14Medicare benefit not to exceed medical expenses incurred

14 Medicare benefit not to exceed medical expenses incurred

(1) A medicare benefit payable in respect of a professional service shall not exceed the medical expenses incurred in respect of the professional service. (2) Subsection (1) does not apply if: (a) the rendering of the professional service is covered by an agreement between a private health insurer and another person; and (b) the amount payable under the agreement for the professional service is not determined on a fee for service basis.