Bill 22 — Fourth Session, 22Nd Legislature, 41 Elizabeth Ii the Legislative Assembly of Alberta Bill 22 Health Statutes Amendment Act, 1992 (Legislature 22, Session 4)

L22 S4 2376

Alberta — Bills

1992 BILL 22 Fourth Session, 22nd Legislature, 41 Elizabeth II THE LEGISLATIVE ASSEMBLY OF ALBERTA BILL 22 HEALTH STATUTES AMENDMENT ACT, 1992 MR. THURBER First Reading Second Reading Committee of the Whole Third Reading Royal Assent Title: 1992 (22nd, 4th) Bill 22, Health Statutes Amendment Act, 1992

Crown’s right of recovery Bill 22 Mr. Thurber BILL 22 1992 HEALTH STATUTES AMENDMENT ACT, 1992 (Assented to , 1992) HER MAJESTY, by and with the advice and consent of the Legislative Assembly of Alberta, enacts as follows: Alberta Health Care Insurance Act 1(1) The Alberta Health Care Insurance Act is amended by this section.

(2) Section 13 is amended by adding the following after subsection (1):

(1.1) The Minister or any person authorized by the Minister may, for the purpose of enforcing the Crown’s right of recovery under

Part 5 of the Hospitals Act, disclose information acquired under this Act.

(3) Section 16 is repealed and the following is substituted: 16 The Crown in right of Alberta is entitled to recover the Crown’s cost of health services under

Part 5 of the Hospitals Act. 1

Explanatory Notes Alberta Health Care Insurance Act 1(1) This

section will amend

chapter A-24 of the Revised Statutes of Alberta 1980.

(2) Section 13 presently reads in part: 13(1) The Minister and every person employed in the administration of this Act shall preserve secrecy with respect to all matters that come to his knowledge in the course of his employment and shall not communicate any of those matters to any other person except as otherwise provided in this section.

(3) Section 16 presently reads: 16 When, as a result of the wrongful act or omission of another (in this

section called the “wrong-doer"), (

a) a resident suffers personal injuries and receives health services as a consequence of those injuries, and (

b) the Minister has paid or is liable to pay benefits in respect of those services, no person has any right or cause of action against the wrong-doer or any other person for the recovery of damages for the cost of those health services. 1 Explanatory Notes

Ambulance Services Act 2(1) The Ambulance Services Act is amended by this section.

(2) The following is added after

section 34: Crown’s right of recovery 34.1 The Crown in right of Alberta is entitled to recover the Crown’s cost of ambulance services, air ambulance services and inter-hospital transfer services under

Part 5 of the Hospitals Act. Hospitals Act 3(1) The Hospitals Act is amended by this section.

(2) Section 40 is amended (

a) in subsection (2) by adding “enforcing the Crown’s right of recovery under

Part 5,” after “conducting medical research,”; (

b) by adding the following after subsection (4):

(4.1) Notwithstanding subsection (3) or any other law, the Minister or any person authorized by the Minister may, for the purpose of enforcing the Crown’s right of recovery under

Part 5, disclose information obtained under subsection (2).

(3) Section 47 is amended by adding the following after subsection (1): 2

Ambulance Services Act 2(1) This

section will amend unproclaimed

chapter A-40.5 of the Statutes of Alberta, 1990.

(2) Crown’s right of recovery. Hospitals Act 3(1) This

section will amend

chapter H-ll of the Revised Statutes of Alberta 1980.

(2) Section 40 presently reads in part:

(2) For the purposes of assessing the standards of care furnished to patients, improving hospital or medical procedures, compiling medical statistics, conducting medical research, or for any other purpose considered by the Minister to be in the public interest, the Minister, or a person authorized by the Minister, may require that all or any of the following be sent to him or a person designated by him: (

a) medical and other records of any patient; (

b) extracts from and copies of any medical or other records of any patient; (

c) diagnoses, charts or any information available in respect of a patient.

(3) Information obtained from hospital records or from persons having access thereto shall be treated as private and confidential information in respect of any individual patient and shall be used solely for the purposes described in subsection (2) and the information shall not be published, released or disclosed in any manner that would be detrimental to the personal interests, reputation or privacy of a patient or the patient’s attending physician or any other person providing diagnostic or treatment services to a patient.

(3) Section 47(1) presently reads: 47(1) The board of an approved hospital that furnishes hospital 2 Explanatory Notes

(1.1) In subsection (1), “the amount owing to the hospital” refers to the amount for services not provided as insured services under

Part 3 or an amount for which patients are liable pursuant to

Part 3 or the regulations.

(4) Section 58 is repealed. 3

care and treatment to a person (

a) who has been injured in an accident and requires the hospital care and treatment as a result of the injuries, and (

b) who is entitled to recover damages against some other person on account of the injuries, has, for the amount owing to the hospital for the care and treatment, a lien on the amount of any damages that are awarded in an action to the injured person, or on any amount that is agreed on as payable as damages to that person for the injuries by the person liable or admitted to be liable for them, and also on any claim accruing to the injured person on account of the injuries.

(4) Section 58 presently reads: 58(1) When as a result of a wrongful act or omission of another, a person suffers personal injuries and becomes a beneficiary, (

a) the beneficiary has the same right to recover the cost of insured services against the person guilty of the wrongful act or omission as he would have had if he had been required to pay for the whole cost of the hospital services which he received, and (

b) the Minister is subrogated to the right of recovery of the beneficiary in respect of the cost of insured services furnished and the Minister may maintain an action either in his own name or in the name of the beneficiary to recover the cost of the insured services to which he is hereby subrogated.

(2) A beneficiary, or his agent, shall promptly inform the Minister when the beneficiary or his agent has consulted a solicitor in respect of the damages sustained by him by reason of personal injuries and therewith shall inform the Minister of the name and address of that solicitor.

(3) The Minister may at any time engage a solicitor to prosecute recovery of the cost of the insured services to a beneficiary to which the Minister is subrogated and for that purpose may engage the solicitor of the beneficiary.

(4) The solicitor of a beneficiary who has been engaged by the Minister for the purposes of this

section shall, in addition to proper disbursements, if any, be paid in accordance with a

schedule of fees established by the Lieutenant Governor in Council, and a solicitor separately engaged for these purposes shall be paid his proper and reasonable fees and disbursements determined pursuant to the Alberta Rules of Court.

(5) A beneficiary may at any time settle his claim for damages sustained by reason of personal injuries, other than the cost of 3 Explanatory Notes

Definitions

(5) The following is added after

section 79:

PART 5 CROWN’S RIGHT TO RECOVER HEALTH COSTS 80 In this Part, (a) “beneficiary” means a person who receives health services for personal injuries; (b) “Crown” means Her Majesty in right of Alberta; (c) “Crown’s cost of health services” means the direct and indirect costs of the Crown for health services as determined and calculated in accordance with this Part and the regulations; (d) “Crown’s right of recovery” means the Crown’s right, under this Part, to recover the Crown’s cost of health services; (e) “Director” means the Director of Third Party Liability appointed under

section 100; (f) “health services” means the following, whether provided inside or outside of Alberta: (

i) in-patient and out-patient services provided in a hospital or other facility; 4

insured services to which the Minister is subrogated, but the claim of the Minister shall not be settled without the prior written consent of the Minister and any settlement made without his prior written consent is void.

(6) The obligation of an insurer to an insured person against whom a claim by a beneficiary for personal injuries and the cost of insured services could be made, shall not be discharged until the subrogated claim of the Minister is paid or settlement of it as aforesaid is made and the amount of the settlement is paid.

(7) In this section, “cost of insured services” means the difference between the amount that the person, as a beneficiary, is liable to pay to the hospital and the amount for which he would have been liable to the hospital if he were not a beneficiary.

(8) Repealed 1983 c32 s2.

(5) Crown’s right to recover health costs. 4 Explanatory Notes

Crown’s right of recovery Determining contributory negligence (ii) health services as defined in the Alberta Health Care Insurance Act; (iii) transportation services, including air and ground ambulance services; (iv) public health services; (

v) mental health services; (vi) drug services; (vii) any good or service prescribed to be a health service by the regulations; (g) “settlement” means an agreement to terminate a legal dispute; (h) “wrongdoer” means a person whose wrongful act or omission results in personal injuries to a beneficiary. 81(1) If a beneficiary receives health services for personal injuries suffered as a result of a wrongful act or omission of a wrongdoer, the Crown has the right to recover from the wrongdoer the Crown’s cost of health services for health services (

a) that a beneficiary has received for those personal injuries, and (

b) that a beneficiary will receive for those personal injuries.

(2) If a beneficiary is contributorily negligent, the Crown is entitled to recover 100% of the Crown’s cost of the beneficiary’s health services less a percentage for the beneficiary’s contributory negligence as determined under sections 82 and 83. 82(1) This

section applies when the beneficiary has obtained a judgment against a wrongdoer that is based on a claim that gives rise to the Crown’s right of recovery before the Crown has obtained a judgment 5

5 Explanatory Notes

against or entered into a settlement with the wrongdoer based on the Crown’s right of recovery.

(2) This

section does not apply when the judgment obtained by the beneficiary implements or approves a structured settlement.

(3) If a beneficiary obtains a judgment that indicates that the beneficiary’s claim has been reduced by a specified percentage because of the beneficiary’s contributory negligence, the specified percentage in the judgment is the percentage of contributory negligence to be used to calculate the Crown’s entitlement under

section 81(2). Determining contributory negligence 83 Unless

section 82 applies, the percentage of contributory negligence to be used to calculate the Crown’s entitlement under

section 81(2) is, (

a) if the Crown obtains a judgment against the wrongdoer, the percentage specified in the judgment, or (

b) if the Crown enters into a settlement with the wrongdoer, the percentage specified in the settlement Commence ment of Crown’s right 84 The Crown’s right of recovery arises for all purposes when the beneficiary receives health services for which there is a cost to the Crown for personal injuries suffered as a result of a wrongful act or omission of a wrongdoer. Interest 85(1) When the Crown obtains a judgment based on the Crown’s right of recovery, the court shall award interest calculated in accordance with the regulations from the date that the Crown’s right of recovery arose to the date of the judgment.

(2) The interest shall be awarded on that part of the judgment that represents the Crown’s cost of health services for health services that a beneficiary has received to the date of the judgment.

(3) The rate of interest to be used to calculate the award of interest is the rate of interest for pecuniary 6

6 Explanatory Notes

Limitation period damages that is established for each year under

Part 1 of the Judgment Interest Act.

(4) For the purposes of enforcing a judgment, interest awarded under this

section is included in the judgment.

(5) If a wrongdoer (

a) pays money into court in satisfaction of the claim of the Crown, or (

b) makes an offer of judgment specifying the terms on which the wrongdoer is willing to settle the claim of the Crown, and the Crown does not accept the payment or the offer and obtains a judgment for an amount equal to or less than the amount paid into court or the amount offered, the court shall award interest from the date that the Crown’s right of recovery arose only to the day the payment into court was made or the date of service of the offer of judgment, as the case may be.

(6) Except for the rate of interest referred to in subsection (3),

Part 1 of the Judgment Interest Act does not apply to the Crown’s right of recovery. 86 The limitation period to commence an action based on the Crown’s right of recovery is the period described in clause (

a) or (

b) that ends on the later date: (a) 6 months after the expiration of the beneficiary’s limitation period to commence an action against the wrongdoer; (b) 6 months after the Director receives a written notice under this Part that a beneficiary who received health services may have or have had a claim for damages against a wrongdoer. Settlement 87(1) The Director may enter into a settlement of the Crown’s right of recovery.

(2) When the terms of a settlement are met, the Director may release a person from liability to the Crown in respect of the Crown’s right of recovery. 7

7 Explanatory Notes

Director’s certificate Priority of beneficiary’s payments

(3) If the Director believes that the cost of pursuing the Crown’s right of recovery in a particular case will exceed the benefit to the Crown, the Director may release a person from liability to the Crown in respect of that right without receiving any payment. 88(1) The Director may make one or more certificates that set out (

a) the health services a beneficiary has received and the health services a beneficiary will receive for personal injuries suffered as a result of a wrongful act or omission of a wrongdoer for which there is a cost to the Crown, and (

b) the Crown’s cost of those health services.

(2) For the purposes of the Crown’s right of recovery, a certificate is prima facie proof of the health services for which there is a cost to the Crown referred to in subsection (1)(a).

(3) For the purposes of the Crown’s right of recovery, after the health services for which there is a cost to the Crown have been determined, a certificate is conclusive proof of the Crown’s cost of those health services.

(4) A certificate is admissible in evidence without proof of the signature, authority or office of the person purporting to have signed the certificate. 89(1) Subject to subsection (2) and the regulations, payments to a beneficiary under a judgment obtained against or a settlement entered into with a wrongdoer that is based on a claim that gives rise to the Crown’s right of recovery have priority over payments to the Crown under a judgment obtained against or a settlement entered into with the wrongdoer that is based on the Crown’s right of recovery. (2) Subsection (1) does not apply to a payment received by the Crown under a judgment obtained against or a settlement entered into with a wrongdoer before the beneficiary has obtained a judgment against or entered into a settlement with the wrongdoer. 8

8 Explanatory Notes

Beneficiary's duty Information from beneficiary Insurer’s duty Information relating to health services

(3) When the Crown has received a payment under a judgment obtained against or a settlement entered into with a wrongdoer before the beneficiary has obtained a judgment against or entered into a settlement with the wrongdoer, the Director may pay some or all of the money from the payment to the beneficiary if (

a) the beneficiary subsequently obtains a judgment or enters into a settlement with the wrongdoer, and (

b) the Director believes that the beneficiary will not receive the full amount to which the beneficiary is entitled under the judgment or settlement. 90 A beneficiary who consults a lawyer or has someone consult a lawyer on his behalf in respect of personal injuries suffered by the beneficiary as a result of a wrongful act or omission of a wrongdoer shall, as soon as possible after the consultation, provide the Director with the information prescribed by the regulations. 91(1) The Director may request a beneficiary to provide information relating to the wrongful act or omission of the wrongdoer, the personal injuries that the beneficiary has suffered and the health services that have been received for those injuries.

(2) A beneficiary who receives a request to provide information under subsection (1) shall, as soon as possible, comply with the request. 92 An insurer who is notified of circumstances in which the Crown’s right of recovery may arise shall, as soon as possible, notify the Director of those circumstances and provide the Director with the information prescribed by the regulations. 93(1) The Director may request any person who has information respecting the health services provided to a beneficiary to provide the Director with that information. 9

9 Explanatory Notes

Structured settlements Wrongdoer’s Insurance policy Order for information and documents

(2) A person who receives a request to provide information under subsection (1) shall, as soon as possible, comply with the request.

(3) The provision of information under this

section is subject to any privilege that exists between a lawyer and client. 94(1) If a beneficiary enters into a structured settlement with a wrongdoer that is based on a claim that gives rise to the Crown’s right of recovery, the wrongdoer shall, as soon as possible after entering into the structured settlement, provide the Director with a copy of it.

(2) The Director may impose terms and conditions specified by the regulations on a structured settlement that is entered into by a beneficiary and a wrongdoer or contained in a judgment obtained by a beneficiary against a wrongdoer that is based on a claim that gives rise to the Crown’s right of recovery.

(3) If the Director imposes terms and conditions under subsection (2), (

a) the Crown is deemed to be a party to the structured settlement, and (

b) the terms and conditions form part of the structured settlement. 95 If a beneficiary obtains a judgment against or enters into a settlement with a wrongdoer that is based on a claim that gives rise to the Crown’s right of recovery, the wrongdoer shall, as soon as possible after the judgment has been obtained or the settlement has been entered into, provide the Director with a copy of any insurance policy that insures the wrongdoer against liability in respect of the personal injuries suffered by the beneficiary. 96(1) If a beneficiary, insurer or other person fails to provide information under one or more of sections 90 to 93 or if a wrongdoer fails to provide a copy of a structured settlement under

section 94 or a copy of an insurance policy under

section 95, the Director may apply by originating notice to the Court of Queen’s 10

10 Explanatory Notes

Offence Bench for an order compelling the beneficiary, insurer or other person to provide the information or compelling the wrongdoer to provide a copy of the structured settlement or insurance policy.

(2) The Court may, subject to any conditions that it considers appropriate, grant an order compelling the beneficiary, insurer or other person to provide the information if it is satisfied that (

a) the information is in the possession or under the control of the beneficiary, insurer or other person, and (

b) the information is relevant to the Crown’s right of recovery.

(3) The Court may, subject to any conditions that it considers appropriate, grant an order compelling the wrongdoer to provide a copy of the structured settlement if it is satisfied that the wrongdoer has entered into a structured settlement with a beneficiary that is based on a claim that gives rise to the Crown’s right of recovery.

(4) The Court may, subject to any conditions that it considers appropriate, grant an order compelling the wrongdoer to provide a copy of the insurance policy if it is satisfied that (

a) the beneficiary has obtained a judgment against or entered into a settlement with the wrongdoer that is based on a claim that gives rise to the Crown’s right of recovery, and (

b) the wrongdoer has an insurance policy that insures the wrongdoer against liability in respect of the personal injuries suffered by the beneficiary. 97(1) A beneficiary, insurer or other person or a wrongdoer who fails to comply with an order obtained under

section 96 is guilty of an offence and is liable to a fine of not more than $10 000.

(2) Nothing in this

section affects the remedies available to enforce an order obtained under

section 96. 11

11 Explanatory Notes

Order for medical examination 98(1) The Director may, after an action based on the Crown’s right of recovery is commenced against a wrongdoer, apply for an order directing the beneficiary to submit to an examination by a physician under

Part 14 of the Alberta Rules of Court, and that Part applies to the Crown’s right of recovery.

(2) The Crown is responsible for the reasonable expenses incurred by the beneficiary as a result of an examination ordered under this section. Regulations99(1) The Lieutenant Governor in Council may make regulations (

a) prescribing a good or service to be a health service for the purposes of this Part; (

b) respecting the calculation of interest for the purposes of

section 85; (

c) for the purposes of

section 89, (

i) respecting the conditions and circumstances in which the priority for payment to the beneficiary operates, including special provisions for structured settlements, and (ii) respecting the determination of amounts that have priority; (

d) respecting the terms and conditions that may be imposed on structured settlements under

section 94; (

e) respecting the payment of legal counsel, physicians and other persons for services provided to the Crown for the purposes of the Crown’s right of recovery; (

f) generally for giving effect to any of the purposes or provisions of this Part.

(2) The Minister may make regulations (

a) for the purposes of determining the Crown’s cost of health services, 12

12 Explanatory Notes

Appointment of Director Certain powers of the Director Transitional (

i) respecting what is a cost of the Crown, and (ii) respecting whether something is a capital cost or an operating cost and whether a health service has a capital cost; (

b) respecting the calculation of the Crown’s cost of health services under the Crown’s right of recovery, including (

i) the establishment of a capital cost factor to be used to determine capital costs, and (ii) the establishment of discount rates to be used to determine future costs; (

c) prescribing the information to be provided to the Director under sections 90 and 92. 100 The Minister may appoint a Director of Third Party Liability. 101(1) The Director may hire legal counsel for the purpose of recovering the Crown’s cost of health services under this Part.

(2) The Director may establish forms for use under this Part

(3) The Director may authorize a person to exercise any power or to perform any duty of the Director under this Part or the regulations made under this Part. 102(1 ) An action based on the Crown’s right of recovery may be commenced only if the wrongful act or omission of the wrongdoer occurs after this

Part comes into force.

(2) A beneficiary’s rights and the Minister’s right of subrogation in respect of a wrongful act or omission that occurred before this

Part comes into force is governed by the provisions of this Act in force when the wrongful act or omission occurred. 13

13 Explanatory Notes

Mental Health Act 4(1) The Mental Health Act is amended by this section.

(2) Section 17 is amended (

a) in subsection (3) by adding “or enforcing the Crown’s right of recovery under

Part 5 of the Hospitals Act” after “or procedures”; (

b) by adding the following after subsection (5):

(5.1) Notwithstanding subsection (4) or any other law, the Minister or any person authorized by the Minister may, for the purpose of enforcing the Crown’s right of recovery under

Part 5 of the Hospitals Act, disclose information obtained under subsection (3).

(3) The following is added after

section 49: Crown’s right of recovery49.1 The Crown in right of Alberta is entitled to recover the Crown’s cost of mental health services under

Part 5 of the Hospitals Act. Public Health Act 5(1) The Public Health Act is amended by this section.

(2) The following is added before

section 76: 14

Mental Health Act 4(1) This

section will amend

chapter M-13.1 of the Statutes of Alberta, 1988.

(2) Section 17 presently reads in part:

(3) For the purpose of assessing the standards of care furnished to persons in a diagnostic and treatment centre or improving mental health care facilities or procedures or for any other purpose considered by the Minister to be in the public interest, the Minister or any person authorized in writing by the Minister may require that all or any of the following be sent to the Minister or any person designated by the Minister: (

a) medical and other records in a centre; (

b) extracts from and copies of those records; (

c) diagnoses, charts or information available in respect of any person receiving diagnostic and treatment services in a centre.

(4) Information obtained from records maintained in a diagnostic and treatment centre or from persons having access to them shall be treated as private and confidential information in respect of the person receiving diagnostic and treatment services in the centre and shall be used solely for the purposes described in subsection (3), and the information shall not be published, released or disclosed in any manner that would be detrimental to the personal interest, reputation or privacy of that person or that person’s attending physician or any other person providing diagnostic or treatment services to that person.

(3) Crown’s right of recovery. Public Health Act 5(1) This

section will amend

chapter P-27.1 of the Statutes of Alberta, 1984.

(2) Crown’s right of recovery. 14 Explanatory Notes

Crown’s right of recovery 75.1 The Crown in right of Alberta is entitled to recover the Crown’s cost of public health services under

Part 5 of the Hospitals Act. Commencement 6 This Act comes into force on Proclamation. 15

Commencement 6 Coming into force. 15 Explanatory Notes Title: 1992 (22nd, 4th) Bill 22, Health Statutes Amendment Act, 1992

Document details

Collection	Alberta — Bills
Citation	L22 S4 2376
Type	bill
Volume / chapter	L22 S4 2376
Language	en
Format	json
Source	PROVINCIAL
Identifier	24f3aa63a2b5bc4039e3f436a4021e9a30d52d2c

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