

Retention of moneys by minister in reduction of overpayments

60(1)       Where, at any time during the course of a year, it appears to the minister from an examination of the accounts of a hospital that the sum of the amounts paid by the minister to the hospital during the year up to that time, together with the sum of the amounts to be paid to the hospital on an estimated basis in respect of the remainder of that year, will exceed the amount to be determined under subsection (2) in respect of the hospital for that year, the minister may retain such portion as the minister deems advisable of the amounts to be paid as aforesaid in respect of the remainder of that year, pending final determination under subsection (2), of the amount which the hospital is entitled to be paid in respect of that year.

Annual adjustment of payments to hospitals

60(2)       Notwithstanding the rates established as hereinbefore provided, the total amount that a hospital, other than a hospital owned or operated by the Government of Canada, is entitled to receive in respect of

(a) hospital services; and

(b) other services to which reference is made in sub-clause 57(1.1)(c)(ii);

that have been received in the hospital by insured persons during any year, and in respect of the costs to which reference is made in sub-clause 57(1.1)(c)(ii) incurred in that year, shall be determined by the minister at the end of that year in the manner provided in the regulations.

Additions and deductions

60(3)       In settling the amount to be paid to a hospital in respect of any year

(a) if the total of the sums paid to the hospital by the minister during that year is less than the amount determined under subsection (2), the minister shall pay to the hospital an amount equal to that deficiency; and

(b) if the total of the sums paid to the hospital by the minister during that year exceeds an amount equal to the amount determined under subsection (2) plus an amount determined by the minister but not exceeding 2% of the approved operating costs of the hospital, the minister shall, for that year, recover from the institution an amount equal to that excess;

but, if it is not practicable to deduct the amount recoverable under clause (b) from the amount the hospital is otherwise entitled to receive in respect of that year, it may be deducted in the manner provided in the regulations.

S.M. 1991-92, c. 8, s. 14; S.M. 1992, c. 35, s. 11 and 21.

Application of budget review to personal care homes

61          Sections 55, 57, 58 and 60 apply, with such modifications as the circumstances require, to a personal care home that is owned and operated by a municipality or by a non-profit corporation or organization and that is not in a health region.

S.M. 1992, c. 35, s. 22; S.M. 1996, c. 53, s. 82.

Accounting systems required

62          Every hospital, other than a hospital owned and operated by the Government of Canada, shall install and maintain an accounting system in such form and manner as the minister may require, and shall maintain records in accordance with the regulations.

S.M. 1992, c. 35, s. 23.

Inspectors

63(1)       The minister may, in writing, appoint inspectors for the purpose of this section.

Certificate to be produced

63(2)       An inspector exercising a power under this section must produce a certificate of appointment when requested to do so.

Entry and inspection

63(3)       An inspector may, at any reasonable time when required to determine compliance with this Act or the regulations or an agreement referred to in section 64.1,

(a) enter a hospital, surgical facility or other health care facility; and

(b) require the hospital, surgical facility or other health care facility to produce for examination, audit or copying, any books, records or things relating to its activities which are in its possession or under its control.

Assistance to inspector

63(4)       Any person who operates or is in charge of a hospital, surgical facility or other health care facility or who has custody or control of any books, records or things referred to in subsection (3) shall give an inspector all reasonable assistance to enable the inspector to carry out his or her duties, and shall provide the inspector with any information the inspector may reasonably require.

S.M. 1992, c. 35, s. 24; S.M. 2001, c. 21, s. 4.

Rates of payments to hospitals and personal care homes

64(1)       Payments for services provided to insured persons

(a) by a hospital or personal care home in a health region, shall be made to the hospital or personal care home in accordance with any agreement between the regional health authority for the health region which has the responsibility to provide the hospital services or personal care services, as the case may be, and the operator of the hospital or personal care home; and

(b) by a hospital or personal care home which is not in a health region and to which subsection 57(1.1) does not apply shall be at the rates set by the minister;

(c) [repealed] S.M. 2001, c. 21, s. 5.

Rates of payments to surgical facilities

64(2)       Payments for out-patient services that a surgical facility has provided to insured persons shall be made to the operator of the facility and, where the operator is not a regional health authority, shall be made

(a) only if the operator has an agreement with the minister under section 64.1; and

(b) only in accordance with the terms of that agreement.

S.M. 1991-92, c. 8, s. 15; S.M. 1992, c. 35, s. 25; S.M. 1996, c. 53, s. 82; S.M. 1997, c. 41, s. 20; S.M. 1998, c. 53, s. 8; S.M. 2001, c. 21, s. 5.

Agreement with surgical facility

64.1(1)     The minister may enter into an agreement with the operator of a surgical facility respecting payment to the operator for or in relation to providing out-patient services to insured persons in the facility.

Requirements for agreement

64.1(2)     The minister shall not enter into an agreement under subsection (1) unless the minister is satisfied that

(a) the surgical facility is accredited by the College of Physicians and Surgeons;

(b) the provision of insured services as contemplated under the proposed agreement will be consistent with the principles of the Canada Health Act; and

(c) the agreement will serve the public interest.

S.M. 2001, c. 21, s. 6.

No overnight stay in surgical facility

64.2(1)     No operator of a surgical facility, and no medical practitioner, shall provide a surgical service in a surgical facility if the person receiving the service would normally require post-operative care in the facility after 11:00 p.m. on the day the service is provided.

Restraining order

64.2(2)     The minister may, by notice of application, apply to a judge of the Court of Queen's Bench for an order restraining any person from contravening subsection (1).  On an application, the judge may make any order the judge considers appropriate.

Offence

64.2(3)     Any person who contravenes subsection (1) is guilty of an offence and is liable on summary conviction to a fine not exceeding $30,000.

S.M. 2001, c. 21, s. 6.

Agreement with outside hospitals

65          The minister may enter into an agreement with the operator of an institution situated outside Manitoba and that provides facilities for care and treatment of disease or injury respecting the payment for hospital services provided to insured persons in the institution.

S.M. 1992, c. 35, s. 11.

Unauthorized charging an offence

66          Any person who

(a) knowingly makes a charge, or renders an account, or causes an account to be rendered, to an insured person for hospital services or for or in relation to out-patient services provided in a surgical facility, other than for authorized charges; or

(b) knowingly collects any sum of money or other thing of value from an insured person for hospital services or for or in relation to out-patient services provided in a surgical facility, other than in respect of authorized charges; or

(b.1) knowingly contravenes subsection 48(4);

(c) knowingly makes a charge, or renders an account, or causes an account to be rendered to an insured person for personal care provided in a personal care home other than for authorized charges; or

(d) knowingly collects any sum of money or other thing of value from an insured person for personal care provided in a personal care home other than in respect of authorized charges;

is guilty of an offence and liable, on summary conviction, to a fine not exceeding $30,000.

S.M. 1998, c. 53, s. 9; S.M. 2001, c. 21, s. 7.

67          [Repealed]

S.M. 1992, c. 35, s. 26.

Agreements with participating hospital and medical provinces

68(1)       The minister may, with the approval of the Lieutenant Governor in Council, enter into an agreement with the Crown in right of a participating hospital province or participating medical province, or with an authority duly constituted in the participating hospital province or participating medical province to administer matters relating to hospital or medical services insurance, respecting the provision of hospital or medical services

(a) to residents of Manitoba who are in the participating hospital province or participating medical province; and

(b) to residents of the participating hospital province or participating medical province who are in Manitoba;

including in each case, if so provided in the agreement, services equivalent to hospital or medical services.

Rights under agreement

68(2)       Notwithstanding any other provision of this Act, where an agreement is made under subsection (1), the persons to whom it relates are entitled to receive hospital or medical services or reimbursement for the cost thereof as provided in the agreement.

R.S.M. 1987 Supp., c. 31, s. 10; S.M. 1992, c. 35, s. 11.

Agreements to act as trustee for hospitals

69          The minister may enter into an agreement with any hospital which is not in a health region

(a) by which the hospital assigns to the minister out of funds payable by the minister to the hospital in each year, an amount that is equal to the total of principal and interest payable by the hospital in that year on securities issued by it, or for sinking funds created in respect thereof; and

(b) in which the minister undertakes to hold the moneys so assigned in trust, and to pay, or arrange for the payment, from those moneys of the principal and interest on the securities as it becomes payable, or the sinking funds created in respect thereof.

S.M. 1992, c. 35, s. 27; S.M. 1996, c. 53, s. 82.

Restrictions respecting sale of facilities

70(1)       Where the government or a regional health authority has provided funds under this Act respecting the construction, expansion, conversion or relocation of, or major renovations to, a hospital, personal care home or facility, no person may sell, lease or otherwise dispose of the hospital, personal care home or other health facility, or real property associated with the hospital, personal care home or other health facility, without the approval of

(a) the minister; or

(b) where the hospital, personal care home or other health facility is in a health region, the regional health authority for that health region which has the responsibility to provide the hospital services, personal care services or other health services that were last provided by the hospital, personal care home or other health facility.

Regional health authority requires approval of minister

70(2)       A regional health authority shall not provide an approval under clause (1)(b) without the prior approval of the minister.

Approvals may be subject to conditions

70(3)       An approval given by the minister or a regional health authority under this section may be subject to terms and conditions.

S.M. 1992, c. 35, s. 28; S.M. 1996, c. 53, s. 82; S.M. 1997, c. 41, s. 20.

Insurance for other health services

71          The Lieutenant Governor in Council may order that this Act applies to chiropractic, optometric, or midwifery services, or to services provided in hospitals by certified oral and maxillofacial surgeons, or to services provided in hospitals by licensed dentists, or to the provision of prosthetic or orthotic devices, or to any or all of those services, or to any class of those services, and to insurance in respect of the cost of those services or that class of those services, and that the minister shall provide insurance in respect of the cost of those services or that class of those services in the same manner as the minister provides insurance in respect of the cost of medical services; and upon an order being made under this section in respect of any of those services or class thereof, this Act applies mutatis mutandis to and in respect of

(a) those services or that class of those services;

(b) insurance in respect of the cost of those services or that class of those services; and

(c) persons lawfully entitled to render those services or that class of those services within Manitoba or in the place where they are rendered.

S.M. 1990-91, c. 12, s. 10; S.M. 1992, c. 35, s. 29; S.M. 1997, c. 9, s. 63.

Communication of information

72          The minister may communicate

(a) information pertaining to the utilization of chiropractic services to The Manitoba Chiropractors Association;

(b) information pertaining to the utilization of optometric services to the Manitoba Association of Optometrists;

(c) information pertaining to the utilization of dental services to The Manitoba Dental Association; and

(d) information respecting the utilization of medical services, hospital services, dental services and other health services by a worker or workers, as defined in The Workers Compensation Act, to The Workers Compensation Board.

S.M. 1991-92, c. 36, s. 64; S.M. 1992, c. 35, s. 11; S.M. 1995, c. 26, s. 4.

73          [Repealed]

S.M. 1992, c. 35, s. 30.

Agreements re medical fees and payments

74          The minister, with the approval of the Lieutenant Governor in Council, and notwithstanding that it is not an incorporated association, the Manitoba Medical Association, through its officers, may enter into an agreement respecting all matters relevant to

(a) a schedule of fees to be paid by the minister to medical practitioners in respect of medical services rendered to insured persons;

(b) terms and conditions relating to the application of the schedule of fees in respect of medical services rendered to insured persons; and

(c) methods of payment to medical practitioners of benefits payable in respect of medical services rendered to insured persons.

S.M. 1992, c. 35, s. 11.

Interpretation

75(1)       In this section and in sections 75.1.1 to 75.2, "practitioner" means a medical practitioner and any other health practitioner who provides services for which payment is made under this Act.

Special arrangements for remuneration

75(2)       The minister may pay remuneration, either directly or through another person, to practitioners who provide services to residents on a basis other than a fee for services rendered.

Amount of remuneration

75(3)       Payments under subsection (2) shall be made at a rate prescribed in the regulations.

S.M. 1991-92, c. 8, s. 16; S.M. 1992, c. 35, s. 11 and 31; S.M. 2005, c. 38, s. 2.

Agreements with Workers Compensation Board

75.1(1)     The minister may enter into agreements with The Workers Compensation Board respecting methods of payment by the minister or The Workers Compensation Board of the costs of medical aid provided under The Workers Compensation Act.

Agreement with M.P.I.C.

75.1(2)     The minister may enter into agreements with The Manitoba Public Insurance Corporation respecting methods of payment by the minister or The Manitoba Public Insurance Corporation of the costs of medical aid provided under The Manitoba Public Insurance Corporation Act.

S.M. 1991-92, c. 36, s. 64; S.M. 1992, c. 35, s. 11; S.M. 1993, c. 36, s. 6.

Particulars of claims

75.1.1      Every practitioner shall, for the purpose of assessment, payment and audit of claims, provide the minister with the particulars of the services and claims that are required by this Act and the regulations.

S.M. 1991-92, c. 8, s. 17; S.M. 1992, c. 35, s. 32.

Information to be given to patient utilization review committee

75.1.2(1)   Without limiting section 75.1.1, a practitioner must, upon the committee's request, provide information about the practitioner's care of a patient to a committee established by the minister to monitor patient utilization of health services.

Minimum amount of information

75.1.2(2)   A committee referred to in subsection (1) must limit its request for information about the care of a patient to the minimum amount necessary to properly carry out its duties.

S.M. 2005, c. 38, s. 3.

Inspection of records

75.2(1)     The minister may, in writing, appoint inspectors who may, at any reasonable time and upon presentation of identification,

(a) enter the office of a practitioner or group of practitioners, or a hospital, personal care home, surgical facility or other health care facility in which a practitioner's books, accounts or records referred to in clause (b) are kept; and

(b) require the production of, examine, audit and make copies of any books, accounts and records, including medical or clinical records, kept there that relate to claims for benefits for insured services.

Use of data processing system and copying equipment

75.2(2)     In carrying out an inspection or examination under this section, an inspector may

(a) use a data processing system at the place where the books, accounts or records are kept to examine any data contained in or available to the system;

(b) reproduce, in the form of a print-out or other intelligible output, any record from the data contained in or available to a data processing system at the place; and

(c) use any copying equipment at the place to make copies of any record or document.

Assistance to inspectors

75.2(3)     A practitioner and any other person who has custody or control of a book, account or record must give an inspector all reasonable assistance to enable the inspector to carry out his or her duties and must furnish to the inspector any information the inspector may reasonably require.

Warrant by justice

75.2(4)     A justice who is satisfied by information on oath that an inspector has been prevented from exercising his or her powers under this section may issue a warrant authorizing the inspector and any other person named in the warrant to exercise those powers.

S.M. 1991-92, c. 8, s. 17; S.M. 1992, c. 35, s. 11; S.M. 1995, c. 26, s. 5; S.M. 2005, c. 38, s. 4.

Agreement re medical review committee

76(1)       With the approval of the Lieutenant Governor in Council, the minister may enter into an agreement with the Manitoba Medical Association or the College of Physicians and Surgeons of Manitoba, or both, respecting

(a) the establishment of a medical review committee;

(b) the number of members that constitute the committee and their terms of office;

(c) the remuneration and expenses to be paid to the members;

(d) the conduct of the affairs of the committee;

(e) the administrative support to be provided to the committee by the minister; and

(f) the duties of the committee in addition to those described in section 76.1.

Agreement with M.M.A.

76(2)       Notwithstanding that it is not an incorporated association, the Manitoba Medical Association may, through its officers, enter into an agreement under subsection (1).

Where no agreement concluded

76(3)       If no agreement is concluded under subsection (1), the minister, with the approval of the Lieutenant Governor in Council, may appoint a medical review committee of not less than 3 members, and may pay such remuneration to the members as the Lieutenant Governor in Council determines.

S.M. 1991-92, c. 8, s. 18; S.M. 1992, c. 35, s. 58.

Duties of medical review committee

76.1(1)     The medical review committee shall review the past and present patterns of medical practice of medical practitioners.

Application to former practitioners

76.1(2)      If a medical practitioner's right to practice medicine is suspended, cancelled or not renewed, whether before or after this subsection comes into force, this section and sections 77 to 85.1 apply as if his or her right to practice were still in effect.

S.M. 1991-92, c. 8, s. 18; S.M. 1995, c. 26, s. 6.

Investigation

77(1)       When it appears to the medical review committee that the past or present pattern of practice of a medical practitioner departs from the average pattern of practice of medical practitioners who, in the opinion of the committee, practice in comparable circumstances, the committee may conduct an investigation of the pattern of practice of that medical practitioner.

Records and information

77(2)       In the conduct of an investigation, the medical review committee may require the investigated medical practitioner

(a) to produce to the committee any records in his or her possession or under his or her control;

(b) to produce in a form acceptable to the committee information that the committee requests in respect of the care of patients by the medical practitioner; and

(c) to attend at the investigation.

Failure to produce records

77(3)       The medical review committee may summarily apply ex parte to the Court of Queen's Bench for an order

(a) directing the investigated medical practitioner to produce to the medical review committee any records in his or her possession or under his or her control, if it is shown that the medical practitioner failed to produce them when required to do so by the committee; or

(b) directing any person to produce to the medical review committee any records that are or may be relevant to the matter being investigated.

S.M. 1991-92, c. 8, s. 18.

Confidential information

77.1        Every insured person is deemed to have authorized a medical practitioner who rendered services to which the insured person is entitled as a benefit under this Act to provide any of the following committees with such information as it requires:

(a) the medical review committee;

(b) the formal inquiry committee established by subsection 79(1);

(c) a committee established by the minister to monitor patient utilization of health services.

No action lies against a medical practitioner for providing such information.

S.M. 1991-92, c. 8, s. 18; S.M. 2005, c. 38, s. 5.

Decision of medical review committee

78(1)       At the conclusion of an investigation, the medical review committee shall direct that no further action be taken if

(a) in the opinion of the committee, the pattern of practice of the investigated medical practitioner does not depart unjustifiably from the average pattern of practice to which that medical practitioner's pattern has been compared; or

(b) the investigated medical practitioner has entered into an agreement with the minister to pay to the minister an amount of money that the minister considers reasonable because the pattern of practice of the investigated medical practitioner has departed unjustifiably from the average pattern of practice to which that medical practitioner's pattern has been compared.

Referral to formal inquiry committee

78(2)       If it does not make a direction under subsection (1), the medical review committee shall, at the conclusion of an investigation, refer the matter under investigation to the formal inquiry committee.

Decision to be served on physician

78(3)       The medical review committee shall notify the investigated medical practitioner and the minister, in writing, of any decision it makes under subsection (1) or (2), and the reasons for its decision.

Examination of documentary evidence

78(4)       The investigated medical practitioner and the minister may examine any documentary evidence that the medical review committee has considered in making a decision under this section.

S.M. 1991-92, c. 8, s. 18: S.M. 1992, c. 35, s. 58.

Formal inquiry committee

79(1)       A formal inquiry committee of 3 medical practitioners entitled to practise in Manitoba is hereby established consisting of

(a) a medical practitioner appointed by the minister;

(b) a medical practitioner appointed by the College of Physicians and Surgeons of Manitoba; and

(c) a medical practitioner appointed by the Manitoba Medical Association.

Where College or M.M.A. does not appoint

79(2)       If no appointment is made to the formal inquiry committee by the College of Physicians and Surgeons of Manitoba or the Manitoba Medical Association, the minister shall appoint a member for the College or the Manitoba Medical Association, or both, as the case may be.

Term of appointment

79(3)       An appointment of a member to the formal inquiry committee shall be for a term of 3 years and may be renewed once, and where a term has expired, the member shall continue to act until a successor is appointed.

Chairperson

79(4)       The medical practitioner appointed by the College of Physicians and Surgeons of Manitoba shall be the chairperson of the formal inquiry committee.

Appointment of alternate members

79(5)       When a member is absent or unable to act for any reason, an alternate may be appointed in accordance with this section to act in that person's place for such period as the appointment may specify.

Disqualification

79(6)       No person who is or has been a member of the medical review committee shall subsequently be appointed as a member of the formal inquiry committee.

Quorum

79(7)       A quorum at a hearing of the formal inquiry committee is 3.

S.M. 1991-92, c. 8, s. 18; S.M. 1992, c. 35, s. 58.

Remuneration

80(1)       The minister shall pay the members of the formal inquiry committee such remuneration and expenses as the minister determines.

Administrative support

80(2)       The formal inquiry committee shall be provided with such clerical and other administrative support, including the engaging of assistance for the committee, as the minister determines.

S.M. 1991-92, c. 8, s. 18; S.M. 1992, c. 35, s. 58.

Procedure

80.1        The formal inquiry committee may determine its own practice and procedure.

S.M. 1991-92, c. 8, s. 18.

Hearing by formal inquiry committee

81(1)       On referral of a matter to the formal inquiry committee under subsection 78(2), the formal inquiry committee shall hold a hearing to determine whether the past or present pattern of practice of the investigated medical practitioner departs from the average pattern of practice of medical practitioners who, in the opinion of the committee, practice in comparable circumstances.

Notice of hearing

81(2)       At least 30 days before the date of the hearing, the formal inquiry committee shall provide a notice of hearing to the minister, the medical review committee and the investigated medical practitioner, and the copy provided to the medical practitioner shall either be served personally or sent by registered mail to the last address of the medical practitioner shown in the records of the minister.

Contents of notice

81(3)       The notice of hearing under subsection (2) shall state the date, time and place at which the formal inquiry committee will hold a hearing and shall identify the specific matters in respect of which the hearing will be held.

Appearances at hearing

81(4)        The minister, the medical review committee and the investigated medical practitioner may appear and be represented by counsel or an agent at a hearing of the formal inquiry committee.

Hearing to be private

81(5)       A hearing of the formal inquiry committee shall be held in private.

S.M. 1991-92, c. 8, s. 18; S.M. 1992, c. 35, s. 58; S.M. 1995, c. 26, s. 7.

Medical review committee to forward material

81.1        The medical review committee shall forward to the formal inquiry committee any information or material in its possession that the formal inquiry committee requests, and the formal inquiry committee shall give the minister and the investigated medical practitioner an opportunity to examine any information and material that it receives.

S.M. 1991-92, c. 8, s. 18; S.M. 1992, c. 35, s. 58.

Power to administer oaths

82(1)       A member of the formal inquiry committee has power to administer oaths and affirmations for the purpose of a hearing of the committee.

Witnesses and records

82(2)       The formal inquiry committee may at a hearing

(a) examine witnesses under oath or affirmation;

(b) require the attendance of the investigated medical practitioner and any other witnesses; and

(c) require the production of any records relevant to the proceedings.

Notice to attend and produce records

82(3)       The attendance of witnesses before the formal inquiry committee and the production of records may be enforced by a notice issued by the committee requiring the witness to attend and stating the date, time and place at which the witness is to attend and the records, if any, that the witness is required to produce.

Exception for patients

82(4)       A patient who is given a notice under subsection (3) is excused from testifying before the formal inquiry committee if he or she provides a certificate of a medical practitioner certifying that testifying would likely jeopardize the patient's health.

Failure to attend or give evidence

82(5)       Proceedings for civil contempt of court may be brought against a witness

(a) who fails to attend before the formal inquiry committee in compliance with a notice to attend;

(b) who fails to produce any records in compliance with a notice to produce them; or

(c) who refuses to be sworn or to answer any question he or she is asked by the formal inquiry committee.

S.M. 1991-92, c. 8, s. 18.

Hearing in absence of investigated medical practitioner

82.1        The formal inquiry committee, on proof of service on the investigated medical practitioner of the notice of hearing, may

(a) proceed with the hearing in the absence of the medical practitioner or his or her agent; and

(b) determine the matter being heard in the same way as if the medical practitioner were in attendance.

S.M. 1991-92, c. 8, s. 18.

Recording of evidence

83          The oral evidence given at a hearing of the formal inquiry committee shall be recorded.

S.M. 1991-92, c. 8, s. 18.

Finding of formal inquiry committee

83.1        The formal inquiry committee may find that the pattern of practice of an investigated medical practitioner

(a) departs unjustifiably; or

(b) does not depart unjustifiably;

from the average pattern of practice to which the medical practitioner's pattern has been compared.

S.M. 1991-92, c. 8, s. 18.

Order of formal inquiry committee

84(1)       Where the formal inquiry committee determines that, by reason of an unjustifiable departure by the medical practitioner from the average pattern of practice to which that medical practitioner's pattern has been compared, the minister has paid amounts to the medical practitioner or any other person, or both, the formal inquiry committee may by written order require the practitioner to pay to the minister a sum of money that the committee specifies.

Costs

84(2)       An order made under subsection (1) may include a requirement to pay all or part of the costs of the investigation and of the hearing.

Service of order

84(3)       The formal inquiry committee shall provide a copy of an order made under subsection (1) to the minister and to the medical practitioner affected by it, and the copy provided to the medical practitioner shall either be served personally or sent by registered mail to the last address of the medical practitioner shown in the records of the minister.

S.M. 1991-92, c. 8, s. 18; S.M. 1992, c. 35, s. 58.

Record of hearing

84.1(1)     The formal inquiry committee shall, at the request of the minister or an investigated medical practitioner who intends to appeal the order of the committee under section 84.4, compile a record of the hearing it has held which shall include

(a) the notice of hearing;

(b) all documentary evidence;

(c) the transcript of any oral evidence given at the hearing; and

(d) the order of the committee and the reasons for the order.

Identifying information

84.1(2)     When compiling the record under subsection (1), the formal inquiry committee shall strike out or delete information that might identify individual patients.

Examination of record

84.1(3)     The minister and the investigated medical practitioner may examine the record described in subsection (1).

Copies of the record

84.1(4)     An investigated medical practitioner is entitled to a copy of the record referred to in subsection (1),

(a) at no cost, if the minister or the medical practitioner appeals the order of the formal inquiry committee under section 84.4; and

(b) on payment of the reasonable costs of providing the record as determined by the committee, if no appeal is taken from the order of the committee under section 84.4.

S.M. 1991-92, c. 8, s. 18; S.M. 1992, c. 35, s. 58.

Recovery of amount owing

84.2(1)     The minister may withhold from money owing or money that becomes owing to a medical practitioner any amount that the medical practitioner is, by order of the formal inquiry committee made under subsection 84(1), required to pay to the minister.

Filing of order

84.2(2)     The minister may cause to be filed a copy of an order made under subsection 84(1) in the Court of Queen's Bench, and on the order being filed it may be enforced in the same manner as a judgment of the court.

S.M. 1991-92, c. 8, s. 18; S.M. 1992, c. 35, s. 58.

Interest on unpaid amount

84.3(1)     If a medical practitioner is served with an order under subsection 84(3) and does not pay the amount specified in the order within 30 days of receiving a demand for payment from the minister, the minister is entitled to be paid interest on the amount not paid, and the rate of interest per annum shall

(a) for the period January 1 to June 30 in each year, be the prime lending rate of the fund's principal banker as that rate stood on January 1 of that year, plus 1%; and

(b) for the period July 1 to December 31 in each year, be the prime lending rate of the fund's principal banker as that rate stood on July 1 of that year, plus 1%;

compounded annually.

Interest may be recovered

84.3(2)     Interest payable under subsection (1) is a debt owing to the minister and the minister may recover the amount of the interest by action or by withholding it from money owing or against money that becomes owing by the minister to the medical practitioner.

S.M. 1991-92, c. 8, s. 18; S.M. 1992, c. 35, s. 58.

Appeal to Court of Appeal

84.4(1)     An investigated medical practitioner or the minister may appeal to the Court of Appeal a finding or an order, or both, made by the formal inquiry committee.

Notice of appeal

84.4(2)     An appeal under this section shall be commenced by filing a notice of appeal with the Registrar of the Court of Appeal within 30 days from the date on which the order of the formal inquiry committee is served under subsection 84(3).

Appeal on the record

84.4(3)     An appeal to the Court of Appeal shall be founded on the record of the hearing before the formal inquiry committee.

Powers of Court on appeal

84.4(4)     The Court of Appeal on hearing an appeal may

(a) make any decision or order that in its opinion should have been made;

(b) quash, vary or confirm the order of the formal inquiry committee or any part of it; or

(c) refer the matter back to the formal inquiry committee for further consideration in accordance with any direction of the Court.

S.M. 1991-92, c. 8, s. 18; S.M. 1992, c. 35, s. 58.

Appeal does not operate as stay

85          An appeal taken under section 84.4 does not operate as a stay of an order appealed against.

S.M. 1991-92, c. 8, s. 18.

Disclosure of information

85.1(1)     Except for the purpose of enforcement of this Act or the regulations, information obtained by or provided to the minister or a person engaged in the administration of this Act or the regulations, the board, the medical review committee, the formal inquiry committee or a committee established by the minister to monitor patient utilization of health services, and relating to

(a) the relationship of a medical practitioner to a patient; or

(b) the medical services rendered by a medical practitioner to a patient, including information contained in a medical or clinical record;

is confidential and shall not be communicated to any person not entitled by law to that information.

Right of M.M.A. and College of Physicians and Surgeons to information

85.1(2)     Despite subsection (1), the minister or a person engaged in the administration of this Act or the regulations, the board, the medical review committee and the formal inquiry committee may communicate any information referred to in subsection (1) to the Manitoba Medical Association and the College of Physicians and Surgeons of Manitoba.

Exception re order of formal inquiry committee

85.1(3)     Notwithstanding subsection (1), the minister or the formal inquiry committee may disclose information respecting an order made by the formal inquiry committee under section 84, including

(a) the name of the medical practitioner affected by the order;

(b) the amount the medical practitioner has been required to pay by the order; and

(c) the reasons for the order;

provided that no information which could reasonably be expected to identify a patient who has received medical services from the medical practitioner shall be disclosed.

S.M. 1991-92, c. 8, s. 18; S.M. 1992, c. 35, s. 58; S.M. 1996, c. 43, s. 3; S.M. 2005, c. 38, s. 6.

Payment of benefits direct to insured persons

86(1)       If an insured person

(a) receives medical services in Manitoba from a medical practitioner who has elected under section 91 to collect his fees otherwise than from the minister in accordance with this Act and the regulations; or

(b) receives elsewhere than in Manitoba medical services designated or described in the regulations as medical services in respect of which benefits are payable when they are rendered to an insured person elsewhere than in Manitoba;

the minister, upon receipt of a proven claim, and subject to sections 87 and 88, shall pay to the insured person, or in accordance with an agreement made under section 89, the amount that would have been paid a medical practitioner who collects fees for medical services rendered to insured persons from the minister in accordance with this Act and the regulations.

Larger payment for services received outside province

86(2)       Notwithstanding subsection (1), if an insured person receives elsewhere than in Manitoba medical services designated or described in the regulations as medical services in respect of which benefits are payable when they are rendered to an insured person elsewhere than in Manitoba, the minister, upon receipt of a proven claim, and subject to sections 87 and 88, may pay to the insured person a greater amount, as provided in the regulations, than would have been paid a medical practitioner who collects fees from the minister in accordance with this Act and the regulations for medical services rendered to insured persons in Manitoba.

Direct payments to out of province practitioners

86(3)       In lieu of making payments as provided in subsection (1) or (2), if the insured person has not paid the fees for services rendered to him elsewhere than in Manitoba, the minister may pay an amount, the payment of which is authorized under subsection (1) or (2), directly to the medical practitioner who rendered those services to the insured person.

S.M. 1992, c. 35, s. 11.

Payment not to exceed benefits

87          The minister is not liable to pay fees for any medical service rendered to an insured person in excess of the benefits payable under this Act and the regulations in respect of the medical service.

S.M. 1992, c. 35, s. 11.

Payment not to exceed fees charged

88          Where the amount of any fee charged by a medical practitioner is less than the amount of benefit payable under this Act and the regulations for the medical services that were rendered, the minister shall pay only the amount charged by or paid to the medical practitioner in respect of those medical services.

S.M. 1992, c. 35, s. 11.

Payment of benefits to government

89(1)       The minister may pay from the fund to the Minister of Finance amounts in respect of the cost of medical services or other health services rendered to insured persons by medical practitioners, or persons authorized by law to provide those health services, who are employed by the government.

Agreements with doctors outside Manitoba

89(2)       The minister may enter into an agreement with a medical practitioner practising medicine outside Manitoba who frequently renders medical services to insured persons providing for the payment of benefits in respect of those medical services directly to the medical practitioner.

S.M. 1992, c. 35, s. 11 and 35.

Right to select medical practitioner

90(1)       Subject to subsection (2), nothing in this Act or in the regulations interferes with the right of an insured person to select the medical practitioner from whom he wishes to receive medical services.

Right of medical practitioner to refuse service

90(2)       Nothing in this Act or the regulations imposes any obligations upon any medical practitioner to render medical services to any insured person.

Medical practitioner may opt out

91(1)       A medical practitioner, by giving to the minister at any time notice in writing, may elect to collect his fees for medical services rendered to insured persons otherwise than from the minister in accordance with this Act and the regulations.

Date of effect of notice by new doctor

91(2)       Where a medical practitioner gives notice under subsection (1) within one month after the date on which he first becomes entitled to practise medicine in Manitoba, the election takes effect on the date on which he becomes entitled to practise medicine in Manitoba.

Date of effect of notice by other doctors

91(3)       Where a notice under subsection (1) is given otherwise than as mentioned in subsection (2) the election takes effect on the first day of the first month beginning after the expiration of 90 days after the date on which the notice is given.

S.M. 1992, c. 35, s. 11.

Revocation of election

92          A medical practitioner who has made an election under subsection 91(1) may, by giving to the minister at any time notice in writing, revoke the election; and from and after the first day of the first month beginning after the date on which the notice of revocation is given to the minister the election ceases to have effect.

S.M. 1992, c. 35, s. 11.

Collection of medical fees direct from patient

93          Unless

(a) he has made an election under subsection 91(1) which is in effect; and

(b) prior to rendering a medical service to an insured person he has given to the insured person reasonable notice that he proposes to collect the amount of his fees for the medical services from the insured person and not from the minister;

a medical practitioner shall not collect from the insured person or any other person except the minister that part of any fee for the medical service rendered to the insured person that is paid as a benefit in respect of the medical service.

S.M. 1992, c. 35, s. 11.

Statement by opted out doctor

94          When a medical practitioner who has made an election under subsection 91(1) renders a medical service to an insured person, he or she shall

(a) send to the minister, on behalf of the insured person, a claim for the services in the form the minister requires; and

(b) send to the insured person a statement of the fees and charges for the services.

S.M. 1992, c. 35, s. 36; S.M. 2001, c. 21, s. 8.

Fees in excess of benefits prohibited

95(1)       A medical practitioner, whether or not he has made an election under section 91 which is in effect, who renders medical services, and any person rendering other health services to which this Act applies by reason of an order made under section 71, shall not charge to or collect from an insured person, in respect of those medical services or other health services, a fee in excess of the benefits payable in respect thereof under this Act and the regulations.

Penalty

95(2)       Any medical 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 $30,000. for each contravention.

Refund of excessive part of fee

95(3)       A judge who convicts a medical practitioner or other person of collecting an excessive fee from an insured person in contravention of subsection (1) shall order the medical practitioner or other person, as the case may be, to pay into court, in addition to any fine the judge may impose, an amount equivalent to that part of the fee that is excessive, and the court shall upon the receipt thereof refund the amount to the insured person.

S.M. 1998, c. 53, s. 10; S.M. 2001, c. 21, s. 9.

Interpretation

95.1(1)     In this section, "practitioner" means a medical practitioner and any other health practitioner who provides services for which payment is made under this Act.

Recovery of money from persons

95.1(2)     If the minister pays an amount under the plan to or on behalf of a person for a service rendered and

(a) the person was not an insured person when the service was rendered;

(b) the service rendered was not a service to which the person is entitled as a benefit under this Act; or

(c) the person misrepresented to the minister the nature or extent of the services;

the amount so paid is a debt owed by the person to the minister.

Recovery of money from practitioners

95.1(3)     If the minister pays an amount under the plan to or on behalf of a practitioner in respect of a service, or to an insured person in respect of a service provided by a medical practitioner who has made an election under subsection 91(1), and

(a) the amount was claimed by the practitioner in respect of a service that was not rendered;

(b) the practitioner misrepresented to the minister the nature or extent of the service rendered; or

(c) the practitioner has failed to provide the information referred to in section 75.1.1 in respect of a service;

the amount so paid is a debt owed by the practitioner to the minister.

Minister may recover money by action

95.1(4)     The minister may recover a debt referred to in this section by action or by set-off against money owing or that becomes owing by the minister to the person or to the practitioner.

Application

95.1(5)     If a medical practitioner's right to practice medicine is suspended, cancelled or not renewed, whether before or after this subsection comes into force, this section applies as if his or her right to practice were still in effect.

S.M. 1991-92, c. 8, s. 19; S.M. 1992, c. 35, s. 11; S.M. 1995, c. 26, s. 8; S.M. 1996, c. 43, s. 4.

Termination of certain contracts and prohibition of others

96(1)       Subject to subsections (2) and (4)

(a) every contract under which a resident is to be provided with, or to be reimbursed or indemnified for, the costs of hospital services, or medical services, or health services, that are benefits under this Act, has no force or effect and no payments shall be made thereunder to reimburse or indemnify any person for those costs; and

(b) no person shall make or renew a contract under which a resident is to be provided with, or be reimbursed or indemnified for the costs of hospital services, or medical services, or other health services that are benefits under this Act; and

(c) subject to subsection (5), no person shall make or renew a contract under which any amount that is payable to the person insured by reason of his being a patient in a hospital exceeds the cost to that person of services other than hospital services that are benefits under this Act received by him while he is such a patient.

Limitation on subsection (1)

96(2)       Clauses (1)(a) and (b) do not apply to a contract, or to that part of a contract,

(a) under which the sole payment or advantage provided is that a resident is to be provided with, or is to be reimbursed or indemnified for, the cost of any services other than the cost of hospital services, medical services, or other health services, that are benefits under this Act; or

(b) wherein the sole payments or advantages provided are those payable to third persons under an insurance contract in respect of third party liability, or under a motor vehicle liability contract, issued in accordance with The Insurance Act.

Offence and penalty

96(3)       Any person who contravenes, or refuses, or fails to comply with subsection (1) is guilty of an offence and liable, on summary conviction, to a fine not exceeding $2,000.

Insurance during waiting period permitted

96(4)       This section does not prohibit an insurer making or keeping in force a contract with a person who is not an insured person, under which that person is to be indemnified for the costs of hospital services, medical services, or other health services, that are benefits under this Act, and that are required by him, or by any of his dependants, during any waiting period.

Saving

96(5)       A contract is not prohibited under clause (1)(c) solely because payment of the benefits payable thereunder begins earlier if the person insured is a patient in a hospital than it would begin if he were not.

Definition of past and future insured services

97(1)       In this section,

"future cost of insured services" means the estimated total cost of the future insured hospital, medical or other health services made necessary as the result of a bodily injury that will probably be required by an insured person after the date of settlement or, where there is no settlement, the first day of trial; (« coût futur des services assurés »)

"past cost of insured services" means the total cost of the insured hospital, medical or other health services made necessary as the result of a bodily injury and provided to an insured person up to and including the date of settlement or, where there is no settlement, the first day of trial. (« coût antérieur des services assurés »)

Action by insured person for cost of insured services

97(2)       When, as a result of the negligence or other wrongful act or omission of another person, an insured person suffers bodily injuries for which he or she receives insured hospital, medical or other health services under this Act, and he or she is not entitled to receive compensation under Part 2 of The Manitoba Public Insurance Corporation Act, the person may, subject to section 101, bring an action against and recover from that other person

(a) the past cost of the insured services; and

(b) the future cost of insured services;

for which the person, if he or she were not an insured person, would be legally liable to pay.

Cost of hospital services

97(3)       For the purpose of this section, the cost of insured hospital services shall be the per diem rate approved by the minister.

Certificate

97(4)       For the purpose of an action referred to in this section, the minister may issue one or more certificates that set out

(a) the insured hospital, medical or other health services that an insured person has received for bodily injuries suffered as a result of the negligence or other wrongful act or omission of another person; and

(b) the cost of those services.

Admissibility of certificate

97(5)       A certificate under subsection (4) is admissible in evidence as proof, in the absence of evidence to the contrary, of the facts stated in the certificate without proof of the minister's appointment or signature.

S.M. 1991-92, c. 8, s. 20; S.M. 1992, c. 35, s. 37; S.M. 1993, c. 36, s. 6; S.M. 2001, c. 21, s. 10.

Requirement to notify the minister

98          When an insured person to whom section 97 applies retains a lawyer to pursue recovery of damages for bodily injuries the insured person has suffered — or when a lawyer is retained on the insured person's behalf — the insured person shall, within 30 days after the lawyer is retained,

(a) notify the minister in writing of the claim; and

(b) provide the minister with the information prescribed in the regulations.

S.M. 1991-92, c. 8, s. 21; S.M. 1992, c. 35, s. 11; S.M. 2001, c. 21, s. 11.

Information from insured person

98.1(1)     At the minister's request, every insured person to whom section 97 applies shall promptly provide the minister with information about

(a) the negligence or other wrongful act or omission that caused the person bodily injuries;

(b) the bodily injuries suffered;

(c) the insured hospital, medical or other health services received for the bodily injuries; and

(d) any other matter the minister may specify.

Information from others

98.1(2)     Any person who has information about insured hospital, medical or other health services provided to an insured person to whom section 97 applies shall, at the minister's request, promptly provide that information to the minister.  However, this requirement does not apply to information subject to solicitor-client privilege.

S.M. 2001, c. 21, s. 11.

Duty to cooperate

98.2(1)     An insured person to whom section 97 applies shall cooperate fully with the minister and his or her officials and lawyers in establishing and proving the minister's right to recover the past cost of insured services and the future cost of insured services that have been provided to or that will be required by the insured person.

Duty applies in all cases

98.2(2)     The duty to cooperate applies whether the costs are included in a claim brought by the insured person, or are claimed in an action brought in the name of Her Majesty in right of the province.

S.M. 2001, c. 21, s. 11.

Judgment creditor a trustee for minister

99          A person who recovers any amount under section 97 shall receive and hold it in trust for the minister, and shall pay it to the minister forthwith.

S.M. 1992, c. 35, s. 11.

Judge to divide award

99.1        The judge at trial shall, if the evidence permits, apportion the elements of the insured person's loss and damages so as to clearly designate the amount of the recovery for the past cost of insured services and separate it from the amount of the recovery of future cost of insured services, if any.

S.M. 1991-92, c. 8, s. 22; S.M. 1992, c. 35, s. 38.

Insufficient amount of recovery

99.2(1)     Where the amount of money recovered by an insured person to whom section 97 applies, whether by action or on settlement, is, after deduction of the costs of the recovery, not sufficient to provide complete indemnity for the loss or damage suffered, the amount remaining after deduction of the costs of recovery shall be divided between the insured person and the minister in the proportion in which the loss or damage has been borne by them.

Exception for undue hardship

99.2(2)     Subsection (1) does not apply where a division between the minister and the insured person of money recovered would result in undue hardship to the insured person.

Minister may waive rights

99.2(3)     The minister may waive the minister's right to recovery under subsection (1) on such terms and conditions as he or she considers appropriate.

S.M. 1991-92, c. 8, s. 22; S.M. 1992, c. 35, s. 11 and 39.

Payment to minister by judgment debtor

100         A person liable under section 97 to pay any amount may pay it to the minister, the receipt of which given therefor is a discharge of the liability and of any judgment recovered against him by reason thereof, to the extent of the amount so paid.

S.M. 1992, c. 35, s. 11.

Recovery of proportionate parts of damages

101         Where, by reason of The Tortfeasors and Contributory Negligence Act, a person by whom an action may be maintained under section 97 is entitled to recover only a portion of the damages suffered by him by reason of the bodily injuries, he is entitled to claim and recover under section 97 only an equal proportion of the amount of the cost of the hospital services that are benefits and the amount of the benefits with respect to the costs of medical services and other health services for which he may maintain an action under that section.

Consent of minister to settlement

102(1)      Subject to subsection (2), a settlement of the claim that any person has under section 97, whether before or after an action based thereon is brought is void unless the minister consents thereto; and where such a consent is given, the person liable to pay the amount agreed upon shall pay it to the minister forthwith.

Consent not required

102(2)      Where a person having a claim under section 97 makes a settlement thereof whereby an amount equal to the cost of the hospital services that are benefits or an amount equal to the benefits with respect to the cost of medical services, or other health services, or all or any of them, to which reference is made in section 97 becomes payable by an insurance company, if the insurance company pays that amount to the minister within 30 days from the date of the settlement, the consent of the minister to the settlement is not required.

S.M. 1992, c. 35, s. 11.

Action under M.P.I.C. Act

103         An insured person who may bring an action against another person under section 97 may also, in respect of bodily injuries arising out of the operation of a motor vehicle in Manitoba by a person whose identity or whereabouts cannot be ascertained, bring an action under The Manitoba Public Insurance Corporation Act or the regulations under that Act for the amount for which an action may be brought under section 97.

S.M. 1991-92, c. 8, s. 23.

Appeal by minister

104(1)      Where judgment has been given in an action to which reference is made in section 97, if the plaintiff has not appealed therefrom within the period limited for making such an appeal, the minister, on behalf of and in the name of the plaintiff, may appeal against the judgment as the plaintiff might have done, notwithstanding that the time has elapsed within which the plaintiff could appeal; but no appeal by the minister under this section may be begun after 60 days have elapsed since the end of the period within which the plaintiff could have appealed.

Notice of intention to appeal

104(2)      Before beginning an appeal under subsection (1) the minister shall give to the defendant in the action notice in writing of his or her intention to appeal and shall file a copy of the notice in the proper office of the court in which the action was brought.

Stay of proceedings and abandonment of appeal

104(3)      Subject as herein provided, upon the filing of a notice by the minister under subsection (2), all proceedings under the judgment shall be stayed until the expiration of the period of 60 days mentioned in subsection (1); but if within that period the minister decides not to appeal the minister may, without payment of costs to any party to the action, file a notice of abandonment of the appeal in the office in which the notice was filed, and thereupon any proceedings under the judgment may be begun or continued.

S.M. 1992, c. 35, s. 11 and 40; S.M. 1994, c. 20, s. 10.

Consent of minister to abandonment of action

105         Where an insured person to whom section 97 applies brings an action in which he includes a claim as provided in that section, he shall not abandon or discontinue the action in so far as that claim is affected, unless he has received the written consent of the minister thereto; and any abandonment or discontinuance without such a consent is void.

S.M. 1992, c. 35, s. 11.

Right of minister to bring action

106(1)      Subject to sections 109 and 110, where a person who may claim and recover an amount under section 97,

(a) does not bring an action;

(b) brings an action that does not include or that in the opinion of the minister is insufficient to adequately recover the past cost of insured services and the future cost of insured services; or

(c) does not effect a settlement of the claim in an amount and subject to terms and conditions that are acceptable to the minister;

the minister may, upon notice to the insured person, bring an action in the name of Her Majesty in right of the province under section 97.

Action under M.P.I.C. Act

106(2)      The minister may, under The Manitoba Public Insurance Corporation Act or the regulations made under that Act, bring an action in the name of Her Majesty in right of the province to recover past and future costs of insured services where the costs are incurred in respect of bodily injuries arising out of the operation of a motor vehicle in Manitoba by a person whose identity or whereabouts cannot be ascertained.

S.M. 1991-92, c. 8, s. 24; S.M. 1992, c. 35, s. 41.

Defences to action by minister

107         Where the minister brings an action under section 106, the defendant may raise any defence to the action that he could have raised against the person who under section 97 could bring, or could have brought an action, including a defence under The Tortfeasors and Contributory Negligence Act; and, if necessary, the court shall determine the degree of negligence of the defendant, and the minister shall recover only that part of the cost of the hospital services that are benefits and of the benefits with respect to the cost of medical services and other health services or both parts, incurred or to be incurred that is proportionate to that degree of negligence.

S.M. 1992, c. 35, s. 11.

Action of minister on death of insured person

108         Where a person who, under section 97 may claim and recover an amount as therein provided dies without bringing an action under that section, and his personal representative does not bring action under that section within the period to which reference is made in section 110, the minister may thereafter but subject to section 109, bring action as provided in section 106.

S.M. 1992, c. 35, s. 11; S.M. 2001, c. 21, s. 12.

Limitation on minister's right to bring action

109         Except as provided in section 110, the minister may only bring an action under section 106 within 2 years from the date the bodily injuries are suffered, unless a justice is satisfied, on application by the minister, that the minister did not know that a cause of action had arisen under section 97 and the justice permits the minister to bring an action after the 2 years has elapsed.

S.M. 1991-92, c. 8, s. 25; S.M. 1992, c. 35, s. 42.

Extension of time: abandonment or discontinuance

110(1)      If an insured person

(a) brings an action under section 97; and

(b) abandons or discontinues the action insofar as the claim for the amounts described in clauses 97(2)(a) and (b) are concerned;

the minister may bring an action in the name of Her Majesty in right of the province within 3 months from the date the minister receives written notice of the abandonment or discontinuance.

Extension of time: failure to give notice

110(2)      If an insured person

(a) brings an action under section 97 without including in the claim the amounts described in clauses 97(2)(a) and (b); and

(b) fails to give notice of the action to the minister under subsection 98(1);

the minister may bring an action in the name of Her Majesty in right of the province within 3 months from the date the minister receives notice that the insured person has brought an action, or within the 2 year period set out in section 109, whichever comes later.

S.M. 1991-92, c. 8, s. 25; S.M. 1992, c. 35, s. 43; S.M. 2001, c. 21, s. 13.

Interest

110.1(1)    When a claim for amounts described in clause 97(2)(a) or (b) is settled or a judgment is obtained, the settlement or judgment must include an amount for prejudgment interest.

Calculation

110.1(2)    Prejudgment interest is to be calculated in accordance with Part XIV of The Court of Queen's Bench Act from the date the cause of action arose to the date of the settlement or judgment.

S.M. 2001, c. 21, s. 14.

Periodic payments

110.2       If an insured person to whom section 97 applies

(a) enters into a settlement that provides for amounts described in clause 97(2)(a) or (b) to be paid wholly or partly by periodic payments; or

(b) obtains a judgment that orders amounts described in clause 97(2)(a) or (b) to be paid wholly or partly by periodic payments;

the insured person shall provide the minister with a copy of the settlement document or judgment as soon as possible after the settlement is entered into or the judgment is obtained.

S.M. 2001, c. 21, s. 14.

Application for joint trial

111         Where the minister brings an action as provided in section 106, the minister may on giving reasonable notice to the insured person apply to a judge of the court in which the action is brought for an order to have the action tried together with any action in the same court brought by the insured person to recover damages in respect of the same occurrence and the judge, if he deems it just and reasonable, may make the order.

S.M. 1992, c. 35, s. 44.

Settlement and discharge of liability

112         Where the minister has a right of action against a person under section 106, the minister may enter into an agreement with that person to settle the claim on payment of an amount agreed upon, and on receipt of that amount, the minister may give the person a release that discharges the person from all further liability to the minister under section 106 in respect of that claim.

S.M. 1992, c. 35, s. 45.

Protection from liability

112.1       Members of the board, the medical review committee, the formal inquiry committee, a committee established by the minister to monitor patient utilization of health services, persons acting on the instructions of the board or any of those committees, and persons engaged in the administration of this Act, are not personally liable for any act done in good faith in the performance or intended performance of a duty or in the exercise or intended exercise of a power under this or any other Act or regulation, or for any neglect or default in the performance or exercise in good faith of the duty or power.

S.M. 1995, c. 26, s. 9; S.M. 2005, c. 38, s. 7.

Regulations by L.G. in C.

113(1)      The Lieutenant Governor in Council may make regulations

(a) establishing classifications, the persons who come within which are residents within the meaning of this Act in addition to those who, in section 2, are defined as residents;

(a.1) providing for the exemption of surgical procedures from the definition of "surgical service" in subsection 2(1);

(b) prescribing the waiting period, if any, that must elapse after a person becomes a resident before he becomes an insured person;

(c) prescribing the time when and the person with whom registration shall be made, and specifying the persons, if any, who are exempt from the requirements as to registration;

(d) designating or describing classes and kinds of persons who are recipients of public assistance for the purposes of this Act and the regulations;

(e) prescribing the waiting period that must elapse after a person becomes a resident before he is entitled as an insured person to personal care as provided under clause 46(1)(c);

(f) in all respects relating to personal care and personal care homes respecting those matters mentioned in clauses (h) to (x) as those clauses relate to hospital services or hospitals;

(g) specifying goods and services that are provided as part of personal care;

(h) designating the benefits to which an insured person is entitled under this Act, except to the extent provided for in clause 116(g);

(i) designating and describing medical services in respect of which benefits are payable when they are rendered to an insured person elsewhere than in Manitoba;

(j) prescribing the benefits to which an insured person who ceases to be a resident is entitled;

(k) prescribing the services, or respecting the manner of determining the services, in respect of which an insured person is not entitled to receive benefits;

(k.1) for the purpose of clauses (h) and (k), requiring as a condition of entitlement to receive benefits that services be provided

(i) in a specified hospital or facility or any class of hospitals or facilities,

(ii) by a specified class of medical practitioners or other health care professionals,

(iii) under any other circumstances or subject to any other conditions or limitations that the regulations may specify;

(k.2) designating hospitals for the purpose of this Act;

(l) fixing the amounts, in any year, for which a person will be reimbursed in respect of admission to a hospital outside the province under section 53;

(m) prescribing the authorized charges or governing the manner of determining the authorized charges that may be made directly to a person, and governing the information or documentation that is to be provided before a determination is made;

(n) fixing the maximum and minimum charges that may be made for private and semi-private wards in hospitals;

(o) specifying the services that are in-patient services and those that are out-patient services;

(p) specifying the in-patient and out-patient services that are additional hospital services under the plan;

(q) designating the persons or classes of persons who, in addition to those persons who come within the definition of "out-patient" in subsection 2(1) are out-patients for the purposes of this Act and the regulations;

(r) prescribing the conditions under which licensed dentists may admit persons to hospitals;

(s) prescribing the time for and the manner of making claims for payment or for benefits;

(t) respecting the manner of, and other details relating to, payments of benefits to or on behalf of insured persons, except to the extent provided for in clause 116(g);

(t.1) respecting, for the purpose of section 75, the remuneration to be paid to medical practitioners and other health practitioners who provide services to residents under this Act on a basis other than a fee for services rendered;

(t.2) prescribing information that medical practitioners and other health practitioners who provide services to insured persons under this Act are required to file with the minister for the purpose of facilitating the assessment, payment and audit of claims, including the form in which such information must be filed;

(t.2.1) governing the fees that may be charged to medical practitioners and other health practitioners for processing claims for payment, and governing the manner of recovering such fees including authorizing the minister to withhold payment of claims to practitioners if the fees are not paid;

(t.3) prescribing the times by which and the circumstances under which practitioners referred to in clause (t.2) are required to file information under the regulations made under that clause;

(t.4) authorizing the minister to withhold the payment of claims to practitioners referred to in clause (t.2) until the regulations made under clauses (t.2) and (t.3) are complied with;

(t.5) requiring practitioners referred to in clause (t.2) to keep and maintain for a prescribed period such books and records as are prescribed;

(u) respecting the manner of, and other details relating to, payments by the minister to hospitals, both within and outside the province, as provided in sections 51 and 53;

(u.1) respecting the manner of, and other details relating to, adjustment of total annual payments to hospitals as provided in subsection 60(2);

(u.2) respecting the manner of, and other details relating to, making deductions for excess payments to hospitals as provided in subsection 60(3);

(v) respecting the assignment of benefits, and, without limiting the generality of the foregoing, allowing, restricting, or prohibiting the assignment of benefits, and prescribing conditions to acceptance by medical practitioners of assignments of benefits, or doing any of those things;

(w) prescribing forms to be used for various purposes in respect of the administration of this Act and the regulations;

(x) prescribing the reports required from hospitals, medical practitioners and persons providing other health services;

(y) [repealed] S.M. 1998, c. 53, s. 11;

(z) permitting personal care homes to hold funds in trust for residents, including

(i) regulating the manner in which the funds are to be held and administered,

(ii) governing agreements between residents and personal care homes about the funds,

(iii) permitting personal care homes to deposit the funds in an interest-bearing account kept by the personal care home for its residents generally, and

(iv) permitting any interest earnings accrued from an account kept for residents generally to be used for the benefit of residents generally;

(aa) establishing the maximum proportion of the total accommodation in personal care homes that may be used to provide services to persons who are not entitled to receive personal care under section 46;

(bb) [repealed] S.M. 1998, c. 53, s. 11;

(cc) prescribing rates that may be charged by personal care homes for services provided to persons who are not entitled to receive personal care under section 46;

(dd) prescribing classes of persons who may make appeals to the board;

(ee) defining any word or expression used in this Act but not defined in this Act.

Retroactive regulations

113(2)      A regulation under clause (1)(h), (i), (t) or (t.1) may be made effective retroactively to a date fixed in the regulation.

Regulations prescribing authorized charges

113(3)      A regulation under clause (1)(m) may prescribe or determine different authorized charges for different classes of persons.

S.M. 1988-89, c. 13, s. 15; S.M. 1991-92, c. 8, s. 26 and 27; S.M. 1992, c. 35, s. 46; S.M. 1993, c. 30, s. 3; S.M. 1995, c. 26, s. 10; S.M. 1996, c. 43, s. 5; S.M. 1998, c. 53, s. 11; S.M. 2001, c. 21, s. 15; S.M. 2005, c. 38, s. 8.

114         [Repealed]

S.M. 1992, c. 35, s. 47.

Application of provisions to personal care and personal care homes

115         Sections 41, 43, 47, 48, 50, 51, 55, 62, 63, 69, 96 to 112 apply with such modifications as the circumstances require to and in respect of personal care which an insured person is entitled, under section 46, to receive in personal care homes as though that personal care were hospital services, and to and in respect of personal care homes as though personal care homes were hospitals.

S.M. 1992, c. 35, s. 48.

Regulations by minister

116(1)      The minister may make regulations

(a) authorizing and prescribing the terms and conditions for the refunding of premiums;

(b) designating premises situated in Manitoba as personal care homes for the purpose of section 46;

(c) designating institutions for the purpose of section 57;

(d) designating the services and costs, not included in an agreement, for which a budget must be approved for a hospital and the rates payable for those services and costs for the purpose of section 57;

(e) establishing the proportion of total bed capacity to be designated and retained as standard ward accommodation by hospitals in Manitoba that are not owned or operated by the Government of Canada;

(f) establishing the proportion of total accommodation to be designated and retained as standard accommodation by personal care homes;

(g) designating the benefits to which an insured person is entitled under this Act in relation to services rendered by medical practitioners, and respecting the manner of, and other details relating to, payments of those benefits to or on behalf of insured persons;

(h) for the purpose of clause (g), requiring as a condition of entitlement to receive benefits that services be provided

(i) in a specified hospital or facility or any class of hospitals or facilities,

(ii) by a specified class of medical practitioners, or

(iii) under any other circumstances or subject to any other conditions or limitations that the regulations may specify;

(i) prescribing information required to be provided by an insured person under section 98.

Retroactive regulation

116(2)      A regulation under clause (1)(g) may be made effective retroactively to a date fixed in the regulation.

S.M. 1991-92, c. 8, s. 28; S.M. 1992, c. 35, s. 49; S.M. 1996, c. 43, s. 6; S.M. 1998, c. 53, s. 12; S.M. 2001, c. 21, s. 16.

Regulations respecting personal care

117         The minister may make regulations for the purpose of bringing the provision of personal care in personal care homes within the plan as an insured service.

S.M. 1992, c. 35, s. 50.

Personal care home licence

118(1)      No person shall establish or operate a personal care home except under the authority of a personal care home licence issued under this Act.

Application for licence

118(2)      A person may apply for a personal care home licence by filing an application with the minister in accordance with, and including the information and the fee required by, the regulations.

Regional health authority approval

118(3)      An application may be made under subsection (2) only if the operation of the personal care home has been approved under subsection 28(1) of The Regional Health Authorities Act.

Transitional

118(4)      Subsection (3) does not apply if the application is made for a personal care home that is licensed under The Public Health Act on the day this section comes into force.

S.M. 1991-92, c. 8, s. 29; S.M. 1992, c. 35, s. 51; S.M. 1998, c. 53, s. 13.

Issuing a licence

118.1(1)    The minister may issue a personal care home licence to operate a personal care home if he or she is satisfied that

(a) the applicant and the personal care home meet the requirements of this Act and the regulations; and

(b) the personal care home would, if licensed, be operated and maintained in compliance with this Act and the regulations.

Terms and conditions

118.1(2)    The minister may issue a personal care home licence subject to any terms and conditions that the minister considers appropriate.

Term of licence

118.1(3)    A personal care home licence is valid for the term provided for in the regulations.

Licence not transferable

118.1(4)    A personal care home licence is not transferable.

S.M. 1998, c. 53, s. 13.

Refusal to issue a licence

118.2(1)    If the minister refuses to issue a personal care home licence, the minister shall notify the applicant of the refusal and the reasons for it in writing and shall inform the applicant of the right to appeal the minister's decision to the board.

Suspension or cancellation of licence

118.2(2)    The minister may suspend or cancel or refuse to renew a personal care home licence if the minister is of the opinion that

(a) the operator of the personal care home has failed to comply with this Act or the regulations or the terms and conditions of the personal care home licence;

(b) the continued operation of the personal care home by the operator would be hazardous to the health, safety or well-being of residents;

(c) the operator of the personal care home has failed to meet its financial obligations or show financial responsibility for the personal care home; or

(d) it is otherwise in the public interest to do so.

Notice

118.2(3)    If the minister suspends, cancels or refuses to renew a personal care home licence, the minister shall notify the operator of the decision and the reasons for it in writing and shall inform the operator of the right to appeal the decision to the board.

Interim licence

118.2(4)    If the minister suspends, cancels or refuses to renew a personal care home licence and the operator of the personal care home appeals the minister's decision, the minister may, if satisfied that continued operation of the personal care home would not be hazardous to the health, safety or well-being of residents, issue an interim licence for the personal care home for a term that expires on the earlier of

(a) the day the board finally disposes of the appeal; or

(b) six months after the day the earlier licence expired or was suspended or cancelled.

S.M. 1998, c. 53, s. 13.

Appeal

118.3       An operator of a personal care home who receives a notice under subsection 118.2(1) or (3) may appeal the decision of the minister to the board by filing a notice of appeal with the board within 30 days of receiving the notice.

S.M. 1998, c. 53, s. 13.

Inspectors

118.4(1)    The minister may appoint one or more persons as inspectors for the purpose of sections 118 to 118.5.

Powers of inspectors

118.4(2)    For the purpose of determining whether there is compliance with this Act and the regulations, an inspector may

(a) at any reasonable time, and upon presentation of identification, enter and inspect a personal care home and the operations in the personal care home;

(b) inspect any records, documents or other things relevant to the inspection;

(c) demand the production for inspection of records, documents or other things relevant to the inspection, including records, documents or other things that are not kept on the premises of the personal care home;

(d) conduct any examination or test that is reasonably necessary for the inspection; and

(e) on providing a receipt, remove a record, document, sample of a substance, or any other thing, if it is relevant to the inspection.

Unlicensed premises

118.4(3)    An inspector may enter and inspect any premises that the minister believes on reasonable grounds is operated as a personal care home in contravention of this Act.

Use of data processing system and copying equipment

118.4(4)    In carrying out an inspection or examination under this Act, an inspector may

(a) use a data processing system at the personal care home or the place where the records, documents or things are kept to examine any data contained in or available to the system;

(b) reproduce, in the form of a print-out or other intelligible output, any record from the data contained in or available to a data processing system at the personal care home or in the place; and

(c) use any copying equipment at the personal care home or place to make copies of any record or document.

Assistance to inspectors

118.4(5)    An operator of a personal care home and any other person who has custody or control of a record, document or thing referred to in subsection (2) shall give an inspector all reasonable assistance to enable the inspector to carry out his or her duties and shall furnish to the inspector any information the inspector may reasonably require.

Warrant by justice

118.4(6)    A justice, who is satisfied by information on oath that an inspector has been prevented from exercising his or her powers under this section, may at any time issue a warrant authorizing the inspector and any other person named in the warrant to exercise the powers granted.

Obstruction

118.4(7)    No person shall hinder, obstruct or interfere with an inspector conducting an inspection under this section.

S.M. 1998, c. 53, s. 13.

Regulations

118.5(1)    For the purpose of sections 118 to 118.4, the minister may make regulations

(a) respecting the licensing of personal care homes, including the fees payable for licences;

(b) respecting the management and operation of personal care homes;

(c) respecting the construction, establishment, location, safety, equipment, maintenance and repair of personal care homes;

(d) respecting standards for personal care homes and their operation, including but not limited to standards of care, accommodation, services and programs;

(e) governing the staff requirements for personal care homes;

(f) governing the qualifications of administrators, staff and employees of personal care homes and governing their powers and duties;

(g) requiring operators of personal care homes to make by-laws that include matters specified in the regulations;

(h) respecting the admission of residents to personal care homes and their discharge from personal care homes;

(i) respecting the books, accounts and records, including health records, that are to be kept and retained by operators of personal care homes;

(j) requiring operators of personal care homes to provide such financial statements, reports and returns as the minister may require in the form and in the manner and at the time required by the minister;

(k) respecting the establishment and operation of resident councils for personal care homes;

(l) concerning the discontinuance or suspension of operation of personal care homes;

(m) establishing transitional provisions respecting personal care homes that are licensed under The Public Health Act on the day this section comes into force;

(n) respecting any matter necessary or advisable to carry out the intent and purpose of this Act effectively.

Scope of regulations

118.5(2)    A regulation under subsection (1) may be made applicable to different classes of personal care homes.

S.M. 1998, c. 53, s. 13.

Definitions

119         In sections 120 to 130,

"laboratory" means a place where

(a) the diagnostic examination or treatment of patients is performed by means of radiation emitting or non-radiation emitting medical imaging devices, or

(b) operations and procedures, including the collection of specimens from the human body, are performed for the purpose of obtaining information for diagnosis, prophylaxis or treatment,

but does not include

(c) the office of a medical practitioner where diagnostic laboratory procedures prescribed by regulation are performed by the medical practitioner or an employee under his or her supervision solely for the diagnosis of patients of the medical practitioner,

(d) the office of a dentist, as defined in The Dental Association Act, where diagnostic laboratory procedures are performed solely for the diagnosis of patients, or

(e) the office of a chiropractor, as defined in The Chiropractic Act, where diagnostic laboratory procedures are performed solely for the diagnosis of patients; (« laboratoire »)

"officer" means the person appointed as an approving officer under section 120; (« agent »)

"specimen collection centre" means a place where specimens are taken or collected from the human body for examination to obtain information for diagnosis, prophylaxis or treatment, but does not include

(a) the office of a medical practitioner where specimens are taken or collected by the medical practitioner or an employee under his or her supervision solely for the diagnosis of patients of the medical practitioner, or

(b) a laboratory that is established, operated or maintained under an approval under this Act. (« centre de prélèvements »)

S.M. 1991-92, c. 8, s. 30.

Appointment of approving officer

120         The minister shall appoint an approving officer for the purpose of sections 119 to 130.

S.M. 1991-92, c. 8, s. 30; S.M. 1992, c. 35, s. 11.

Approval required for laboratory

121(1)      No person shall

(a) establish, operate or maintain a laboratory or a specimen collection centre; or

(b) enlarge, relocate, or establish a branch of a laboratory or specimen collection centre;

except under the authority of an approval granted by the officer under this Act.

Granting of approval

121(2)      The officer may grant an approval,

(a) in the case of a laboratory, to perform such tests or classes of tests and collect such specimens as the officer may specify in the approval; and

(b) in the case of a specimen collection centre, to take or collect such specimens or classes of specimens as the officer may specify in the approval.

Conditions of approval

121(3)      The officer, when granting an approval or by written notice at any time, may impose on the approval such conditions as the officer considers necessary.

Entitlement to approval

121(4)      A person who applies in accordance with this Act and the regulations for an approval

(a) to establish, operate or maintain a laboratory or a specimen collection centre; or

(b) to enlarge, relocate, or establish a branch of a laboratory or specimen collection centre;

and who meets the requirements of this Act and the regulations is entitled to be granted the approval.

S.M. 1991-92, c. 8, s. 30.

Grounds for refusal — location

122(1)      Despite subsection 121(4), the officer shall not grant an approval if in the officer's opinion it is not in the public interest to grant an approval in the area where the applicant proposes

(a) to establish, operate or maintain a laboratory or specimen collection centre; or

(b) to enlarge, relocate, or establish a branch of a laboratory or specimen collection centre.

Grounds for refusal — tests and specimens

122(2)      Despite subsection 121(4), if the officer is of the opinion that it is not in the public interest to grant an approval,

(a) in the case of a laboratory, for any of the tests or classes of tests, diagnostic examinations or treatments in respect of which the application is made; or

(b) in the case of a specimen collection centre, to take or collect such specimens or classes of specimens in respect of which the application is made;

the officer shall not grant the approval for those tests or classes of tests or for taking or collecting those specimens or classes of specimens.

S.M. 1991-92, c. 8, s. 30.

Matters to be considered

123         In considering, under section 122, whether it is in the public interest to grant an approval, the officer shall take into account the following:

(a) the number of laboratories or specimen collection centres that operate under the authority of approvals granted under this Act in the area for which the approval is sought or in any other area;

(b) the number of laboratories or specimen collection centres operated by the government in the area for which the approval is sought or in any other area;

(c) the tests and classes of tests performed in the laboratories or the specimens or classes of specimens taken or collected in the specimen collection centres in the area for which the approval is sought or in any other area;

(d) the utilization of existing laboratories or specimen collection centres and their capacity to handle increased volume;

(e) the availability of facilities for the transportation of persons and specimens to laboratories or for the transportation of persons to specimen collection centres, in the area for which the approval is sought or in any other area; and

(f) the funds available to provide payment for laboratory tests that are insured under this Act.

S.M. 1991-92, c. 8, s. 30.

Further grounds for refusal of approval

124         In addition to the grounds for refusal set out in section 122, the officer may refuse to grant an approval if in the officer's opinion,

(a) the past conduct of the applicant or, where the applicant is a corporation, of its officers or directors affords reasonable grounds for belief that the laboratory or specimen collection centre will not be operated in accordance with the law and with honesty and integrity;

(b) the proposed laboratory or specimen collection centre or its operation would contravene this Act or the regulations or any other Act or regulation;

(c) the applicant is not competent to operate a laboratory or specimen collection centre in accordance with this Act and the regulations; or

(d) the equipment or premises are not suitable for the performance of the tests or the taking or collecting of the specimens for which the approval is sought.

S.M. 1991-92, c. 8, s. 30.

Operator to be named in approval

125(1)      It is a condition of an approval that the operation of the laboratory or specimen collection centre be under the charge and control of the operator named in the approval as operator and that the ownership of the laboratory or specimen collection centre be only in the person named in the approval as owner.

Notice of changes

125(2)      If the operator or the owner named in the approval is a corporation, the corporation shall notify the minister in writing within 15 days of any change in the officers or directors of the corporation.

S.M. 1991-92, c. 8, s. 30; S.M. 1992, c. 35, s. 11.

Revocation of approval

126         The officer may revoke an approval if

(a) a person has made a false statement in the application for the approval or in any report, document or other information required by this Act or the regulations;

(b) a test or specimen taking or collecting authorized by the approval is carried out incompetently;

(c) there is a breach of a condition of the approval;

(d) the owner or operator does not comply with this Act or the regulations;

(e) the services that can be provided by the laboratory or specimen collection centre are misrepresented; or

(f) a change in the officers or directors of a corporation which is an operator or an owner of a laboratory or specimen collection centre named in the approval would afford grounds for refusing to grant an approval under clause 124(a).

S.M. 1991-92, c. 8, s. 30.

Appeal

127(1)      Where the officer,

(a) refuses to grant an approval;

(b) grants an approval subject to conditions or imposes new conditions on an approval; or

(c) revokes an approval;

the officer shall by written notification inform the applicant or the owner and operator that the officer's decision may be appealed to the board by mailing or delivering to the board, within 30 days of receipt of the written notification, a request for an appeal.

127(2) and (3) [Repealed] S.M. 1992, c. 35, s. 52.

S.M. 1991-92, c. 8, s. 30; S.M. 1992, c. 35, s. 52.

Appointment of inspectors

128(1)      The minister may appoint 1 or more persons as inspectors for the purpose of sections 119 to 130.

Powers of inspectors

128(2)      When claims have been submitted to the minister for services rendered in a laboratory or a specimen collection centre, an inspector may, without a warrant, during ordinary business hours enter the premises of the laboratory or the specimen collection centre and may inspect and examine

(a) the premises;

(b) any records, facilities and equipment located on the premises that are relevant to the submission of claims and the payment of benefits under the plan for services rendered by the laboratory or specimen collection centre; and

(c) any records, facilities and equipment located on the premises that will aid the minister in determining whether the standards of testing and analysis, the qualifications and number of skilled personnel, and the range and availability of services and equipment provided are appropriate to the operation of the laboratory or specimen collection centre and the functions performed under the approval granted in respect of it.

Entry to be permitted

128(3)      A person who operates a laboratory or a specimen collection centre approved under this Act shall, on the request of an inspector and on presentation of identification, permit entry onto the premises of the laboratory or the specimen collection centre and permit the inspector to inspect or examine, in accordance with subsection (2), the premises and the records, facilities and equipment located on the premises.

Records to be produced

128(4)      When records of a kind referred to in subsection (2) are not located on the premises of a laboratory or a specimen collection centre approved under this Act, a person who has possession of the records shall, on the request of an inspector, produce the records and permit inspection of them by the inspector.

Use of data processing system and copying equipment

128(5)      In carrying out an inspection or examination under this section, an inspector may

(a) use a data processing system at the place where records, facilities or equipment are kept to examine any data contained in or available to the system;

(b) reproduce, in the form of a print-out or other intelligible output, any record from the data contained in or available to a data processing system at the place; and

(c) use any copying equipment at the place to make copies of any record or document.

Assistance to inspectors

128(6)      A person who has custody or control of records, facilities or equipment must give an inspector all reasonable assistance to enable the inspector to carry out his or her duties and must furnish to the inspector any information the inspector may reasonably require.

Warrant by justice

128(7)      A justice who is satisfied by information on oath that an inspector has been prevented from exercising his or her powers under this section may issue a warrant authorizing the inspector and any other person named in the warrant to exercise those powers.

S.M. 1991-92, c. 8, s. 30; S.M. 1992, c. 35, s. 11; S.M. 2005, c. 38, s. 9.

Regulations

129         For the purpose of carrying out the provisions of sections 119 to 128, the minister may make regulations

(a) [repealed] S.M. 1998, c. 53, s. 14;

(b) respecting standards and other requirements for the operation of laboratories and specimen collection centres;

(c) prescribing procedures that medical practitioners may perform in their offices without requiring an approval under section 121.

S.M. 1991-92, c. 8, s. 30; S.M. 1992, c. 35, s. 11; S.M. 1998, c. 53, s. 14.

Offence and penalty

130         A person who contravenes a provision of

(a) sections 118 to 128;

(b) a condition of an approval granted under section 121; or

(c) a regulation made under section 118.5 or 129;

is guilty of an offence and is liable, on summary conviction, to a fine of not more than $5,000. for each day the contravention continues.

S.M. 1991-92, c. 8, s. 30; S.M. 1998, c. 53, s. 15.

131         [Repealed]

S.M. 1988-89, c. 11, s. 11; S.M. 1991-92, c. 8, s. 31; S.M. 1998, c. 53,  s. 15.

Commission discontinued

132(1)      Upon the coming into force of this section, the Manitoba Health Services Commission (the commission) is discontinued.

Property, assets, etc. of commission transferred

132(2)      All property, assets, rights and interests held by, in the name of or in trust for the commission are deemed to be the property, assets, rights and interests of Her Majesty in right of the province.

Obligations of commission transferred

132(3)      All obligations and liabilities of the commission are deemed to be the obligations and liabilities of Her Majesty in right of the province.

Licences, approvals, etc.

132(4)      Every licence, approval, registration, order, decision and any other act or thing issued, given, made or done by or on behalf of the commission shall be deemed to have been issued, given, made or done by Her Majesty in right of the province.

References in documents

132(5)      Every reference to the commission in any deed, lease, licence, contract, trust agreement or in any other document, whether executed by the commission in its own name or not, shall be read as a reference to Her Majesty in right of the province.

Closing out affairs of commission

132(6)      The minister may do and perform all acts and things necessary for or incidental to the transferring of all property, assets, rights, interests, obligations and liabilities from the commission to Her Majesty, and for the closing out of the affairs of the commission.

Commencement of legal proceedings

132(7)      Any action, suit or other legal proceeding in respect of an obligation or liability incurred by the commission, or by the minister in closing out the affairs of the commission, may be brought against Her Majesty in any court or before any body that would have had jurisdiction if the action, suit or other legal proceeding had been brought against the commission.

Continuation of legal proceedings

132(8)      Any action, suit or other legal proceeding brought by, on behalf of or against the commission, including any action by an insured person under section 97 or section 103 of this Act, which is pending in any court or before any body on the coming into force of this Act may be continued by, on behalf of or against Her Majesty in like manner and to the same extent as it could have been continued by, on behalf of or against the commission.

S.M. 1992, c. 35, s. 53; S.M. 1993, c. 48, s. 18.