Observation:
I do not know the qualifying requirements for BC health care.
BUT I can offer some clarification about benefit-fraud cases in general. The patron's status at the time the benefits were used/obtained can make a huge, huge difference.
If at the time the benefits were actually used (such as at the time the PR was a patient getting very expensive care), the PR had the status of a covered-person, even if actual qualification for the benefits is subject to be rescinded (such as for SUBSEQUENT failure to meet a residency requirement), there is NO fraud involved in actually using the benefits . . . even if the PR's coverage is ultimately rescinded retroactively.
Unless, of course, there was actual fraud.
Thus, for example, a PR who comes to a province and meets the initial waiting period requirements and then applies for and obtains coverage representing he or she has established residence in the province and will be present in the province sufficient to meet an annual or first-year presence requirement, does NOT commit fraud if subsequently the PR moves out of the province before meeting the annual or first-year presence requirement.
If the PR made material misrepresentations of fact in applying for and obtaining the coverage, sure that would be fraud. If, for example, the PR did not actually intend to stay, already had a job or established residence elsewhere, and was obtaining coverage specifically with the intent to have certain expensive medical procedures paid for by the program, knowing he or she planned to soon leave the province, sure that would be fraud. And if discovered by the province, there is a substantial risk the province would at least seek recovery of the expenses paid and some risk of criminal prosecution. But again, that would be if there was overt fraud for which there is some direct evidence of the fraud.
Again, I am not familiar with the BC plan in particular. Such plans vary some in the terms which would allow the province to recoup expenses for rescinded coverage in non-fraud cases. But, yes indeed, some of these plans (which may or may not include BC's plan; I do not know) have some fairly strong provisions which will enable the province to pursue repayment of expenses paid on behalf of an individual who fails to meet an annual or first-year presence requirement, no need to show fraud.
That said, most indications suggest that provincial authorities tend to NOT pursue such payment recovery UNLESS actual fraud is suspected, in which cases they pursue recovery based on these provisions in lieu of pursuing a far more difficult to prove fraud case.
Appearance of fraud can tip the scales, to be sure. But the mere fact of having used the benefits and subsequently, due to this or that circumstance, leaving the province before meeting an annual or first-year presence requirement, is NOT likely targeted much.
In contrast, if the PR moved out of the province and then, after it is relatively clear the PR does not meet a presence or residency requirement, the PR then comes into the province to receive expensive care under the plan, that tends to be the sort of case many provinces seem quite likely to pursue . . . and to pursue them criminally if evidence of intentional fraud is available. (Recognizing that more than a little fraud goes undetected, escaping enforcement; but this tends to go in favour of the other-guy while, for many, the hammer-of-the-law comes down hard.)