Inspections | The RAMQ loses a round against Medical Specialists

Ten doctors from Roberval and Alma in Saguenay-Lac-Saint-Jean have won a round in the legal saga pitting them against an inspector from the Régie de l’assurance maladie du Québec (RAMQ). This win was about the RAMQ inspection protocol.

Those 10 specialists, who are linked to two clinics in Saguenay-Lac-Saint-Jean, were accused of violating a signage law, according to a July 7 judgment by the Quebec court.

In one of the clinics, the costs that could be claimed by an insured person were not posted in the waiting room.

In the second clinic, it was not clearly stated that a patient might be entitled to reimbursement.

Under the Health Insurance Act, Each doctor was fined $2,500 plus expenses ($3,750). In her view, however, the way the inspection was conducted did not respect her fundamental rights such as the right to silence, to a lawyer or to privacy.

The doctors therefore demanded that the evidence against them, i.e. the testimony of the RAMQ inspector, be withdrawn. Judge Pierre Lortie of the Quebec Court eventually agreed with them.

Inspect or investigate?

This ruling calls into question the way the RAMQ conducts its inspections, which could result in criminal prosecution. However, there is case law on this subject in Canada.

In fact, the RAMQ employee forced the doctors to cooperate appropriately by posing as an inspector. Only one of the 10 doctors signed a statement refusing to exercise her right to an attorney. However, subsequent prosecutions are actually conducted by the Director of Criminal and Penal Prosecutions (DPCP).

According to Judge Lortie, “The evidence indicates that the primary purpose of the visits to the two clinics was to gather evidence for possible prosecution.” In these circumstances, the inspector’s actions failed to respect certain rights.

Judge Lortie points to the ambiguity between an inspection, which allows for the collection of evidence leading to prosecution, and a search. However, a search cannot be carried out without a search warrant, “unless the person responsible for the premises [y] consent or if there is an emergency,” he recalls.

The judge also found that the inspector lacked training or sufficient knowledge of legal matters or the Canadian Charter of Rights and Freedoms.

In dismissing the evidence (that is, the inspector’s testimony), Judge Lortie still believes a decision must be made on the matter.

Jordan Johnson

Award-winning entrepreneur. Baconaholic. Food advocate. Wannabe beer maven. Twitter ninja.

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