ACCESSORY FEES IN MEDICAL CLINICS

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NOTICE


(Class Actions)
SUPERIOR COURT
CANADA
PROVINCE OF QUÉBEC
DISTRICT OF MONTRÉAL
No.: 500-06-000695-144

PHILIPPE LÉVEILLÉ

Plaintiff

v.

THE ATTORNEY GENERAL OF QUÉBEC, THE RÉGIE DE L’ASSURANCE MALADIE DU QUÉBEC, CENTRE DE GASTRO-ENTÉROLOGIE (WEST-ISLAND) INC., CLINIQUE DE L’ALTERNATIVE INC., GESTION PLEXO INC., INSTITUT DU GLAUCOME DE MONTRÉAL INC., CLINIQUE O, CHIRURGIE PLASTIQUE ET ESTHÉTIQUE DE L’ŒIL INC., FRÉDÉRIC LORD, operating under the name Clinique ophtalmologique de l’ouest, JURATE ULECKAS, operating under the name Jurate Uleckas, M.D. #88-610, ROBERT SABBAH, operating under the name Robert Sabbah, M.D., FRCSC, Obstetrician-Gynecologist, FRANÇOIS LAVIGNE, operating under the name Institut ORL de Montréal, GROUPE OPMEDIC INC., CLINIQUE DE GASTRO-ENTÉROLOGIE DE LAVAL INC., DR ISABELLE DELORME INC., CLINIQUE DERMATOLOGIQUE DE LA RIVE-SUD, J.S. BENHAMRON M.D. INC., MICHÈLE LECLERC, operating under the name Dr. Michèle Leclerc 176-186, 7044968 CANADA INC., operating under the name Clinique de physiatrie et de médecine du sport de Montréal, IMAGERIE MÉDICALE WESTMOUNT SQUARE INC., LE GROUPE SPÉCIALISTE ENT, S.E.N.C., INSTITUT DE L’ŒIL DE MONTRÉAL INC., MARIE-MICHELLE CAYER, GIRAIR BASMADJIAN, JACQUES BELLEFEUILLE, ÉLIZABETH GARIÉPY M.D. INC., LUC LECLAIRE, OPHTALMOLOGIE LANAUDIÈRE-SUD S.E.N.C., CHRISTIAN PERREAULT, MARTINE JEAN, RRX MÉDICAL INC., ÉTIENNE GAUVIN, DRE JOËLLE BARIL INC., APRIL WOOTTEN, STEEVE LÉTOURNEAU M.D. INC., 9084-7757-QUÉBEC INC., operating under the name Clinix la Cité, CENTRE OCULAIRE DE QUÉBEC INC., 2835631 CANADA INC., operating under the name Clinique médicale Solumed, SHAWN COHEN, PIJOCO INC., CONTACT OPTICO INC., OCULO VISION INC., CENTRE DE PHYSIATRIE SHERBROOKE INC., operating under the name Institut de physiatrie du Québec, FRANCINE CARDINAL, ANTRANIK BENOHANIAN, INSTITUT DE L’ŒIL DES LAURENTIDES INC., YVON BENOIT, LA CLINIQUE DE SANTÉ VISUELLE DE MONTRÉAL INC., LA CLINIQUE D’OPHTALMOLOGIE DU HAUT RICHELIEU INC., 9189-2984 QUÉBEC INC., operating under the name Clinique médicale d’ophtalmologie de Granby, PIERRE BLONDEAU, operating under the name Dr. Pierre Blondeau, surgeon-ophthalmologist, F. ROSS M.D. INC., operating under the name Clinique familiale St-Vincent, PIERRE TURCOTTE M.D. INC., ZIEUTÉ INC., operating under the name VU Vision Ultime, RADIOLOGIE VARAD S.E.N.C.R.L., operating under the name Radiologie Varad HTM, LUC COMTOIS, 2645-8224 QUÉBEC INC., operating under the name Clinique médicale Plateau Marquette, INSTITUT DE CHIRURGIE SPÉCIALISÉE DE MONTRÉAL INC., operating under the name Clinique d’endoscopie Digestive HD-Sanctuaire, CLINIQUE DE RADIOLOGIE DE GRANBY INC., operating under the name IMAGIX Radiologie Granby, 100% VISION INC., operating under the name 100% Vision, GROUPE VISION NEW LOOK INC., operating under the name Greiche & Scaff, ALFRED BALBUL, operating under the name Dr. Alfred BALBUL, CLINIQUE D’OPHTALMOLOGIE FERREMI BOILEAU INC., operating under the name IRIS Clinique d’ophtalmologie, JEAN-JUNIOR NORMANDIN, operating under the name Dr. Jean-Junior Normandin, CENTRE DE SANTÉ INTÉGRALE ET DE RECHERCHE CLINIQUE À COOKSHIRE INC., operating under the name Centre de Santé Cookshire, FYI SERVICES ET PRODUITS QUÉBEC INC., operating under the name Groupe Marchand, CENTRE DE RECHERCHE ET D’ENSEIGNEMENT D’ÉCHOENDOSCOPIE DE MONTRÉAL INC., operating under the name Clinique 1037 – Centre de prévention du cancer digestif, BÉATRICE WANG, operating under the name Béatrice Wang – 194202, FRANÇOIS ROBERGE, OPHTALMOLOGUE INC., CLINIQUE DE L’ŒIL ROCKLAND INC., operating under the name Clinique de l’œil Rockland, JOËL CLAVEAU, operating under the name Clinique Dermatologique Joël Claveau (1-93-209), MICHEL GRAVEL, operating under the names Michel Gravel MD and Clinique Ophtalmovision, CLINIQUE OPHTALMOLOGIQUE DANIEL YU INC., ALAN COFFEY, operating under the name Alan Coffey M.D., FRCSC, RENÉE CARIGNAN, operating under the name Dr. Renée Carignan, DAN BERGERON, operating under the names Dr. Dan Bergeron M.D. and Clinique d’ophtalmologie et de verres de contact, MD EYECARE INC., BEAUCE OPTIQUE INC., operating under the name Clinique Oculus, JOHN CHEN, operating under the name Dr. John Chen, CHRISTA STAUDENMAIER, operating under the name Christa Staudenmaier, MD., SERVICE D’UROLOGIE S.E.N.C.R.L., operating under the name Service d’urologie et centre de la prostate, 1843-1353 QUÉBEC INC., operating under the name Clinique familiale de St-Hyacinthe, GESTION C.D.Q.M. INC., operating under the name Centre Dermatologique du Québec Métropolitain, SYLVAIN PIERRE MORIN, operating under the name Clinique d’ophtalmologie de Lévis, MARIAN ZAHARIA, ENDOVISION PLUS INC., operating under the name Clinique ENDOVISION Clinic Inc., JACQUES SAMSON, operating under the name Clinique d’ophtalmologie de Lévis, DR. F. CARDINAL INC., operating under the name Clinique de dermatologie Griffintown, RADIOLOGISTES UNIVERSITAIRES DE MONTRÉAL S.E.N.C.R.L., operating under the name Léger & Associés, Radiologistes, GMF CENTRE MÉDICAL DU PARC, LOUKIA MITSOS, operating under the name Dr. Loukia Mitsos, DIMITRIOS KYRITSIS, operating under the name Dr. Dimitrios Kyritsis Lic. #14596, CLINIQUE D’OPTOMÉTRIE BELLEVUE INC., operating under the name Clinique d’optométrie Bellevue, CLINIQUE D’OPHTALMOLOGIE BELLEVUE LAVAL, operating under the name Clinique Bellevue, PHILIPPE LAFAILLE, operating under the names Dr. Philippe Lafaille MD., FRCPC and Clinique médicale Plateau Mont-Royal, D.S. ET J.C. CHAPLEAU O.O.D. INC., operating under the name Chapleau Laroche, LA VUE CAPITALE INC., operating under the name La Vue Capitale, BÉNÉDICTE MORISSE, operating under the name Cliniques d’optométrie en vue, HÉLÈNE MALTAIS, operating under the name Cliniques d’optométrie en vue, LAKESHORE OPHTALMOLOGIE, 9204-9204 QUÉBEC INC., operating under the name OPTIQUE Donnelly, CENTRE MÉDICAL FONTAINEBLEAU INC., operating under the name Centre médical Fontainebleau, PLACEMENTS OPTIBUI INC., operating under the name Clinique des yeux, INSTITUT DE LA RÉTINE DE MONTRÉAL INC., operating under the name Montreal Retina Institute, CLINIQUE D’OPHTALMOLOGIE LEBOURGNEUF, INSTITUT PRIVÉ DE CHIRURGIE INC., operating under the name Institut privé de chirurgie, CLINIQUE MÉDICALE PIERRE-BERTRAND, CLINIQUE MÉDICALE STE-ADÈLE INC., operating under the name Clinique médicale Sainte-Adèle, JACQUES GRÉGOIRE, operating under the name Dr. Jacques Grégoire, 9151-6062 QUÉBEC INC., operating under the name Œil Santé MD, JACQUES SALEM, operating under the names Jacques Salem M.D. and Centre médical Mira

Defendants


NOTICE TO MEMBERS
(sections 576 (2) and 579 C.C.P.)


  1. BE ADVISED that a class action was authorized on August 18, 2017, against the ATTORNEY GENERAL OF QUÉBEC, the RÉGIE DE L’ASSURANCE MALADIE DU QUÉBEC and the above-named medical clinics, physicians and optometrists, on behalf of all persons who are part of the following class:

    All persons who paid an amount, after having been invoiced, in excess of the cost price for drugs or anesthetic agents that were accessory to an insured service provided by a physician, an optometrist, or a medical clinic that was paid for by the RAMQ, between May 15, 2011, and January 26, 2017.

  2. The class action authorized by this judgment will be brought in the district of Montreal.

  3. The status of representative for this class action was attributed to PHILIPPE LÉVEILLÉ, who, for the purposes of this class action, has elected domicile at the offices of his attorneys GRENIER VERBAUWHEDE AVOCATS, 5215, rue Berri, bureau 102, Montréal (Québec) H2J 2S4.

  4. The following principal questions of fact and law will be collectively decided:

    • Were insured persons, within the meaning of the Health Insurance Act (“HIA”), required to pay the named defendant physicians, optometrists and medical clinics accessory fees to insured services, within the meaning of Article 3 HIA, in the form of drugs and anesthetic agents that were billed in excess of their cost price?

    • What interpretation should be given to the following sentences: “compensation for the cost of drugs and anesthetic agents that were administered” in the Manual for General Practitioners; “compensation for certain office expenses. These expenses include drugs and anesthetic agents” in the Manual for Medical Specialists, and “compensation for the cost of drugs and anesthetic agents administered in connection with an insured act” in the Manuel for Optometrists?

    • Do these sentences authorize physicians, optometrists and medical clinics to invoice insured persons for accessory fees that do not correspond to the cost price for drugs and anesthetic agents accessory to insured service, while indicating that the invoice covers these drugs and anesthetic agents?

    • Does this manner of invoicing represent a supplemental remuneration to the basic remuneration paid by the Régie de l’assurance maladie du Québec for an insured act? If so, is it a prohibited form of billing under the Health Insurance Act?

    • In this context, do the class members have the right to be reimbursed by the named defendant physicians, optometrists, or medical clinics for the amount that was illegally charged, plus the legal interest and the additional indemnity provided for in Article 1619 C.C.Q.?

    • In this context, did the Minister of Health and Social Services and the Régie de l’assurance maladie du Québec commit civil faults, rendering themselves liable to pay, jointly and severally, an amount equivalent to all of the fees illegally billed to the class members, plus the legal interest and the additional indemnity provided for in Article 1619 C.C.Q.?

    • If so, are the extracontractual obligation of the MHSS and the RAMQ, and the contractual obligation of the physicians, optometrists and medical clinics to reimburse the amount overcharged in solidum obligations?

  5. The following conclusions are sought in relation to these questions:

    • GRANT the class action against the defendants;

    • CONDEMN the physicians, optometrists and medical clinics named as defendants to provide restitution to their class-member patients for the amount illegally invoiced, with legal interest and the additional indemnity stipulated in Article 1619 C.C.Q., and ORDER the collective recovery of these sums;

    • CONDEMN the RAMQ and the MHSS to pay each class member a sum equivalent to the amount illegally invoiced by a physician, optometrist or medical clinic, with legal interest and the additional indemnity stipulated in Article 1619 C.C.Q., and ORDER the collective recovery of these sums;

    • DECLARE the obligation of restitution by the physicians, optometrists and medical clinics named as defendants, on the one hand, and the obligation of compensation by the RAMQ and the MHSS, on the other hand, as joint and several obligations;

    • ORDER the defendants, according to their liability, to deposit in the office of this Court the totality of the sums which form part of the collective recovery, with interest and the additional indemnity;

    • TAKE any other measure that the Court deems necessary to safeguard the rights of the parties;

    • THE WHOLE with costs, including expert and notice fees.

  6. The class action brought by the representative on behalf of the class members will be an action for reimbursement of the amounts invoiced for insured services to insured individuals by physicians, optometrists and medical clinics in excess of the cost price of drugs and anesthetics, as well as an action for civil liability of the Attorney General of Québec and the Régie de l’assurance maladie du Québec.

  7. Any class member who does not opt out in the manner hereinafter indicated shall be bound by any judgment to be rendered on the class action.

  8. The date after which a member can no longer opt out without special permission has been set as October 22, 2018.

  9. Any class member who has not already brought a suit in their own name may opt out of the class by advising the office of the Superior Court of the district of Montréal (1, rue Notre-Dame Est, Montréal, Québec H2Y 1B6) by registered or certified mail, before the time limit for opting out.

  10. Any class member who has brought a suit that would be decided by the final judgment on the class action is deemed to have opted out of the class if they do not discontinue their suit before the time limit for opting out.

  11. Any class member other than a representative or an intervener cannot be ordered to pay the costs of the class action.

  12. A member may voluntarily intervene in the class action only to assist the representative, support their suit, or defend their allegations. The Court may permit a member to intervene if it considers such intervention useful to the class. A party may not submit a member, other than the representative or an intervener, to an examination for discovery.

  13. More information can be found at www.surfacturation.ca or by contacting GRENIER VERBAUWHEDE AVOCATS at 514-866-5599, ext. 1.



The publication of this notice was ordered by the Superior Court.




5215, rue Berri, Bureau 102
Montréal (Québec) H2J 2S4
T. 514 866-5599 | F. 514 866-3151
info@surfacturation.ca