Health Insurance Act, R.S.O. 1990, c. H.6

Reimbursement, non-entitled person

18.0.1 The General Manager may make a decision to require a person to reimburse the Plan for an amount paid for an insured service rendered to the person if, after the payment is made, the General Manager determines that the person was not an insured person and was not entitled to have a payment paid from the Plan with respect to the service. 2019, c. 15, Sched. 15, s. 16 (1).

Section Amendments with date in force (d/m/y)

2004, c. 13, s. 1 - 01/09/2004

Debt

18.0.2 A requirement to reimburse the Plan created by a decision of the General Manager under subsection 18 (3) creates a debt owed to the Crown in right of Ontario in the amount set out in the decision of the General Manager, and a requirement to reimburse the Plan created by a decision of the Appeal Board creates a debt owed to the Crown in right of Ontario in the amount set out in the decision of the Appeal Board. 2019, c. 15, Sched. 15, s. 16 (1).

Section Amendments with date in force (d/m/y)

2004, c. 13, s. 1 - 01/09/2004

Transitional

18.0.3 Sections 18 and 18.0.1 apply whether the service or payment in question occurred before or after the coming into force of subsection 17 (1) of Schedule 15 to the Plan to Build Ontario Together Act, 2019. 2019, c. 15, Sched. 15, s. 16 (1).

Note: On a day to be named by proclamation of the Lieutenant Governor, section 18.0.3 of the Act is repealed. (See: 2019, c. 15, Sched. 15, s. 16 (2))

Section Amendments with date in force (d/m/y)

2004, c. 13, s. 1 - 01/09/2004

2019, c. 15, Sched. 15, s. 16 (1) - 10/12/2019; 2019, c. 15, Sched. 15, s. 16 (2) - not in force

Settlement

18.0.4 Nothing in this Act prevents the General Manager and a person, physician, practitioner or health facility from entering into an agreement at any time, and despite any other provision of this Act, with respect to amounts to be paid or recovered with respect to claims for services. However, for greater certainty, the General Manager is not required to enter into any such agreement. 2019, c. 15, Sched. 15, s. 16 (1).

Section Amendments with date in force (d/m/y)

2004, c. 13, s. 1 - 01/09/2004

18.0.5 Repealed: R.S.O. 1990, c. H.6, s. 18.0.5 (2). (See: 2007, c. 10, Sched. G, s. 10.)

Section Amendments with date in force (d/m/y)

2004, c. 13, s. 1 - 01/09/2004

2007, c. 10, Sched. G, s. 10 - 04/09/2007

Settlement

18.0.6 (1) Where, during the time that any of sections 18.0.1, 18.0.2, 18.0.3 and 18.0.4 and paragraph 3 of subsection 20 (1) are in force, the General Manager and a physician come to an agreement regarding a matter to which one of those sections applies, the General Manager shall be deemed to have had the authority to enter into the agreement, and no action shall, either during the time they are in force or after, be commenced against any of the following as a result of entering into the agreement:

1. The General Manager.

2. The Minister, the Crown in right of Ontario or an employee or agent of the Crown.

3. The Medical Review Committee, any of its members, inspectors or employees or agents, if any.

4. The Appeal Board or any of its members, employees or agents. 2007, c. 10, Sched. G, s. 11 (1).

(2), (3) Repealed: 2019, c. 15, Sched. 15, s. 17.

Section Amendments with date in force (d/m/y)

2007, c. 10, Sched. G, s. 11 (1-3) - 04/09/2007

2019, c. 15, Sched. 15, s. 17 - 10/12/2019

Transitional

18.0.7 (1) Where, by virtue of subsection 18.0.2 (11) as it existed during the time it was in force, payments to a physician continued to be suspended, the suspension shall remain in effect until the physician has complied with subsections 37 (1) and (3) to the satisfaction of the General Manager. 2007, c. 10, Sched. G, s. 12.

(2) Repealed: 2019, c. 15, Sched. 15, s. 18.

Section Amendments with date in force (d/m/y)

2007, c. 10, Sched. G, s. 12 - 04/09/2007

2019, c. 15, Sched. 15, s. 18 - 10/12/2019

18.1 Repealed: 2015, c. 20, Sched. 15, s. 4.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 13 - 01/05/1996

2002, c. 18, Sched. I, s. 8 (1-6) - 26/11/2002

2007, c. 10, Sched. G, s. 13 (1-15) - 04/09/2007

CTS 23 OC 07 - 1

Recovery from requesting physician

18.2 If the General Manager is of the opinion that a service performed by a physician, practitioner, health facility or an integrated community health services centre is not medically necessary, and that service was requested by a physician other than the one who performed the service, the General Manager may give notice to the Appeal Board of a request to hold a hearing and at the same time give notice to the physician who requested the provision of the service. 2019, c. 15, Sched. 15, s. 19; 2023, c. 4, Sched. 1, s. 71 (4).

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 13 - 01/05/1996

2002, c. 18, Sched. I, s. 8 (7-9) - 26/11/2002

2007, c. 10, Sched. G, s. 14 - 31/03/2010

2017, c. 25, Sched. 9, s. 97 (5) - no effect - see 2019, c. 15, Sched. 15, s. 19 - 10/12/2019

2019, c. 15, Sched. 15, s. 19 - 10/12/2019

2023, c. 4, Sched. 1, s. 71 (4) - 25/09/2023

18.2.1

Section Amendments with date in force (d/m/y)

2009, c. 26, s. 11 (3) - no effect - see Table of Public Statute Provisions Repealed Under Section 10.1 of the Legislation Act, 2006 - 31/12/2019

2017, c. 25, Sched. 9, s. 97 (6) - no effect - see 2009, c. 26, s. 11 (3) - 31/12/2019

Interest

18.3 Where the General Manager has required reimbursement under section 18, interest accrues on the amount that is required to be paid commencing on the date of the General Manager’s decision at the rate for postjudgment interest provided for under section 127 of the Courts of Justice Act. 2019, c. 15, Sched. 15, s. 19.

Section Amendments with date in force (d/m/y)

2007, c. 10, Sched. G, s. 14 - 31/03/2010

2019, c. 15, Sched. 15, s. 19 - 10/12/2019

19 Repealed: 2019, c. 15, Sched. 15, s. 20.

Section Amendments with date in force (d/m/y)

2019, c. 15, Sched. 15, s. 20 - 10/12/2019

19.1 Repealed: 2004, c. 5, s. 39.

Section Amendments with date in force (d/m/y)

1993, c. 32, s. 2 (5) - 14/12/1993; 1996, c. 1, Sched. H, s. 14 - no effect

2004, c. 5, s. 39 - 23/09/2004

Refusal of claims, entitlement

19.2 (1) The General Manager may refuse a claim for payment for insured services if, in the opinion of the General Manager, the person who received the services was not an insured person at the time the services were rendered.

Direction by Appeal Board to pay

(2) The Appeal Board may direct the General Manager to pay any claims he or she refused to pay under subsection (1) if, after a hearing, the Appeal Board determines that the person to whom the insured services were rendered was an insured person at the time the services were rendered. 1994, c. 17, s. 71.

Section Amendments with date in force (d/m/y)

1994, c. 17, s. 71 - 18/05/1994

Hearing by Appeal Board

20 (1) The following persons may request a hearing by the Appeal Board:

1. A person who has applied to become or continue to be an insured person, in respect of the review of a decision of the General Manager refusing the application.

2. An insured person who has made a claim for payment for insured services, in respect of the review of a decision of the General Manager refusing the claim or reducing the amount so claimed to an amount less than the amount payable by the Plan.

3. A physician, in respect of a decision of the General Manager referred to in subsection 18 (7).

4. The General Manager, where the General Manager has formed an opinion under subsection 18 (8) or section 18.2.

5. A person who has been required to reimburse the Plan under section 18.0.1, in respect of the review of the decision of the General Manager requiring the reimbursement. 2019, c. 15, Sched. 15, s. 21 (1).

Notice of request

(2) A person or physician requesting a hearing under paragraph 1, 2, 3 or 5 of subsection (1) shall file a notice of the request within 30 days after receiving notice of the decision of the General Manager. 2019, c. 15, Sched. 15, s. 21 (1).

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 15 - 01/05/1996

2002, c. 18, Sched. I, s. 8 (10, 11) - 26/11/2002

2007, c. 10, Sched. G, s. 15 - 04/09/2007

2009, c. 26, s. 11 (4) - no effect - see 2019, c. 15, Sched. 15, s. 21 (1) - 10/12/2019

2015, c. 20, Sched. 15, s. 5 (1, 2) - 29/10/2015

2019, c. 15, Sched. 15, s. 21 (1) - 10/12/2019

Powers of Appeal Board

21 (1) If a person requests a hearing under section 20, the Appeal Board shall appoint a time for and hold the hearing and following the hearing may, by order, direct the General Manager to take such action as the Appeal Board considers the General Manager should take in accordance with this Act and the regulations. 2019, c. 15, Sched. 15, s. 21 (1).

Extension of time for hearing

(2) The Appeal Board may extend the time for the giving of notice by a person requesting a hearing under this section, either before or after expiration of such time, where it is satisfied that there are apparent grounds for granting relief to the claimant pursuant to a hearing and that there are reasonable grounds for applying for the extension, and the Appeal Board may give such directions as it considers proper consequent upon the extension. 2019, c. 15, Sched. 15, s. 21 (1).

Certain hearings

(3) Despite section 13 of the Ministry of Health and Long-Term Care Appeal and Review Boards Act, 1998, a hearing under paragraph 3 or 4 of subsection 20 (1) shall be heard and decided as provided for in Schedule 1. 2019, c. 15, Sched. 15, s. 21 (1).

Interest payable by the Plan

(4) If the Appeal Board has concluded that an amount is payable by the Plan to a physician in a hearing under paragraph 3 of subsection 20 (1), interest calculated at the rate for postjudgment interest provided for under section 127 of the Courts of Justice Act accrues from the date that the claims were submitted in accordance with this Act and regulations. 2019, c. 15, Sched. 15, s. 21 (1).

Interest payable to the Plan

(5) If the Appeal Board has concluded that an amount is payable to the Plan by a physician in a hearing under paragraph 4 of subsection 20 (1), interest calculated at the rate for postjudgment interest provided for under section 127 of the Courts of Justice Act accrues from the date of the request for a hearing by the General Manager. 2019, c. 15, Sched. 15, s. 21 (1).

(6) Repealed: 2019, c. 15, Sched. 15, s. 21 (2).

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 16 - 01/05/1996

2002, c. 18, Sched. I, s. 8 (12) - 26/11/2002

2007, c. 10, Sched. G, s. 16 (1, 2)- 04/09/2007

2015, c. 20, Sched. 15, s. 6 (1, 2) - 29/10/2015

2019, c. 15, Sched. 15, s. 21 (1) - 10/12/2019; 2019, c. 15, Sched. 15, s. 21 (2) - 28/06/2023

Parties

22 (1) The General Manager is a party to all proceedings before the Appeal Board. 2015, c. 20, Sched. 15, s. 7.

Same

(2) The Appeal Board may add any other parties to a proceeding that it considers appropriate. 2015, c. 20, Sched. 15, s. 7.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 17 - 01/05/1996

2007, c. 10, Sched. G, s. 17 - 04/09/2007

2015, c. 20, Sched. 15, s. 7 - 29/10/2015

Evidence

Examination of documentary evidence

23 (1) A person who is a party to proceedings before the Appeal Board shall be afforded an opportunity to examine before the hearing any written or documentary evidence that will be produced or any report the contents of which will be given in evidence at the hearing. R.S.O. 1990, c. H.6, s. 23 (1).

Board members not to have investigated prior to hearing

(2) Members of the Appeal Board holding a hearing shall not have taken part, before the hearing, in any investigation or consideration of the subject-matter of the hearing and shall not communicate directly or indirectly in relation to the subject-matter of the hearing with any person or with any party or representative of the party except upon notice to and with opportunity for all parties to participate, but the Appeal Board may seek legal advice from an adviser independent from the parties and in such case the nature of the advice should be made known to the parties in order that they may make submissions as to the law. R.S.O. 1990, c. H.6, s. 23 (2).

Recording evidence

(3) The oral evidence taken before the Appeal Board at a hearing shall be recorded and, if so required, copies of a transcript thereof shall be furnished upon the same terms as in the Superior Court of Justice. R.S.O. 1990, c. H.6, s. 23 (3); 2006, c. 19, Sched. C, s. 1 (1).

Findings of fact

(4) The findings of fact of the Appeal Board pursuant to a hearing shall be based exclusively on evidence admissible or matters that may be noticed under section 15 or 16 of the Statutory Powers Procedure Act. R.S.O. 1990, c. H.6, s. 23 (4).

(5) Repealed: 1998, c. 18, Sched. G, s. 54 (5).

Release of documents, etc.

(6) Documents and things put in evidence at the hearing shall, upon the request of the person who produced them, be released to the person by the Appeal Board within a reasonable time after the matter in issue has been finally determined. R.S.O. 1990, c. H.6, s. 23 (6).

Section Amendments with date in force (d/m/y)

1998, c. 18, Sched. G, s. 54 (5) - 01/02/1999

2006, c. 19, Sched. C, s. 1 (1) - 22/06/2006

Appeal to Divisional Court

24 (1) Any party to the proceedings before the Appeal Board under this Act may appeal from its decision or order to the Divisional Court in accordance with the rules of court. R.S.O. 1990, c. H.6, s. 24 (1); 1998, c. 18, Sched. G, s. 54 (6).

Exception

(1.1) Despite subsection (1), a party may not appeal from a decision or order of the Appeal Board respecting a matter heard under paragraph 3 or 4 of subsection 20 (1). 2019, c. 15, Sched. 15, s. 22.

Record to be filed in court

(2) Where any party appeals from a decision or order of the Appeal Board, the Appeal Board shall forthwith file in the Divisional Court the record of the proceedings before it in which the decision was made, which, together with the transcript of evidence if it is not part of the Appeal Board’s record, shall constitute the record in the appeal.

Minister to be heard

(3) The Minister is entitled to be heard by counsel or otherwise upon the argument of an appeal under this section.

Powers of court on appeal

(4) An appeal under this section may be made on questions of law or fact or both and the court may affirm or may rescind the decision of the Appeal Board and may exercise all powers of the Appeal Board to direct the General Manager to take any action which the Appeal Board may direct the General Manager to take and as the court considers proper and for such purposes the court may substitute its opinion for that of the General Manager or of the Appeal Board, or the court may refer the matter back to the Appeal Board for rehearing, in whole or in part, in accordance with such directions as the court considers proper. R.S.O. 1990, c. H.6, s. 24 (2-4).

(5) Repealed: 2015, c. 20, Sched. 15, s. 8.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 18 - 01/05/1996; 1998, c. 18, Sched. G, s. 54 (6) - 01/02/1999

2015, c. 20, Sched. 15, s. 8 - 29/10/2015

2019, c. 15, Sched. 15, s. 22 - 10/12/2019

25 Repealed: 2019, c. 15, Sched. 15, s. 23.

Section Amendments with date in force (d/m/y)

2002, c. 18, Sched. I, s. 8 (13-17) - 26/11/2002

2004, c. 5, s. 40 (1-4) - 23/09/2004

2007, c. 10, Sched. G, s. 18 - 04/09/2007

2019, c. 15, Sched. 15, s. 23 - 10/12/2019

Service of notice

26 (1) Except where otherwise provided, any notice required by or provided for in this Act may be served,

(a) by personal service;

(b) by courier;

(d) by any other prescribed method. 2007, c. 10, Sched. G, s. 19.

When effective

(2) Service of a notice is effective,

(a) in the case of a notice under clauses (1) (a) to (c), on the day of delivery; and

(b) in the case of a notice under clause (1) (d), as provided for in the regulations. 2007, c. 10, Sched. G, s. 19.

Service by lettermail

(3) Where an attempt has been made to effect service by a method set out in subsection (1), and for any reason service could not be effected, service may be made by lettermail. 2007, c. 10, Sched. G, s. 19.

Same

(4) Service by lettermail shall be deemed to be effective 14 business days after the day of mailing, unless the person or entity on whom service is to be made establishes that the notice was not received until a later date for reasons that he, she or it could not control, in which case service is effective on the day that the notice is actually received. 2007, c. 10, Sched. G, s. 19.

Section Amendments with date in force (d/m/y)

2007, c. 10, Sched. G, s. 19- 04/09/2007

26.1 Repealed: 1996, c. 1, Sched. H, s. 19.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 19 - 01/05/1996

Proposed revision of O.M.A. schedule of fees

27 At least six months before any proposed revision of the schedule of fees of the Ontario Medical Association, the Ontario Medical Association shall notify the Minister of the proposed revision and the Minister shall arrange and implement discussions with representatives of the said Association respecting the details and extent of any proposed changes in the schedule of fees. R.S.O. 1990, c. H.6, s. 27.

Contributions to the Plan

27.1 (1) Every physician, practitioner and health facility who provides insured services shall make such contribution to the Plan as may be prescribed relating to the amount of fees payable to him, her or it under the Plan during such prior period as may be prescribed.

Amount

(2) The amount of the basic contribution from each physician, practitioner or health facility shall be determined in accordance with the regulations.

Adjustment

(3) The basic contribution from a physician, practitioner or health facility may be increased or decreased as provided in the regulations based upon such factors as may be prescribed.

Exemption

(4) Such classes of physicians, practitioners or health facilities as may be prescribed are exempt from making a contribution to the Plan. 1996, c. 1, Sched. H, s. 20.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 20 - 01/05/1996

Payments, etc., to the Plan

27.2 (1) The General Manager may obtain or recover money that a physician, practitioner or health facility owes to the Plan by set off against any money payable to him, her or it under the Plan. 1996, c. 1, Sched. H, s. 21.

(2) Repealed: 2019, c. 15, Sched. 15, s. 24.

(3), (4) Repealed: 2004, c. 5, s. 41.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 21 - 01/05/1996

2004, c. 5, s. 41 - 23/09/2004

2007, c. 10, Sched. G, s. 20 - 04/09/2007

2015, c. 20, Sched. 15, s. 9 - 29/10/2015

2019, c. 15, Sched. 15, s. 24 - 10/12/2019

Payment by contribution to annual expenditures

28 Any amounts payable to or on behalf of an insured person under the Plan in respect of insured services provided by or in a hospital or health facility may be paid in the form of the payment by the Province of all or any part of the annual expenditures of such hospital or health facility, where such payment by the Province is authorized under any Act. R.S.O. 1990, c. H.6, s. 28.

Disclosure authorized

29 (1) Every insured person shall be deemed to have authorized his or her physician or practitioner, a hospital or health facility which provided a service to the insured person and any other prescribed person or organization to give the General Manager particulars of services provided to the insured person,

(a) for the purpose of obtaining payment under the Plan for the services;

(b) for the purpose of enabling the General Manager to monitor and control the delivery of insured services;

(c) for the purpose of enabling the General Manager to monitor and control payments made under the Plan or otherwise for insured services; and

(d) for such other purposes as may be prescribed. 1996, c. 1, Sched. H, s. 22.

Immunity

(2) No action lies against a person or organization for giving information to the General Manager under the Act. 1996, c. 1, Sched. H, s. 22.

(3) Repealed: 2019, c. 15, Sched. 15, s. 25.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 22 - 01/05/1996

2004, c. 3, Sched. A, s. 85 (2) - 01/11/2004

2019, c. 15, Sched. 15, s. 25 - 10/12/2019

29.1-29.8 Repealed: 2007, c. 10, Sched. G, s. 21.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 23 - no effect

2007, c. 10, Sched. G, s. 21 - 04/09/2007

Subrogation

30 (1) Where, as the result of the negligence or other wrongful act or omission of another, an insured person suffers personal injuries for which he or she receives insured services under this Act, the Plan is subrogated to any right of the insured person to recover the cost incurred for past insured services and the cost that will probably be incurred for future insured services, and the General Manager may bring action in the name of the Plan or in the name of that person for the recovery of such costs.

Payment by Plan recoverable by insured

(2) For the purposes of subsection (1), the payment by the Plan for insured services shall not be construed to affect the right of the insured person to recover the amounts so paid in the same manner as if such amounts are paid or to be paid by the insured person.

Cost of hospital services

(3) For the purposes of this section, the cost of insured services rendered to an insured person in or by a hospital or health facility shall be at the rate charged by the hospital or health facility to a person who is not an insured person. R.S.O. 1990, c. H.6, s. 30 (1-3).

Exception

(4) Despite subsection (1), the Plan is not subrogated to the rights of an insured person in respect of personal injuries arising directly or indirectly from the use or operation, after the 21st day of June, 1990 and before the day section 267.1 of the Insurance Act comes into force, of an automobile in Canada, the United States of America or any other jurisdiction designated in the Statutory Accident Benefits Schedule under the Insurance Act. 1993, c. 10, s. 53.

Exception

(5) Despite subsection (1), the Plan is not subrogated to the rights of the insured person, as against a person who is insured under a motor vehicle liability policy issued in Ontario, in respect of personal injuries arising directly or indirectly from the use or operation, after section 29 of the Automobile Insurance Rate Stability Act, 1996 comes into force, of an automobile in Ontario or in any other jurisdiction designated in the Statutory Accident Benefits Schedule under the Insurance Act.

Definition

(6) In subsection (5),

“motor vehicle liability policy” has the same meaning as in the Insurance Act. 1996, c. 21, s. 51.

Section Amendments with date in force (d/m/y)

1993, c. 10, s. 53 - 1/01/1994; 1996, c. 21, s. 51 - 1/11/1996

Subrogated claim included in action

31 (1) Any person who commences an action to recover for loss or damages arising out of the negligence or other wrongful act of a third party, to which the injury or disability in respect of which insured services have been provided is related shall, unless otherwise advised in writing by the General Manager, include a claim on behalf of the Plan for the cost of the insured services. R.S.O. 1990, c. H.6, s. 31 (1).

Recovery paid to Ontario

(2) Where a person recovers a sum in respect of the cost of insured services, the person shall forthwith pay the sum recovered to the Minister of Finance. R.S.O. 1990, c. H.6, s. 31 (2); 2006, c. 19, Sched. L, s. 11 (5).

Section Amendments with date in force (d/m/y)

2006, c. 19, Sched. L, s. 11 (5) - 22/06/2006

Motor Vehicle Accident Claims Fund

32 The Plan is not an insurer within the meaning of the Insurance Act, as referred to in section 22 of the Motor Vehicle Accident Claims Act, and may be awarded payment from the Motor Vehicle Accident Claims Fund. R.S.O. 1990, c. H.6, s. 32.

Judge to divide award

33 The judge at trial shall, if the evidence permits, apportion the elements of the injured person’s loss and damages so as to clearly designate the amount of the Plan’s recovery for the past cost of insured services and separate it from the amount of the Plan’s recovery of future cost of insured services, if any. R.S.O. 1990, c. H.6, s. 33.

Release not to bind Plan

34 No release or settlement of a claim for damages for personal injuries in a case where the injured person has received insured services under this Act shall be binding on the Plan unless the General Manager has approved the release or settlement. R.S.O. 1990, c. H.6, s. 34.

Insurer to pay Ontario

35 A liability insurer shall notify the General Manager of negotiations for settlement of any claim for damages including insured services and may pay to the Minister of Finance any amount referable to a claim for recovery of the cost of insured services and such payment discharges the obligation of the liability insurer to pay that amount to the insured person. R.S.O. 1990, c. H.6, s. 35; 2006, c. 19, Sched. L, s. 11 (5).

Section Amendments with date in force (d/m/y)

2006, c. 19, Sched. L, s. 11 (5) - 22/06/2006

Future insured services

36 Where a judgment or settlement includes future cost of insured services, the Plan shall provide the future insured services included in the judgment or settlement. R.S.O. 1990, c. H.6, s. 36.

Direct Recovery

Direct cause of action

36.0.1 (1) If the Plan has paid for insured services as a result of the negligence or other wrongful act or omission of a person, the Plan has a right, independent of its subrogated right under subsections 30 (1) and 46 (5), to recover, directly against that person, the costs for insured services that have been incurred in the past and that will probably be incurred in the future as a result of the negligence or the wrongful act or omission.

Action

(2) The General Manager may bring an action in the name of the Plan or the Minister may bring an action in his or her own name for recovery of the costs referred to in subsection (1).

Exception

(3) The Plan shall not recover costs under this section,

(a) against a physician if the negligence or wrongful act or omission of the physician occurred while the physician was acting within the scope of his or her practice and in such circumstances as may be prescribed;

(b) against a hospital under the Public Hospitals Act or a laboratory under the Laboratory and Specimen Collection Centre Licensing Act if the negligence or wrongful act or omission upon which the action is based occurred in the course of providing services that the hospital is approved to provide, or that the laboratory is licensed to provide, as the case may be, and in such circumstances as may be prescribed; or

Preservation of rights of insured persons

(4) An action under this section shall not prevent an insured person from recovering the cost or damages to which the person would otherwise be entitled.

Cost of hospital services

(5) For the purposes of this section, the cost of insured services rendered in or by a hospital or health facility shall be at the rate charged by the hospital or health facility to persons who are not insured.

Disclosure of information

(6) To the extent that any information relating to insured services is produced in a proceeding under this section, the information shall be produced in a manner that protects the identity of the insured person and of the provider of insured services. 1999, c. 10, s. 1.

Section Amendments with date in force (d/m/y)

1999, c. 10, s. 1 - 05/01/2000

Third Party Services

Third party service

36.1 (1) For the purposes of this section and sections 36.2 to 36.4, a third party service is a service that,

(a) is provided by a service provider in connection or partly in connection with,

(i) a request or requirement, made by a person or entity, that information or documentation relating to an insured person be provided, or

(ii) a request or requirement, made by a person or entity, that an insured person obtain a service from a service provider;

(b) is not an insured service or is deemed, by a regulation made under clause 45 (1) (i), not to be an insured service; and

(c) is prescribed as a third party service or is prescribed as a third party service in circumstances specified in the regulation. 1993, c. 32, s. 2 (7).

Third party

(2) For the purposes of this section and sections 36.2 to 36.4, a third party is a person or entity who makes a request or requirement referred to in clause (1) (a). 1993, c. 32, s. 2 (7).

Service provider

(3) For the purposes of this section and sections 36.2 to 36.4, a service provider is a physician, practitioner, hospital or health facility, or an integrated community health services centre within the meaning of the Integrated Community Health Services Centres Act, 2023. 1993, c. 32, s. 2 (7); 2023, c. 4, Sched. 1, s. 71 (5).

Regulations re third parties

(4) Despite subsection (2), a regulation may be made, in relation to a specified third party service or in relation to a third party service provided in specified circumstances,

(a) prescribing another person or entity as a third party instead of or in addition to the person or entity who makes the request or requirement referred to in clause (1) (a);

(b) if more than one person or entity make the request or requirement referred to in clause (1) (a), prescribing one or more of them as third parties and providing that the others are not third parties; or

Deemed requirement or request

(5) For the purpose of subsection (1), a person or entity shall be deemed to have required or requested that information or a document relating to the insured person be provided, or that the insured person obtain a service from a service provider, if providing the information or document or obtaining the service is related to the person or entity doing or not doing anything in relation to the insured person or related to the insured person receiving or not receiving anything from the third party. 1993, c. 32, s. 2 (7).

Section Amendments with date in force (d/m/y)

1993, c. 32, s. 2 (7) - 14/12/1993

2017, c. 25, Sched. 9, s. 97 (7) - no effect - see 2023, c. 4, Sched. 1, s. 67

2023, c. 4, Sched. 1, s. 71 (5) - 25/09/2023

Third party liable

36.2 (1) If a service provider who provides a third party service to an insured person renders an account for payment to the third party, the third party is liable for payment of the account, subject to subsection 36.3 (3).

Same

(2) If an insured person pays all or part of an account rendered to him or her by a service provider for a third party service provided to the insured person, the third party is liable to reimburse the insured person for the amount paid, subject to subsection 36.3 (4).

Insured person’s liability to pay

(3) Nothing in this section affects any liability of an insured person to pay a service provider’s account for a third party service.

Right to render account at time of service

(4) Nothing in sections 36.1 to 36.4 affects any right of a service provider to render an account for a third party service at the time the service is rendered.

No double recovery

(5) The total amount that the service provider recovers in respect of a third party service shall not exceed the amount of the account rendered. 1993, c. 32, s. 2 (7).

Section Amendments with date in force (d/m/y)

1993, c. 32, s. 2 (7) - 14/12/1993

Amounts owing by third parties

Application of section

36.3 (1) This section applies to,

(a) an amount owing by a third party to a service provider under subsection 36.2 (1);

(b) an amount owing by a third party to an insured person under subsection 36.2 (2); and

(c) an amount owing by an insured person to a service provider for a third party service provided to the insured person by the service provider.

Proceeding to recover payment

(2) An amount referred to in subsection (1) may be recovered in a court proceeding or, if a body is designated or established under clause 45 (1.1) (f), in a proceeding before the body.

Court, body may reduce amount payable

(3) In a proceeding to recover an amount referred to in clause (1) (a) or (c), the court or body, in addition to any other order it may make, may order the third party or the insured person, as the case may be, to pay the service provider an amount that is less than the amount charged by the service provider for the third party service if the court or body finds that the amount charged by the service provider for the third party service is excessive.

Same

(4) In a proceeding to recover an amount referred to in clause (1) (b), the court or body, in addition to any other order it may make, may order the third party to pay the insured person an amount that is less than the amount paid by the insured person to the service provider for the third party service if the court or body finds that the amount charged by the service provider for the third party service is excessive.

Determining whether excessive

(5) In determining whether an amount charged by a service provider other than a physician for a third party service is excessive, the court or body shall consider any applicable guidelines respecting third party services and any applicable schedule of fees, and may consider any other relevant factors.

Same

(6) In determining whether an amount charged by a physician for a third party service is excessive, the court or body shall consider the Ontario Medical Association’s guidelines respecting third party services and its schedule of fees, and may consider any other relevant factors.

Same

(7) The Lieutenant Governor in Council may, in a regulation, provide that the court or body shall consider other matters in addition to or instead of the guidelines and schedules of fees referred to in subsections (5) and (6).

Adding service provider as party

(8) No order shall be made under subsection (4) unless the service provider has been added as a party to the proceeding.

Same

(9) The service provider may be added as a party to the proceeding referred to in subsection (4) on such terms as the court or body considers just. 1993, c. 32, s. 2 (7).

Section Amendments with date in force (d/m/y)

1993, c. 32, s. 2 (7) - 14/12/1993

Service provider to reimburse insured person

36.4 If, under subsection 36.3 (4), the court or body orders the third party to pay the insured person an amount that is less than the amount paid by the insured person to the service provider for the third party service, the service provider is liable to repay the difference to the insured person. 1993, c. 32, s. 2 (7).

Section Amendments with date in force (d/m/y)

1993, c. 32, s. 2 (7) - 14/12/1993

General

37 Repealed: 2019, c. 15, Sched. 15, s. 26.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 30 - 01/05/1996

2006, c. 19, Sched. L,s. 3 (6) - 22/06/2006

2007, c. 10, Sched. G, s. 22 (1, 2) - 04/09/2007; 2007, c. 10, Sched. P, s. 16 - 1/07/2015

2009, c. 26, s. 11 (5) - no effect - see 2019, c. 15, Sched. 15, s. 38 - 10/12/2019

2017, c. 25, Sched. 9, s. 97 (8, 9) - no effect - see 2019, c. 15, Sched. 15, s. 39 - 10/12/2019

2019, c. 15, Sched. 15, s. 26 - 10/12/2019

37.1 Repealed: 2019, c. 15, Sched. 15, s. 26.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 31 - 01/05/1996

2002, c. 18, Sched. I, s. 8 (18, 19) - 26/11/2002

2007, c. 10, Sched. G, s. 23 (1-5) - see Table of Public Statute Provisions Repealed Under Section 10.1 of the Legislation Act, 2006 - 31/12/2017; 2007, c. 10, Sched. G, s. 23 (6) - no effect - see 2015, c. 20, Sched. 15, s. 19 - 04/06/2015; 2007, c. 10, Sched. G, s. 23 (7) - 31/03/2010

2009, c. 26, s. 11 (6-10) - no effect - see 2019, c. 15, Sched. 15, s. 38 - 10/12/2019

2015, c. 20, Sched. 15, s. 10 - 29/10/2015

2017, c. 25, Sched. 9, s. 97 (10) - no effect - see 2019, c. 15, Sched. 15, s. 26 - 10/12/2019

2019, c. 15, Sched. 15, s. 26 - 10/12/2019

Information confidential

38 (1) The persons listed in subsection (1.1) shall preserve secrecy with respect to all matters that come to their knowledge in the course of their employment or duties pertaining to insured persons and any insured services rendered and the payments made for those services, and shall not communicate any such matters to any other person except as otherwise provided in this Act, the Personal Health Information Protection Act, 2004 and the Freedom of Information and Protection of Privacy Act. 2007, c. 10, Sched. G, s. 24 (1).

Persons referred to in subs. (1)

(1.1) The following are listed for the purposes of subsection (1):

1. The members of the Appeal Board.

2. The employees and agents, if any, of the Appeal Board.

3. The General Manager and persons engaged in the administration of this Act. 2007, c. 10, Sched. G, s. 24 (1); 2015, c. 20, Sched. 15, s. 11 (1, 2); 2019, c. 15, Sched. 15, s. 27 (1).

(2), (3) Repealed: 2007, c. 10, Sched. G, s. 24 (2).

(4) Repealed: 2019, c. 15, Sched. 15, s. 27 (2).

Section Amendments with date in force (d/m/y)

1992, c. 32, s. 15 - 3/04/1995; 1998, c. 18, Sched. G, s. 54 (7) - 01/02/1999

2002, c. 18, Sched. I, s. 8 (20) - 26/11/2002

2006, c. 19, Sched. L, s. 11 (3) - 22/06/2006

2007, c. 10, Sched. G, s. 24 (1-4) - 04/09/2007

2015, c. 20, Sched. 15, s. 11 (3) - 29/10/2015

2019, c. 15, Sched. 15, s. 27 (1, 2) - 10/12/2019

Filing with court

38.1 (1) A copy of any of the following may be filed with the Superior Court of Justice after the time in which an appeal may be made has passed, and once filed shall be entered in the same way as a judgment or order of the Superior Court of Justice and is enforceable as an order of that court:

1. A decision of the Appeal Board made under this Act.

2. Repealed: 2019, c. 15, Sched. 15, s. 28 (1).

3. An agreement to reimburse the Plan signed by a physician.

4. Repealed: 2019, c. 15, Sched. 15, s. 28 (2).

2007, c. 10, Sched. G, s. 25; 2019, c. 15, Sched. 15, s. 28 (1, 2).

Personal property charge

(2) Anything that may be filed under subsection (1) may also be entered as a lien and charge with the registrar under the Personal Property Security Act. 2019, c. 15, Sched. 15, s. 28 (3).

Set-off

(3) For greater certainty, nothing under this section affects any right of set-off that the General Manager possesses under this Act. 2019, c. 15, Sched. 15, s. 28 (3).

Section Amendments with date in force (d/m/y)

2004, c. 5, s. 42 - 23/09/2004

2007, c. 10, Sched. G, s. 25 - 04/09/2007

2009, c. 26, s. 11 (11) - no effect - see 2019, c. 15, Sched. 15, s. 38 - 10/12/2019

2019, c. 15, Sched. 15, s. 28 (1-3) - 10/12/2019

Limitation of liability

39 (1) No action or other proceeding shall be commenced against the Crown, the Minister, the General Manager, any employee or agent of the Crown or a reviewer for anything done or omitted to be done in good faith in the execution or intended execution of a power or duty under this Act. 2019, c. 15, Sched. 15, s. 29.

No remedy

(2) Despite any other Act or law, no costs, compensation or damages are owing or payable to any person and no remedy, including but not limited to a remedy in contract, restitution, tort or trust, is available to any person against the Crown, the Minister, the General Manager, any employee or agent of the Crown or a reviewer in connection with anything referred to in subsection (1) except as otherwise provided under this Act. 2019, c. 15, Sched. 15, s. 29.

Section Amendments with date in force (d/m/y)

1998, c. 18, Sched. G, s. 54 (8) - 01/02/1999

2007, c. 10, Sched. G, s. 26 (1) - 04/09/2007; 2007, c. 10, Sched. G, s. 26 (2) - 01/09/2009

2015, c. 20, Sched. 15, s. 12 - 29/10/2015

2019, c. 15, Sched. 15, s. 29 - 10/12/2019

Limitations on remedies

39.1 (1) No cause of action arises as a direct or indirect result of,

(a) the enactment or repeal of any provision of this Act; or

(b) the making or revocation of any provision of the regulations made under this Act. 2019, c. 15, Sched. 15, s. 29.

No remedy

(2) No costs, compensation or damages are owing or payable to any person and no remedy, including but not limited to a remedy in contract, restitution, tort or trust, is available to any person in connection with anything referred to in clause (1) (a) or (b). 2019, c. 15, Sched. 15, s. 29.

Proceedings barred

(3) No proceeding, including but not limited to any proceeding in contract, restitution, tort or trust, that is directly or indirectly based on or related to anything referred to in subsection (1) may be brought or maintained against any person. 2019, c. 15, Sched. 15, s. 29.

Same

(4) Subsection (3) applies regardless of whether the cause of action on which the proceeding is purportedly based arose before or after that subsection came into force. 2019, c. 15, Sched. 15, s. 29.

Person defined

(5) In this section,

“person” includes the Crown and its employees and agents and members of the Executive Council. 2019, c. 15, Sched. 15, s. 29.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 33 - 01/05/1996

2002, c. 18, Sched. I, s. 8 (21) - 26/11/2002

2007, c. 10, Sched. G, s. 27 (1-4) - 04/09/2007

2015, c. 20, Sched. 15, s. 13 - 29/10/2015

2019, c. 15, Sched. 15, s. 29 - 10/12/2019

No Crown liability

39.2 (1) No cause of action arises against the Crown, a minister of the Crown, a Crown employee, a Crown agent or the General Manager as a result of any act or omission of a person who is not a minister of the Crown, a Crown employee, a Crown agent or the General Manager if the act or omission is related, directly or indirectly, to the activities or affairs of a reviewer or to the administration of this Act. 2019, c. 15, Sched. 15, s. 29.

No proceeding

(2) No proceeding for damages, including but not limited to a proceeding for a remedy in contract, restitution, tort or trust, shall be instituted against the Crown, a minister of the Crown, a Crown employee, a Crown agent or the General Manager by a person who has suffered any damages, injury or other loss based on or related to any act or omission described in subsection (1). 2019, c. 15, Sched. 15, s. 29.

Section Amendments with date in force (d/m/y)

2019, c. 15, Sched. 15, s. 29 - 10/12/2019

Amendments apply despite agreements

39.3 The amendments to this Act made by Schedule 15 to the Plan to Build Ontario Together Act, 2019, and any regulations made in consequence of those amendments, apply despite any agreement or arrangement entered into by the Minister, regardless of when the agreement or arrangement might have been made. 2019, c. 15, Sched. 15, s. 29.

Section Amendments with date in force (d/m/y)

2019, c. 15, Sched. 15, s. 29 - 10/12/2019

Publication

39.4 (1) Subject to the regulations, if any, the General Manager is authorized to publish information, including personal information other than personal health information, that relates to any payments under this Act to a physician, practitioner or health facility, including payments that are made to a person or entity pursuant to an arrangement under clause 2 (2) (a) or a direction under section 16.1. 2019, c. 15, Sched. 15, s. 29.

Exception

(2) This section does not authorize the publication by the General Manager or the Minister of information concerning an opinion that the General Manager has formed under subsection 18 (8) or section 18.2, or a hearing that the General Manager has requested in connection with such an opinion. 2019, c. 15, Sched. 15, s. 29.

Section Amendments with date in force (d/m/y)

2019, c. 15, Sched. 15, s. 29 - 10/12/2019

40 Repealed: 2015, c. 20, Sched. 15, s. 13.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 34 - 01/05/1996

2007, c. 10, Sched. G, s. 28 - 04/09/2007

2015, c. 20, Sched. 15, s. 13 - 29/10/2015

40.1 Repealed: 2015, c. 20, Sched. 15, s. 13.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 34 - 01/05/1996

2007, c. 10, Sched. G, s. 29 (1-3) - 04/09/2007

2009, c. 33, Sched. 6, s. 61 - 1/06/2011

2015, c. 20, Sched. 15, s. 13 - 29/10/2015

40.2 Repealed: 2015, c. 20, Sched. 15, s. 13.

Section Amendments with date in force (d/m/y)

1996, c. 1, Sched. H, s. 34 - 01/05/1996

2007, c. 10, Sched. G, s. 30 (1, 2) - 04/09/2007

2015, c. 20, Sched. 15, s. 13 - 29/10/2015

Suspension of payments

40.3 The General Manager may suspend payments or a portion of payments to a physician, practitioner or health facility from the Plan,

(a) during any period when they fail to comply with section 17.3, whether or not they are convicted of an offence;

(b) during any period where they fail to co-operate with a reviewer; or

(c) during any other period as may be prescribed, or for any other reason as may be prescribed. 2019, c. 15, Sched. 15, s. 30.

Section Amendments with date in force (d/m/y)

2007, c. 10, Sched. G, s. 31 - 31/03/2010

2019, c. 15, Sched. 15, s. 30 - 10/12/2019

Appointment of reviewers

41 (1) The Minister or the General Manager may appoint, in writing, one or more persons as reviewers for the purposes of this Act and the regulations. 2019, c. 15, Sched. 15, s. 31 (1).

Other reviewers

(2) Every inspector appointed by the Director or Minister under the Integrated Community Health Services Centres Act, 2023 is, by virtue of office, also a reviewer for the purposes of this Act. 2019, c. 15, Sched. 15, s. 31 (1); 2023, c. 4, Sched. 1, s. 71 (6).

Certificate of appointment

(3) The Minister or General Manager shall issue to every reviewer, other than reviewers mentioned in subsection (2), a certificate of appointment which the reviewer shall produce, upon request, when acting in the performance of their duties. A reviewer mentioned in subsection (2) shall produce their certificate of appointment issued under the Integrated Community Health Services Centres Act, 2023. 2019, c. 15, Sched. 15, s. 31 (1); 2023, c. 4, Sched. 1, s. 71 (6).

Purpose of inspection

(4) In order to conduct inspections for the purpose of ensuring compliance with this Act and the regulations, a reviewer may, at any reasonable time, enter any place where a physician, practitioner or health facility provides services or any place where a physician, practitioner or health facility or any person on their behalf may maintain any record that relates in any manner to the provision of services for which they submit or have submitted claims to the Plan. 2019, c. 15, Sched. 15, s. 31 (1).

Physicians

(5) Despite anything else in this section, only a reviewer who is a physician may enter a place for the purpose of conducting an inspection to ensure compliance with this Act and the regulations by a physician. 2019, c. 15, Sched. 15, s. 31 (1).

Dwellings

(6) No reviewer shall enter a part of a place that is being used as a dwelling, except with the consent of the occupier of the part of the place or under the authority of an order under section 42.1. 2019, c. 15, Sched. 15, s. 31 (1).

Use of force

(7) A reviewer is not entitled to use force to enter and inspect a place. 2019, c. 15, Sched. 15, s. 31 (1).

Powers of reviewer

(8) A reviewer conducting an inspection may, if the reviewer considers it to be relevant to the inspection,

(a) examine records or anything else;

(b) demand the production of a record or any other thing;

(d) in order to produce a record in readable form, use data storage, information processing or retrieval devices or systems that are normally used in carrying on business in the place;

(e) take photographs or make any other kind of recording but only in a manner that does not intercept any private communication and that is in keeping with reasonable expectations of privacy;

(f) question a person about a matter relevant to the inspection; and

(g) call upon experts who may enter the premises and provide assistance to the reviewer in carrying out the inspection in any manner that the reviewer considers necessary. 2019, c. 15, Sched. 15, s. 31 (1).

Written demand

(9) A demand under this section that a record or any other thing be produced must be in writing and must include,

(a) a statement of the nature of the record or thing required; and

(b) a statement of when the records and other things are to be produced. 2019, c. 15, Sched. 15, s. 31 (1).

Obligation to produce and assist

(10) If a reviewer demands that a record or any other thing be produced under this section, the person who has custody of the record or thing shall produce it and, in the case of a record, shall, on request, provide any assistance that is reasonably necessary to interpret the record or to produce it in a readable form. 2019, c. 15, Sched. 15, s. 31 (1).

Records and things removed from place

(11) A record or other thing that has been removed for review, examination or copying,

(a) shall be made available to the person from whom it was removed on request and at a time and place that are convenient for the person and for the reviewer; and

(b) shall be returned to the person within a reasonable time. 2019, c. 15, Sched. 15, s. 31 (1).

Co-operation

(12) Every person shall give all reasonable assistance to a reviewer in the exercise of the reviewer’s powers or the performance of the reviewer’s duties under this Act or the regulations. 2019, c. 15, Sched. 15, s. 31 (1).

Confidentiality

(13) A reviewer shall keep confidential all information that comes to his or her knowledge in the course of his or her duties under this section and shall not communicate any information to any other person except as permitted or required by law or except where the communication is to the General Manager or a person employed in or performing services for the Ministry. 2019, c. 15, Sched. 15, s. 31 (1).

Inspection report

(14) Within a reasonable period of time after completing an inspection, the reviewer shall make a report in writing to the General Manager. 2019, c. 15, Sched. 15, s. 31 (1).

Record

(15) In this section,

“record” means any document or record of information, in any form, including a record that contains personal information. 2019, c. 15, Sched. 15, s. 31 (1).

Section Amendments with date in force (d/m/y)

2000, c. 26, Sched. H, s. 1 (7) - 06/12/2000

2019, c. 15, Sched. 15, s. 31 (1) - 10/12/2019; 2019, c. 15, Sched. 15, s. 31 (2) - no effect - see 2023, c. 4, Sched. 1, s. 76 (3)

2023, c. 4, Sched. 1, s. 71 (6) - 25/09/2023

Copy constitutes evidence

42 (1) In any proceeding, other than a prosecution, a copy of an inspection report that appears to be signed by a reviewer or the General Manager, or a copy of a decision of the General Manager made under this Act or the regulations, is admissible as evidence of the inspection report or decision and of the facts appearing in the document without further proof. 2019, c. 15, Sched. 15, s. 31 (1).

Same

(2) In any proceeding, other than a prosecution, a copy of a record or thing made under clause 41 (7) (c) that appears to be certified as a true copy of the original by a reviewer is admissible as evidence of the record or thing and of the facts appearing in it without further proof. 2019, c. 15, Sched. 15, s. 31 (1).

Same, prosecution

(3) In any prosecution, a copy of a decision, direction or inspection report made under this Act or the regulations that appears to be signed by a reviewer or the General Manager is admissible as evidence, in the absence of evidence to the contrary, of the decision, direction or inspection report and of the facts appearing in the document without further proof. 2019, c. 15, Sched. 15, s. 31 (1).

Same

(4) In any prosecution, a copy of a record or thing made under clause 41 (7) (c) that appears to be certified as a true copy of the original by a reviewer is admissible as evidence, in the absence of evidence to the contrary, of the record or thing and of the facts appearing in it without further proof. 2019, c. 15, Sched. 15, s. 31 (1).

Transition

(5) This section applies, with necessary modification, to any notice of the General Manager issued under subsection 18 (14) or (15) of this Act as they existed before subsection 32 (1) of Schedule 15 to the Plan to Build Ontario Together Act, 2019 came into force. 2019, c. 15, Sched. 15, s. 31 (1).

Section Amendments with date in force (d/m/y)

2000, c. 26, Sched. H, s. 1 (7) - 06/12/2000

Order to enter

42.1 (1) On application without notice, a justice may issue an order authorizing a reviewer named in the order to enter a place specified in the order and to exercise any of the powers mentioned in subsection 41 (7), if the justice is satisfied on information under oath that the reviewer has been prevented from entering a place that may be entered under section 41, or has been prevented from exercising a power mentioned in subsection 41 (7), or that there are reasonable grounds to believe that the reviewer will be prevented from entering the place or exercising the power. 2019, c. 15, Sched. 15, s. 31 (1).

Expiry

(2) An order shall name a date on which it expires, which shall not be later than 30 days after the order is issued. 2019, c. 15, Sched. 15, s. 31 (1).

Extension of time

(3) A justice may extend the date on which an order expires for an additional period of no more than 30 days, upon application without notice by the reviewer named in the order. 2019, c. 15, Sched. 15, s. 31 (1).

Police assistance

(4) A reviewer named in an order may call upon a police officer for assistance in executing the order and the police officer may use whatever force the police officer considers necessary to execute the order. 2019, c. 15, Sched. 15, s. 31 (1).

Time of execution

(5) An order may be executed only between 6 a.m. and 9 p.m. unless the order specifies otherwise. 2019, c. 15, Sched. 15, s. 31 (1).

Other matters

(6) Subsections 41 (3) to (4) and (6) to (14) apply, with necessary modifications, to the execution of an order. 2019, c. 15, Sched. 15, s. 31 (1).

Section Amendments with date in force (d/m/y)

Obstruction offence

42.2 Where a reviewer is conducting an inspection under section 41 or executing an order under section 42.1 or where a provincial offences officer is executing a warrant under section 158 or 158.1 of the Provincial Offences Act with respect to a matter relevant to this Act, no person shall,

(a) hinder, obstruct or interfere with the reviewer or officer, or otherwise impede the reviewer or officer;

(b) destroy or alter a record or other thing that has been demanded under clause 41 (8) (b) or that is the subject of a warrant under section 158 or 158.1 of the Provincial Offences Act; or

(c) fail to do anything required under subsections 41 (9) or (11) or subsection 42.3 (7). 2019, c. 15, Sched. 15, s. 31 (1).

Section Amendments with date in force (d/m/y)

Production order

42.3 (1) On application without notice by a provincial offences officer, a justice may issue a production order to a person, other than a person under investigation for an offence, requiring the person to,

(a) produce documents or copies of documents, certified by affidavit to be true copies, or produce data; or

(b) prepare a document based on documents or data already in existence and produce it. 2019, c. 15, Sched. 15, s. 31 (1).

Contents of order

(2) A production order must stipulate when, where and how the documents or data are to be produced, and to whom they are to be produced. 2019, c. 15, Sched. 15, s. 31 (1).

Grounds

(3) A justice may make a production order if satisfied by information given under oath or affirmation that there are reasonable grounds to believe that,

(a) an offence under this Act has been or is being committed;

(b) the document or data will provide evidence respecting the offence or suspected offence; and

(c) the person who is subject to the order has possession or control of the document or data. 2019, c. 15, Sched. 15, s. 31 (1).

Conditions

(4) A production order may contain any conditions the justice considers advisable. 2019, c. 15, Sched. 15, s. 31 (1).

Evidence

(5) A copy of a document or data produced under this section, on proof by affidavit that it is a true copy, is admissible in evidence in proceedings under this Act and has the same probative force as the original document or data would have if it had been proved in the ordinary way. 2019, c. 15, Sched. 15, s. 31 (1).

No return of copies

(6) Copies of documents or data produced under this section are not required to be returned to the person who provided them. 2019, c. 15, Sched. 15, s. 31 (1).

Compliance required

(7) A person to whom a production order is directed shall comply with the order according to its terms. 2019, c. 15, Sched. 15, s. 31 (1).

Section Amendments with date in force (d/m/y)

Not compellable witness

42.4 A reviewer or person who, at the request of a reviewer, accompanies a reviewer in doing anything authorized under this Act is not a compellable witness in a civil suit or any proceeding respecting any information or material furnished, obtained, made or received by them under this Act while acting within the scope of their employment. 2019, c. 15, Sched. 15, s. 31 (1).

Section Amendments with date in force (d/m/y)

Protection of information

42.5 In a prosecution for an offence under this Act or where documents or materials provided for under section 42.3 of this Act or sections 158 to 160 of the Provincial Offences Act are filed with a court in relation to an inspection or an investigation into an offence under this Act, the court may, at any time, take precautions to avoid the disclosure by the court or any person of any personal information about an individual, including, where appropriate,

(a) removing the identifying information of any person whose personal information is referred to in any documents or materials;

(b) receiving representations without notice;

(d) sealing all or part of the court files. 2019, c. 15, Sched. 15, s. 31 (1).

Section Amendments with date in force (d/m/y)