Skip to main content
The Health Services Insurance Act
This is an unofficial archived version of The Health Services Insurance Act
as enacted by SM 1987-88, c. 9 on July 17, 1987.

R.S.M. 1987, 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 that may, as prescribed in the regulations, be made directly to patients for hospital services, medical services or other health services under the plan, but does not include charges by way of 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")

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

"commission" means Manitoba Health Services Commission; ("Commission")

"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 19 years, or

(b) 19 years of age or older and mentally or physically incapacitated, or

(c) 19 years of age or older but not more than two years older than 19 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 the Crown 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")

"hospital" means a hospital or other facility that is named, or is included in a category described, in an agreement made under section 50 and, where the context so requires, includes the owner of a hospital as hereinbefore in this clause defined; but does not include a tuberculosis hospital or sanatorium, a hospital or institution for the mentally ill or defective, a nursing home, a home for the aged, an infirmary, or other institution the purpose of which is the provision of custodial care; ("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 or, subject to the conditions prescribed in the regulations, on the order of a registered dentist; ("malade hospitalisé")

"in-patient services" means such services supplied to an in-patient as are specified in the regulations; ("services 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 soins de santé")

"out-patient" means a patient who is not an inpatient and who is received by a hospital for necessary diagnostic or treatment services but who is not assigned to a bed in thé hospital, other than to an emergency bed or a holding bed for temporary purposes, and includes

(a) a person who is designated in the regulations as an out-patient, and

(b) a person who is declared to be an outpatient by the commission or by an officer or employee of the commission authorized by it for that purpose; ("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 Hospital Insurance and Diagnostic Services Act (Canada) 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 Medical Care 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 premises in which personal care is provided to persons residing therein and which have been designated by the commission for the purposes of section 46 and, where the context so requires, includes the owner of a personal care home as hereinbefore in this clause defined; ("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")

"resident" means a person who is legally entitled to be in Canada and who makes his home in Manitoba and is physically present in the province at least six months a year and includes any other person who under the regulations is classified as a resident, but does not include a tourist, a transient, or a visitor to the province. ("résident" )

Determination of municipal residence.

2(2)

Where a dispute arises

(a) as to whether a person is a resident of a municipality; or

(b) as to which of two or more municipalities is the municipality in which a person is resident;

the dispute may be referred to The Municipal Board which shall decide the matter in accordance with the rules for determining residence as set out in The Municipal Act, and its decision shall be final and binding on all parties to the dispute.

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 commission as to those facts and files with it 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.

Continuation of commission.

3

The commission known as "Manitoba Health Services Commission" is hereby continued.

Corporate status of commission.

4

The persons who are members of the commission are a body corporate.

Agent of government.

5

The commission is an agent of Her Majesty in right of Manitoba.

Continuation of Manitoba Health Services Commission.

6

For all purposes the commission shall be deemed to be a continuation of the Manitoba Health Services Commission in existence immediately prior to the coming into force of this Act.

Composition of commission.

7

The commission shall be composed of not less than five members appointed by the Lieutenant Governor in Council.

Term of office.

8

Unless a member sooner dies, resigns, or is removed from office, each member shall serve for such period as is specified in the order by which he is appointed and thereafter until his successor is appointed; and a member may be re-appointed for succeeding terms.

Chairman and Vice-Chairman.

9

The Lieutenant Governor in Council shall designate one of the members of the commission to be chairman and another to be vice-chairman thereof.

Remuneration and expenses.

10

The commission shall pay to the chairman, vice-chairman and each other member of the commission such remuneration as may be fixed by the Lieutenant Governor in Council and such reasonable out-of-pocket expenses as may be incurred by the members in the performance of their duties as members.

Meetings.

11

The commission shall meet at the call of the chairman or at the direction of the minister.

Meeting at request of commission.

12

The chairman shall call a meeting of the commission immediately upon being requested so to do, in writing, by a majority of the other members of the commission.

Quorum.

13

A majority of the members of the commission, including the chairman or vice-chairman, constitutes a quorum at any meeting of the commission.

Validity of acts where a vacancy exists.

14

The fact that there are vacancies in the membership of the commission does not affect the validity of any act or thing done by or in the name of the commission.

Liability of members, officers, etc.

15

Members of the commission, the chairman, officers, or employees of the commission and persons acting under the instructions of any of them or under the authority of this Act or the regulations, are not personally liable for any loss or damage suffered by any person by reason of anything in good faith done, caused, permitted, or authorized to be done, or omitted to be done, by him or them, pursuant to, or in exercise of, or supposed exercise of, the powers given by this Act or the regulations.

Application of Insurance Act and Corporations Act.

16

The Insurance Act does not apply to the commission, to the Manitoba Health Services Insurance Plan, or to the insurance in respect of the costs of hospital or medical services or other health services provided under this Act and The Corporations Act does not apply to the commission.

Duties of chairman and vice-chairman.

17(1)

The chairman shall preside at all meetings of the commission; but when the office of chairman is vacant or in the case of his illness, absence from the province, or incapacity from any other cause to act, or on the request of the minister or the chairman, the vice-chairman shall act as chairman and while so acting, the vice-chairman has all the powers and authority and shall discharge all the duties of the chairman.

Chief Executive Officer.

17(2)

The Lieutenant Governor in Council may appoint an executive director who shall be the chief executive officer of the commission and may act for, on behalf of, and in the name of the commission in the execution, performance and carrying out of any act, matter or thing that is within the power of the commission subject only to such express directions and decisions as may have been given or made by resolution of the commission passed at a duly constituted meeting thereof.

Evidence as to signature of chairman, etc.

17(3)

Any order, regulation, direction, or other document whatsoever, purporting to be signed by the authority of the commission shall, when signed by the chairman, vice-chairman or executive director, as the case may be, be admitted as prima facie proof of the contents thereof without any proof of the signature of the chairman, vice-chairman or executive director, as the case may be, or of the authority of the chairman, vice-chairman or executive director, as the case may be, to sign it.

Employees.

18(1)

Subject to subsection (2), The Civil Service Act applies to employees of the commission and to all full time members of the commission.

Retention of services of professional persons.

18(2)

The commission may retain the services of such architects, barristers, solicitors, consultants, engineers, medical practitioners and other professional or expert persons as are deemed necessary for the proper and convenient transaction of the business of the commission, and may fix their remuneration.

Acquisition of property.

19(1)

Subject to subsections (2) and (3), the commission may acquire by purchase, lease, licence or otherwise and hold, develop, construct, use, maintain, repair, operate, improve, sell, lease or otherwise dispose of any property, real or personal, in each case upon such terms and conditions as the commission deems proper.

Acquisition of hospitals, etc.

19(2)

With the approval of the Lieutenant Governor in Council, the commission may acquire by purchase, lease, licence or otherwise and hold, operate, sell, lease or otherwise dispose of a hospital or related health facility.

Purchase of land, etc.

19(3)

The commission shall not purchase land or buildings without the approval of the Lieutenant Governor in Council.

Property in name of commission.

19(4)

Property owned or acquired by the commission shall be held or acquired in the name of the commission.

Contracts, etc.

20

The commission may enter into such contracts and agreements as may be necessary for its purposes, or as expressly provided in this Act.

General powers of commission.

21

The commission shall perform the duties and functions, and may exercise the rights imposed upon or granted to it under this Act, or any other Act of the Legislature and it shall discharge, perform and carry out such other duties and functions as may from time to time be assigned to it by the Lieutenant Governor in Council or by the minister.

Powers of the commission.

22

Without restricting the generality of section 21, but subject as otherwise expressly provided in this or any other Act of the Legislature, it is the function of the commission and it has power

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

(b) subject to the approval of the minister, to plan, organize and develop throughout the province a balanced and integrated system of hospitals and related health facilities and services commensurate with the needs of the residents of the province.

Duties of the commission.

23

The commission shall

(a) administer this Act;

(b) recommend to the minister in respect of each year, a program, including an operating budget and a capital budget;

(c) carry out such surveys, research, inquiries and investigations relating to health facilities and the provision of health services within the province as may be directed by the minister; and

(d) carry out such public educational programs relating to health, either alone or in cooperation with others, as may be directed by the minister.

Annual report.

24(1)

The commission shall submit to the minister each year, on or before a date fixed by the Lieutenant Governor in Council, a report in such form as may be prescribed by the Lieutenant Governor in Council covering its activities for its latest preceding fiscal year and the report shall include an audited balance sheet of the commission and an audited statement of operating revenues and expenditures of the commission together with such other information as may be required.

Statements separate.

24(2)

The audited statement of the operating revenues and expenditures of the commission shall show separately the expenditures for hospital services, medical services and other health services.

Tabling Annual Report.

24(3)

Upon receiving the report of the commission, the minister shall table a copy of the report before the assembly forthwith if it is then in session, and, if it is not then in session, within 15 days of the commencement of the next ensuing session thereof.

Audit by Provincial Auditor.

25(1)

The accounts of the commission shall be audited and reported on by the Provincial Auditor and the cost thereof shall be paid by the commission.

Special Audit.

25(2)

Notwithstanding subsection (1) the Lieutenant Governor in Council may, at any time, order, in addition to the audits made under subsection (1), an audit or investigation into the affairs of the commission and require a report thereon.

Fiscal year.

26

The fiscal year of the commission shall be such period, not in any case exceeding 15 months, as may be prescribed by the Lieutenant Governor in Council.

Disposal of moneys received from Canada.

27

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 credited to the trust and special division thereof; and, on the written requisition of the commission the Minister of Finance may pay over to it out of the moneys so contributed, credited, and remaining on deposit in that division, such amount as may be stated in the requisition.

Fund continued.

28

The Manitoba Health Services Fund is continued in the custody and control of the commission on behalf of Her Majesty in right of the province.

Credits to fund.

29

The commission shall place 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 by or for the commission 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 commission, on its 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 commission.

Payments from fund.

30

The commission shall pay from the fund such amounts as it may be required to pay under this Act or the regulations for the purposes of this Act and of the commission, including the costs of administration, and all salaries and remuneration of members of the commission and of officers and employees employed under the commission.

Fund kept in a bank.

31(1)

Subject to subsection (2) the commission shall deposit and keep all amounts credited to the fund in a chartered bank or credit union.

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 commission shall pay over any surplus funds to the Minister of Finance for investment for and on behalf of the commission.

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.

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 commission such amounts as may from time to time be requisitioned by the commission.

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 commission from and out of the Consolidated Fund at such time and upon such terms and conditions as the Lieutenant Governor in Council may prescribe.

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.

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 commission.

Registration by employers.

38

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

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 commission.

Issue of registration certificates.

40

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

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 commission, an agent, or other person to whom any information is required to be given in a report or statement made under this Act, 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 $200., 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.

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 $200.

Disposal of additional fine.

44

The amount of any additional fine imposed under section 42 and paid to the convicting magistrate shall be remitted by him to the commission forthwith.

Additional duties of the commission.

45

In addition to the functions enumerated elsewhere in this Act, the commission shall,

(a) ensure that adequate standards are maintained in hospitals and related health facilities including the supervision, licensing, equipping and inspection, or make such arrangements as, in the opinion of the commission, are necessary to ensure that such adequate standards are maintained;

(b) provide a consulting service to hospitals in the province, exclusive of individual patient care, or make such arrangements as, in the opinion of the commission, are necessary to ensure that such a consulting service is provided; and

(c) ensure that hospital records are audited annually and that the returns in respect of hospitals that are required by the Government of Canada are submitted.

Insured hospital and personal care services.

46(1)

The services that an insured person is entitled under this Act to receive at any hospital 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;

(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 by the commission as personal care homes for the purposes of this section.

Designation of personal care homes.

46(2)

The commission may by regulation designate premises situated in Manitoba as personal care homes for the purposes of this section.

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 Hospital Insurance and Diagnostic Services Act (Canada);

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

Right to payment for hospital services.

48

Subject as provided herein and in the regulations, every insured person is entitled to have the commission pay to any hospital in which the insured person has received hospital services while he was an insured person, amounts in respect of those hospital services; and the hospital shall not make any charge to the insured person for providing those hospital services, other than authorized charges.

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.

Agreement with Canada.

50(1)

The Government of Manitoba, represented therein by the minister, may, with the approval of the Lieutenant Governor in Council, enter into agreements with the Government of Canada under the Hospital Insurance and Diagnostic Services Act (Canada), to provide for contributions under that Act by the Government of Canada towards the cost of providing hospital services to insured persons; and may, in like manner, vary or amend the agreements.

Payment by commission of cost of hospital services to insured persons.

50(2)

Subject to subsection (2) and in accordance with sections 60 and 64 and the regulations, the commission 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.

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 commission may withhold payments due to it until the hospital complies with this Act and the regulations.

Effect of making payments.

51

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.

Payments to Canadian Government Hospitals.

52

The commission 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.

Payments in respect of hospitalization outside the province.

53(1)

Subject to subsection (2) the commission 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 commission may

(a) pay an amount the payment of which is authorized under clause (l)(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 (l)(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.

Hospitalization in mental hospitals outside province.

54(1)

Notwithstanding clause 47(b), and as provided in section 53, the commission 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 defective that is outside the province and that is named in the regulations; ("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). ("soins hospitaliers")

Recovery of overpayments.

55

In making payments to a hospital the commission 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.

Designation of chief budget officer.

56

The commission shall designate one of its senior officers or employees as the chief budget officer for the purposes of this Act.

Duties of chief budget officer re. hospital budgets.

57(1)

Subject to the direction of the commission, the chief budget officer shall

(a) examine the budget of

(i) each hospital in Manitoba in respect of which a licence under The Hospitals Act has been issued and is in effect;

(ii) each institution that is not ordinarily described as a hospital but that is a hospital within the meaning of this Act as defined in subsection 2(1) and that provides in the province facilities for the treatment of disease or injury, and that is designated in the regulations as an institution to which this section applies;

each of which hospitals and institutions are, for the purposes of this section, included in the expression "hospital";

(b) subject to subsection (2), approve and recommend to the commission 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 commission the rates of payment that should be made in respect of each hospital and that should be approved by the commission, 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)

Upon examining the budget of a hospital and recommending rates in respect of the hospital as provided in subsection (1), but before sending his recommendations to the commission, the chief budget officer shall notify the hospital of the budget and rates to be recommended, and give the hospital an opportunity of requesting the making of changes therein and of being heard with respect thereto.

Recommendations to commission.

57(3)

Where the hospital does not request the making of changes or, after considering changes requested, the chief budget officer makes a decision with respect thereto, the chief budget officer shall forward his recommendations to the commission and, at the same time, notify the hospital that he has done so.

Notice of appeal to commission.

57(4)

Where the hospital is dissatisfied with the budget or rates recommended, it may, within seven days after receiving the notice under subsection (3), notify the commission in writing that it desires to be heard with respect thereto.

Approval of budgets and establishment of rates.

58

On the expiration of the time for giving notice under subsection 57(4) or, if notice has been given under subsection 57(4), on hearing the hospital, the commission shall make its decision with respect thereto and approve a budget for that hospital, either as recommended or as it shall see fit.

Regulation establishing rates.

59

On approval of a budget for a hospital, the commission shall make a regulation establishing the rates of payment in respect of that hospital, either as recommended or as it may see fit and the regulation may establish rates of payments for periods commencing prior to the making of the regulation.

Retention of moneys by commission in reduction of overpayments.

60(1)

Where, at any time during the course of a year, it appears to the commission from an examination of the accounts of a hospital that the sum of the amounts paid by it 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 commission may retain such portion as it 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)(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(l)(c)(ii) incurred in that year, shall be determined by the commission 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 commission during that year is less than the amount determined under subsection (2), the commission 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 commission during that year exceeds an amount equal to the amount determined under subsection (2) plus an amount determined by the commission but not exceeding 2% of the approved operating costs of the hospital, the commission 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.

Application of budget review to personal care homes.

61

Sections 55, 57, 58, 59 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.

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 commission may prescribe, and shall maintain records in accordance with the regulations.

Power to inspect and audit.

63

The commission may cause the books, accounts, and records of any hospital to be inspected or audited, or both, at any time and it may require the hospital to verify, in a manner satisfactory to it, any information submitted to it by the hospital.

Rates of payment to certain hospitals.

64

The rates at which payment shall be made to hospitals and personal care homes to which subsection 57(1) does not apply, shall be those established in regulations made by the commission.

Agreement with outside hospitals.

65

The commission 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.

Unauthorized charging for hospital services 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 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, other than in respect of authorized charges; or

(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 $500.

Payment of grants.

67(1)

The commission may, as may be prescribed in the regulations, pay grants to the operators of hospitals or other persons, corporations, institutions or organizations, generally for the benefit of hospitals and the care and treatment of persons who are in-patients therein or out-patients thereof, and without restricting the generality of the foregoing, for purposes of matters relating to

(a) hospital operation and maintenance; or

(b) hospital construction, enlargement, renovation or repair; or

(c) educational or research programs.

Definition of hospital expanded.

67(2)

In this section,

"hospital" includes a hospital as defined in this Act, a medical nursing unit under The Health Services Act, a medical service unit, and also includes a building or part of a building for the accommodation of staff of a hospital; ("hôpital")

"medical service unit" means a building containing offices and treatment rooms for physicians and other health personnel and includes any building or part of a building used as a residence for medical practitioners and other health personnel. ("centre de service médical")

Agreements with participating hospital provinces.

68(1)

The commission 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 with an authority duly constituted in the participating hospital province to administer matters relating to hospital services insurance, respecting the provision of hospital services

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

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

including in each case, if so provided in the agreement, services equivalent to hospital 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 services or reimbursement for the cost thereof as provided in the agreement.

Agreements to act as trustee for hospitals.

69

The commission may enter into an agreement with any hospital

(a) by which the hospital assigns to the commission out of funds payable by it 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 debentures issued by it; and

(b) in which the commission 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 debentures as it becomes payable.

Restriction on sale of real property.

70

No hospital or personal care home that has received payments under this Act towards the payment of capital expenses incurred for construction or major renovation shall, without the consent of the minister, sell or dispose of any real property that has been used for the provision of insured services; and the minister may impose conditions on the granting of any consent given for the purpose of this section.

Insurance for other health services.

71

The Lieutenant Governor in Council may order that this Act applies to chiropractic or optometric services, or to services provided in hospitals by registered oral surgeons, or to services provided in hospitals by registered dental surgeons, 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 commission shall provide insurance in respect of the cost of those services or that class of those services in the same manner as it 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.

Communication of information.

72

The commission 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 Optometric Society; and

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

Development of medical and other health services.

73

Where in the opinion of the commission residents of Manitoba, for whatever reason, do not have available medical services and other health services; the commission may, with the approval of the Lieutenant Governor in Council, take such measures as are necessary to plan, organize and develop such services commensurate with the needs of the residents of the province.

Agreements re. medical fees and payments.

74

The commission, 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 commission 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.

Special arrangements.

75

With the approval of the Lieutenant Governor in Council, the commission may

(a) enter into agreements; or

(b) make arrangements;

for payment of remuneration either directly or through another person to medical practitioners rendering medical services to residents on a basis other than a fee for services rendered.

Agreement re. medical review committee.

76(1)

The commission, with the approval of the Lieutenant Governor in Council, and

(a) notwithstanding that it is not an incorporated association, the Manitoba Medical Association, through its officers; or

(b) The College of Physicians and Surgeons of Manitoba; or

(c) both;

may enter into an agreement respecting all matters relevant to the establishment, duties and functions of a medical review committee.

Where no agreement concluded.

76(2)

If no agreement is concluded under subsection (1), the commission, with the approval of the Lieutenant Governor in Council, may appoint a medical review committee.

Powers of review committee to obtain information etc.

77

The medical review committee has access to the records of any person that relate to a matter before the committee and is entitled to obtain from any person information that relates to a matter before the committee.

Evidence under oath.

78

For the purposes of carrying out its functions, the medical review committee may receive evidence under oath, and the chairman or secretary of the medical review committee may administer an oath to any person appearing before it.

Rules of procedure.

79

The medical review committee may establish rules of procedure, and may include in those rules, rules dealing with the manner in which the medical review committee will receive evidence.

Order of medical review committee.

80(1)

The medical review committee may review past or present patterns of medical practice of a medical practitioner, and may, by written order, require the medical practitioner to pay to the commission amounts that, in the opinion of the committee, he has received or may receive from the commission or that he has caused or may cause the commission to pay to any person, or both, either directly or indirectly, by reason of any departure from the pattern of medical practice established by the committee.

Service of order.

80(2)

The medical review committee shall serve a copy of any order made under subsection (1) upon the medical practitioner affected thereby; and the copy shall be served either personally or by prepaid registered mail to the last address of the medical practitioner shown in the records of the commission.

Order binding.

81

An order made by the medical review committee under subsection 80(1) is binding upon the medical practitioner affected thereby and the commission.

Filing of order.

82

The commission may file a duplicate original of any order of the medical review committee made under subsection 80(1) in the Court of Queen's Bench, and, upon the order being filed in the court, it shall be conclusively deemed to be, for all purposes, a judgment of the court and enforceable as such.

Action by commission.

83

Notwithstanding any appeal, the commission may withhold from moneys otherwise due and payable to a medical practitioner, any amount which the medical practitioner has, by order of the medical review committee, been required to pay to the commission.

Appeal from order.

84

Any medical practitioner affected by an order of the medical review committee made under subsection 80(1) who is dissatisfied with the order may, by written notice of appeal served on the commission within one month after the date on which the order is served on the medical practitioner, appeal the order to a board of arbitration composed of three medical practitioners entitled to practise medicine in the province,

(a) one of whom shall be appointed in writing by the medical practitioner;

(b) one of whom shall be appointed in writing by the commission; and

(c) one of whom, who shall be the chairman of the board of arbitration, shall be selected by the persons appointed under clauses (a) and (b);

and the decision of the board of arbitration is binding on the medical practitioner and the commission.

Disclosure of information.

85(1)

Information obtained by or furnished to the commission or the medical review committee, and relating to or respecting

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

(b) the medical services rendered by a medical practitioner to a patient;

shall not be communicated to any person not legally entitled thereto.

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

85(2)

Notwithstanding subsection (1), the commission or the medical review committee may communicate any information referred to in subsection (1) to the Manitoba Medical Association or The College of Physicians and Surgeons of Manitoba or both.

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 commission 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 commission, 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 commission 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 commission, 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 commission 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 commission 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.

Payment not to exceed benefits.

87

The commission 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.

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 commission shall pay only the amount charged by or paid to the medical practitioner in respect of those medical services.

Payment of benefits to government

89(1)

The commission may pay to the government 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 commission 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.

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 commission at any time notice in writing, may elect to collect his fees for medical services rendered to insured persons otherwise than from the commission 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.

Revocation of election.

92

A medical practitioner who has made an election under subsection 91(1) may, by giving to the commission 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 commission the election ceases to have effect.

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 commission;

a medical practitioner shall not collect from the insured person or any other person except the commission 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.

Statement by opted out doctor.

94

Where a medical practitioner has made an election under subsection 91(1) which is in effect, and he renders medical service to an insured person, if he does not send to the commission on behalf of the insured person a claim in respect of the medical services in a form prescribed by the commission, he shall include in the statement of his fees and charges for the medical services which he sends to the insured person a notice indicating that he has not done so and advising the insured person to make a claim to the commission.

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 $1,000. 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.

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 (l)(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 (l)(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.

Action by insured person for cost of insured services.

97

Where an insured person who suffers bodily injuries occasioned by the wrongful act, omission, neglect, or default of another person would, if he were not an insured person, be entitled to recover, as general or special damages, an amount that he has paid or is legally liable to pay to a hospital for care, treatment, drugs, medicines, supplies and medical or nursing services, or both, or for any of those things, received in a hospital, or, an amount that he has paid or is legally liable to pay for medical services or other health services received, or both amounts, he may, subject to section 101, claim and recover from that other person an amount equal to the cost of the hospital services that are benefits, or, an amount equal to the benefits with respect to the medical services, or other health services insured, or both amounts,

(a) that, by reason of those bodily injuries,

(i) he has received before beginning the action, and

(ii) he will subsequently receive, as computed by the court in the case of hospital services on the per diem basis on which charges are made by that hospital to persons who are not insured persons; and

(b) for which, if he were not an insured person, he would be legally liable to pay for the hospital service or for the medical services or other health services or all or any of them.

Notice of action excluding insured costs.

98(1)

Where an insured person to whom section 97 applies intends to bring an action for damages for the bodily injuries suffered by him, if he does not intend to include in his claim the amount that, under section 97, he is entitled to claim and recover, he shall, not less than seven days before beginning action, notify the commission in writing to that effect.

Notice of action including insured costs.

98(2)

Where an insured person to whom section 97 applies brings an action and includes in his claim an amount equal to the cost of hospital services that are benefits or an amount equal to the benefits with respect to medical services and other health services received by him or both, he, or if he is represented by a solicitor, his solicitor, shall, not less than seven days after filing a statement of claim, serve a copy thereof on the commission, and the service may be effected by mailing by registered mail.

Judgment creditor a trustee for commission.

99

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

Payment to commission by judgment debtor.

100

A person liable under section 97 to pay any amount may pay it to the commission, 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.

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 commission 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 commission consents thereto; and where such a consent is given, the person liable to pay the amount agreed upon shall pay it to the commission 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 commission within 30 days from the date of the settlement, the consent of the commission to the settlement is not required.

Action under section 12 Unsatisfied Judgment Fund Act.

103

A person who may, under section 97, brings an action against another person may also bring an action against the Attorney-General under section 12 of The Unsatisfied Judgment Fund Act, subject to his compliance with that Act, for the amount for which, under section 97, he could bring action against that other person.

Appeal by commission.

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 commission, 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 commission 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 commission shall give to the defendant in the action notice in writing of its 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 commission 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 commission decides not to appeal it 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.

Consent of commission 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 commission thereto; and any abandonment or discontinuance without such a consent is void.

Right of commission to bring action.

106

Where a person who, under section 97 may claim and recover an amount as therein provided does not bring an action therefor, or with the consent of the commission, effect a settlement of the claim, the commission, notwithstanding subsection 12(1) of The Unsatisfied Judgment Fund Act, may, subject to sections 109 and 110, maintain an action against the person legally liable under section 97 or an action under section 12 of The Unsatisfied Judgment Fund Act (subject to compliance with that section), for the amount that under section 97, the person suffering the bodily injuries could recover or, but for the expiration of the time, could recover.

Defences to action by commission.

107

Where the commission 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 commission 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.

Action of commission 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 106, the commission may thereafter but subject to section 109, bring action as provided in section 106.

Limitation on right to bring action.

109

Subject to section 110, the commission may bring action under section 106 at any time within 24 months from the time when the bodily injuries were suffered by the person who could make a claim under section 97, but not thereafter.

Extension of time for action by commission.

110

Where an insured person to whom section 97 applies brings an action as provided in section 97 and subsection 98(1), if after 21 months have elapsed from the time when the bodily injuries were suffered by him, he abandons or discontinues the action in so far as the amount to which reference is made in clauses 97(a) and (b) is affected, the commission may bring action under section 106 within three months from the date of the abandonment or discontinuance.

Application for joint trial.

111

Where the commission brings an action as provided in section 106, it 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.

Settlement and discharge of liability.

112

Where the commission has, under section 106, a right of action against any person, it may enter into an agreement with that person to settle the claim and discharge the liability to the commission on payment of an amount agreed upon; and upon receipt of that amount, the commission may give to the person liable a release discharging him from all further liability to the commission under section 106 in respect of that claim.

Regulations.

113

For the purpose of carrying out the provisions of this Act according to their intent, the commission with the approval of the Lieutenant Governor in Council, may make regulations ancillary thereto and not inconsistent therewith, and every regulation made under and inaccordance with the authority granted by this section has the force of law, and without restricting the generality of the foregoing the commission, with the approval of 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;

(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(l)(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;

(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) excepting services rendered by a medical practitioner from the services in respect of which an insured person is entitled to receive benefits;

(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 that may be made directly to a patient;

(n) fixing the maximum and minimums 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 registered dentists may admit persons to hospitals;

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

(t) respecting the manner of and other details relating to payments of benefits to insured persons and to medical practitioners;

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

(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) prescribing books, records and accounts to be kept by personal care homes.

Review of benefits.

114

Not less frequently than once in each year, and at such other times as the minister may request, the commission shall give detailed consideration to the benefits designated under clause 113(h).

Application of provisions to personal care and personal care homes.

115

Subsection 19(2), and sections 22, 41, 43, 45, 47, 48, 50, 51, 55, 62, 63, 67, 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.

Regulations by commission.

116(1)

The commission may make regulations, not inconsistent with any provision of this Act,

(a) on the budget for a hospital being approved as provided in section 58, establishing rates of payment as provided in section 59;

(b) 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;

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

(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;

(e) establishing the rates to which section 64 applies;

(f) on the budget for a personal care home being approved as provided in section 58, establishing rates of payment as provided in section 59;

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

(h) 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;

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

(j) prescribing procedures and standards for admission of persons into personal care homes;

(k) 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;

and every regulation made under, and in accordance with the authority granted by this section has the force of law.

Application of Regulations Act.

116(2)

The Regulations Act does not apply to regulations made under clause (1)(a), (e) or (f).

Special regulations respecting personal care and personal care homes.

117

For the purpose of bringing the provision of personal care in personal care homes within the plan as an insured service, the commission may make regulations ancillary to this Act and not inconsistent therewith, and every regulation made under and in accordance with the authority granted by this section has the force of law.

Operation of personal care homes

118(1)

No person shall operate a personal care home except pursuant to the approval of the commission, and in accordance with any terms and conditions subject to which the approval is granted, and such standards and other requirements as may be prescribed therefor under section 120.

Approval to operate personal care homes

118(2)

The commission may grant any approval required under subsection (1) for the operation of a personal care home or a proposed personal care home, where the commission is satisfied, upon the receipt of an application therefor in a form prescribed by the commission and supported by such documents and information as the commission may require,

(a) that there is a need for the personal care home or proposed personal care home;

(b) that the premises in and upon which the personal care home is being operated or is proposed to be operated, and the personal care being provided in the personal care home or to be provided in the proposed personal care home, are in compliance with such standards and other requirements as may be prescribed therefor under section 120; and

(c) that granting the approval would not be contrary to the public interest.

Terms and conditions of approval

118(3)

The commission may make any approval granted under subsection (2) subject to such terms and conditions as it deems necessary, and may at any time for cause revoke the approval.

Appeals

118(4)

A person

(a) whose application for an approval is refused; or

(b) who is granted an approval subject to terms and conditions; or

(c) whose approval is revoked;

under this section, may appeal to the minister from the refusal or the terms and conditions or the revocation, as the case may be, within 30 days of the receipt of written notification thereof from the commission and in accordance with such procedure as the minister may prescribe, and the decision of the minister upon the appeal is final and binding and is not subject to further appeal.

Operation of diagnostic laboratories.

119(1)

No person shall operate a diagnostic laboratory except

(a) pursuant to the approval of an officer of the commission, designated for the purpose by the executive director of the commission and hereinafter in this section referred to as "the officer" ; and

(b) in accordance with such terms and conditions subject to which the approval under clause (a) may be granted, and such requirements as may be prescribed therefor under section 120.

Approval to operate diagnostic laboratories.

119(2)

The officer may grant any approval required under subsection (1) for the operation of a diagnostic laboratory or a proposed diagnostic laboratory, where the officer is satisfied, upon the receipt of an application therefor in a form prescribed by the officer and supported by such documents and information as the officer may require,

(a) that there is a need for the diagnostic laboratory or proposed diagnostic laboratory ;

(b) that the diagnostic laboratory or proposed diagnostic laboratory, and the operation thereof, is or, as proposed, will be, in compliance with such standards as may be prescribed therefor by The College of Physicians and Surgeons of Manitoba and such requirements as may be prescribed therefor under section 120; and

(c) that granting the approval would not be contrary to the public interest.

Terms and conditions of approval.

119(3)

The officer may make any approval granted under subsection (2) subject to such terms and conditions as the officer deems necessary, and may at any time for cause revoke the approval.

Appeals.

119(4)

A person

(a) whose application for an approval is refused; or

(b) who is granted an approval subject to terms and conditions; or

(c) whose approval is revoked;

under this section, may appeal to the commission from the refusal or the terms and conditions or the revocation, as the case may be, within 30 days of the receipt of written notification thereof from the officer and in accordance with such procedure as the commission may prescribe, and the decision of the commission upon the appeal is final and binding and is not subject to further appeal.

"Diagnostic laboratory" defined.

119(5)

In this section and in section 120, "diagnostic laboratory" means, subject to subsection (6), a place where

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

(b) operations and procedures for the examination and analysis of specimens taken from the human body are performed to obtain information for diagnosis, prophylaxis or treatment.

Exclusions.

119(6)

The expression "diagnostic laboratory", as defined in subsection (5), does not include

(a) the office of a medical practitioner, wherein diagnostic laboratory procedures are performed solely for the diagnosis of patients of the medical practitioner, and where the procedures are confined to such procedures as may be listed from time to time in the "Short List" of laboratory procedures set out in the laboratory section of the Physicians' Manual published by the commission; or

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

(c) the office of a chiropractor, as defined in The Chiropractic Act, wherein diagnostic laboratory procedures are performed solely for diagnostic purposes.

Regulations for secs. 118 and 119.

120

For the purpose of carrying out the provisions of sections 118 and 119, the commission may make regulations ancillary thereto and not inconsistent therewith or with any other provision of this Act or a regulation made thereunder; and every regulation made pursuant to, and in accordance with the authority granted by, this section has the force of law; and, without restricting the generality of the foregoing, the commission may make regulations

(a) prescribing standards and other requirements respecting the premises within or upon which any personal care home is or is proposed to be operated, and respecting the personal care to be provided in personal care homes;

(b) prescribing requirements for diagnostic laboratories and the operation thereof.

Offence and penalty.

121

Any person who fails to observe a provision of section 118 or 119 or a regulation made under section 120 is guilty of an offence and liable on summary conviction to a fine of not more than $1,000. for each day that the offence continues.

Commencement of section 118

122

Section 118 shall come into force on a day to be fixed by proclamation.