Inspections | The RAMQ loses a round against medical specialists

2023-08-05 02:07:46

Ten doctors from Roberval and Alma, in Saguenay–Lac-Saint-Jean, have won a round in the legal saga opposing them to an inspector from the Régie de l’assurance maladie du Québec (RAMQ). At issue in this victory, the RAMQ inspection protocol.


These ten medical specialists linked to two clinics in Saguenay–Lac-Saint-Jean have been accused of having violated a law on signage, according to a judgment rendered by the Court of Quebec on July 7.

In one of the clinics, the costs that might be claimed from an insured person were not displayed in the waiting room.

In the second clinic, it was not clearly indicated that a patient might claim reimbursement of costs.

Under the Health Insurance Act, each physician was fined $2,500 plus costs ($3,750). But according to them, the way the inspection was carried out did not respect their fundamental rights, such as the right to silence, to a lawyer or to privacy.

The doctors therefore asked that the evidence once morest them, that is to say the testimony of the RAMQ inspector, be withdrawn. Judge Pierre Lortie, of the Court of Quebec, finally agreed with them.

Inspect or investigate?

This judgment calls into question the way the RAMQ conducts its inspections, which can lead to criminal proceedings. However, on this subject, there is case law in Canada.

In fact, by presenting herself as an inspector, the RAMQ employee was forcing doctors to cooperate in a reasonable manner. Only one of the ten doctors signed a notice in which she did not exercise her right to a lawyer. However, subsequent prosecutions are indeed conducted by the Director of Criminal and Penal Prosecutions (DPCP).

According to Justice Lortie, “it appears from the evidence that the predominant purpose of the visits to the two clinics was to gather evidence for a possible criminal prosecution”. In the circumstances, the inspector’s approach did not respect certain rights.

Judge Lortie noted the vagueness between an inspection which allows the collection of evidence leading to prosecution, and a search. However, a search cannot be carried out without a warrant, “unless the person in charge of the premises [y] consent or if there is an emergency,” he recalls.

The judge also observed the lack of training or sufficient knowledge on the part of the inspector in legal matters or the Canadian Charter of Rights and Freedoms.

If he rejects the evidence (that is to say the testimony of the inspector), Judge Lortie nevertheless considers that a decision must be rendered on the merits of the case.

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