Medical Services Commission

The Medical Services Commission manages the Medical Services Plan (MSP) on behalf of the Government of British Columbia in accordance with the Medicare Protection Act and Regulations.

The commission is a nine-member statutory body made up of three representatives from government, three representatives from the Doctors of BC and three members from the public. The public members are nominated by the Doctors of BC and government to represent MSP beneficiaries. This unique partnership ensures government, doctors and B.C. residents all have a voice in the administration of MSP. Current members of the commission are listed in the Directory of Agencies on the Crown Agencies and Board Resourcing Office web site.

• Crown Agencies and Board Resourcing Office

Mandate

To facilitate reasonable access throughout B.C. to quality medical care, health care and diagnostic facility services for B.C. residents under the Medical Services Plan.

Responsibilities

The responsibilities of the Medical Services Commission are two-fold: to ensure that all B.C. residents have reasonable access to medical care; and to manage the provision and payment of medical services in an effective and cost-efficient manner.

The commission oversees a budget of more than $2.5 billion. About 99 per cent of these funds go directly for payment of medical and supplementary health-care services insured under the Medical Services Plan (MSP). The other one per cent covers administrative and operational costs of MSP, including salaries of MSP employees.

Committees

A number of committees assist the Medical Services Commission in the management of the Medical Services Plan. Recommendations of advisory committees are not binding; the commission retains the authority to make final decisions. Learn more about each of these committees and how they assist the commission.

• Committees

Medical Practitioners

The Medical Services Commission is authorized to assess the billing and payment of claims to medical practitioners in order to manage expenditures for medical benefits on behalf of Medical Services Plan (MSP) beneficiaries.

The Billing Integrity Program audits and investigates billing patterns and practices of medical practitioners to detect and deter inappropriate and incorrect billing of MSP claims

Each audit results in the submission of a detailed report to the Audit and Inspection Committee. Subsequently, the Audit and Inspection Committee makes recommendation to the Medical Services Commission to assist the commission in determining if recovery should be pursued. Practitioners have a right to be heard before the commission makes a determination.

A hearing is held before a panel of three or more persons who are appointed by the Medical Services Commission to represent the Doctors of BC, beneficiaries and government. A panel has authority to make an order for recovery of money and other remedies. The hearing affords the practitioner a fair process, adhering to the rules of natural justice.

• Panel Decisions and Reasons

Alternative Dispute Resolution Process

A discretionary alternative dispute resolution process allows the Medical Services Commission and practitioner the opportunity to reach a negotiated settlement. The alternative dispute resolution process can employ the use of a mediator for negotiation. In this way, a co-operative rather than adversarial process can be used to reach a fair and appropriate settlement reflective of particular circumstances.

Publications

To view Medical Services Commission publications, including the annual report, financial statement and audit reports please visit the Medical Services Plan Practitioner and Professional Resources page at www.gov.bc.ca/msppublications.