A-29 - Health Insurance Act

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47. Where the Board believes that the insured services or a part of them for which a professional in the field of health has claimed or obtained payment during the 60 preceding months were not justified by medicine, optometry, dentistry or pharmacy and therefore were furnished more frequently than necessary or were dispensed in an excessive manner, it shall refer the matter to the appropriate revisory committee and must then inform the professional concerned.
Before making its recommendation, the revisory committee must allow the professional concerned to present observations.
Notification of a notice of investigation to the health professional by the Board suspends the 60-month prescription provided for in the first paragraph until the expiry of one year from the notification or until the investigation report is completed, whichever comes first.
1970, c. 37, s. 34; 1970, c. 38, s. 13; 1973, c. 30, s. 9; 1973, c. 49, s. 45; 1974, c. 40, s. 12; 1979, c. 1, s. 34; 1997, c. 43, s. 62; 2016, c. 282016, c. 28, s. 24.
47. Where the Board believes that the insured services or a part of them for which a professional in the field of health has claimed or obtained payment during the 36 preceding months were not justified by medicine, optometry, dentistry or pharmacy and therefore were furnished more frequently than necessary or were dispensed in an excessive manner, it shall refer the matter to the appropriate revisory committee and must then inform the professional concerned.
Before making its recommendation, the revisory committee must allow the professional concerned to present observations.
1970, c. 37, s. 34; 1970, c. 38, s. 13; 1973, c. 30, s. 9; 1973, c. 49, s. 45; 1974, c. 40, s. 12; 1979, c. 1, s. 34; 1997, c. 43, s. 62.
47. Where the Board believes that the insured services or a part of them for which a professional in the field of health has claimed or obtained payment during the 36 preceding months were not justified by medicine, optometry, dentistry or pharmacy and therefore were furnished more frequently than necessary or were dispensed in an excessive manner, it shall refer the matter to the appropriate revisory committee and must then inform the professional concerned.
Before making its recommendation, the revisory committee must allow the professional concerned to be heard.
1970, c. 37, s. 34; 1970, c. 38, s. 13; 1973, c. 30, s. 9; 1973, c. 49, s. 45; 1974, c. 40, s. 12; 1979, c. 1, s. 34.
47. When the Board believes that the insured services for which a physician, a dentist or an optometrist has claimed or obtained payment during the thirty-six preceding months were not required so frequently or that such services have been rendered in an improper or unjustified manner, it may refer the matter to the appropriate revisory committee and must, in writing, inform the physician, dentist or optometrist concerned who is entitled to be heard before the revisory committee before it makes its recommendation.
1970, c. 37, s. 34; 1970, c. 38, s. 13; 1973, c. 30, s. 9; 1973, c. 49, s. 45; 1974, c. 40, s. 12.