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HEALTH INSURANCE, GOVERNMENT - Administration of provincial insurance plan

Wednesday, October 16, 2019 @ 2:58 AM  


Appeal by the Pacific Centre for Reproductive Medicine (PCRM) from a judicial review judgment affirming a decision by the Medical Services Commission. The appellant was a private medical clinic providing reproductive, endocrinology and fertility services. Its services included ultrasounds for women experiencing high-risk pregnancies. The appellant applied to the Commission for approval as a diagnostic facility to bill the Medical Services Plan (MSP) for the ultrasounds. The Commission denied the application, citing the mandatory language of the Medical and Health Care Services Regulation requiring refusal of approval unless the criteria were met. The Commission concluded that the appellant failed to establish unmet medical need for its services, acceptable quality, or that it avoided potential conflicts of interest. The Commission expressed additional concerns regarding sustainability of public services and the impact on technician shortages. The appellant sought judicial review and submitted the Commission failed to exercise its statutory powers in a manner consistent with Charter values promoting timely health care in accordance with s. 7. The reviewing court found an inadequate record to address the Charter issue, as no natural person sought relief based on a s. 7 deprivation. The Commission's findings regarding the approval criteria were reasonable. PCRM appealed.

HELD: Appeal dismissed. The appellant failed to establish that the reviewing court failed to give adequate reasons. The Commissions' decision on the issue of medical need was reasonable and supported by evidence. No misapprehension of the evidence occurred, and there was nothing arbitrary about the decision-making process. It was not the role of the Court to reweigh the evidence and come to a different conclusion. The Commission's decision reflected a reasonable balancing of the competing demands on the system, undertaken within the expertise and prerogative of the Commission. While it was not strictly necessary to consider the Commission's decision on the remaining criteria, those conclusions were also acceptable and rational based on the evidentiary record. Although the Commission's decision was discretionary in nature, given the insufficient evidentiary basis to establish a breach of s. 7 Charter rights, it was not unreasonable for the Commission to decline to consider the issue.

Pacific Centre for Reproductive Medicine v. British Columbia (Medical Services Commission), [2019] B.C.J. No. 1701, British Columbia Court of Appeal, S.D. Frankel, N.J. Garson and G. Dickson JJ.A., September 11, 2019. Digest No. TLD-October142019004