18 April 2012 Government Notices

NO. 289

THE LIQUOR LICENCE ACT, 1974

NOTICE OF HEARING

TAKE NOTICE of a Special Session of The Liquor Licensing Authority for the Central District on the 28th day of May, 2012 at 9:15 a.m. at Hamilton Magistrates’ Court No. 1, to hear the application of Alan Brooks for the grant of a Members’ Club Licence in respect of Bermuda Music and Dramatic Society  located at Corner of Dundonald Street and Park Road, Hamilton.

The Manager of the Business is Bermuda Music and Dramatic Society.

Any person ordinarily resident in the Parish or any owner or occupier of any property lying within three hundred yards of the premises in respect of which this application is made may object to the grant of the license provided written notice containing, in general terms, the grounds of the objection is served on The Chairman of The Liquor Licensing Authority, The Commissioner of Police and The Applicant not less than three days before the hearing.

Wor. Archibald Warner

Chairman

Liquor Licensing Authority

NO. 290

THE LIQUOR LICENCE ACT, 1974

NOTICE OF HEARING

TAKE NOTICE of a Special Session of The Liquor Licensing Authority for the Eastern District on the 28th day of May, 2012 at 9:15 a.m. at Hamilton Magistrates’ Court No. 1, to hear the application of White Horse Pub & Restaurant for the grant of a Restaurant Licence in respect of White Horse Pub & Restaurant located at 8 Kings Square, St. George’s GE 05.

The Managers of the Business are Kevin Sousa, Daniel Melnyk, Jermaine Burgess and Jeff Schweiger.

Any person ordinarily resident in the Parish or any owner or occupier of any property lying within three hundred yards of the premises in respect of which this application is made may object to the grant of the license provided written notice containing, in general terms, the grounds of the objection is served on The Chairman of The Liquor Licensing Authority, The Commissioner of Police and The Applicant not less than three days before the hearing.

Wor. Archibald Warner

Chairman

Liquor Licensing Authority

NO. 291

ACTING APPOINTMENT

Judicial Department

His Excellency The Governor, after consultation with the Chief Justice, has approved the appointment of Mr. Peter Miller, Assistant Registrar to act as Registrar for the period 23rd April to 9th May 2012.

Dated this 30th  day of  March 2012

Signed

DEPUTY GOVERNOR

No. 292

ACTING APPOINTMENT 

DEPARTMENT OF CIVIL AVIATION

DIRECTOR OF CIVIL AVIATION

Mr. Christopher Pearce (Operations Registrations Officer) has been appointed to act as Director of Civil Aviation from Tuesday, 17th April to Tuesday, 24th April, 2012.

Donald Scott

Secretary to the Cabinet 

No. 293

ACTING APPOINTMENT 

DEPARTMENT OF CIVIL AVIATION

DIRECTOR OF CIVIL AVIATION

Mr. Peter Adhemar (Head of Operations) has been appointed to act as Director of Civil Aviation from Saturday, 12th May to Thursday, 17th May, 2012.

Donald Scott

Head of Civil Service

NO. 294

THE ASSENT OF THE GOVERNOR WAS GIVEN ON THE 27TH DAY OF MARCH 2012 TO THE FOLLOWING:

Bermuda Monetary AuthorityAmendment Bill Act 2012

Customs Tariff Amendment Bill 2012

 Government Loans Amendment Bill 2012

 Land Tax Amendment Bill 2012

Public Holidays Amendment Bill 2012

Public Service Superannuation Amendment Bill 2012

Public Service Superannuation Temporary Amendment Bill 2012; and

Stamp Duties Amendment Bill 2012

NO. 295

THE ASSENT OF THE GOVERNOR WAS GIVEN ON  THE 30TH DAY OF MARCH 2012 TO THE FOLLOWING:

Appropriation Bill 2012;

Bermuda Hospitals Board Amendment Bill 2012;

Health Insurance Amendment Bill 2012; and

Miscellaneous Taxes Amendment Bill 2012

NO. 296

CLEAN AIR ACT

NOTICE OF INTENTION TO

CONSTRUCT A CONTROLLED PLANT

Pursuant to Part II of the Clean Air Rules 1993, application has been made to the Environmental Authority for a permit to construct a controlled plant as follows:

NAME OF APPLICANT

Tia Andrew

ADDRESS OF THE PROPOSED

CONTROLLED PLANT

16 Commonland Point

Hamilton Parish  FL 04

DESCRIPTION OF PROPOSED

CONTROLLED PLANT

One 6.12 kW photovoltaic electricity generator

This application is available for inspection at the Department of Environmental Protection during normal working hours.  Any person wishing to object to the proposed plant may, within 14 days of the date of this publication, lodge their objection with the Department of Environmental Protection, 169 South Road, Paget DV 04.  Letters of objection must state the name and address of the objector; the grounds of the objection; whether the objector has an interest in land near to that which the application relates; and be signed by the objector.

DATE:  12 April 2012

NO. 297

THE LIQUOR LICENCE ACT, 1974

NOTICE OF HEARING

TAKE NOTICE of a Special Session of The Liquor Licensing Authority for the Western District on the 28th day of May, 2012 at 9:15 a.m. at Hamilton Magistrates’ Court No. 1, to hear the application of Riddell’s Bay Golf & Country Club for the grant of a Restaurant Licence in respect of Riddell’s Bay Golf & Country Club Ltd. located at #26 Riddell’s Bay Road, Warwick WK 04.

The Manager of the Business is Dennis L. Paul.

Any person ordinarily resident in the Parish or any owner or occupier of any property lying within three hundred yards of the premises in respect of which this application is made may object to the grant of the license provided written notice containing, in general terms, the grounds of the objection is served on The Chairman of The Liquor Licensing Authority, The Commissioner of Police and The Applicant not less than three days before the hearing.

Wor. Archibald Warner

Chairman

Liquor Licensing Authority

NO. 298

BERMUDA

PROTECTED SPECIES (DELEGATION OF POWERS) NOTICE 2012

The Minister responsible for conservation services, in exercise of the powers conferred by section 27(1) of the Interpretation Act 1951, issues the following Notice:

Citation

1This Notice may be cited as the Protected Species (Delegation of Powers) Notice 2012.

Delegation of Powers

2The Minister responsible for conservation services hereby authorises and deputes the Director of the Department of Conservation Services to exercise on his behalf the power to issue licences and permits under sections 8 and 8A of the Protected Species Act 2003.

Made this 9th day of Feb 2012

Minister of Public Works

NO. 299

ACTING APPOINTMENT

MINISTRY OF YOUTH, FAMILIES AND SPORTS

PERMANENT SECRETARY

Mr. Kevin Monkman, Permanent Secretary, Ministry of Health, has been appointed to act as Permanent Secretary, Ministry of Youth, Families and Sports from 16th April 2012 to 20th April 2012, inclusive.

Donald Scott

Head of the Civil Service

NO. 300

WHEREAS, CORNELIA MANAGEMENT LTD. was put in Voluntary Winding-Up effective 30 December 2010 pursuant to the Companies Act 1981.

I, The Registrar of Companies, HEREBY GIVE NOTICE to all concerned that CORNELLA MANAGEMENT LTD. has been restored to the Register and as such is deemed to have continued in existence as if its named had never been in Voluntary Winding-Up pursuant to the Companies Act 1981.

Stephen Lowe

REGISTRAR OF COMPANIES

16 April 2012

BERMUDA

PUBLIC SERVICE (DELEGATION OF POWERS) AMENDMENT REGULATIONS

2012

BR 27/ 2012

The Governor, in exercise of the power conferred by section 83(1) of the Constitution of Bermuda, acting in accordance with the recommendation of the Public Service Commission, makes the following Regulations:

Citation

1These Regulations may be cited as the Public Service (Delegation of Powers) Amendment Regulations 2012.

Amends Schedule

2The Schedule to the Public Service (Delegation of Powers) Regulations 2001 is amended by, immediately after paragraph 13, inserting the following—

“

”.

Made this 27th day of March 2012

Governor

BERMUDA

HEALTH INSURANCE (HEALTH SERVICE PROVIDERS AND INSURERS)

(CLAIMS) REGULATIONS 2012

BR 28/ 2012

TABLE OF CONTENTS

PART 1

PRELIMINARY

1Citation

1Interpretation 

PART 2

DUTY OF HEALTH SERVICE PROVIDER

3Prohibition against requiring payment of insured portion

4Submitting a claim

5Health service provider may apply to require payment of insured portion

PART 3

DUTY OF INSURER

6Information to health service providers

7Notice of receipt of a claim

8Notice of a defective claim

9Time for paying a claim

10Application to vary time to pay claims

11Insurer not required to pay expired claim

PART 4

DUTY OF COUNCIL

12Council may impose penalty on health service provider

13Council may impose penalty on insurer

14Council to pay penalty into Consolidated Fund

PART 5

FINAL PROVISIONS

15Transitional

16Commencement

SCHEDULE 1

Data to be Submitted with a Claim

SCHEDULE 2

Information to be Provided by an Insurer

The Minister responsible for health, in exercise of the powers conferred by section 40 of the Health Insurance Act 1970, makes the following Regulations:

PART 1

PRELIMINARY

Citation

1These Regulations may be cited as the Health Insurance (Health Service Providers and Insurers) (Claims) Regulations 2012.

Interpretation

2In these Regulations—

“the Act” means the Health Insurance Act 1970;

“claim” means an electronic claim, unless indicated otherwise;

“clean claim” means a claim submitted by a health service provider which contains the required data and material information which enables an insurer to pay the claim;

“data” means the data referred to in paragraph 4(1)(b) and Schedule 1;

“defective claim” means a claim submitted by a health service provider which is not a clean claim;

“electronic means” means—

(a)an “electronic record” as defined under section 2 of the Electronic Transactions Act 1999;

(b)an electronic data interchange;

“expired claim” has the meaning given in paragraph 11(2);

“health professional” means a person who is registered to practice his or her health profession by the relevant regulatory authority;

“health service provider” means a person, group of persons, or organization that operates a business in Bermuda offering health services to the public, but does not include a person who is an employee under a contract of service;

“insured portion” means that part of the cost of a procedure which is eligible for payment by a person’s insurer;

“insurer” means an insurer licensed under section 28 of the Act, and includes the Committee and an employer who operates an approved scheme pursuant to section 26 of the Act;

“notice” means a notice issued by electronic means, unless indicated otherwise;

“procedure” means any clinical service provided by a registered health professional.

PART 2

DUTY OF HEALTH SERVICE PROVIDER

Prohibition against requiring payment of insured portion

3(1)If a person is insured for a procedure—

(a)a health service provider must not require the person to pay the insured portion of a procedure unless the Council has granted the provider permission to do so pursuant to paragraph 5(5) or paragraph 10(4)(e);

(b)a health service provider must not require the person to pay the insured portion of a procedure where the claim has expired.

(2)A person who is insured may notify the Council in writing where he believes a health service provider has contravened subparagraph (1).

Submitting a claim

4(1)A health service provider must submit a claim, whether electronic or paperbased, to an insurer—

(a)no later than thirty days from the date on which the procedure was completed; and

(b)which contains all the data referred to in Schedule 1.

(2)Where, after submitting a claim, a health service provider receives a notice from an insurer that the claim is defective, he must submit the data or information required by the insurer under paragraph 8(2)(b) no later than seven days from the date of the notice of a defective claim.

Health service provider may apply to require payment of insured portion

5(1)A health service provider may apply to the Council for permission to require payment by an insured person of the insured portion of a procedure.

(2)The Council shall not accept an application under subparagraph (1) where—

(a)the insurer has made an application under paragraph 10(1) and—

(i)the Council has granted the application; or

(ii)the application has not as yet been determined by the Council; or

(b)the insurer agrees to make an application under paragraph 10(1).

(3)When making an application under subparagraph (1), the health service provider—

(a)must provide evidence that, with respect to at least five percent of claims submitted to the insurer over a period of three months—

(i)the insurer has failed to pay clean claims by the time prescribed under paragraph 9(1); or

(ii)the insurer has failed to pay clean claims by the time directed by the Council pursuant to paragraph 10(3)(a); and

(b)must provide any documentation or answer any questions which the Council may consider relevant to the application.

(4)The Council may also require the insurer to provide any documentation or to answer any questions which it may consider relevant, including whether the insurer intends to apply to the Council under paragraph 10(1) to vary the time requirement.

(5)In granting permission, the Council—

(a)must specify the period within which the permission has effect; and

(b)may impose such terms and conditions as it deems fit.

PART 3

DUTY OF INSURER

Information to health service providers

6An insurer must provide the following information to a health service provider at the time of the procedure—

(a)the name, date of birth, and address of—

(i)the person who is the policyholder; and

(ii)any other persons who are insured under the policy;

(b)the policy and group numbers of persons who are insured under the policy;

(c)procedures covered by the insurer; and

(d)the amount of the insured portion of the procedure which is eligible for payment by the insurer.

Notice of receipt of a claim

7When an insurer receives a claim, he must notify the health service provider of receipt of the claim by the following day.

Notice of a defective claim

8(1)Where a claim is defective, the insurer must notify the health service provider that the claim is defective no later than seven days from the date of the notice of receipt of the claim.

(2)The notice of a defective claim must contain the following—

(a)a statement explaining the omission or defect which prevents payment of the claim;

(b)the data or material information required to complete the claim or to correct the defect; and

(c)the information required under Schedule 2.

(3)On the date an insurer receives the data or information required to complete or correct a defective claim, the defective claim becomes a clean claim.

Time for paying a claim

9(1)An insurer must pay a clean claim no later than—

(a)thirty days from the date of the notice of receipt of the claim, where the claim was submitted by the time prescribed under paragraph 4(1)(a); or

(b)ninety days from the date of the notice of receipt of the claim, where the claim was submitted after the time prescribed under paragraph 4(1)(a), provided the claim has not expired.

(2)The date of payment is the date of the instrument of payment.

(3)Upon payment of a claim, the insurer must also provide an explanation of benefits to which the claim relates.

Application to vary time to pay claims

10(1)An insurer who is unable to pay claims by the time prescribed under paragraph 9(1) may apply to the Council for permission to vary the time requirement.

(2)In determining an application, the Council may require the insurer to provide any documentation or to answer any questions which the Council may consider relevant.

(3)Where permission is granted, the Council—

(a)shall direct the insurer to comply with paragraph 9(1), by the time as varied by the Council;

(b)may impose terms and conditions as it deems fit; and

(c)shall specify the time period within which the permission has effect.

(4)The Council shall notify health service providers—

(a)of the name of the insurer who has been granted permission under subparagraph (3);

(b)of the time in respect of paragraph 9(1) with which the insurer must comply;

(c)of the time period within which the permission has effect;

(d)of any terms and conditions imposed on the insurer, if the Council deems fit; and

(e)that health service providers may require payment by an insured person of the insured portion of a procedure while the permission is in effect.

Insurer not required to pay expired claim

11(1)An insurer is not required to pay the following—

(a)an expired claim, whether or not it is a clean claim;

(b)a defective claim, where data or information required to complete or correct the claim is submitted 366 days or more from the date the procedure was completed.

(2)In these Regulations “expired claim” means a claim received by an insurer 366 days or more from the date the procedure was completed, and includes a defective claim to which subparagraph (1)(b) applies.

PART 4

DUTY OF COUNCIL

Council may impose penalty on health service provider

12(1)The Council may impose a penalty on a health service provider in the amount of $500 for each contravention, where the Council has determined that a health service provider required an insured person to pay the insured portion of a procedure—

(a)in contravention of paragraph 3(1);

(b)in contravention of any permission granted under paragraph 5(5).

(2)Where a penalty is unpaid the Council—

(a)shall not register a health service provider under any regulations made under the Bermuda Health Council Act 2004, until such amount is paid; and

(b)may recover the amount as a civil debt in a court of summary jurisdiction.

(3)A health service provider who is aggrieved by the determination of the Council may appeal to the Supreme Court.

Council may impose penalty on insurer

13(1)The Council may impose a penalty on an insurer in the amount of $500 for each contravention, where the Council has determined that the insurer—

(a)failed to pay a claim by the time prescribed under paragraph 9(1);

(b)failed to comply with any permission granted under paragraph 10(3).

(2)Where a penalty is unpaid the Council—

(a)shall not licence an insurer under the Act until such amount is paid; and

(b)may recover the amount as a civil debt in a court of summary jurisdiction.

Council to pay penalty into Consolidated Fund

14All sums received by the Council in payment of a penalty shall be paid into the Consolidated Fund.

PART 5

FINAL PROVISIONS

Transitional

15(1)These Regulations do not apply to claims received by an insurer prior to the Regulations coming into operation.

(2)Notwithstanding paragraph 3(1)(a), the Council may grant permission to a health service provider to require payment of the insured portion of a procedure by an insured person where the Council is of the opinion that it would be unreasonable for the health service provider to comply with paragraph 3(1)(a).

(3)Any permission granted under subparagraph (2) shall expire on such date as the Council shall specify.

Commencement

16These Regulations come into operation on 1 August 2012.

SCHEDULE 1

(paragraph 4(1)(b))

DATA TO BE SUBMITTED WITH A CLAIM

1.Name of patient

2.Date of birth of the patient

3.Name of insured person

4.Relationship of the patient with the insured person (i.e. self, spouse, child)

5.Address and telephone number of insured person

6.Whether insured person is employed or self-employed

7.Name of insured person’s employer

8.Date of the procedure

9.Name of any referring provider

10.Health policy number

11.Certificate number

12.Relevant current diagnostic and procedural code

13.Total fee amount charged

14.Whether the claim is a maternity claim, or the result of a road traffic accident, or a work-related injury

15.Place of service

SCHEDULE 2

(paragraph 8(2)(c))

INFORMATION TO BE PROVIDED BY AN INSURER

1.Name of the health service provider

2.Name of patient

3.Date of the procedure

4.Date claim was received

5.Brief statement of the procedure to which the claim relates, if applicable

6.Whether the claim is clean, defective, or expired

7.Date of payment of the claim

8.Whether claim has been paid, is pending, or has been declined

9.Commentary, if any, in respect of any of the above

Made this 30th day of March 2012

Minister of Health