Definition

1   In this regulation:

"Act" means the Medicare Protection Act;

"contact information" has the same meaning as in Schedule 1 of the Freedom of Information and Protection of Privacy Act.

Prescribed information for section 49 (2) (b) (i) of the Act

2   (1) Subject to subsection (2), the following information is prescribed for the purposes of section 49 (2) (b) (i) of the Act:

(a) whether a hearing is scheduled and, if so, when it is scheduled;

(b) whether the hearing is under way and the number of days remaining for which it has been scheduled;

(c) whether the matter that resulted in the hearing has been settled or discontinued and whether the hearing has concluded or been discontinued, dismissed or adjourned;

(d) the order or a copy of the order made by the commission in relation to the hearing;

(e) subject to subsection (3), the reasons or a copy of the reasons given by the commission for the order referred to in paragraph (d).

(2) Subsection (1) applies only in relation to a hearing that results from one or more of any of the following:

(a) an audit of claims for payment by a practitioner or of patterns of billing followed by a practitioner, to determine compliance with section 17 of the Act;

(b) an audit referred to in section 36 (2) (b) or (c) of the Act;

(c) an inspection in respect of an audit referred to in paragraph (a) or (b).

(3) If the reasons referred to in subsection (1) (e) include

(a) the name, personal health number or contact information of a beneficiary, or

(b) the name or contact information of a practitioner who is not the subject of the hearing,

the prescribed information is the reasons or a copy of the reasons without that information.

Prescribed information for section 49 (2) (b) (ii) of the Act

3   (1) Subject to subsection (2), the following information is prescribed for the purposes of section 49 (2) (b) (ii) of the Act:

(a) whether the commission has considered the information provided by the person;

(b) if the commission has considered the information provided by the person, the determination of the commission about whether an audit or inspection will occur;

(c) when the audit or inspection is scheduled to begin or whether one or both are under way or have concluded or been abandoned;

(d) if an audit or inspection has concluded, whether the report referred to in section 36 (11) of the Act has been made;

(e) a copy of the report under section 36 (11).

(2) Subsection (1) applies only in relation to the following:

(a) an audit of claims for payment by a practitioner or of patterns of billing followed by a practitioner, to determine compliance with section 17 of the Act;

(b) an audit referred to in section 36 (2) (b) or (c) of the Act;

(c) an inspection in respect of an audit referred to in paragraph (a) or (b).

(3) If the report referred to in subsection (1) (e) includes

(a) the name, personal health number or contact information of a beneficiary, or

(b) the name or contact information of a practitioner who is not the subject of the audit,

the prescribed information is a copy of the report without that information.

Prescribed information for section 49 (2) (b) (iii) of the Act

4   For the purposes of section 49 (2) (b) (iii) of the Act, the following information is prescribed:

(a) that an application for an injunction has been made to the Supreme Court under section 45.1 of the Act, the court registry in which the application has been filed and the court file number;

(b) the date scheduled for hearing of the application;

(c) the court order or a copy of the court order resulting from the application.

Prescribed information for section 49 (2) (c) of the Act

5   (1) For the purposes of section 49 (2) (c) of the Act, the following information is prescribed:

(a) subject to subsection (2), in the case of a hearing under section 15 (2) or 37 (1) of the Act,

(i) whether a hearing is scheduled and, if so, when it is scheduled;

(ii) whether the hearing is under way and the number of days remaining for which it has been scheduled;

(iii) whether the matter that resulted in the hearing has been settled or discontinued and whether the hearing has concluded, or been discontinued, dismissed or adjourned;

(iv) the order or a copy of the order made by the commission in relation to the hearing;

(v) subject to subsection (4), the reasons or a copy of the reasons given by the commission for the order referred to in subparagraph (iv);

(b) subject to subsection (3), in the case of an audit under section 36 of the Act,

(i) when the audit or inspection is scheduled to begin or whether one or both are under way or have concluded or been abandoned;

(ii) if the audit or inspection has concluded, whether the report referred to in section 36 (11) of the Act has been made;

(iii) a copy of the report made under section 36 (11) of the Act;

(c) in the case of an application for an injunction,

(i) that an application for an injunction has been made to the Supreme Court under section 45.1 of the Act, the court registry in which the application has been filed and the court file number;

(ii) the date scheduled for hearing of the application;

(iii) the court order or a copy of the court order resulting from the application.

(2) Subsection (1) (a) applies only to a hearing that results from one or more of any of the following:

(a) an audit of claims for payment by a practitioner or of patterns of billing followed by a practitioner, to determine compliance with section 17 of the Act;

(b) an audit referred to in section 36 (2) (b) or (c) of the Act;

(c) an inspection in respect of an audit referred to in paragraph (a) or (b).

(3) Subsection (1) (b) applies only to the following:

(a) an audit of claims for payment by a practitioner or of patterns of billing followed by a practitioner, to determine compliance with section 17 of the Act;

(b) an audit referred to in section 36 (2) (b) or (c) of the Act;

(c) an inspection in respect of an audit referred to in paragraph (a) or (b).

(4) If the reasons referred to in subsection (1) (a) (v) include

(a) the name, personal health number or contact information of a beneficiary, or

(b) the name or contact information of a practitioner who is not the subject of the hearing,

the prescribed information is the reasons or a copy of the reasons without that information.

(5) If the report referred to in subsection (1) (b) (ii) includes

(a) the name, personal health number or contact information of a beneficiary, or

(b) the name or contact information of a practitioner who is not the subject of the audit,

the prescribed information is a copy of the report without that information.