Bill 69 (Legislature 17, Session 1)

L17 S1 5050

Alberta — Bills

1972 Bill 69 First Session, 17th Legislature, 21 Elizabeth II THE LEGISLATIVE ASSEMBLY OF ALBERTA BILL 69 The Alberta Health Care Insurance Amendment Act, 1972 HONOURABLE MISS HUNLEY First Reading Second Reading ... Third Reading ... Printed by L. S. Wall, Queen's Printer, Edmonton

BILL 69 1972 THE ALBERTA HEALTH CARE INSURANCE AMENDMENT ACT, 1972 (Assented to , 1972) HER MAJESTY, by and with the adv;ice and consent of the Legis}ative Assembly of Alberta, enacts as follows: 1. The Alberta Health Care Insurance Act is hereby amended.

Section 2 is amended by adding the following clause after clause (t): (tl) "practitioner" means a chiropractor, dental surgeon, optometrist, podiatrist, physician or osteopath;

Section 19 is amended by adding the following sub sections after subsection (2):

(2.1) When the Commission determines that on or after July 1, 1969, a payment of a claim was or is made in error or upon erroneous or false information from a resident or practitioner, the Commission may reassess the claim paid and make any appropriate adjustment in the amount paid with respect to the claim.

(2.2) Whenever the Commission reassesses a claim under subsection (2.1) it may with respect to any adjustment of the amount paid therefor, (

a) if the amounts paid were in excess of the benefits payable under the adj ustment, recover from the resident or the practitioner to whom the amounts were paid, as the case may be, the excess (

i) by withholding from any benefits payable to the resident or the practitioner, as the case may be, an amount equivalent to the excess, or (ii) by civil action as though it were a debt owing to the Commission, or

Explanatory Notes 1. This Bill will amend

chapter 166 of the Revised Statutes of Alberta 197·0. 2. New definition. 3. New. On some o.ccasions it has been bro.ught to the attentio.n of the Commission that an adjustment of an assessed claim should be made because the assessment was in error. The amendment em powers the Co.mmission specifically to. reassess claims where the original assessment was wrong.

(

b) if the amounts paid were less than the benefits payable under the adj ustment, pay to the resident or the practitioner to whom the benefits were paid, as the case may be, the amount of the deficiency.

(2.3) The Commission, with respect to benefits referred to in subsection (2.2), may charge or pay simple interest in such amount as it may determine but not exceeding 8 per cent per annum.

Section 21 is amended (

a) as to subsection (1) (

i) by adding the following clause after clause (c): (c1) providing, in respect of benefits for any or all basic health services rendered outside Alberta or any specified place outside Al berta, that the benefits may be paid only for services rendered during a specified period of time or that the Commission is empowered in a particular case to pre scribe the period in respect of which bene fits may be paid; (ii) in clause (e), by adding after the words "for a person who" the words "is or", (

b) by striking out subsection (2).

Section 32 is amended by striking out subsection (3). 6. The following

section is added after

section 38: 38.1

(1) No subscript~on is payable under an optional contract where the subsrcriber Dr his spouse is 65 years of age or over. (2) Subsection (1) applies to an optional contract (

a) where the subscriber or spouse is 65 years of age at the time the contract is issued, or (

b) on the first day of the first month following the 65th birthday of the subscriber or spouse, where that birthday occurs after the contract is issued, or (c) 'On the 65th bjrthday of the subscriber Dr spouse, where that birthday falls on the first day of a month and occurs after the contract is issued.

Section 44 is amended by adding the following sHb

section after subsection (2): (2.1). Subsection (2) does not apply where the resident or spouse IS 65 years of age or over at the time of enrolment. 8. This Act comes into force on the day upon which it is assented to and upon so coming into force

section 7 shall be deemed to have been in force at all times on and after January 1, 1972. 2

Section 21, subsection 0), clauses (

c) and (

e) and subsection (2), presently read: 21.

(1) The Lieutenant Governor in Council may make regulations (

c) prescribing the benefits payable in respect of basic health services 'other than physiclians' services; (

e) prescribing the waiting period (not exceeding three months) for a person who be·comes a resident 'Of Alberta and in respect of which the costs of any basic health services rendered dur\ing that period to that person are not payable as benefits;

(2) The regulations under subsection (1), clause (

e) may, with respect to benefits for any or all basic health services (other than insured services) that are rendered anywhere outside Alberta Dr at any specified place outside Alberta, prescribe that no benefits are payable or that benefits are to be paid at rates different from those that apply for services rendered inside Alberta. 5. See Note

Section 32, subsection (3) presently reads:

(3) In this

section "practitioner" means a physician, dental surgeDn, optometrist, chiropractor, pDdiatrist 'or osteopath.

Section 38.1 is added to

Part 4 entitled '~Optional Health Contracts".

Part 4 allows for a plan for providing "optional health services" by the Commission alone but it is not operative because this coverage is being provided under an arrangement with the Alberta Blue Cross: Plan. However,

section 38.1 is added S'O that if regUlations are ever made under

Part 4, there will be an exemption for residents 65 years or over equivalent to the exemption from premium payments under The Health Insurance Premiums Act.

Section 44 deals with enrolment in the Alberta Blue Cross Plan through the Commission. Subsection (2) reads:

(2) A resident is not entitled to enrol himself or any of his dependants as members of The Blue Cross Plan pursuant to the Blue Cross agree ment. unless he is registered under this Act and is not in arrears 'Of premIUms under The Health Insurance Premiums Act. Premiums for persons enrolled under

section 44 are payable under The Health Insurance Premiums Act. See the Bill to amend that Act for the provision to exempt residents 65 and over from premium payments. 2 Title: 1972 (17th, 1st) Bill 69, The Alberta Health Care Insurance Amendment Act, 1972

Document details

Collection	Alberta — Bills
Citation	L17 S1 5050
Type	bill
Volume / chapter	L17 S1 5050
Language	en
Format	json
Source	PROVINCIAL
Identifier	a657aab87e6cfa81f81f31fe13b5b76db4108736

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