Additional Costs for Medical Procedures Covered by the RAMQ
On March 25, 2021, the Quebec Court of Appeal heard this case jointly with the Léveillé matter, in a dispute regarding the Superior Court’s jurisdiction to hear the class action. In a judgment (French only) rendered on April 23, 2021, the appeal on the declinatory exception was dismissed with respect to all parties except the RAMQ. The class action therefore moved forward to the authorization stage.
On December 7, 2022, the Superior Court authorized the class action.
On April 23, 2023, the Court of Appeal refused leave to appeal of the authorization judgment. The class action therefore proceeds.
The members of this class action include all those who paid for a procedure covered by the RAMQ. The costs covered by the Léveillé recourse are not included in this recourse.
Are you a member?
You are covered by this class action if:
– You paid fees, directly or indirectly, to a physician or an optometrist for a procedure covered by an agreement with the RAMQ (excluding private clinics); AND
– The fees claimed were greater than the cost price explicitly allowed by the agreement with the RAMQ.
Summary of the class action
The plaintiffs allege that medical and optometry clinics illegally billed for procedures that are covered by an agreement with the public health insurance plan (RAMQ) under the Health Insurance Act (HIA). The plaintiffs are also bringing the action against the various professional orders of physicians and optometrists who negotiated the agreements with RAMQ but then encouraged their members to bill additional fees. The plaintiffs are also suing the Government of Quebec because it knew about this illicit practice for years and encouraged it through its inaction.
The HIA strictly prohibits extra-billing, including the billing of accessory fees, since its purpose is to ensure that the health system is free of charge to the public. Because the defendants charged fees that were beyond the cost price of certain supplies for which billing is permitted, their activities were unlawful.
The plaintiffs seek to put an end to this harmful practice on behalf of the Quebec public and obtain a just compensation for the fees that were illegally collected, as well as punitive damages in certain cases.
The members are jointly represented by TJL and Grenier Verbauwhede Avocats.