First Session, 48th

General Assembly

65 Elizabeth II,

BILL 24

AN ACT RESPECTING INSURED MEDICAL

AND HOSPITAL SERVICES IN THE PROVINCE

Received

and Read the First Time ................................................................

Second

Reading ............................................................................................

Committee .....................................................................................................

Third

Reading ...............................................................................................

Royal

Assent .................................................................................................

HONOURABLE JOHN

HAGGIE

Minister of Health

and Community Services

Ordered to be printed by

the Honourable House of Assembly

EXPLANATORY NOTES

This Bill would enact the Medical Care and Hospital Insurance Act and repeal the Medical Care Insurance Act, 1999 and the Hospital Insurance Agreement Act .

The Bill would

continue the medical care and

hospital insurance plans for the residents of the province;

provide for the payment to

medical and dental practitioners for insured services provided by them to

beneficiaries of the medical care insurance plan;

prohibit medical and dental

practitioners in the province from billing a beneficiary of the medical care

insurance plan for more than the rate at which the medical care insurance plan

will pay for those services;

continue the levy paid by motor

vehicle insurers to recover the cost of insured services resulting from injuries

caused by motor vehicle accidents; and

allow the minister to recover

the cost of insured services resulting from injuries caused by persons who are

not insured by a policy to which the levy applies.

A BILL

AN ACT RESPECTING INSURED MEDICAL AND

HOSPITAL SERVICES IN THE PROVINCE

Analysis

Short title

Definitions

PART

RIGHTS AND CONFIDENTIALITY

Rights

Confidentiality of information

PART

PLANS

Medical care and hospital insurance

plans

Duty of residents to register

PART

III

ACCOUNTS AND PAYMENTS

Extra billing

Enrollment and election

Accounts

Time to submit account

Payments generally

Payment to participating practitioner

Payments to beneficiaries

Right not to be assigned or attached

Residents of other jurisdictions

Exception for emergencies

Professional corporation

Non-application of Act

Penalties for false statements

PART

AUDITS

Definition

Audits

Powers and duties

Notice to practitioner

Withholding of payments

Overpayments

Review

Review board

Panel

Orders

Interest

Joint and individual liability

Appeal

Advisory committee

Alternative dispute resolution

PART

LEVY

Levy generally

Calculation and payment

Report and adjustment

Interest

Unpaid levy

Effect on licence

PART

RECOVERY OF COSTS FOR SERVICES

Recovery by injured person generally

Claim for recovery

Proof of amount

Settlement of claim

Fees

PART

VII

GENERAL

Consultation with associations

Regulations

Regulations by minister

Offence and penalty

Date and effect of regulations

Offence

Actions barred

Non-liability

Practitioner liability

PART

VIII

TRANSITIONAL, CONSEQUENTIAL, REPEAL AND COMMENCEMENT

Transitional

RSNL1990 cA-22 Amdt.

SNL2004 cC-5.1 Amdt.

RSNL1990 cI-10 Amdt.

SNL1991 c16 Amdt.

SNL2008 cP-7.01 Amdt.

SNL1992 cR-17 Amdt.

SNL2001 cT-4.2 Amdt.

Repeal

Commencement

Be it enacted by the Lieutenant-Governor and

House of Assembly in Legislative Session convened, as follows:

Short title

1. This

Act may be cited as the Medical Care and

Hospital Insurance Act .

Definitions

2. In

this Act

(a) "beneficiary" means a person who is

so defined under the regulations but does not include

(

i) a member of the Canadian Forces,

(ii) a person serving a term of imprisonment in a

penitentiary as defined in the Corrections

and Conditional Release Act ( Canada ), or

(iii) a resident for whom the required waiting

period prescribed by the regulations has not elapsed;

(b) "dental association" means the Newfoundland and

Labrador Dental Association continued under the Dental Act, 2008 ;

(c) "department" means the department

presided over by the minister;

(d) "documentation" includes correspondence,

health records, notes, charts, documents, material and other information;

(e) "earned vehicles" means the

aggregate exposure, in car years, for automobile liability coverage derived

from all statistical experience reported and accepted by the Superintendent of

Insurance under all types of business other than type 3, miscellaneous and

fleets on an earnings, receipts or payroll basis, for those vehicle types

exhibited annually in the Actual Loss Ratio Exhibits covering the general

categories of private passenger, farmers, commercial, motor cycles, snow

vehicles and interurban trucks;

(f) "hospital" means an institution operated

by the Crown or an agent of the Crown for the care of diseased, injured or sick

people;

(g) "hospital insurance plan" means the

hospital insurance plan referred to in

section 5;

(h) "hospital service" means a service

so defined under the regulations;

(i) "injury" includes a disability;

(j) "insured service" means the medical services

and hospital services so defined under the regulations;

(k) "levy year" means a calendar year in

which a levy is due from insurance companies with respect to automobile insurance

business transacted in the province;

(l) "medical association" means the Newfoundland and Labrador

Medical Association continued under the Medical

Act, 2011 ;

(m) "medical care insurance plan" means

the medical care insurance plan referred to in

section 5;

(n) "medical service" means a service so

defined under the regulations;

(o) "minister" means the minister appointed

under the Executive Council Act to

administer this Act;

(p) "participating practitioner" means a

practitioner who is enrolled with the medical care insurance plan as a

practitioner and for whom an election under

section 8 is not in effect;

(q) "practitioner" means a person who is

(

i) lawfully entitled to practise medicine or

dentistry in the province, or

(ii) entitled under the regulations to provide

insured services;

(r) "professional corporation" means a

corporation

(

i) permitted under the Medical Act, 2011

to provide the services of a medical practitioner,

(ii) permitted under the Dental Act, 2008 to

provide the services of a dentist, or

(iii) permitted under another statute to provide the

services of a practitioner referred to in subparagraph (q)(ii);

(s) "resident" means a person who

(

i) is lawfully entitled to be or to remain in Canada ,

(ii) makes his or her home in the province, and

(iii) is ordinarily present in the province,

but does not include a tourist, transient or

visitor to the province; and

(t) "Superintendent of Insurance" means

the Superintendent of Insurance appointed under the Insurance Companies Act .

PART I

RIGHTS AND CONFIDENTIALITY

Rights

3. Nothing

in this Act or the regulations shall

(

a) interfere with or restrict the right of a beneficiary

to select the practitioner, or other person providing services, from whom he or

she will receive insured services;

(

b) interfere with or restrict the right of a practitioner,

or other person providing services, to accept or refuse to accept a patient who

is a beneficiary; or

(

c) interfere with or restrict the right of a practitioner,

or other person providing services, to charge for insured services provided to

a patient who is not a beneficiary.

Confidentiality

of information

(1) A

person employed in the administration of this Act shall maintain

confidentiality with respect to all matters that come to his or her knowledge

in the course of that person's employment and shall not communicate the matters

to another person, including an employee of the government, except

(

a) to a person to whom an insured service is provided

about that insured service;

(

b) to a practitioner for a purpose relating to insured

services that the practitioner has provided;

(

c) to a professional corporation and its

directors, officers and employees for a purpose relating to insured services that

were provided through the corporation;

(

d) for the purpose of the administration of this

Act;

(

e) for the purpose of consultation between the

minister and the medical association or the dental association;

(

f) to a person employed by the government to

enforce support orders under the Support

Orders Enforcement Act, 2006 ;

(

g) to a professional regulatory or licensing body

for the purpose of making an allegation;

(

h) to a peace officer for the purpose of

reporting a suspected offence;

(

i) to a person who is empowered by a statute

which requires disclosure of information;

(

j) for the purpose of releasing information,

including personal health information as

defined in the Personal Health Information

Act , to the Newfoundland and Labrador Centre for Health Information in

accordance with the Centre for Health

Information Act and regulations made under that Act; or

(

k) in other circumstances that may be established

by the Lieutenant-Governor in Council.

(2) The Crown is not liable for damages caused to

a person as a result of the release of information under subsection (1).

(3) An action for defamation against the minister

or an employee of the department shall not be founded on the disclosure of information

released under subsection (1).

PART II

PLANS

Medical care and

hospital insurance plans

(1) The

minister shall administer a medical care insurance plan and a hospital

insurance plan for the residents of the province.

(2) Each plan shall be administered and operated

on a non-profit basis.

Duty of residents

to register

(1) Every

resident shall register in accordance with the regulations.

(2) A resident who wilfully gives false

information or withholds information necessary for the purpose of registration

is guilty of an offence and liable on

summary conviction to a fine of not more

than $10,000.

PART III

ACCOUNTS AND PAYMENTS

Extra billing

(1) A

practitioner who provides insured services, whether or not he or she has made

an election under

section 8 which is in effect, shall not charge or collect

from a beneficiary a fee for those insured services in excess of the amount payable

under this Act and the regulations.

(2) A practitioner or other person who contravenes

subsection (1) is guilty of an offence and liable on

summary conviction to

a fine of not more than $20,000 for each contravention.

Enrollment and

election

(1) A

practitioner who wishes to submit accounts and collect payments directly from

the medical care insurance plan for insured services provided to beneficiaries

shall enroll with that plan as a participating practitioner in accordance with

the regulations.

(2) The minister may refuse, suspend or cancel the

enrollment of a practitioner as a participating practitioner under the medical

care insurance plan in the circumstances prescribed by the regulations.

(3) A practitioner may, in writing, notify the

minister of his or her election to collect payments in respect of insured services

provided by the practitioner to beneficiaries otherwise than from the minister.

(4) An election under subsection (3) shall have

effect from the first day of the first month beginning after the expiration of

60 days after the date on which the minister receives the notice of election.

(5) A practitioner who has made an election under

subsection (3) may revoke the election by written notice to the minister.

(6) A revocation of election under subsection

(5) shall have effect from the first day of the first month beginning after the

expiration of 60 days after the date on which the minister receives the notice

of revocation.

(7) Notwithstanding subsections (4) and (6), the

minister may waive the time periods in those subsections where, in his or her opinion,

it is reasonable to do so.

Accounts

(1) In

order to receive payment for an insured service provided to a beneficiary, a

participating practitioner shall submit an account for the service to the

minister together with the information that is required to substantiate the

claim for payment in the form prescribed by the minister.

(2) In order to receive payment for an insured

service provided to a beneficiary by a practitioner who is not a participating

practitioner, the beneficiary shall submit an account to the minister together

with the information that is required to substantiate the claim for payment in

the form prescribed by the minister.

(3) Participating practitioners and beneficiaries shall

supply further information where the minister requires it to clarify or substantiate

his or her claim for payment.

Time to submit

account

(1) A

participating practitioner shall submit an account for an insured service no

later than 90 days after the practitioner provides the insured service.

(2) A beneficiary shall submit an account no later

than 2 years after the insured service is provided to him or her.

(3) Notwithstanding subsections (1) and (2), the

minister may extend the time for submitting an account where, in his or her

opinion, good cause for the extension is shown.

Payments generally

11. The minister shall not pay for an insured service

where the account for the service is not in accordance with this Act and the regulations.

Payment to participating

practitioner

(1) The

minister shall, under this Act and the regulations, make payment to a

participating practitioner for providing an insured service to a beneficiary according

to the terms, conditions and rates prescribed by the minister.

(2) Where a participating practitioner provides an

insured service to a beneficiary, he or she shall accept payment from the

minister in respect of that insured service, and the participating practitioner

shall accept the payment as payment in full for that service.

(3) Notwithstanding subsection (1), where a

participating practitioner performs professional services for a public

authority or body that has received the prior approval of the minister in

addition to the provision of insured services to beneficiaries, the minister

may, upon being satisfied that the participating practitioner is receiving

remuneration for the provision of those professional services, enter into an

arrangement with the public authority or body providing for the payment to it

for the insured services provided to beneficiaries, and the minister shall make

the payment in accordance with the arrangements made.

(4) A practitioner shall not receive payment from

the minister for an insured service provided to a beneficiary unless the

practitioner was a participating practitioner when the insured service was

provided.

Payments to beneficiaries

(1) Where

an insured service is provided in the province to a beneficiary by a

practitioner other than a participating practitioner, the minister shall, under

this Act and the regulations, make payment to the beneficiary in respect of

that insured service according to the terms, conditions and rates prescribed by

the minister.

(2) Where an insured service is provided outside

the province to a beneficiary, the minister shall make payment in accordance

with this Act and the regulations.

(3) The right of the beneficiary to receive

payment from the minister for insured services provided under subsection (1) is

a contractual right and the beneficiary is entitled to receive payment from the

minister in respect of those services in an amount equal to the amount that

would be payable to a participating practitioner by the minister under this Act

and the regulations.

Right not to be

assigned or attached

14. The

right of a beneficiary to receive payment from the minister in respect of insured

services provided to the beneficiary shall not be assigned, and an amount owing

in respect of the right shall not be charged or attached, and a transaction

purporting to assign the right or to charge or attach the amount is void.

Residents of

other jurisdictions

15. Where

an insured service is provided in the province to a person who is an insured person

of another jurisdiction in Canada

by other than a participating practitioner, the responsibility for payment will

not rest with the medical care insurance plan or the hospital insurance plan.

Exception for

emergencies

16. Notwithstanding subsection 12(4), where an insured service

is provided in the province to a beneficiary in an emergency, the minister may make

payment to a practitioner for that insured service even though the practitioner

was not a participating practitioner when the service was provided.

Professional corporation

(1) Notwithstanding any other provision of this Act or the regulations, a professional

corporation may submit accounts and be paid by the minister in respect of insured

services provided by a participating practitioner through the professional

corporation to a beneficiary.

(2) A professional corporation submitting accounts

shall comply with sections 9, 10 and 12 of this Act as if it were a

participating practitioner.

(3) Where a professional corporation submits an

account for insured services, every participating practitioner whose services

are included in that account is considered to have certified that the information

provided about his or her services is true.

Non-application

of Act

(1) Where

a practitioner providing insured services is not a participating practitioner

and the practitioner provides an insured service to a beneficiary, the

practitioner is not subject to this Act or the regulations relating to the

provision of insured services to beneficiaries or the payment to be made for

the services except that he or she shall

(

a) provide the beneficiary to whom the practitioner

has provided the insured service with the information required by the minister

to enable payment to be made under this Act to the beneficiary in respect of

the insured service; and

(

b) not charge or collect from a beneficiary in respect

of an insured service an amount in excess of the amount which would be payable to

a participating practitioner by the minister under this Act or the regulations.

(2) Where a practitioner who is not a participating

practitioner provides insured services through a professional corporation, the professional

corporation is not, in relation to those services, subject to this Act or the regulations

relating to the provision of insured services to beneficiaries or the payment

to be made for the services except that the professional corporation and the

practitioner providing the insured services shall comply with paragraphs (1)(

a) and (b).

(3) Notwithstanding subsections (1) and (2), a practitioner

providing insured services who is not a participating practitioner and a professional

corporation through which a practitioner who is not a participating

practitioner provides insured services are subject to

Part IV of this Act.

Penalties for

false statements

(1) A

practitioner providing insured services to a beneficiary who wilfully gives

false information or wilfully makes a false statement in a report, form or return

required to enable a payment to be made under this Act or the regulations is

guilty of an offence and liable on

summary conviction to a fine of not less than

$10,000 and not more than $20,000.

(2) A person, other than a practitioner providing insured

services to a beneficiary, who wilfully gives false information or wilfully makes

a false statement in a report, form or return prescribed by or required for the

purpose of this Act or the regulations is guilty of an offence and liable on

summary

conviction to a fine of not less than $10,000 and not more than $20,000.

(3) A professional corporation that wilfully gives

false information or wilfully makes a false statement in a report, form or

return required to enable a payment to be made under this Act or the regulations

is guilty of an offence and liable on

summary conviction to a fine of not less

than $15,000 and not more than $25,000.

(4) The liability of a practitioner under subsection

(1) is not affected because the practitioner provides services through a professional

corporation.

PART IV

AUDITS

Definition

20. In

this Part, "practitioner" includes

(

a) a participating practitioner;

(

b) a person who was formerly a participating

practitioner under this Act or a participating physician under the Medical Care Insurance Act, 1999 ; and

(

c) a person who was formerly a practitioner.

Audits

(1) The

minister may appoint auditors under this Act to audit accounts and claims for

payment by practitioners and the patterns of practice or billing followed by

practitioners including

(

a) accounts and claims without proper

documentation;

(

b) accounts and claims for services which are not

insured services;

(

c) accounts and claims for insured services which

contain billing errors for services provided;

(

d) accounts and claims for insured services which

are not medically necessary;

(

e) accounts and claims in violation of this Act

or the regulations; and

(

f) patterns of practice or billing that do not

follow the average pattern of practice or billing.

(2) An audit may be performed in respect of accounts

and claims for payment made and patterns of practice or billing followed by

practitioners before this Act came into force.

(3) Audits performed under this Act shall be

performed according to generally accepted auditing standards including

statistical sampling, estimation, extrapolation or those techniques prescribed

by the regulations.

(4) The minister may prepare guidelines and

criteria for the guidance of practitioners that may be applied to the patterns

of practice or billing followed by practitioners.

Powers and duties

(1) An

auditor performing an audit may, at reasonable times and for reasonable purposes

of the audit,

(

a) without a warrant, enter and inspect premises where

insured services are provided or where documentation required for the purpose

of this Act is stored;

(

b) examine documentation and make copies of it;

(

c) interview or question a practitioner and his

or her employees on matters that relate to the provision of insured services;

(

d) interview or question persons employed in a

hospital, clinic or other premises in which insured services are provided on

matters that relate to the provision of insured services; and

(

e) interview or question a person on matters that

may be relevant to an audit.

(2) An examination of documentation referred to in

paragraph (1)(

b) includes an examination of electronic records and an auditor

may make a copy of that documentation, including electronic records, in the

manner that, in his or her opinion, is necessary, including photocopying,

scanning and electronic copying of data.

(3) Notwithstanding paragraph (1)(a), an auditor

performing an audit shall not enter a dwelling-house without the consent of the

occupant except under the authority of a warrant.

(4) A person shall, on the request of an auditor,

(

a) produce documentation and permit examination of

it;

(

b) provide information required and answer all

questions of the auditor relating to the documentation; and

(

c) supply copies of or extracts from the documentation.

(5) The minister may set time periods for

producing and examining documentation, providing information, answering

questions or supplying copies or extracts under subsection (4).

(6) Notwithstanding subsection (5), where the auditor

and the person agree, the time periods set by the minister under subsection

(5) may be extended.

(7) A person shall not hinder, obstruct or

interfere with an auditor doing anything that the auditor is authorized to do

under this

section or prevent or attempt to prevent the auditor from doing any

such thing.

(8) A person shall not knowingly make a false or

misleading statement, either orally or in writing, or provide or produce false documentation

to an auditor who is carrying out duties and functions under this Act.

(9) An action shall not lie against a person for

providing documentation under this section.

(10) Paragraphs (1)(

b) to (

e) and subsection (4)

apply notwithstanding a provision of any other Act.

Notice to

practitioner

(1) Upon

completion of the audit, the auditor shall notify the practitioner in writing

of the findings of the audit and advise the practitioner of the right to alternative

dispute resolution, a review of the audit under

section 26 or both.

(2) Notice under this

section shall be sent by

registered mail.

(3) Notice of the findings of an audit sent by

registered mail in accordance with subsection (2) shall be considered to be received

on the fifth day following the day the notice is sent by registered mail,

unless the person to whom it is sent establishes that, acting in good faith,

the person did not receive the notice or did not receive it until a later date.

(4) Within 30 days of the auditor notifying the

practitioner of the findings of the audit under subsection (1), the minister

shall refer the findings of the audit in writing to the medical association or

the dental association which shall, where appropriate, make submissions to the

minister relating to the findings within 14 days of the referral.

(5) The practitioner may respond to the findings

of the audit in writing to the minister no more than 30 days from the receipt

of the notice of the findings of the audit under subsection (1).

(6) After reviewing the practitioner's response,

the minister may revoke one or more of the findings of the audit and notify the

practitioner accordingly.

Withholding of

payments

24. Where

an auditor notifies a practitioner of the findings of an audit under subsection

23(1), the minister may withhold from payments which would, apart from findings

of the audit to the contrary, be due to be paid to a participating practitioner

or professional corporation under

section 12 for the provision of insured services,

up to the amount which, in the opinion of the minister, constitutes the value

of the subject matter raised by the audit, but only until the matter has been

finally determined, subject always to the right of permanent retention or withholding

for the purpose of compliance with an order made under

section 29 or an

agreement made under paragraph 25(1)(a).

Overpayments

(1) Where

the findings of an audit indicate that there has been an overpayment to the

practitioner or the professional corporation, the minister may recover all or

part of the amount of the overpayment plus interest under

(

a) an agreement between the minister and the

practitioner or the professional corporation; or

(

b) an order of the minister made under

section 29.

(2) Where there is an agreement under paragraph (1)(a),

the minister shall not make an order under

section 29 unless the practitioner

or professional corporation does not comply with the agreement.

Review

(1) A

practitioner, either personally or through another person acting on his or her

behalf with his or her written consent, may request a review by a review board of

the findings of an audit performed under this Act.

(2) A request for a review under this

section

shall be made in writing to the minister no more than 30 days from the receipt

of the notice of the findings of the audit provided under subsection 23(1).

(3) A request for review may be included in a

response submitted under subsection 23(5).

(4) A review board shall be appointed within 60

days of receipt of the request for a review.

(5) The review board shall conduct a hearing

within 60 days of its appointment.

(6) The review board shall make a written report of

its findings and recommendations to the minister within 30 days of the

completion of the hearing.

(7) Notwithstanding subsections (2), (4), (5) and

(6), where the parties to the hearing agree, the time periods referred to in those

sections may be extended.

(8) The parties to the hearing are the

practitioner, the professional corporation and the minister.

(9) A practitioner shall not request a review of

an amount identified as owing under an audit conducted in accordance with this

Act by reason only that the amount was determined from a random sample of the

practitioner's accounts or claims for payment and by the application of

statistical methodology to the account or claim for payment from which the

sample was drawn as opposed to a case by case examination of the accounts and claims

for payment in respect of which the audit is made.

(10) Only non-identifying personal health

information shall be disclosed in written or oral representations to the review

board.

Review board

(1) A

review board appointed under subsection 26(4) shall consist of the following persons,

all of whom shall first be appointed to the panel established under

section 28:

(

a) one member appointed by the minister;

(

b) one member appointed by the practitioner or professional

corporation; and

(

c) one member appointed jointly by the minister

and the practitioner or professional corporation.

(2) Where an appointment to the review board under

paragraph (1)(

b) is not made within 30 days of the request to review, the

minister shall appoint a member to the review board on behalf of the

practitioner or professional corporation from the panel established under

section 28.

(3) Where the minister and the practitioner or professional

corporation are not able to agree on the appointment of a member under paragraph

(1)(c), the members appointed under paragraphs (1)(

a) and (

b) shall appoint the

third member of the review board.

(4) Where the members appointed under paragraphs

(1)(

a) and (

b) are not able to agree on the appointment of the third member under

subsection (3), the minister or the practitioner or professional corporation

may apply to the Trial Division for an order appointing the third member of the

review board.

(5) The review board shall determine the procedure

for the hearing.

(6) Notwithstanding subsection (5), the procedure

adopted for the hearing shall permit the parties to be represented by a

solicitor or other person, to lead evidence from witnesses and to produce documents.

(7) For the purpose of this Act, the review board

has the powers that are or may be conferred on a commission under the Public Inquiries Act, 2006 .

Panel

(1) The

Lieutenant-Governor in Council shall appoint a panel of not more than 15

persons to act as members of review boards and

(

a) at least 5 of those persons shall be medical

practitioners selected from a list of nominees provided by the medical association;

and

(

b) at least 2 of those persons shall be dentists

selected from a list of nominees provided by the dental association.

(2) The members of the panel shall be appointed

for a term of up to 3 years and are eligible for reappointment.

(3) Where the term of a member of the panel

expires, he or she continues to be a member until reappointed or replaced.

Orders

(1) The

minister may make a written order after reviewing

(

a) the audit findings;

(

b) the submissions made by the medical

association or the dental association, where the association made submissions under

subsection 23(4);

(

c) the practitioner's response, where the

practitioner responded to the audit findings under subsection 23(5);

(

d) the report of the review board, where a hearing

is held by a review board appointed under subsection 26(4); and

(

e) the advice of the advisory committee, where the

minister referred the matter to a committee under subsection 33(1).

(2) In an order under subsection (1), the minister

may do one or more of the following:

(

a) order the practitioner or the professional

corporation to pay to the minister, within the time period specified in the

order, an amount determined to have been overpaid to the practitioner or the professional

corporation and where the minister makes such an order, he or she shall also

order the practitioner or professional corporation to pay interest on the

amount of the overpayment;

(

b) where the minister makes an order under paragraph

(a), also order that all or part of the amount of the overpayment and interest be

deducted from an amount payable to the practitioner or the professional

corporation under the medical care insurance plan;

(

c) order the practitioner or the professional

corporation to adopt an appropriate pattern of practice or billing, as specified

by the minister in the order;

(

d) order the practitioner or professional

corporation to pay a penalty totalling an amount not greater than the amount estimated

to be the loss sustained by the Crown because of a payment to the practitioner,

professional corporation or beneficiary for insured services which relate to

the subject of the audit plus 10% of that amount and, for the purpose of this paragraph,

the estimated amount shall, subject to proof to the contrary or appeal in

accordance with

section 32, be considered to be the loss sustained;

(

e) strike the name of the practitioner from the

list of participating practitioners under the medical care insurance plan for the

time period specified in the order;

(

f) reduce an amount payable to a practitioner or professional

corporation under the medical care insurance plan by a percentage for the time

period specified in the order; or

(

g) order the practitioner or professional

corporation to pay all or part of the costs of either or both of the audit or

the review board hearing.

(3) The minister may base an order on any relevant

source of information, including a source created on a statistical basis or by

a comparison between insured services provided by the practitioner and

corresponding insured services provided by other practitioners, but the

minister is not required to review a particular insured service the practitioner

provided.

(4) Notwithstanding subsection 27(5) or (6), the

minister may make an order where the practitioner or professional corporation does

not appear at the review board hearing after having been given written notice

of the review board hearing.

(5) The minister shall provide a copy of an order

made under this

section to

(

a) the practitioner or the professional

corporation; and

(

b) the medical association or the dental

association.

(6) Where the minister makes an order, he or she may

advise the appropriate professional regulatory or licensing body that an order

has been made respecting the practitioner or the professional corporation.

(7) An order made by the minister may be filed with

the Trial Division and, upon filing, is enforceable in the same manner as an order

or a judgment of that court.

Interest

30. Interest

ordered to be paid to the minister under paragraph 29(2)(

a) or agreed to be

paid under an agreement under paragraph 25(1)(

a) shall be calculated in accordance

with the regulations.

Joint and individual

liability

31. Where

an order is made under

section 29 against a professional corporation, a

practitioner who provided services which are, or are related to, the subject of

the audit in respect of which the order was made, is jointly and individually

liable with the professional corporation for the order imposed on the professional

corporation.

Appeal

(1) A

practitioner or professional corporation aggrieved by an order of the minister

under

section 29 may, within 60 days from the date of the order, appeal against

the order to a judge of the Trial Division by filing a notice of appeal with

the court, and by serving a copy of the notice of appeal on the minister.

(2) Not withstanding a

rule or practice to the contrary, the notice of appeal shal l

(

a) set out in detail the allegations of the

appellant and the grounds upon which the order is appealed; and

(

b) be signed by the appellant or his or her solicitor.

(3) The appellant shall, within 14 days after serving

the notice of appeal on the minister under this section, apply to a judge for

the appointment of a day for the hearing of the appeal and shall, not less than

30 days before the hearing, serve upon the minister a written notice of the day

appointed for the hearing of the appeal.

(4) The minister shall produce to the judge hearing

the appeal all papers and documents in his or her possession relevant to the

subject matter of the appeal.

(5) The judge shall hear the appeal and the evidence

presented by the appellant and the minister in a

summary manner and, after reviewing

all aspects which the judge, in his or her discretion believes to be appropriate

in the interests of justice, equity and fairness, decide the appeal by

(

a) upholding, amending or revoking the order; or

(

b) making another order or decision which he or

she believes to be appropriate in the circumstances.

(6) The judge may order costs for or against the

appellant or the Crown and fix the amount.

(7) An appeal may be taken from an order or decision

of the judge to the Court of Appeal upon a point of law raised on the hearing

of the appeal, and the rules governing appeals to that court from an order or

decision of a judge of the Trial Division apply to appeals under this subsection.

(8) The filing of a notice of appeal under this

section

or the appeal itself shall not affect the order of the minister which shall remain

in force pending the outcome of the appeal.

Advisory committee

(1) The

minister may, in accordance with the regulations, appoint a committee to review

and advise upon matters relating to audits performed under this Act that are

referred to it by the minister.

(2) The minister shall, by regulation, prescribe

the terms of reference for the committee, the composition of the committee and

the duties of the committee.

Alternative

dispute resolution

34. Notwithstanding

any other provision of this Part, the minister may employ alternative dispute resolution

mechanisms in resolving the matters related to audit reviews and appeals in the

manner prescribed by the regulations.

PART V

LEVY

Levy generally

(1) This

Part applies where insured services are provided with respect to an injury and the

injury is caused by, or contributed to by, or results from, a motor vehicle

accident in which the person, whose negligence, act or omission caused,

contributed to or resulted in the injury, is insured at the date of the

accident by a policy of insurance through a licensed insurer on whom a levy was

imposed under this Act for the levy year in which the accident occurred.

(2) The minister shall impose a levy to be paid by

every licensed motor vehicle insurer with respect to each vehicle insured by

that insurer for the purpose of recovering the cost of insured services received

by beneficiaries as a result of injuries where the injuries were caused by, or contributed

to by, or result from, motor vehicle accidents.

Calculation and

payment

(1) Every

licensed insurer who carries on the business of automobile insurance in the

province shall, in respect of each levy year, pay to the minister a levy

determined by multiplying the base rate per vehicle by the number of earned

vehicles at the end of each levy year.

(2) Every licensed insurer liable to pay a levy

under subsection (1) shall before the last day of March, June, September and December

in each levy year pay one quarter of the levy estimated to be payable as

calculated by the minister or his or her representative by reference to the

number of earned vehicles and the base rate per vehicle for the immediately

preceding levy year.

(3) Where a licensed insurer provides the minister

with satisfactory proof that the actual earned vehicle count will vary

significantly from the previous year on which the estimated levy is based, the

minister may adjust the estimated levy.

Report and adjustment

(1) The

Superintendent of Insurance shall provide annually to the minister a report

detailing actual automobile experience including the number of earned vehicles

and the number of claims for every licensed insurer as provided under the Insurance Companies Act .

(2) Based on the report in subsection (1), the minister

shall issue an adjustment invoice or credit as applicable to licensed insurers

in respect of the immediately preceding levy year payable or refundable within

30 days of issuance.

Interest

38. Where

the levy is not paid in full on the due date, the licensed insurer shall pay to

the minister interest on the unpaid portion from the due date at an annual rate

equal to the sum of the prime lending rate of the bank holding the province's

general revenue fund plus 4 percentage points.

Unpaid levy

39. An

amount payable under sections 35 to 38 constitutes a debt due the Crown and the

minister may bring an action for its recovery in a court in the province.

Effect on licence

40. The

insurer shall pay a levy payable under sections 35 to 38 before the issuance or

renewal of a licence under the Insurance

Companies Act .

PART VI

RECOVERY OF COSTS FOR SERVICES

Recovery by injured

person generally

(1) This Part applies where

insured services are provided with respect to an injury and the injury is

caused by, contributed to by or results from

(

a) the negligence, act or omission of a person;

(

b) a motor vehicle accident in which the person

whose negligence, act or omission caused, contributed to or resulted in the

injury is not insured at the date of the accident by a policy of insurance

through a licensed insurer liable to pay a levy under this Act.

(2) For the purpose of this Part,

(

a) the amount paid for insured hospital services that

are received by a beneficiary shall be an amount equal to the charges of the hospital

in which the services were provided, calculated in accordance with this Act and

the regulations, that the beneficiary would have been required to pay if he or

she was not entitled to receive the services as insured hospital services under

this Act; and

(

b) the cost of insured medical services provided

is the cost as established in this Act and the regulations.

(3) I n this

Part, "insured services" includes any services for which an amount has

been or may in the future be paid by the minister in relation to negligence or

an act or omission including medical and hospital services and any services prescribed

by the regulations as insured services for the purpose of this Part.

Claim for

recovery

(1) Where

a beneficiary suffers an injury caused by, contributed to by or resulting from

the negligence, act or omission of a person for which the beneficiary received insured

services, including the costs of future insured services, the beneficiary

(

a) has the same right to

recover the amount paid for the insured services against the person whose

negligence, act or omission caused, contributed to or resulted in the injury as

the beneficiary would have had if the beneficiary had been required to pay for

the insured services; and

(

b) shall claim and seek to

recover the costs of the insured services if the beneficiary makes a claim for

the injury suffered against the person whose negligence, act or omission

caused, contributed to or resulted in the injury.

(2) Where a beneficiary recovers an amount in respect of insured

services under subsection (1), he or she shall without delay pay the amount recovered

to the minister.

(3) Where a beneficiary does not pay the amount to

the minister under subsection (2) within a reasonable time, the minister may recover

the amount from the beneficiary as a debt due the Crown.

(4) The

minister shall be subrogated to the rights of a beneficiary under this

section to recover any amount paid by the minister

for insured services provided to that beneficiary and an action may be brought by the minister, either in his or her name

or in the name of the beneficiary , for the

recovery of that amount.

(5) It is not a defence to an action brought by the minister

under subsection (4) that a claim for damages has been adjudicated upon unless

the claim included a claim for the amount paid for insured services and it is

not a defence to an action for damages for an injury brought by a beneficiary who has received insured services that an action taken by

the minister under subsection (4) has been adjudicated upon.

(6) Where an action has not been brought by or on

behalf of that beneficiary under subsection (1) for the recovery of damages

arising out of the injury, the minister upon service of notice on the beneficiary

may bring an action in his or her own name or in the name of the beneficiary

for the recovery of the cost of the insured services, and before trial of the

action that beneficiary may join in the action another claim arising out of the

same occurrence upon the conditions as to costs or otherwise that to the court

may seem just and may in that case effect settlement of that claim.

(7) A

beneficiary and the minister shall share in proportion to their respective

by the regulations where, as a result of a claim under

this section,

(

a) the claim is settled or

a judgment is obtained; and

(

b) insufficient funds are

available to provide complete recovery to the beneficiary for his or her losses

and injuries and to pay the costs of the insured services referred to in

section

41,

but nothing in this subsection prevents

the minister from waiving in whole or in part the minister's share of an amount

recovered where, in the opinion of the minister, the circumstances warrant.

(8) Where a person whose

negligence, act or omission caused, contributed to or resulted in injury to a beneficiary is

insured by a liability insurer, the liability insurer may pay to the minister

any amount referable to a claim for recovery of the cost of insured services

that would otherwise be paid to the beneficiary and payment of that amount to

the minister discharges the liability of the insurer to pay that amount to the

beneficiary or to any person claiming on behalf of the beneficiary.

Proof of amount

43. In an action under

section 42, a

certificate of a person designated by the minister as to the amount paid for or

cost of insured services provided to a beneficiary is admissible in evidence

and is, in the absence of evidence to the contrary, proof of that amount.

Settlement of

claim

(1) A release or settlement of a claim

or judgment based upon a cause of action for damages for an injury where the beneficiary

has received insured services shall not be binding upon the Crown unless the minister

has approved the release or settlement in writing.

(2) A

beneficiary acting on his or her own behalf or a

person acting on behalf of a beneficiary shall not make a settlement of a claim

based upon a cause of action for damages for an injury where the beneficiary has received insured services without the approval of the

minister in writing.

(3) Notwithstanding anything in this section, the

approval of the minister in writing is required under subsections (1) and

(2) even where the beneficiary or a person acting on his or her behalf has not made

a claim.

Fees

45. Notwithstanding any other

provision of this Act, the minister may, in accordance with the regulations,

authorize the payment of a fee to a barrister or solicitor who makes a claim and

recovers an amount in respect of the cost of insured services that are received

by the beneficiary.

PART VII

GENERAL

Consultation with

associations

46. The

medical association and the dental association shall be consulted by the

minister with reference to the rates of payments to be made under this Act in respect

of insured services provided to beneficiaries by practitioners, the manner and

form in which the payments to practitioners shall be made and changes in

connection with payments and, where in the opinion of the minister it is necessary,

with reference to general questions of principle concerning the practices of

medicine and dentistry.

Regulations

47. The

Lieutenant-Governor in Council may make regulations

(

a) prescribing which services are insured services

for the purpose of this Act;

(

b) prescribing which services are not insured

services for the purpose of this Act;

(

c) prescribing the facilities in which insured

services may be provided;

(

d) prescribing which services are hospital services

for the purpose of this Act;

(

e) prescribing which services are medical services

for the purpose of this Act;

(

f) prescribing to what extent and under what

circumstances insured services shall be paid for by the minister where the insured

services are received by beneficiaries while they are out of the province;

(

g) prescribing a procedure for reviewing decisions

relating to whether, under this Act and the regulations,

(

i) a person is a resident,

(ii) a person is a beneficiary, and

(iii) a beneficiary is entitled to payment;

(

h) respecting the techniques that may be used

during an audit;

(

i) respecting the calculation of interest for the

purpose of

section 30;

(

j) defining the term "policy of

insurance" for the purpose of subsections 35(1) and 41(1);

(

k) prescribing the fees that may be paid to

respecting the payment of those fees;

(

l) providing for the investigation of complaints

of violations of this Act or regulations or of an order made under this Act or

the regulations;

(

m) providing for the holding of inquiries into a

complaint referred to in paragraph (

l) or into the operation of this Act or

into a charge or complaint that a person has contravened this Act or the

regulations, or has wilfully made a false statement in a form, return, account

or statement required to be completed or made under this Act, or into another

matter arising in the administration of this Act, and providing that the person

holding the inquiry shall have the powers that may be conferred upon a commission

under the Public Inquiries Act, 2006 including

the power to take evidence under oath or affirmation;

(

n) notwithstanding any other provision of this

Act, adapting, modifying, qualifying or altering the provisions of this Act to

meet the requirements of the Canada

Health Act for the purpose of rendering the medical care insurance plan one

in respect of which a contribution is payable by Canada under the Canada Health Act ;

(

o) defining a word or phrase used but not defined

in this Act; and

(

p) generally, to give effect to the purpose of

this Act.

Regulations by

minister

(1) The

minister may make regulations

(

a) to prevent unnecessary use or abuse of insured

services;

(

b) prescribing the waiting period that is

required to elapse before a resident becomes a beneficiary and the other conditions

to be observed by a resident in order that he or she may qualify as a beneficiary;

(

c) prescribing the conditions to be observed by a

resident to continue to qualify as a beneficiary;

(

d) respecting the registration of residents for

the purpose of this Act, including the information required and the form of

proof of that information;

(

e) respecting the expiry of registration of

residents;

(

f) defining which residents are beneficiaries for

the purpose of this Act;

(

g) respecting the manner in which persons may be

identified as beneficiaries including the use, return, replacement or destruction

of identification issued by the minister;

(

h) defining

provision of dental and other health related services, and

(ii) to what extent and under what circumstances

dental and other health related services shall be paid for by the minister;

(

i) prescribing for the purpose of subparagraph 2 (q)(ii) which persons are entitled to provide insured

services;

(

j) establishing the procedure by which practitioners

enroll as participating practitioners;

(

k) following consultation with the medical

association and the dental association, prescribing the circumstances under

which the minister may refuse, suspend or cancel the enrollment of a

practitioner as a participating practitioner under the medical care insurance plan;

(

l) respecting the manner and form in which accounts

and claims for payment shall be submitted;

(

m) respecting the information that shall be

submitted with accounts and claims for payment including the manner and form of

that information;

(

n) presc ribing, by

reference to professional or other scales of fees, the rates of payments to be

made under this Act in respect of insured services provided to beneficiaries by

practitioners;

(

o) respecting the manner and form in which

payments to practitioners, professional corporations and other persons shall be

made under this Act;

(

p) governing the method of assessing accounts and

claims for payment submitted by practitioners, professional corporations and

other persons;

(

q) prescribing the manner in which alternative

dispute resolution mechanisms may be employed in resolving matters related to

audits including reviews and appeals of audits;

(

r) respecting the application of this Act to a professional

corporation;

(

s) following consultation with the medical

association and the dental association, prescribing a formula for the determination

of the average pattern of practice for the whole or an area of the province and

defining the words "pattern of practice" for the purpose of sections

21 and 29;

(

t) establishing an advisory committee under

section

33;

(

u) establishing a formula for the determination

of the base rate for each vehicle under

section 36;

to the minister and a beneficiary sharing in proportion their respective losses

under subsection 42(7);

(

w) for the provision by hospitals of insured

under the conditions specified in the Canada

Health Act and regulations made under that Act;

(

x) for the payment of amounts to hospitals from

funds voted by the Legislature in respect of the cost of insured services, and

the payment of those amounts that may be specified in an agreement when insured

services are provided to beneficiaries of the province, who are eligible for

them and entitled to them by hospitals that are owned or operated by Canada or

are situated outside the province;

(

y) providing for the furnishing to the Minister

of Health for Canada

of the information and at the times that the minister may require for the

purpose of the Canada Health Act ;

(

z) defining a word or phrase used but not defined

in this Act; and

(aa) generally, to give effect to the purpose of

this Act.

(2) Regulations made under paragraph (1)(

n) do not

constitute subordinate legislation for the purpose of the Statutes and Subordinate Legislation Act .

Offence and penalty

49. The

Lieutenant-Governor in Council may, in regulations made under

section 47, and

the minister may, in regulations made under

section 48, provide that a person

who contravenes a specified provision of the regulations is guilty of an

offence and may prescribe penalties to which the person is liable, on

summary

conviction, for failing to comply with or otherwise contravening the provisions

of the regulations.

Date and effect

of regulations

50. Regulations

made under

section 47 or 48 may be made with retroactive effect.

Offence

(1) Unless

otherwise provided, a person who contravenes this Act or the regulations,

except those regulations made under paragraph 48(1)(n), is guilty of an offence

and where no penalty is specifically provided in this Act or the regulations,

liable on

summary conviction in the case of a first conviction to a fine not more

than $10,000 and in the case of a second or subsequent conviction for a similar

offence to a fine not more than $20,000.

(2) For the purpose of subsection (1) a conviction

is not a second or subsequent conviction unless it is in respect of an offence

committed within 12 months after a prior offence.

Actions barred

52. An

action shall not lie against practitioners or professional corporations

providing insured services, or an employee of those practitioners and

professional corporations, relating to information provided to the minister

with respect to an insured service provided to a beneficiary.

Non-liability

(1) An

action relating to providing insured services under this Act shall not lie

against the minister or a person employed in the department with respect to the

negligence, act or omission of a practitioner, professional corporation or

other person providing the services or of an employee or a person acting on

behalf of a practitioner, professional corporation or other person.

(2) An action shall not lie against a member of a

medical or other committee serving the minister in a consultative or advisory capacity

in respect of anything done or omitted to be done in good faith in the

performance of the duties of the member.

Practitioner liability

54. It

is not a defence to a prosecution of a practitioner for an offence under this

Act that insured services were provided through a professional corporation or

that a claim for payment in respect of services provided by that practitioner was

submitted by a professional corporation.

PART VIII

TRANSITIONAL, CONSEQUENTIAL, REPEAL AND COMMENCEMENT

Transitional

(1) Where

a person is registered with the medical care insurance plan in relation to the Medical Care Insurance Act, 1999 or the

hospital insurance plan in relation to the Hospital

Insurance Agreement Act immediately before the coming into force of this

Act, he or she is considered to be registered in the equivalent plan under this

Act.

(2) Where a practitioner is enrolled with the

medical care insurance plan in relation to the Medical Care Insurance Act, 1999 or the hospital insurance plan in

relation to the Hospital Insurance

Agreement Act immediately before the coming into force of this Act, he or

she is considered to be enrolled in the equivalent plan under this Act.

(3) Where an election of a practitioner to collect

payments in respect of insured services provided by the practitioner to

beneficiaries other than from the minister is in effect immediately before the

coming into force of this Act, that election is considered to be an election

under

section 8 of this Act and continues to be in effect.

(4) Where an account for an insured service was

submitted to the minister for payment but had not yet been paid immediately

before the coming into force of this Act, that account is considered to be an

account submitted under this Act.

(5) Where an arrangement under subsection 10(2) of

the Medical Care Insurance Act, 1999

is in effect immediately before the coming into force of this Act, that

arrangement is considered to be an arrangement made under subsection 12(3) of

this Act.

(6) Where a notice under subsection 15(1) of the Medical Care Insurance Act, 1999 was

sent in relation to an audit, investigation or inquiry under that Act before

the coming into force of this Act, the Medical

Care Insurance Act, 1999 shall apply to the audit, investigation or inquiry

as though that Act were still in force.

(7) Notwithstanding subsection (6), subsections

27(2) and 29(4) of this Act shall apply to all audits, investigations and

inquiries regardless of when and whether a notice under subsection 15(1) of the

Medical Care Insurance Act, 1999 has

been sent.

(8) Where a notice under subsection 15(1) of the Medical Care Insurance Act, 1999 was not

sent in relation to an audit, investigation or inquiry under that Act before

the coming into force of this Act and the audit, investigation or inquiry is ongoing

on the coming into force of this Act, this Act shall apply to the audit,

investigation or inquiry.

(9) Persons who are members of a review board

appointed under subsection 15(5) of the Medical

Care Insurance Act, 1999 immediately before the coming into force of this

Act shall continue to be members of that review board.

(10) Persons who are members of the panel referred

to in subsection 15(7) of the Medical

Care Insurance Act, 1999 immediately before the coming into force of this

Act shall continue to be members of the panel referred to in

section 28 of this

Act.

(11) Orders made under

section 15 of the Medical Care Insurance Act, 1999 and

agreements between the minister and a physician after an audit, investigation

or inquiry which are in effect immediately before the coming into force of this

Act continue to be in effect as though they were orders and agreements made

under this Act.

(12) Where a retainer agreement or contingency fee

agreement signed by the minister was in effect immediately before the coming

into force of this Act, the provisions of that agreement relating to the minister's

claim for recovery under the Medical Care Insurance Act, 1999 continue

to be in effect and shall not be subject to this Act but shall be subject to

the Medical Care Insurance Act, 1999 as though that Act were still in

force.

(13) A person shall only claim for the cost of future

insured services under this Act where the cause of action on which the claim is

based arises after this Act comes into force.

(14) Persons who are members of the Medical

Consultants Committee under

section 15 of the Physicians and Fees Regulations under the Medical Care Insurance Act, 1999 immediately before the coming into

force of this Act shall continue to be members of that committee for the purposes

of this Act.

RSNL1990 cA-22

Amdt.

(1) Subsection 45.1(8) of the Automobile Insurance Act is repealed and

the following substituted:

(8) For the purpose of this

section a person shall

not be considered to have insurance coverage or inadequate insurance coverage

only because he or she receives or is entitled to receive compensation or

benefits under the Medical Care and

Hospital Insurance Act , the Income

and Employment Support Act or the Workers'

Compensation Act for injuries or damages arising out of an accident

involving an automobile.

(2) Subsection 45.20(2) of the Act is repealed and

the following substituted:

(2) Subsection (1) shall not apply to applications

under the Medical Care and Hospital

Insurance Act , the Income and

Employment Support Act or the Workers'

Compensation Act .

SNL2004 cC-5.1

Amdt.

57. Subparagraph 16(d)(iv) of the Centre for Health Information Act is

repealed and the following substituted:

(iv) the Medical

Care and Hospital Insurance Act ,

RSNL1990 cI-10

Amdt.

58. Subsection 14(10) of the Insurance Companies Act is repealed and the following substituted:

(10) Effective July 1, 1994, after notification by

the Department of Health to the superintendent of any unpaid levy due under the

Medical Care and Hospital Insurance Act ,

the superintendent shall prohibit the insurer from entering into new contracts

of insurance or renewing existing contracts of insurance until the levy is

paid.

SNL1991 c16 Amdt.

59. Paragraph 11(4)(

c) of the Jury Act, 1991 is repealed and the following substituted:

(

c) the names, addresses and dates of birth of

beneficiaries under the Medical Care and

Hospital Insurance Act , but no other information respecting beneficiaries

shall be provided; and

SNL2008 cP-7.01

Amdt.

60. Paragraph 2(1)(

m) of the Personal Health Information Act is repealed and the following

substituted:

(m) "MCP" means the Newfoundland and Labrador Medical Care Plan

administered under the Medical Care and

Hospital Insurance Act ;

SNL1992 cR-17

Amdt.

61. Subsection 59(3) of the Royal Newfoundland Constabulary Act, 1992 is repealed and the

following substituted:

(3) Paragraph (1)(

b) does not apply to expenses

for which provision is made for recovery by the minister under sections 41 to 45

of the Medical Care and Hospital Insurance

Act .

SNL2001 cT-4.2

Amdt.

62. Subparagraph 2(d)(ii) of the Tobacco Health Care Costs Recovery Act

is repealed and the following substituted:

(ii) insured services as defined under the Medical Care and Hospital Insurance Act ,

and

Repeal

(1) The following Acts are repealed:

(

a) Hospital

Insurance Agreement Act ; and

(

b) Medical

Care Insurance Act, 1999 .

(2) The Medical

Care Insurance Release of Information Order , Newfoundland

and Labrador Regulation 132/97, published

under the Medical Care Insurance Act,

1999 , is repealed.

Commencement

64. This Act comes into force on October 1, 2016.

Queen's Printer