May 26, 2016
Bill 92, An Act to extend the powers of the Régie de l’assurance maladie du Québec (RAMQ) and to amend various legislative provisions was introduced in the Quebec National Assembly in early April.
RAMQ is responsible for the reimbursement of 55 million claims made by physicians and over 220 million pharmaceutical transactions performed on a yearly basis. Given the number of reforms that are taking place, the Health Minister wants to put in place safety and control mechanisms to discourage illegal activity (unauthorized acts) from physicians, pharmacists, wholesalers and pharmaceutical companies. Also included are third-party organisations that could work on their behalf.
The primary objective of Bill 92 is to provide additional power to RAMQ to investigate and sanction more severely unauthorized acts for which healthcare professionals (physicians and pharmacists) claim a reimbursement from RAMQ and also for wholesalers and pharmaceutical companies who contravene their legal commitment towards RAMQ.
For example, should a pharmacist be found guilty of receiving a non-authorized rebate, reward or any other financial advantage associated with the act of prescribing a drug or about a non-authorized pharmaceutical service, then the pharmacist will be sanctioned. The same consequence will apply for wholesalers and pharmaceutical companies should they be found guilty of providing unauthorized financial incentives or rebates to any healthcare professionals.
There is one very important aspect of this bill which touches patient privacy. According the proposed bill, RAMQ will be entitled to access patient records if needed to build the evidence. There is a strong pushback by the Industry with respect to this provision.
We will provide you with more information in a near future about Bill 92 as it will certainly evolve.
Should you have any questions, please do not hesitate to contact Ghislain Gauthier, Director, The Pangaea Group