The Medical Services Commission on Thursday applied for an injunction to stop Telus’s LifePlus program from charging membership fees to patients in return for preferential 24/7 access to a health-care practitioner.
In February, B.C. Health Minister Adrian Dix asked the commission, which oversees the Medical Services Plan, to review private fee-based services offered by Telus Health Care Centres to ensure there’s no queue-jumping for patients who pay the fee, which isn’t allowed under the Canada Health Act.
Dix said he received complaints from the public “alleging illegal extra billing at these LifePlus clinics.”
The commission, an independent body, completed its investigation in the summer and on Thursday applied to the B.C. Supreme Court for an injunction against Telus Health, specifically, Telus’s LifePlus program, alleging contraventions of the Medicare Protection Act.
“It’s very important to uphold the Medicare Protection Act,” Dix said in a media availability on Thursday. “Access to necessary medical care should be based by needs and not on an individual’s ability to pay.”
The act establishes rules regarding billing for services provided by MSP-enrolled physicians, and section 17 prohibits charging for a medical service covered under MSP. Charging in violation of this section is called extra billing.
Court documents filed by the Medical Services Commission Thursday petition the court to declare that Telus Health is in breach of section 17, and to stop Telus Health through its MSP-enrolled physicians from offering and advertising benefits that can be obtained free of charge through Telus Health.
The injunction also seeks to stop Telus Health from charging pre-existing patients of an enrolled physician later associated with Telus Health for continuing that care.
The injunction “solely” relates to Telus’s LifePlus program and the membership fees charged under that program, and does not touch on Telus Health’s “significant role” in delivering virtual healthcare services, said Dix in a media availability.
The commission will argue its case in court in the coming weeks while the government continues to defend the public health care system, he said.
As part of its investigation, the commission asked the Health Ministry’s audit and investigations branch to analyze available data for contraventions of the act.
Mark Winston, 72, is cited in one of several affidavits as a retired university professor who was under the care of Vancouver physician Geoffrey Edwards for 14 years prior to Edwards leaving his practice to join Telus Health. Winston says in an affidavit that he was told he would need to pay the fee to become a LifePlus member to continue receiving care under Edwards.
At no time was Winston told he could continue to receive primary care through Edwards without paying a fee, say the court documents. “The implication was the exact opposite: the only way to keep Dr. Edwards as a family doctor was for Mr. Winston to pay thousands of dollars to join LifePlus,” according to the affidavit.
Winston did not pay and “had no family doctor,” which investigators for the commission say was the case for more than 93 per cent of Edwards’ 1,430 patients. Of the 87 who followed Edwards to the Telus LifePlus program, the vast majority, 68, paid the membership fee, according to the court documents.
The audit and investigations branch determined Telus’s LifePlus members appear to be getting disproportionate and potentially preferential access to MSP-insured services by virtue of their membership in LifePlus.
Telus’s LifePlus package — which costs about $4,650 in the first year and $3,650 for subsequent years — originally offered a team of clinicians, assistance with urgent needs, timely referrals to specialists, and other concierge-type services, although court documents claim the wording of Telus Health’s website has changed since contact with the commission.
Telus Health Care Centres and other fee-based services have drawn criticism that they’re creating a two-tier health-care system. The commission has also been asked to look into physicians in the province charging patients a fee for similar packages that offer fast-track physician access and diagnostic tests.
According to court documents filed by the commission, Telus Health maintains its fees for LifePlus are solely for uninsured preventative services and its members receive equal access to MSP-insured services. Telus Health says it has not contravened the act.
In a statement to the Times Colonist, Telus Health said it has “fully collaborated” with requests for information from the Medical Services Commission regarding its LifePlus program since February, and made “every effort” to engage with members to ensure it is in compliance with all applicable laws.
“Despite our numerous good-faith efforts in this regard, we have not been granted an audience with representatives of the Commission, and we are not aware of any basis for bringing an injunction application. We believe that doing so is unnecessary given our fully cooperative approach and commitment to ensuring regulatory compliance.”
B.C. Green leader Sonia Furstenau, MLA for Cowichan Valley, questioned why the Medical Services Commission investigation results were not previously made public.
“While a million British Columbians go without a family doctor, and our emergency wards are full of sick children, Telus Health has quietly been charging thousands of dollars per year for access to primary healthcare,” she said in a statement. “We have persistently raised this issue with the minister and are relieved that action has finally been taken, but why has it taken so long?”
Dix said Thursday that the commission took time to investigate, talk with Telus, assess the situation and then take action.
“They took the time necessary to make what they believe as an independent commission is the right decision and now it’s a matter that will be before the courts,” said Dix.
In 2018, the province introduced new protections for patients to prevent extra billing, clarified rules around extra billing for medical practitioners and established consequences for those who break the rules, according to the Health Ministry.