A-28 - Hospital Insurance Act

Updated to 22 October 1999

This document has official status.

chapter A-28

Hospital Insurance Act

1. In this Act:

(a)  “Minister” means the Minister of Health and Social Services;

(b)  “regulation” means a regulation made under this Act;

(c)  “insured services” means hospital services defined as such by regulation;

(d)  “hospital centre” means a hospital centre within the meaning of the Act respecting health services and social services (chapter S-4.2) or within the meaning of the Act respecting health services and social services for Cree Native persons (chapter S-5);

(e)  “residential and long-term care centre” means a residential and long-term care centre within the meaning of the Act respecting health services and social services;

(f)  “institution” means a public or private institution under agreement governed by the Act respecting health services and social services or a public or private institution under agreement governed by the Act respecting health services and social services for Cree Native persons;

(g)  “Board” means the Régie de l’assurance maladie du Québec established under the Act respecting the Régie de l’assurance maladie du Québec (chapter R-5);

(h)  “regional board” means a regional health and social services board established under the Act respecting health services and social services.

R. S. 1964, c. 163, s. 1; 1970, c. 42, s. 17; 1979, c. 1, s. 54; 1985, c. 23, s. 24; 1992, c. 21, s. 91; 1994, c. 23, s. 23; 1999, c. 89, s. 53.

2. In order that the residents of Québec and such other persons as are determined by regulation receive, without charge, insured services upon uniform terms and conditions, the Minister shall assign to the institutions governed by the Act respecting health services and social services for Cree Native persons (chapter S-5) which operate a hospital centre and to the institution to which Part IV.2 of the Act respecting health services and social services (chapter S-4.2) applies the amounts needed to finance the cost of the insured services they dispense, and shall ensure that each regional board does likewise with regard to those institutions of its region which operate a hospital centre and those which operate a residential and long-term care centre that are determined by the Minister.

Insured services dispensed by the institutions referred to in the first paragraph shall be financed in accordance with the provisions of the Act respecting health services and social services for Cree Native persons or the Act respecting health services and social services (chapter S-4.2), as the case may be.

R. S. 1964, c. 163, s. 2; 1971, c. 48, s. 161; 1992, c. 21, s. 92; 1994, c. 23, s. 23; 1998, c. 39, s. 176.

2.1. An institution referred to in section 2 may request that a person present, as proof of that person’s admissibility to receive insured services free of charge pursuant to this Act, the health insurance card or eligibility card issued to him by the Board in accordance with section 9 or 9.0.1 of the Health Insurance Act (chapter A-29).

1992, c. 21, s. 93; 1999, c. 89, s. 53.

3. The Minister may, with the approval of the Government, enter into any agreement for the purposes of the application of this Act with any body representing a class of professionals in the field of health within the meaning of the Health Insurance Act (chapter A-29).

An agreement is binding on all the pharmacists practising in a hospital centre operated by an institution governed by the Act respecting health services and social services for Cree Native persons (chapter S-5) and who are members of the body that has entered into the agreement and all the pharmacists whose scope of professional activity is the same as that of such members and who are contemplated by the agreement.

Any agreement or part of an agreement, if it expressly so provides, may bind any institution. However, the Minister must consult the institutions or groups of institutions susceptible to being bound by an agreement or part of an agreement and they may submit recommendations to the Minister regarding the terms and conditions of their participation in the making of such agreement or part of an agreement.

1974, c. 40, s. 25; 1984, c. 27, s. 40; 1992, c. 21, s. 94, s. 375; 1994, c. 23, s. 23.

4. (Repealed).

R. S. 1964, c. 163, s. 3; 1971, c. 48, s. 160, s. 161; 1992, c. 21, s. 95.

5. (Repealed).

R. S. 1964, c. 163, s. 4; 1971, c. 48, s. 161; 1979, c. 1, s. 55.

6. The Minister, with the approval of the Government, may enter into an agreement with the Minister of Health of Canada to provide for the payment by Canada to Québec of contributions to the cost of insured services furnished at the expense of Québec pursuant to this Act.

Such agreement shall provide for payment by Québec for insured services furnished to its residents who are eligible therefore by hospitals of the Government of Canada or of other provinces.

R. S. 1964, c. 163, s. 5; S.C. 1996, c. 8, s. 32.

7. The sums due under the agreements provided for by this Act shall be payable out of the moneys appropriated by Parliament for such purposes.

R. S. 1964, c. 163, s. 6; 1992, c. 21, s. 96.

8. The Government, by regulation in conformity with the foregoing provisions, may:

(a)  establish the plan for the carrying out of this Act;

(b)  define residents of Québec, the insured services to be furnished to them and the other insured persons;

(c)  (paragraph repealed);

(d)  rule upon any other matter requisite for the carrying out of this Act or of an agreement.

R. S. 1964, c. 163, s. 7; 1971, c. 48, s. 161; 1992, c. 21, s. 97.

9. Every regulation shall come into force upon its publication in the Gazette officielle du Québec or on such date, not earlier than such publication, as is fixed in the regulation.

R. S. 1964, c. 163, s. 8.

10. (1)  The State shall be subrogated in the right of recovery of any insured person against any third party to the extent of the cost of all insured services furnished or to be furnished in respect of personal injury caused by the fault of such third party.

(2)  In case of contributory negligence the amount of such subrogation shall be subject to reduction in the same proportion as the insured person’s right of recovery.

(3)  The Minister shall have authority to compromise any claim of the State under this section and may delegate such authority.

(3.1)  An insurer of a third party’s liability shall notify the Board in writing as soon as he begins negotiations to settle a claim for compensation susceptible of entailing the payment of insured services.

(4)  An insurer of a third party’s liability shall not discharge his obligation to indemnify the latter of his liability to the State under this section otherwise than by payment to the State.

(5)  An undertaking by an insured person to discharge a third party’s or an insurer’s liability to the State under this section or to save them harmless from such liability shall be invalid and be deemed unwritten in any agreement, transaction or release.

(6)  The rights acquired by the effect of a subrogation under this section belong to the domain of the State from the day they arise and are subject to the rules applicable to rights belonging to the domain of the State; however, any right of action resulting therefrom is prescribed by three years.

R. S. 1964, c. 163, s. 9; 1989, c. 50, s. 42; 1999, c. 40, s. 28.

11. (1)  No one shall make or renew, or make a payment under a contract under which

(a)  a resident is to be provided with or to be reimbursed for the cost of any hospital service that is one of the insured services;

(b)  payment is conditional upon the hospitalization of a resident; or

(c)  payment is dependent upon the length of time the resident is a patient in a facility maintained by an institution contemplated in section 2.

(2)  This section does not apply for such time after a person arrives in Québec as a resident as he is not an insured person.

(3)  This section does not prohibit a contract or a payment under a contract under which a resident is to be reimbursed or indemnified for

(a)  the cost of any hospital service other than the insured services; or

(b)  (subparagraph repealed);

(c)  loss of time because of disability, whether or not the date of the commencement of the benefit is determined by reference to the date of admission to the institution contemplated in section 2, if the rate of payment is not increased by the hospitalization of the resident.

(4)  No resident shall receive, under one or more contracts to which the next preceding subsection applies, a total sum, in respect of the cost of any hospital service that is not an insured service, that is in excess of the actual charges made for the service by the institution contemplated in section 2.

(5)  This section applies

(a)  to the making or renewing, since 1 January 1961, of a contract that provides for a benefit described in subsection 1; and

(b)  to a payment in respect of hospital services rendered on or since 1 January 1961, except a payment under a contract that is not a group contract for hospital services rendered before 1 April 1961, or before the anniversary in 1961 of the making or renewing thereof, if it occurs before that date.

(6)  In this section, “group contract” means a contract of insurance whereby two or more persons other than members of the same family are insured severally under a single contract of insurance.

R. S. 1964, c. 163, s. 10; 1971, c. 48, s. 161; 1992, c. 21, s. 98.

12. The Minister and the officers and employees charged with the carrying out of this Act shall not reveal, except to the extent prescribed by an agreement made under section 6, any information obtained in the carrying out of this Act and they cannot be compelled to do so before any court of civil jurisdiction.

They shall not be personally responsible for anything done in good faith in the performance of their duties.

R. S. 1964, c. 163, s. 11.

13. No person shall knowingly obtain or receive the benefit of insured services that he is not entitled to obtain or receive under this Act and the regulations.

No person shall knowingly aid or abet another person to obtain or receive insured services that such other person is not entitled to obtain or receive under this Act and the regulations.

Every person who contravenes a provision of this section is guilty of an offence and is liable to a fine not exceeding $500.

R. S. 1964, c. 163, s. 12; 1990, c. 4, s. 73.

14. Every person who obstructs an inspector or a medical practitioner in the performance of his duties under this Act and the regulations is guilty of an offence and is liable to a fine $50 to $500.

R. S. 1964, c. 163, s. 13; 1990, c. 4, s. 74.

15. Every person who contravenes any provision of this Act or the regulations for the violation of which no penalty is specifically provided is guilty of an offence and is liable to a fine of not more than $100.

R. S. 1964, c. 163, s. 14; 1990, c. 4, s. 75.

16. (This section ceased to have effect on 17 April 1987).

1982, c. 21, s. 1; U. K., 1982, c. 11, Sch. B, Part I, s. 33.

REPEAL SCHEDULE

In accordance with section 17 of the Act respecting the consolidation of the statutes (chapter R-3), chapter 163 of the Revised Statutes, 1964, in force on 31 December 1977, is repealed effective from the coming into force of chapter A-28 of the Revised Statutes.