A-2.2 - Act to promote access to family medicine and specialized medicine services

Full text
chapter A-2.2
Act to promote access to family medicine and specialized medicine services
ACCESS TO FAMILY MEDICINE AND SPECIALIZED MEDICINE SERVICESNovember 10 2015November 10 2015
CHAPTER I
GENERAL PROVISIONS
1. The purpose of this Act is to optimize the utilization of the medical and financial resources of the health system with a view to improving access to family medicine and specialized medicine services.
2015, c. 25, s. 1.
2. For the purposes of this Act,
(1)  the expression “institution” means a public institution or a private institution under agreement within the meaning of the Act respecting health services and social services (chapter S-4.2);
(2)  the expression “president and executive director” also means the executive director of a private institution under agreement;
(3)  the regional department of general medicine is the one established under section 417.1 of the Act respecting health services and social services and it exercises the responsibilities conferred on it under the authority of the president and executive director of the integrated health and social services centre, within the meaning of the Act to modify the organization and governance of the health and social services network, in particular by abolishing the regional agencies (chapter O-7.2), to which it belongs.
2015, c. 25, s. 1.
3. The institutions referred to in Schedule I are not subject to this Act.
2015, c. 25, s. 1.
Not in force
CHAPTER II
ACCESS TO SERVICES
Not in force
DIVISION I
OBLIGATIONS
Not in force
§ 1.  — Family medicine
Not in force
4. Every general practitioner subject to an agreement entered into under section 19 of the Health Insurance Act (chapter A-29) must, to the extent prescribed by government regulation,
(1)  provide, individually or with other physicians within a family medicine group, medical care to a minimum caseload of patients; and
(2)  perform, for the benefit of the users of an institution, a minimum number of hours of medical activities that is authorized by the regional department of general medicine in the general practitioner’s region in accordance with section 7.
The government regulation may, in particular, prescribe
(1)  the age as of which a physician is exempted from those obligations;
(2)  the terms governing the medical care provided to patients;
(3)  the minimum patient caseload;
(4)  the medical activities that may be authorized under section 7;
(5)  the minimum number of hours of medical activities that must be performed;
(6)  the special rules that apply when a physician wishes to engage in medical activities in more than one region; and
(7)  any other condition a physician must comply with to fulfil those obligations.
2015, c. 25, s. 1.
Not in force
5. Every institution’s director of professional services determines, in accordance with the directives the Minister sends to the institutions, the number of hours of medical activities available in each centre operated by the institution and informs the regional department of general medicine in the director’s region.
The regional department informs the physicians, in particular on the website of the integrated health and social services centre to which it belongs, of the medical activities available in its region.
2015, c. 25, s. 1.
Not in force
6. All general practitioners must send the regional department of general medicine in the region where they carry on most of their medical practice an application indicating which available medical activities they wish to engage in. The application must indicate, for each activity, the number of hours the physician wishes to perform.
2015, c. 25, s. 1.
Not in force
7. The regional department of general medicine authorizes the physician to perform the minimum number of hours of medical activities required under subparagraph 2 of the first paragraph of section 4, according to the priorities established by government regulation and taking into account the choice indicated by the physician, subject to the required privileges being granted to the physician in accordance with section 242 of the Act respecting health services and social services (chapter S-4.2).
Despite the first paragraph, the regional department may, for the purpose of responding adequately to the needs in its region and in the circumstances prescribed by government regulation, authorize a physician who so requests to perform more than the required minimum number of hours of medical activities. Such a physician is exempted from providing medical care, for the purposes of subparagraph 1 of the first paragraph of section 4, to the caseload of patients determined by government regulation. The regional department informs the Régie de l’assurance maladie du Québec (the Board) of the exemption.
2015, c. 25, s. 1.
Not in force
8. The regional department may, on its own initiative and for the purpose of responding adequately to the needs in its region, revise the authorization granted to a physician; if it does, it must notify him or her at least 90 days beforehand. The regional department may also, at any time, revise such an authorization at the physician’s request.
2015, c. 25, s. 1.
Not in force
9. The hours of temporary support that a physician performs under section 61 of the Act to modify the organization and governance of the health and social services network, in particular by abolishing the regional agencies (chapter O-7.2) must be included when calculating the number of authorized medical activity hours to be performed by the physician.
2015, c. 25, s. 1.
Not in force
10. All general practitioners must, before ceasing to provide medical care to a patient, take the necessary steps to ensure that another physician takes over as provided for in the Code of ethics of physicians (chapter M-9, r. 17).
If no other physician has taken over by the time a physician ceases to provide medical care to a patient, the physician must, after obtaining the patient’s consent, register the patient in the information system, mentioned in the sixth paragraph of section 2 of the Act respecting the Régie de l’assurance maladie du Québec (chapter R-5), which is designed to allow every insured person, within the meaning of the Health Insurance Act (chapter A-29), to find a physician who agrees to provide medical care to the person. A government regulation determines the requirements for using the system, including the information that must be entered in it.
2015, c. 25, s. 1.
Not in force
11. All general practitioners subject to an agreement entered into under section 19 of the Health Insurance Act (chapter A-29) must, to the extent prescribed by government regulation, make themselves available to insured persons within the meaning of that Act by using the medical appointment system mentioned in the sixth paragraph of section 2 of the Act respecting the Régie de l’assurance maladie du Québec (chapter R-5). To that end, all physicians must publish their hours of availability in the system and a certain percentage, determined by that regulation, of those hours must be from Monday to Friday, before 8:00 a.m. and after 7:00 p.m., as well as on Saturday and Sunday.
The regulation provided for in this section must determine, among other particulars, the requirements for using the system and the information that must be entered in it.
2015, c. 25, s. 1.
Not in force
12. Every general practitioner subject to an agreement entered into under section 19 of the Health Insurance Act (chapter A-29) must, before practising in a region, obtain from the region’s regional department of general medicine a notice of compliance with the regional medical staffing plan referred to in section 97 of the Act to modify the organization and governance of the health and social services network, in particular by abolishing the regional agencies (chapter O-7.2). The general practitioner may then practise in the region in compliance with the obligations set out in the notice.
Such a physician must obtain a new notice of compliance when he or she wishes to modify those obligations or wishes to start a primary care family medicine practice or move it to a different location.
2015, c. 25, s. 1.
Not in force
§ 2.  — Specialized medicine
Not in force
13. Every medical specialist subject to an agreement entered into under section 19 of the Health Insurance Act (chapter A-29) and whose specialty is specified by government regulation must, to the extent prescribed in the regulation, participate in the specialized services priority access mechanism established by the Minister. The regulation must determine, among other particulars, the periods and frequency of participation in the mechanism, the requirements for using the mechanism and the information the physician must provide.
In connection with his or her participation in the mechanism, a medical specialist must, at the request of a general practitioner or another health professional specified by government regulation, provide medical consultations, elsewhere than in the emergency department of an institution, to patients who are not users admitted to a centre operated by an institution.
2015, c. 25, s. 1.
Not in force
14. Every medical specialist whose specialty is specified by government regulation and who practises in a department or service of a hospital centre operated by an institution must, to the extent prescribed in the regulation, ensure, as attending physician together with the other physicians with the same specialty in the same department or service, the management and medical care of users admitted to the centre.
2015, c. 25, s. 1.
Not in force
15. Every medical specialist who practises in a hospital centre operated by an institution must
(1)  follow up, at the centre’s emergency department, on consultation requests the specialist receives between 8 a.m. and 4 p.m. within the time determined by government regulation;
(2)  provide specialized or superspecialized services to users who are registered under the specialist’s name on the access list for specialized or superspecialized services referred to in section 185.1 of the Act respecting health services and social services (chapter S-4.2), in the proportion and subject to any other condition prescribed by government regulation.
2015, c. 25, s. 1.
Not in force
DIVISION II
EXEMPTIONS
Not in force
16. General practitioners may, in the cases and on the conditions prescribed by government regulation, apply to the regional department of general medicine in the region where they carry on most of their medical practice to be exempted from all or some of their obligations under the first paragraph of section 4 or sections 11 and 12.
Medical specialists may, in the cases and on the conditions prescribed by government regulation, apply to the president and executive director of the institution where they practise to be exempted from all or some of their obligations under section 13 or 14.
Exceptionally, the regional department or the president and executive director, as applicable, may, in a case that is not covered by regulation and for a serious reason, in particular to meet a specific need of the users an institution serves, temporarily exempt a physician who has applied for an exemption from all or some of the physician’s obligations referred to in the first and second paragraphs.
The regional department or the president and executive director must respond to every application within 15 days of receiving it.
The regulation referred to in the first paragraph must set out the conditions for exemption applicable to general practitioners who carry on all or some of their medical practice in one of the institutions listed in Schedule I or within the Cree Board of Health and Social Services of James Bay established under the Act respecting health services and social services for Cree Native persons (chapter S-5). Such general practitioners must submit their application for an exemption to the regional department of general medicine designated by the Minister.
2015, c. 25, s. 1.
Not in force
17. Physicians who receive an exemption must without delay inform the regional department of general medicine or the president and executive director of the institution that granted it of any change in their circumstances that could call into question the physicians’ entitlement to the exemption.
2015, c. 25, s. 1.
Not in force
18. If the regional department or the president and executive director concludes that the reason for which a physician was granted an exemption no longer exists, the exemption is withdrawn. Before making a decision to that effect, the regional department or the president and executive director must give the physician an opportunity to submit observations. The physician must submit observations within 30 days after receiving an invitation to do so from the regional department or the president and executive director, as applicable.
2015, c. 25, s. 1.
Not in force
19. The regional department or the president and executive director notifies any decision under section 16 or 18 to the physician as soon as possible.
In addition, the regional department informs the Board of any decision affecting the minimum caseload of patients to whom a general practitioner must provide medical care under subparagraph 1 of the first paragraph of section 4 or the general practitioner’s obligation under section 11.
2015, c. 25, s. 1.
Not in force
20. Any person with the authority to attest any fact establishing a physician’s entitlement to an exemption is required to provide any information required for the purposes of this division to the regional department of general medicine or to the president and executive director of an institution, at either’s request. The information provided must not allow a patient to be identified.
2015, c. 25, s. 1.
Not in force
DIVISION III
VERIFICATION AND SANCTION
Not in force
§ 1.  — Verification of fulfillment of obligations
Not in force
21. The Board is responsible for verifying fulfillment of an obligation under subparagraph 1 of the first paragraph of section 4 or under section 10 or 11, the regional department of general medicine is responsible for verifying fulfillment of an obligation under section 6 or 12, and the director of professional services of the institution concerned is responsible for verifying compliance with an authorization granted under section 7 or fulfillment of an obligation under section 14 or 15.
In addition, the president and executive director of the integrated health and social services centre is responsible for verifying fulfillment of the obligation under section 13 by any medical specialist who practises in the territory served by the centre. For that purpose, physicians who practise in a private health facility must provide the president and executive director with any information the latter requires that is necessary to carry out that responsibility. The information provided must not allow a patient to be identified.
2015, c. 25, s. 1.
Not in force
22. The Government may, by regulation, prescribe the periods, measures or any other parameter used to verify fulfillment of any of a physician’s obligations.
2015, c. 25, s. 1.
Not in force
§ 2.  — Physician in default, authorization withdrawal and reduction calculation
Not in force
23. If the president and executive director of an institution concludes that a physician failed to fulfill the obligation under section 13, he or she declares the physician to be in default. After being informed by the director of professional services or the regional department of general medicine, and if of the opinion that a physician has failed to fulfill an obligation or comply with an authorization under section 6, 7, 12, 14 or 15, the president and executive director declares the physician to be in default.
Before rendering such a decision, the president and executive director must give the physician an opportunity to submit observations. The physician must submit observations within 30 days after receiving an invitation to do so from the president and executive director. The latter notifies the decision to the physician within 14 days and informs the Board.
2015, c. 25, s. 1.
Not in force
24. If the Board concludes that a general practitioner has failed to fulfill an obligation under subparagraph 1 of the first paragraph of section 4 or under section 10 or 11, it declares the physician to be in default and notifies the decision to him or her as soon as possible. Before rendering such a decision, the Board must give the physician an opportunity to submit observations. The physician must submit observations within 30 days after receiving an invitation to do so from the Board.
2015, c. 25, s. 1.
Not in force
25. The regional department of general medicine may, at the request of the president and executive director of the institution, withdraw the authorization granted to a general practitioner who has been declared to be in default more than once if the situation significantly affects the services the institution provides. The regional department notifies its decision to the physician as soon as possible and informs the Board. Before rendering its decision, the regional department must give the physician an opportunity to submit observations. The physician must submit observations within 30 days after receiving an invitation to do so from the regional department.
On granting a new authorization in accordance with section 7 to a physician referred to in the first paragraph, a regional department of general medicine informs the Board.
2015, c. 25, s. 1.
Not in force
26. The remuneration of a physician who has been declared to be in default is reduced by an amount determined in accordance with the rules prescribed by government regulation.
On declaring a physician, or being informed that a physician has been declared, to be in default under this subdivision, the Board calculates the amount of the reduction applicable to the physician’s remuneration and notifies its decision to the physician as soon as possible. The decision specifies the nature of the default for which a reduction is being applied.
2015, c. 25, s. 1.
Not in force
§ 3.  — Proceedings before the Administrative Tribunal of Québec
Not in force
27. A physician who believes he or she has been wronged by a decision rendered under the first or second paragraph of section 16 or under section 18 may, within 60 days of notification of the decision, contest it before the Administrative Tribunal of Québec. In such a case, the Tribunal may rule both on the application and, if applicable, on any default arising from the contested decision as well as on the amount of the applicable reduction.
Moreover, a physician who believes he or she has been wronged by a decision rendered under section 23, 24 or 26 may, within 60 days of notification of a decision referred to in section 26, contest the decision before the Administrative Tribunal of Québec.
The Administrative Tribunal of Québec informs the Board of any contestation submitted to it under this section.
2015, c. 25, s. 1.
Not in force
§ 4.  — Application of the reduction
Not in force
28. The Board recovers from a physician referred to in section 26, by compensation or otherwise, the amount of the reduction applicable to the physician’s remuneration.
The Board recovers the amount as of the notification date of the decision rendered under the second paragraph of section 26.
If the Board cannot recover the amount of the reduction by way of compensation, it may issue a certificate. The certificate may not be issued until 60 days have elapsed since the notification date of the decision rendered under the second paragraph or, as applicable, until the expiry of a 30-day period following the date of the decision of the Administrative Tribunal of Québec confirming all or part of the Board’s decision. The certificate states the physician’s name and address and attests the expiry of the applicable period as well as the reduction amount. On the filing of the certificate with the office of the competent court, the decision becomes enforceable as if it were a judgment of that court that has become final, and it has all the effects of such a judgment. If, after the certificate is issued, the Minister of Revenue allocates, in accordance with section 31 of the Tax Administration Act (chapter A-6.002), a refund owed to a physician under a fiscal law to the payment of the amount of the reduction, the allocation interrupts prescription as regards the recovery of that amount.
2015, c. 25, s. 1.
Not in force
CHAPTER III
REPORTING
Not in force
29. Every institution must report on the application of this Act in a separate section of its annual activitiy report.
The Minister may require any institution to provide, in the form and within the time the Minister determines, any information the Minister requires on the functions the president and executive director, director of professional services or regional department of general medicine exercises under this Act. The information provided must not allow a patient or physician to be identified.
2015, c. 25, s. 1.
CHAPTER IV
AMENDING PROVISIONS
HEALTH INSURANCE ACT
30. (Not in force).
2015, c. 25, s. 1.
31. (Not in force).
2015, c. 25, s. 1.
32. (Amendment integrated into c. A-29, s. 22).
2015, c. 25, s. 1.
33. (Amendment integrated into c. A-29, s. 22.0.0.0.0.1).
2015, c. 25, s. 1.
34. (Amendment integrated into c. A-29, s. 22.0.0.0.2).
2015, c. 25, s. 1.
35. (Amendment integrated into c. A-29, s. 22.0.0.1).
2015, c. 25, s. 1.
36. (Amendment integrated into c. A-29, s. 22.0.1).
2015, c. 25, s. 1.
37. (Amendment integrated into c. A-29, s. 65).
2015, c. 25, s. 1.
38. (Amendment integrated into c. A-29, s. 65.0.4).
2015, c. 25, s. 1.
39. (Not in force).
2015, c. 25, s. 1.
ACT RESPECTING PRESCRIPTION DRUG INSURANCE
40. (Amendment integrated into c. A-29.01, s. 8.1).
2015, c. 25, s. 1.
Not in force
ACT RESPECTING ADMINISTRATIVE JUSTICE
41. (Not in force).
2015, c. 25, s. 1.
42. (Not in force).
2015, c. 25, s. 1.
ACT RESPECTING THE MINISTÈRE DE LA SANTÉ ET DES SERVICES SOCIAUX
43. (Amendment integrated into c. M-19.2, s. 10.4).
2015, c. 25, s. 1.
ACT TO MODIFY THE ORGANIZATION AND GOVERNANCE OF THE HEALTH AND SOCIAL SERVICES NETWORK, IN PARTICULAR BY ABOLISHING THE REGIONAL AGENCIES
44. (Amendment integrated into c. O.7.2, s. 55.1).
2015, c. 25, s. 1.
45. (Not in force).
2015, c. 25, s. 1.
46. (Not in force).
2015, c. 25, s. 1.
47. (Not in force).
2015, c. 25, s. 1.
48. (Amendment integrated into c. O.7.2, s. 91).
2015, c. 25, s. 1.
49. (Not in force).
2015, c. 25, s. 1.
ACT RESPECTING THE RÉGIE DE L’ASSURANCE MALADIE DU QUÉBEC
50. (1)  (Amendment integrated into c. R-5, s. 2);
(2)  (Amendment integrated into c. R-5, s. 2);
(3)  (Amendment integrated into c. R-5, s. 2).
2015, c. 25, s. 1.
51. (Amendment integrated into c. R-5, s. 2.0.8).
2015, c. 25, s. 1.
52. (Amendment integrated into c. R-5, s. 2.0.10).
2015, c. 25, s. 1.
ACT RESPECTING HEALTH SERVICES AND SOCIAL SERVICES
53. (Not in force).
2015, c. 25, s. 1.
54. (Not in force).
2015, c. 25, s. 1.
55. (Amendment integrated into c. S-4.2, s. 195).
2015, c. 25, s. 1.
56. (Not in force).
2015, c. 25, s. 1.
57. (Amendment integrated into c. S-4.2, s. 240).
2015, c. 25, s. 1.
58. (Amendment integrated into c. S-4.2, s. 248).
2015, c. 25, s. 1.
59. (Not in force).
2015, c. 25, s. 1.
60. (Not in force).
2015, c. 25, s. 1.
61. (Not in force).
2015, c. 25, s. 1.
62. (Not in force).
2015, c. 25, s. 1.
63. (Not in force).
2015, c. 25, s. 1.
64. (Not in force).
2015, c. 25, s. 1.
65. (Not in force).
2015, c. 25, s. 1.
66. (Not in force).
2015, c. 25, s. 1.
67. (Not in force).
2015, c. 25, s. 1.
CHAPTER V
MISCELLANEOUS AND TRANSITIONAL PROVISIONS
Not in force
68. The first regulation made under Chapter II must be examined by the competent committee of the National Assembly for a period not exceeding six hours before it is approved by the Government.
2015, c. 25, s. 1.
69. Despite section 19 of the Health Insurance Act (chapter A-29) and any stipulation of an agreement under that section, if the Minister is of the opinion that certain amendments to the terms and conditions of remuneration applicable to physicians would improve access to insured services within the meaning of that Act and that an agreement cannot be reached on the amendments with the representative organization concerned within a time the Minister considers reasonable, the Minister may make the amendments, with the approval of the Conseil du trésor.
The amendments bind the parties and apply from the date of their publication on the website of the Régie de l’assurance maladie du Québec. They are not subject to the Regulations Act (chapter R-18.1).
2015, c. 25, s. 1.
(Not in force to the extent that it concern general practitioners, 2015, c. 25, s. 25)
70. Section 69 ceases to have effect on the date set by the Government or not later than 31 March 2020.
The amendments made by the Minister under section 69, in force on the date that section ceases to have effect, remain in force until amended or replaced in accordance with an agreement entered into under section 19 of the Health Insurance Act (chapter A-29).
2015, c. 25, s. 1.
71. The provisions of this Act and of any regulation prevail over any conflicting provisions of any agreement entered into under section 19 of the Health Insurance Act (chapter A-29).
2015, c. 25, s. 1.
72. The Minister publishes the following information every three months for the territory of each integrated health and social services centre and for all those territories combined:
(1)  the percentage of insured persons, within the meaning of the Health Insurance Act (chapter A-29), who are provided medical care by a general practitioner who is subject to an agreement entered into under section 19 of that Act;
(2)  the average patient fidelity rate achieved by all general practitioners combined;
(3)  for each family medicine group, the total caseload of insured persons who are provided medical care by general practitioners included in the family medicine group, and the patient fidelity rate achieved by those physicians;
(4)  the total number of visits made to the emergency room of a health and social services institution and for which the triage priority, established in accordance with the Canadian Triage and Acuity Scale for emergency departments, is level 4 or 5, as well as the proportion of that number in relation to all visits to the emergency department;
(5)  the average wait time to obtain an appointment with a general practitioner using the medical appointment system mentioned in the sixth paragraph of section 2 of the Act respecting the Régie de l’assurance maladie du Québec (chapter R-5);
(6)  the average wait time to obtain an appointment with a medical specialist by a person who has been registered for over six months in the specialized services priority access mechanism.
The information published must not allow the insured persons or physicians concerned to be identified.
2015, c. 25, s. 1.
73. The Lettre d’entente n° 245 concernant la prise en charge et le suivi de tout patient sans médecin de famille sur référence ou non du guichet d’accès du CSSS and the Lettre d’entente n° 246 concernant le suivi et le financement de la mesure relative à la prise en charge du patient sans médecin de famille sur référence ou non du guichet d’accès du CSSS, entered into by the Minister of Health and Social Services and the Fédération des médecins omnipraticiens du Québec and approved by Conseil du trésor decision C.T. 213628 dated 11 February 2014, cease to have effect on 28 November 2014.
2015, c. 25, s. 1.
Not in force
74. The Entente particulière ayant pour objet les activités médicales particulières, entered into by the Minister of Health and Social Services and the Fédération des médecins omnipraticiens du Québec and approved by Conseil du trésor decision C.T. 210874 dated 6 December 2011, ceases to have effect on (insert the date of coming into force of this section), except paragraph 5.1 of that agreement, which ceases to have effect on 31 December 2015 with regard to the undertakings referred to in section 77.
2015, c. 25, s. 1.
Not in force
75. Paragraphs 15.01 to 15.07 of the Entente particulière relative aux services de médecine de famille, de prise en charge et de suivi de la clientèle, entered into by the Minister of Health and Social Services and the Fédération des médecins omnipraticiens du Québec and approved by Conseil du trésor decision C.T. 211816 dated 31 July 2012, cease to have effect on (insert the date of coming into force of this section).
2015, c. 25, s. 1.
76. The services, supplies or accessory costs that, under an agreement entered into under section 19 of the Health Insurance Act (chapter A-29), could be billed by a health professional who was subject to that agreement or by a professional who had withdrawn under the ninth paragraph of section 22 of that Act, as it read before 9 November 2015, may continue to be billed until the coming into force of the first regulation made under the twelfth paragraph of section 22 of that Act, enacted by section 32.
The tariff of fees for services, supplies or accessory costs is subject to the requirements set out in section 22.0.0.1 of that Act.
2015, c. 25, s. 1.
Not in force
77. Any undertaking by a physician under section 363 of the Act respecting health services and social services (chapter S-4.2), in force on (insert the date of coming into force of this section), ceases to have effect on the earlier of the following dates:
(1)  the expiry date of the undertaking;
(2)  (insert the date that precedes the date of coming into force of this section).
However, a general practitioner who, on 31 December 2017, has been performing an activity listed in any of subparagraphs 1 to 5 of the second paragraph of section 361 of the Act respecting health services and social services, as it read on that date, for at least one year has priority with respect to obtaining authorization for medical activity hours authorized in accordance with the first paragraph of section 7 for the same activity, if applicable. If, because of the implementation of the Minister’s directives referred to in the first paragraph of section 5, more than one physician has priority to perform the same medical activity, the hours are authorized for the physician whose initial date of billing to the Board is the earliest.
2015, c. 25, s. 1.
Not in force
78. The Minister must, not later than (insert the date that is two years after the date of coming into force of this section), report to the Government on the implementation of this Act and, subsequently every five years, on the advisability of amending it.
The report is tabled in the National Assembly by the Minister within 30 days or, if the Assembly is not sitting, within 30 days of resumption.
2015, c. 25, s. 1.
Not in force
79. Every general practitioner who, on (insert the date that precedes the date of coming into force of section 12), holds a notice of compliance issued by the regional department of general medicine in the region where he or she practises, under the Entente particulière relative au respect des plans régionaux d’effectifs médicaux (PREM) entered into by the Minister of Health and Social Services and the Fédération des médecins omnipraticiens du Québec and approved by Conseil du trésor decision C.T. 200809 dated 23 March 2004, is deemed to have obtained a notice of compliance with the regional medical staffing plan from that regional department under section 12.
2015, c. 25, s. 1.
80. The Minister of Health and Social Services is responsible for the administration of this Act.
2015, c. 25, s. 1.
SCHEDULE I
(Section 3)
The following institutions are not subject to this Act:
(1) those governed by Part IV.1, Part IV.2 and Part IV.3 of the Act respecting health services and social services (chapter S-4.2);
(2) the Centre intégré de santé et de services sociaux de la Côte-Nord, with respect to the facilities indicated on the permits in force on 31 March 2015 for the Centre de santé et de services sociaux de la Basse-Côte-Nord, the Centre de santé et de services sociaux de l’Hématite and the Centre de santé et de services sociaux de la Minganie.
2015, c. 25, Schedule I.