"It's now up to the government to act and decide whether it will cover the cost of certain services and the use of medical equipment in private practice, or if it wants to revise the agreement on the accessory fees with the medical federations."
Under the Quebec Health and Social Services Act, doctors who work in hospitals cannot bill patients for medically necessary services. These same physicians must abide by certain conditions in their private practice, since they have not opted out of medicare.
They can only charge for "medications and anesthesia agents" in private, and they are not allowed to bill patients for the use of medical equipment. However, there is one exception to the rule: private radiology clinics in Quebec can bill patients for MRI scans - a sore point with Health Canada, which has argued that the exception violates the accessibility provisions of the Canada Health Act.
In addition, Quebec did negotiate with the medical federations a list of fees that are permitted, such as the use of liquid nitrogen to remove moles ($10) or the use of a topical anesthetic for a minor eye wound (also $10). Over the years, many physicians in private practice have started billing for many more items and services, sometimes prompting investigations by the Régie de l'assurance maladie du Québec (RAMQ).