Patients challenging in court bills received for “incidental charges,” such as eye drops, medications or anesthetic agents during medical appointments, scored another victory on Thursday: the Supreme Court of Canada struck down for them an obstacle that stood in the way of their collective actions, brought in the name of all Quebecers.
Three patients have thus sought to bring two class actions in Superior Court for these costs which, according to them, would have been illegally invoiced – or even over-invoiced.
One of the actions is directed against numerous medical clinics and the other against the Federation of Medical Specialists of Quebec (FMSQ), the Federation of General Practitioners of Quebec (FMOQ) and the Association of Optometrists of Quebec.
Both actions also target the Quebec government.
Some defendants, namely the federations of physicians, the government and the New Look Vision Group, maintained that the Superior Court did not have the jurisdiction to judge this case. According to them, it is up to the Régie de l’assurance maladie du Québec (RAMQ) to decide whether or not these costs could be billed. They therefore asked the Court to get rid of class actions now, well before the trial.
This challenge went all the way to the Supreme Court.
The highest court in the country said Thursday that it would not hear the appeal of the Quebec government, the federations and the company Vision New Look.
This means that the judgments of the Court of Appeal remain valid: they had ruled that the Superior Court does indeed have jurisdiction to judge these two cases.
Class actions can now progress and go through all the steps leading to a trial.
We are thus still far from a possible judgment on the merits, which would determine who is right and who is wrong.
Reproaches formulated
The Health Insurance Act prohibits overbilling, including the billing of incidental costs, since it aims to make the health care system free for the Quebec population.
If this law provides for certain exceptions, the amount invoiced must be limited to the professional’s cost price. The defendants having not respected this last condition, it is about illicit invoicing, it is alleged in the action carried out by Philippe Léveillé.
He accuses several doctors, optometrists and medical clinics of illegally billing fees above cost, between May 15, 2011 and January 26, 2017.
This way of proceeding would have ceased on January 26, 2017, he said, following legislative and regulatory amendments formally prohibiting it.
Mr. Léveillé also criticizes the Minister of Health and the RAMQ for turning a blind eye to this “business model”.
In the other case, two Quebecers, Daniel Raunet and Colombe Gagnon, are attacking the various professional orders of physicians and optometrists who, according to them, negotiated agreements with the RAMQ to then encourage their members to bill additional costs, as well as to the Government of Quebec since it would have encouraged this practice by its inaction.
They want to put an end to this way of doing things, which they describe as “harmful” for the Quebec population, to obtain compensation for the fees that have been collected illegally since 2013 as well as punitive damages in certain cases. Their action has not yet received the green light from the Court, unlike that of Mr. Léveillé. And the proof of the reproaches formulated in the two actions has not yet been made before a judge.