A-29 - Health Insurance Act

Full text
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to an insured person who presented his health insurance card or claim booklet, as the case may be, or to be remunerated by an insured person for an insured service he has furnished in person where such insured person did not present his health insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to an insured person even if the latter did not present his health insurance card or claim booklet, in the following circumstances and cases:
(a)  where the insured person is under one year of age;
(b)  where the insured person at the time he received insured services was in a condition requiring emergency care;
(c)  where the insured person is a minor 14 years of age or over and receives insured services to which he gives his consent alone in accordance with the provisions of the Civil Code;
(d)  where the insured person is lodged by an institution which operates a residential and long-term care centre or a rehabilitation centre within the meaning of the Act respecting health services and social services (chapter S‐4.2), or where she is sheltered in a reception centre or a hospital centre belonging to the class of hospital centres for long‐term care within the meaning of the Act respecting health services and social services for Cree Native persons (chapter S‐5) and the regulations made under that Act;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is absolutely null. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
No health professional who is subject to the application of an agreement may receive from an institution any sum of money or any direct or indirect benefit as consideration for providing insured services.
The Board may recover from a health professional who contravenes the fifth paragraph, by compensation or otherwise, any amount or the value of any benefit received, after sending him a notice in writing.
A health professional subject to the application of an agreement shall not exact or receive payment from the Board or an insured person, as the case may be, for an insured service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a non-insured service, or a service not considered insured by regulation or not established as an insured service by regulation.
No payment may be charged to or received from any insured person, directly or indirectly, for costs incurred for insured services provided by a health professional who is subject to the application of an agreement or by a professional who has withdrawn. Such costs include those related to
(1)  the operation of a private health facility or a specialized medical centre within the meaning of the Act respecting health services and social services;
(2)  services, supplies, medications and equipment required to provide an insured service, as well as to perform diagnostic tests related to such a service
Such costs do not include those related to services not considered insured that are required before, during or after the provision of an insured service.
In addition, directly or indirectly requiring an insured person to pay for access to an insured service, and granting an insured person privileged access to such a service in exchange for payment, are prohibited.
Despite the prohibitions set out in the ninth and eleventh paragraphs, the Government may, by regulation, prescribe the cases and conditions in and on which a payment is authorized.
No health professional who is subject to the application of an agreement may allow or accept that the remuneration for insured services furnished by that health professional be claimed in the name of another health professional. Similarly, no health professional who is subject to the application of an agreement may allow or accept that the remuneration for insured services furnished by another health professional be claimed from the Board in his name.
A health professional who contravenes the fourth, seventh, eighth or thirteenth paragraph is guilty of an offence and is liable to a fine of $5,000 to $50,000 and, in the case of a subsequent offence, to a fine of $10,000 to $100,000.
Every person who contravenes the ninth or eleventh paragraph is guilty of an offence and is liable to a fine of $5,000 to $50,000 in the case of a natural person and $15,000 to $150,000 in any other case. In the case of a subsequent offence, the minimum and maximum fines are doubled.
Every person who manages the business of a health professional and makes a false declaration in connection with a claim for payment to the Board is guilty of an offence and is liable to a fine of $5,000 to $50,000 in the case of a natural person and $10,000 to $100,000 in any other case. In the case of a subsequent offence, the minimum and maximum fines are doubled.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6; 1984, c. 27, s. 42; 1984, c. 47, s. 16; 1989, c. 50, s. 27; 1990, c. 4, s. 77; 1991, c. 42, s. 568; 1992, c. 21, s. 107; 1991, c. 42, s. 568; 1992, c. 57, s. 435; 1994, c. 23, s. 23; 1999, c. 40, s. 29; 1999, c. 89, s. 25, s. 42; 2015, c. 25, s. 1; 2016, c. 282016, c. 28, s. 9.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to an insured person who presented his health insurance card or claim booklet, as the case may be, or to be remunerated by an insured person for an insured service he has furnished in person where such insured person did not present his health insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to an insured person even if the latter did not present his health insurance card or claim booklet, in the following circumstances and cases:
(a)  where the insured person is under one year of age;
(b)  where the insured person at the time he received insured services was in a condition requiring emergency care;
(c)  where the insured person is a minor 14 years of age or over and receives insured services to which he gives his consent alone in accordance with the provisions of the Civil Code;
(d)  where the insured person is lodged by an institution which operates a residential and long-term care centre or a rehabilitation centre within the meaning of the Act respecting health services and social services (chapter S‐4.2), or where she is sheltered in a reception centre or a hospital centre belonging to the class of hospital centres for long‐term care within the meaning of the Act respecting health services and social services for Cree Native persons (chapter S‐5) and the regulations made under that Act;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is absolutely null. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
No health professional who is subject to the application of an agreement may receive from an institution any sum of money or any direct or indirect benefit as consideration for providing insured services.
The Board may recover from a health professional who contravenes the fifth paragraph, by compensation or otherwise, any amount or the value of any benefit received, after sending him a notice in writing.
A health professional subject to the application of an agreement shall not exact or receive payment from the Board or an insured person, as the case may be, for an insured service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a non-insured service, or a service not considered insured by regulation or not established as an insured service by regulation.
No payment may be charged to or received from any insured person, directly or indirectly, for costs incurred for insured services provided by a health professional who is subject to the application of an agreement or by a professional who has withdrawn. Such costs include those related to
(1)  the operation of a private health facility or a specialized medical centre within the meaning of the Act respecting health services and social services;
(2)  services, supplies, medications and equipment required to provide an insured service, as well as to perform diagnostic tests related to such a service
Such costs do not include those related to services not considered insured that are required before, during or after the provision of an insured service.
In addition, directly or indirectly requiring an insured person to pay for access to an insured service, and granting an insured person privileged access to such a service in exchange for payment, are prohibited.
Despite the prohibitions set out in the ninth and eleventh paragraphs, the Government may, by regulation, prescribe the cases and conditions in and on which a payment is authorized.
No health professional who is subject to the application of an agreement may allow or accept that the remuneration for insured services furnished by that health professional be claimed in the name of another health professional. Similarly, no health professional who is subject to the application of an agreement may allow or accept that the remuneration for insured services furnished by another health professional be claimed from the Board in his name.
A professional in the field of health who contravenes a provision of the fourth, seventh, eighth or thirteenth paragraph, and every person who contravenes a provision of the ninth or eleventh paragraph, is guilty of an offence and is liable to a fine of $1,000 to $2,000 and, in the case of a second or subsequent conviction, to a fine of $2,000 to $5,000.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6; 1984, c. 27, s. 42; 1984, c. 47, s. 16; 1989, c. 50, s. 27; 1990, c. 4, s. 77; 1991, c. 42, s. 568; 1992, c. 21, s. 107; 1991, c. 42, s. 568; 1992, c. 57, s. 435; 1994, c. 23, s. 23; 1999, c. 40, s. 29; 1999, c. 89, s. 25, s. 42; 2015, c. 25, s. 1.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to an insured person who presented his health insurance card or claim booklet, as the case may be, or to be remunerated by an insured person for an insured service he has furnished in person where such insured person did not present his health insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to an insured person even if the latter did not present his health insurance card or claim booklet, in the following circumstances and cases:
(a)  where the insured person is under one year of age;
(b)  where the insured person at the time he received insured services was in a condition requiring emergency care;
(c)  where the insured person is a minor 14 years of age or over and receives insured services to which he gives his consent alone in accordance with the provisions of the Civil Code;
(d)  where the insured person is lodged by an institution which operates a residential and long-term care centre or a rehabilitation centre within the meaning of the Act respecting health services and social services (chapter S‐4.2), or where she is sheltered in a reception centre or a hospital centre belonging to the class of hospital centres for long‐term care within the meaning of the Act respecting health services and social services for Cree Native persons (chapter S‐5) and the regulations made under that Act;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is absolutely null. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
No health professional who is subject to the application of an agreement may receive from an institution any sum of money or any direct or indirect benefit as consideration for providing insured services.
The Board may recover from a health professional who contravenes the fifth paragraph, by compensation or otherwise, any amount or the value of any benefit received, after sending him a notice in writing.
A health professional subject to the application of an agreement shall not exact or receive payment from the Board or an insured person, as the case may be, for an insured service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a non-insured service, or a service not considered insured by regulation or not established as an insured service by regulation.
No person may exact or receive any payment from any insured person for a service, the supplying of something or costs accessory to an insured service furnished by a professional subject to the application of an agreement or by a professional who has withdrawn, except in the cases prescribed or provided for in an agreement and on the conditions mentioned therein.
Any service rendered by a dentist in his private consulting office and which is related to the insured service referred to in subparagraph b of the first paragraph of section 3 is deemed to be an accessory service.
No health professional who is subject to the application of an agreement may allow or accept that the remuneration for insured services furnished by that health professional be claimed in the name of another health professional. Similarly, no health professional who is subject to the application of an agreement may allow or accept that the remuneration for insured services furnished by another health professional be claimed from the Board in his name.
A professional in the field of health who contravenes a provision of the fourth, seventh, eighth or eleventh paragraph, and every person who contravenes a provision of the ninth paragraph, is guilty of an offence and is liable to a fine of $1,000 to $2,000 and, in the case of a second or subsequent conviction, to a fine of $2,000 to $5,000.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6; 1984, c. 27, s. 42; 1984, c. 47, s. 16; 1989, c. 50, s. 27; 1990, c. 4, s. 77; 1991, c. 42, s. 568; 1992, c. 21, s. 107; 1991, c. 42, s. 568; 1992, c. 57, s. 435; 1994, c. 23, s. 23; 1999, c. 40, s. 29; 1999, c. 89, s. 25, s. 42.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary who presented his health-insurance card or claim booklet, as the case may be, or to be remunerated by a beneficiary for an insured service he has furnished in person where such beneficiary did not present his health-insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary even if the latter did not present his health-insurance card or claim booklet, in the following circumstances and cases:
(a)  where the beneficiary is under one year of age;
(b)  where the beneficiary at the time he received insured services was in a condition requiring emergency care;
(c)  where the beneficiary is a minor 14 years of age or over and receives insured services to which he gives his consent alone in accordance with the provisions of the Civil Code of Québec;
(d)  where the beneficiary is lodged by an institution which operates a residential and long-term care centre or a rehabilitation centre within the meaning of the Act respecting health services and social services (chapter S‐4.2), or where he is sheltered in a reception centre or a hospital centre belonging to the class of hospital centres for long‐term care within the meaning of the Act respecting health services and social services for Cree Native persons (chapter S‐5) and the regulations made under that Act;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is absolutely null. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
No health professional who is subject to the application of an agreement may receive from an institution any sum of money or any direct or indirect benefit as consideration for providing insured services.
The Board may recover from a health professional who contravenes the fifth paragraph, by compensation or otherwise, any amount or the value of any benefit received, after sending him a notice in writing.
A health professional subject to the application of an agreement shall not exact or receive payment from the Board or a beneficiary, as the case may be, for a service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a service not considered insured by regulation or not established as an insured service by regulation.
No person may exact or receive any payment from any beneficiary for a service, the supplying of something or costs accessory to an insured service furnished by a professional subject to the application of an agreement or by a professional who has withdrawn, except in the cases prescribed or provided for in an agreement and on the conditions mentioned therein.
Any service rendered by a dentist in his private consulting office and which is related to the insured service referred to in subparagraph b of the first paragraph of section 3 is deemed to be an accessory service.
A professional in the field of health who contravenes a provision of the fourth, seventh or eighth paragraph, and every person who contravenes a provision of the ninth paragraph, is guilty of an offence and is liable to a fine of $1 000 to $2 000 and, in the case of a second or subsequent conviction, to a fine of $2 000 to $5 000.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6; 1984, c. 27, s. 42; 1984, c. 47, s. 16; 1989, c. 50, s. 27; 1990, c. 4, s. 77; 1991, c. 42, s. 568; 1992, c. 21, s. 107; 1991, c. 42, s. 568; 1992, c. 57, s. 435; 1994, c. 23, s. 23; 1999, c. 40, s. 29.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary who presented his health-insurance card or claim booklet, as the case may be, or to be remunerated by a beneficiary for an insured service he has furnished in person where such beneficiary did not present his health-insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary even if the latter did not present his health-insurance card or claim booklet, in the following circumstances and cases:
(a)  where the beneficiary is under one year of age;
(b)  where the beneficiary at the time he received insured services was in a condition requiring emergency care;
(c)  where the beneficiary is a minor 14 years of age or over and receives insured services to which he gives his consent alone in accordance with the provisions of the Civil Code of Québec;
(d)  where the beneficiary is lodged by an institution which operates a residential and long-term care centre or a rehabilitation centre within the meaning of the Act respecting health services and social services (chapter S-4.2), or where he is sheltered in a reception centre or a hospital centre belonging to the class of hospital centres for long-term care within the meaning of the Act respecting health services and social services for Cree Native persons (chapter S-5) and the regulations made under that Act;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is null ipsofacto. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
No health professional who is subject to the application of an agreement may receive from an institution any sum of money or any direct or indirect benefit as consideration for providing insured services.
The Board may recover from a health professional who contravenes the fifth paragraph, by compensation or otherwise, any amount or the value of any benefit received, after sending him a notice in writing.
A health professional subject to the application of an agreement shall not exact or receive payment from the Board or a beneficiary, as the case may be, for a service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a service not considered insured by regulation or not established as an insured service by regulation.
No person may exact or receive any payment from any beneficiary for a service, the supplying of something or costs accessory to an insured service furnished by a professional subject to the application of an agreement or by a professional who has withdrawn, except in the cases prescribed or provided for in an agreement and on the conditions mentioned therein.
Any service rendered by a dentist in his private consulting office and which is related to the insured service referred to in subparagraph b of the first paragraph of section 3 is deemed to be an accessory service.
A professional in the field of health who contravenes a provision of the fourth, seventh or eighth paragraph, and every person who contravenes a provision of the ninth paragraph, is guilty of an offence and is liable to a fine of $1 000 to $2 000 and, in the case of a second or subsequent conviction, to a fine of $2 000 to $5 000.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6; 1984, c. 27, s. 42; 1984, c. 47, s. 16; 1989, c. 50, s. 27; 1990, c. 4, s. 77; 1991, c. 42, s. 568; 1992, c. 21, s. 107; 1991, c. 42, s. 568; 1992, c. 57, s. 435; 1994, c. 23, s. 23.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary who presented his health-insurance card or claim booklet, as the case may be, or to be remunerated by a beneficiary for an insured service he has furnished in person where such beneficiary did not present his health-insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary even if the latter did not present his health-insurance card or claim booklet, in the following circumstances and cases:
(a)  where the beneficiary is under one year of age;
(b)  where the beneficiary at the time he received insured services was in a condition requiring emergency care;
(c)  where the beneficiary is a minor 14 years of age or over and receives insured services to which he gives his consent alone in accordance with the provisions of the Civil Code of Québec;
(d)  where the beneficiary is lodged by an institution which operates a residential and long-term care centre or a rehabilitation centre within the meaning of the Act respecting health services and social services (chapter S-4.2), or where he is sheltered in a reception centre or a hospital centre belonging to the class of hospital centres for long-term care within the meaning of the Act respecting health services and social services for Cree and Inuit Native persons (chapter S-5) and the regulations made under that Act;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is null ipsofacto. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
No health professional who is subject to the application of an agreement may receive from an institution any sum of money or any direct or indirect benefit as consideration for providing insured services.
The Board may recover from a health professional who contravenes the fifth paragraph, by compensation or otherwise, any amount or the value of any benefit received, after sending him a notice in writing.
A health professional subject to the application of an agreement shall not exact or receive payment from the Board or a beneficiary, as the case may be, for a service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a service not considered insured by regulation or not established as an insured service by regulation.
No person may exact or receive any payment from any beneficiary for a service, the supplying of something or costs accessory to an insured service furnished by a professional subject to the application of an agreement or by a professional who has withdrawn, except in the cases prescribed or provided for in an agreement and on the conditions mentioned therein.
Any service rendered by a dentist in his private consulting office and which is related to the insured service referred to in subparagraph b of the first paragraph of section 3 is deemed to be an accessory service.
A professional in the field of health who contravenes a provision of the fourth, seventh or eighth paragraph, and every person who contravenes a provision of the ninth paragraph, is guilty of an offence and is liable to a fine of $1 000 to $2 000 and, in the case of a second or subsequent conviction, to a fine of $2 000 to $5 000.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6; 1984, c. 27, s. 42; 1984, c. 47, s. 16; 1989, c. 50, s. 27; 1990, c. 4, s. 77; 1991, c. 42, s. 568; 1992, c. 21, s. 107; 1991, c. 42, s. 568; 1992, c. 57, s. 435.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary who presented his health-insurance card or claim booklet, as the case may be, or to be remunerated by a beneficiary for an insured service he has furnished in person where such beneficiary did not present his health-insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary even if the latter did not present his health-insurance card or claim booklet, in the following circumstances and cases:
(a)  where the beneficiary is under one year of age;
(b)  where the beneficiary at the time he received insured services was in a condition requiring emergency care;
(c)  where the beneficiary is over 14 years of age and under 18 years of age and he receives insured services, without parental authorization, in accordance with section 36 of the Public Health Protection Act;
(d)  where the beneficiary is lodged by an institution which operates a residential and long-term care centre or a rehabilitation centre within the meaning of the Act respecting health services and social services (chapter S-4.2), or where he is sheltered in a reception centre or a hospital centre belonging to the class of hospital centres for long-term care within the meaning of the Act respecting health services and social services for Cree and Inuit Native persons (chapter S-5) and the regulations made under that Act;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is null ipsofacto. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
No health professional who is subject to the application of an agreement may receive from an institution any sum of money or any direct or indirect benefit as consideration for providing insured services.
The Board may recover from a health professional who contravenes the fifth paragraph, by compensation or otherwise, any amount or the value of any benefit received, after sending him a notice in writing.
A health professional subject to the application of an agreement shall not exact or receive payment from the Board or a beneficiary, as the case may be, for a service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a service not considered insured by regulation or not established as an insured service by regulation.
No person may exact or receive any payment from any beneficiary for a service, the supplying of something or costs accessory to an insured service furnished by a professional subject to the application of an agreement or by a professional who has withdrawn, except in the cases prescribed or provided for in an agreement and on the conditions mentioned therein.
Any service rendered by a dentist in his private consulting office and which is related to the insured service referred to in subparagraph b of the first paragraph of section 3 is deemed to be an accessory service.
A professional in the field of health who contravenes a provision of the fourth, seventh or eighth paragraph, and every person who contravenes a provision of the ninth paragraph, is guilty of an offence and is liable to a fine of $1 000 to $2 000 and, in the case of a second or subsequent conviction, to a fine of $2 000 to $5 000.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6; 1984, c. 27, s. 42; 1984, c. 47, s. 16; 1989, c. 50, s. 27; 1990, c. 4, s. 77; 1991, c. 42, s. 568; 1992, c. 21, s. 107; 1991, c. 42, s. 568.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary who presented his health-insurance card or claim booklet, as the case may be, or to be remunerated by a beneficiary for an insured service he has furnished in person where such beneficiary did not present his health-insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary even if the latter did not present his health-insurance card or claim booklet, in the following circumstances and cases:
(a)  where the beneficiary is under one year of age;
(b)  where the beneficiary at the time he received insured services was in a condition requiring emergency care;
(c)  where the beneficiary is over 14 years of age and under 18 years of age and he receives insured services, without parental authorization, in accordance with section 36 of the Public Health Protection Act;
(d)  where the beneficiary is lodged by an institution which operates a residential and long-term care centre or a rehabilitation centre within the meaning of the Act respecting health services and social services (chapter S-4.2), or where he is sheltered in a reception centre or a hospital centre belonging to the class of hospital centres for long-term care within the meaning of the Act respecting health services and social services for Cree and Inuit Native persons (chapter S-5) and the regulations made under that Act;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is null ipsofacto. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
No health professional who is subject to the application of an agreement may receive from an institution any sum of money or any direct or indirect benefit as consideration for providing insured services.
The Board may recover from a health professional who contravenes the fifth paragraph, by compensation or otherwise, any amount or the value of any benefit received, after sending him a notice in writing.
He shall not exact or receive payment from the Board or a beneficiary, as the case may be, for a service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a service not considered insured by regulation or not established as an insured service by regulation.
No person may exact or receive any payment from any beneficiary for a service, the supplying of something or costs accessory to an insured service furnished by a professional subject to the application of an agreement or by a professional who has withdrawn, except in the cases prescribed or provided for in an agreement and on the conditions mentioned therein.
Any service rendered by a dentist in his private consulting office and which is related to the insured service referred to in subparagraph b of the first paragraph of section 3 is deemed to be an accessory service.
A professional in the field of health who contravenes a provision of the fourth, fifth or sixth paragraph, and every person who contravenes a provision of the seventh paragraph, is guilty of an offence and is liable to a fine of $1 000 to $2 000 and, in the case of a second or subsequent conviction, to a fine of $2 000 to $5 000.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6; 1984, c. 27, s. 42; 1984, c. 47, s. 16; 1989, c. 50, s. 27; 1990, c. 4, s. 77; 1991, c. 42, s. 568; 1992, c. 21, s. 107.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary who presented his health-insurance card or claim booklet, as the case may be, or to be remunerated by a beneficiary for an insured service he has furnished in person where such beneficiary did not present his health-insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary even if the latter did not present his health-insurance card or claim booklet, in the following circumstances and cases:
(a)  where the beneficiary is under one year of age;
(b)  where the beneficiary at the time he received insured services was in a condition requiring emergency care;
(c)  where the beneficiary is over 14 years of age and under 18 years of age and he receives insured services, without parental authorization, in accordance with section 36 of the Public Health Protection Act;
(d)  where the beneficiary is sheltered in a reception centre or a hospital centre for long term care;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is null ipsofacto. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
He shall not exact or receive payment from the Board or a beneficiary, as the case may be, for a service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a service not considered insured by regulation or not established as an insured service by regulation.
No person may exact or receive any payment from any beneficiary for a service, the supplying of something or costs accessory to an insured service furnished by a professional subject to the application of an agreement or by a professional who has withdrawn, except in the cases prescribed or provided for in an agreement and on the conditions mentioned therein.
Any service rendered by a dentist in his private consulting office and which is related to the insured service referred to in subparagraph b of the first paragraph of section 3 is deemed to be an accessory service.
A professional in the field of health who contravenes a provision of the fourth, fifth or sixth paragraph, and every person who contravenes a provision of the seventh paragraph, is guilty of an offence and is liable to a fine of $1 000 to $2 000 and, in the case of a second or subsequent conviction, to a fine of $2 000 to $5 000.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6; 1984, c. 27, s. 42; 1984, c. 47, s. 16; 1989, c. 50, s. 27; 1990, c. 4, s. 77.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary who presented his health-insurance card or claim booklet, as the case may be, or to be remunerated by a beneficiary for an insured service he has furnished in person where such beneficiary did not present his health-insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary even if the latter did not present his health-insurance card or claim booklet, in the following circumstances and cases:
(a)  where the beneficiary is under one year of age;
(b)  where the beneficiary at the time he received insured services was in a condition requiring emergency care;
(c)  where the beneficiary is over 14 years of age and under 18 years of age and he receives insured services, without parental authorization, in accordance with section 36 of the Public Health Protection Act;
(d)  where the beneficiary is sheltered in a reception centre or a hospital centre for long term care;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is null ipsofacto. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
He shall not exact or receive payment from the Board or a beneficiary, as the case may be, for a service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a service not considered insured by regulation or not established as an insured service by regulation.
No person may exact or receive any payment from any beneficiary for a service, the supplying of something or costs accessory to an insured service furnished by a professional subject to the application of an agreement or by a professional who has withdrawn, except in the cases prescribed or provided for in an agreement and on the conditions mentioned therein.
Any service rendered by a dentist in his private consulting office and which is related to the insured service referred to in subparagraph b of the first paragraph of section 3 is deemed to be an accessory service.
A professional in the field of health who contravenes the fourth, fifth or sixth paragraph, and every person who contravenes the seventh paragraph, is guilty of an offence and liable, on summary proceedings, in addition to costs, to a fine of not less than $1 000 nor more than $2 000 in the case of a first offence, and of not less than $2 000 nor more than $5 000 for any subsequent offence within two years.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6; 1984, c. 27, s. 42; 1984, c. 47, s. 16; 1989, c. 50, s. 27.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary who presented his health-insurance card or claim booklet, as the case may be, or to be remunerated by a beneficiary for an insured service he has furnished in person where such beneficiary did not present his health-insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary even if the latter did not present his health-insurance card or claim booklet, in the following circumstances and cases:
(a)  where the beneficiary is under one year of age;
(b)  where the beneficiary at the time he received insured services was in a condition requiring emergency care;
(c)  where the beneficiary is over 14 years of age and under 18 years of age and he receives insured services, without parental authorization, in accordance with section 36 of the Public Health Protection Act;
(d)  where the beneficiary is sheltered in a reception centre or an extended care hospital centre;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is null ipsofacto. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
He shall not exact or receive payment from the Board or a beneficiary, as the case may be, for a service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a service not considered insured by regulation or not established as an insured service by regulation.
No person may exact or receive any payment from any beneficiary for a service, the supplying of something or costs accessory to an insured service furnished by a professional subject to the application of an agreement or by a professional who has withdrawn, except in the cases prescribed or provided for in an agreement and on the conditions mentioned therein.
Any service rendered by a dentist in his private consulting office and which is related to the insured service referred to in subparagraph b of the first paragraph of section 3 is deemed to be an accessory service.
A professional in the field of health who contravenes the fourth, fifth or sixth paragraph, and every person who contravenes the seventh paragraph, is guilty of an offence and liable, on summary proceedings, in addition to costs, to a fine of not less than $1 000 nor more than $2 000 in the case of a first offence, and of not less than $2 000 nor more than $5 000 for any subsequent offence within two years.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6; 1984, c. 27, s. 42; 1984, c. 47, s. 16.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary who presented his health-insurance card or claim booklet, as the case may be, or to be remunerated by a beneficiary for an insured service he has furnished in person where such beneficiary did not present his health-insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary even if the latter did not present his health-insurance card or claim booklet, in the following circumstances and cases:
(a)  where the beneficiary is under one year of age;
(b)  where the beneficiary at the time he received insured services was in a condition requiring emergency care;
(c)  where the beneficiary is over 14 years of age and under 18 years of age and he receives insured services, without parental authorization, in accordance with section 36 of the Public Health Protection Act;
(d)  where the beneficiary is sheltered in a reception centre or an extended care hospital centre;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is null ipsofacto. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
He shall not exact or receive payment from the Board or a beneficiary, as the case may be, for a service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a service not considered insured by regulation or not established as an insured service by regulation.
No person may exact or receive any payment from any beneficiary for a service accessory to an insured service furnished by a professional subject to the application of an agreement or by a professional who has withdrawn, except in the cases prescribed or provided for in an agreement.
Any service rendered by a dentist in his private consulting office and which is related to the insured service referred to in subparagraph b of the first paragraph of section 3 is deemed to be an accessory service.
A professional in the field of health who contravenes the fourth, fifth or sixth paragraph, and every person who contravenes the seventh paragraph, is guilty of an offence and liable, on summary proceedings, in addition to costs, to a fine of not less than $1 000 nor more than $2 000 in the case of a first offence, and of not less than $2 000 nor more than $5 000 for any subsequent offence within two years.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6; 1984, c. 27, s. 42.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary who presented his health-insurance card or claim booklet, as the case may be, or to be remunerated by a beneficiary for an insured service he has furnished in person where such beneficiary did not present his health-insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary even if the latter did not present his health-insurance card or claim booklet, in the following circumstances and cases:
(a)  where the beneficiary is under one year of age;
(b)  where the beneficiary at the time he received insured services was in a condition requiring emergency care;
(c)  where the beneficiary is over 14 years of age and under 18 years of age and he receives insured services, without parental authorization, in accordance with section 36 of the Public Health Protection Act;
(d)  where the beneficiary is sheltered in a reception centre or an extended care hospital centre;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is null ipsofacto. However, a pharmacist may exact the difference between the price of the medication indicated on the list and the amount whose payment is assumed by the Board.
He shall not exact or receive payment from the Board or a beneficiary, as the case may be, for a service that has not been furnished, that he has not furnished in person, that he has not furnished in conformity with an agreement or that he has falsely described.
He shall not exact or receive payment from the Board for a service not considered insured by regulation or not established as an insured service by regulation.
No person may exact or receive any payment from any beneficiary for a service accessory to an insured service furnished by a professional subject to the application of an agreement or by a professional who has withdrawn, except in the cases prescribed or provided for in an agreement.
A professional in the field of health who contravenes the fourth, fifth or sixth paragraph, and every person who contravenes the seventh paragraph, is guilty of an offence and liable, on summary proceedings, in addition to costs, to a fine of not less than $1 000 nor more than $2 000 in the case of a first offence, and of not less than $2 000 nor more than $5 000 for any subsequent offence within two years.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15; 1981, c. 22, s. 6.
22. A professional in the field of health subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary who presented his health-insurance card or claim booklet, as the case may be, or to be remunerated by a beneficiary for an insured service he has furnished in person where such beneficiary did not present his health-insurance card or claim booklet, as the case may be, provided that such professional in the field of health has complied with the provisions of the agreement.
Nevertheless, provided that he has complied with the provisions of the agreement, a professional in the field of health who is subject to the application of an agreement is entitled to be remunerated by the Board for an insured service he has furnished in person to a beneficiary even if the latter did not present his health-insurance card or claim booklet, in the following circumstances and cases:
(a)  where the beneficiary is under one year of age;
(b)  where the beneficiary at the time he received insured services was in a condition requiring emergency care;
(c)  where the beneficiary is over 14 years of age and under 18 years of age and he receives insured services, without parental authorization, in accordance with section 36 of the Public Health Protection Act;
(d)  where the beneficiary is sheltered in a reception centre or an extended care hospital centre;
(e)  in the other circumstances and cases prescribed.
A pharmacist subject to the application of an agreement is entitled to be remunerated in accordance with the first and second paragraphs, even if the insured service has been legally furnished by one of his employees.
A professional in the field of health subject to the application of an agreement shall not exact or receive for an insured service any other remuneration than that provided for by the agreement and to which he is entitled under the preceding paragraphs; any covenant to the contrary is null ipsofacto.
He shall not exact or receive payment from the Board or a beneficiary, as the case may be, for a service that has not been furnished, that he has not furnished in person or that he has falsely described.
He shall not exact or receive payment from the Board for a service not considered insured by regulation or not established as an insured service by regulation.
No person may exact or receive any payment from any beneficiary for a service accessory to an insured service furnished by a professional subject to the application of an agreement or by a professional who has withdrawn, except in the cases prescribed or provided for in an agreement.
A professional in the field of health who contravenes the fourth, fifth or sixth paragraph, and every person who contravenes the seventh paragraph, is guilty of an offence and is liable, on summary proceeding, in addition to the costs, to a fine of not less than $500 nor more than $2 000 in the case of a first offence, and of not less than $2 000 nor more than $5 000 for any subsequent offence within two years.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9; 1979, c. 1, s. 15.
22. A professional shall be entitled to be remunerated by the Board for the insured services which he has furnished personally to a resident of Québec while such professional was subject to the application of an agreement, provided that he has complied with the provisions of the agreement. A pharmacist authorized by law to furnish insured services is entitled to be remunerated by the Board, on the same conditions, for insured services legally furnished by one of his employees.
He shall not exact or receive for such services any other remuneration than that payable to him by the Board and provided for by the agreement; any agreement to the contrary shall be null ipso facto.
No person shall be remunerated for insured services which he has not furnished in conformity with the law or the regulations or which he has furnished but falsely described.
No person shall be remunerated by the Board for uninsured services.
Every person who contravenes the second, third or fourth paragraph is guilty of an offence and liable upon summary proceeding to a fine of not less than $500 nor more than $2,000 and, for each subsequent offence within two years, to a fine of not less than $2,000 nor more than $5,000.
1970, c. 37, s. 18; 1973, c. 30, s. 7; 1974, c. 40, s. 9.