Ottawa plans to crack down on doctors overcharging for medically necessary health care IG News

IG news Update,

CBC News has learned that an increase in the number of companies offering Canadians faster access to health care is prompting the federal government to begin cracking down on the practice.

Health Minister Jean-Yves Duclos is asking provinces to stop charging patients for medically necessary care – and warns Ottawa will withdraw federal health transfer payments if the charges continue.

“I am deeply concerned by the recent increase in patient fees for medically necessary services,” Duclos said in a letter sent Thursday to all provincial and territorial health ministers. Federal officials provided a copy to CBC News.

“It doesn’t matter where in the country Canadians live or how they get their medically necessary care, they should be able to access these services without paying out of pocket.”

  • Have you paid for a virtual appointment with a doctor? Tell us about your experience by emailing [email protected]

Companies that charge patients for virtual visits with a family doctor are prime targets of federal crackdown, according to a senior government official.

Jean-Yves Duclos standing in front of pharmacy shelves.
Health Minister Jean-Yves Duclos is asking provinces to stop charging patients for medically necessary care and warned Ottawa will withdraw federal health transfer payments if the fees continue. (Tony Davis/CBC)

Although the Canada Health Act prohibits charging “insured persons” for medically necessary services, there has recently been an explosion in the number of companies offering online doctor appointments across the country for $50 to $100 per visit. Fees have been charged in the range of Rs.

Fee-charging companies avoid Canada Health Act prohibitions by connecting the patient to a physician in a different province. Under the medical regulations in the province where the doctor practices, the patient would not technically qualify as an “insured person”.

Some critics have called this a loophole in the Canada Health Act.

In his letter, Duclos states that expanded access to health care using virtual platforms must remain “consistent with the spirit and intent of the Canada Health Act.”

Duclos says he will deliver a document clarifying to provinces and territories that fees for medically necessary services are not allowed, regardless of where the patient lives.

“The complexities of modern family health, virtual and surgical care, including its provision across jurisdictions and the expansion of scope of practice for health workers, should not be used to allow these charges,” the letter said.

A doctor looks at a computer screen showing pictures of a patient undergoing knee replacement surgery.
Dr. Pascal-André Venditoli looking at images of a patient undergoing knee replacement surgery. He is medical director of the Duval Clinic, a private facility in Laval, Que., specializing in joint replacement for fee-paying patients. (Louis-Marie Philidor/CBC)

“As our health care system evolves, it must do so while respecting the Canada Health Act.,

One of the biggest players to charge for virtual therapist care is Maple, which describes itself as “Canada’s top-rated virtual care app” and charges $69 or more for an appointment.

“We charge for our services only if they are not covered by provincial health plans,” says the company’s website.

“We would love to be eligible for consistent public coverage across Canada and we are working hard to ensure Maple joins provincial coverage as soon as possible.”

It’s unclear from Duclos’ letter whether the Trudeau government will also act on other instances of doctors overcharging for medically necessary care, recently revealed by CBC News:

  • Some for-profit surgical clinics are charging patients who travel from another province, up to $28,000 for a hip or knee replacement.
  • Doctor’s offices in Ontario are offering virtual and in-person appointments with a nurse practitioner, with memberships starting at around $30 a month.
A nurse practitioner is pictured with a three-year-old girl.
Nurse Practitioner Olivia Kavanagh visits a three-year-old boy at KinderCare Pediatrics in Toronto. The clinic is offering patients the option of instant access to appointments with a nurse practitioner for a monthly fee. (Craig Chivers/CBC)

Duclos’ move comes at a time of growing debate over the role of the private sector in the delivery of publicly funded health care in Canada, particularly as provinces grapple with surgical backlogs and staff shortages stemming from the COVID-19 pandemic.

In parliament in recent weeks, the New Democrats have repeatedly argued that the Trudeau government is allowing increased privatization of the health system and that for-profit companies are taking an increasing role in providing care.

The federal government last month reached an agreement with the provinces and territories to boost its annual Canada Health Transfer Fund arrangement by 10 years.

Duclos’ letter warns that those transfers could be reduced if patients are charged for medical care.

Duclos writes, “Canadians pay for their health care services through their tax dollars, and when they need to use those services, they are not asked to pay again in the form of in-patient fees.” should go.”

“Where examples of patient charges for these services exist, I will seek a reduction in federal health transfers by a similar amount.”

Computer showing web page for Maple, a virtual health platform
Maple is one of the largest players in this space, selling virtual visits with Canadian physicians starting at $69 per appointment. (Carolyn Ryan / CBC)

Different provinces have different approaches to coverage of virtual medical appointments, and some rules are changing as the COVID-19 pandemic subsides.

  • How do you feel about doctors charging for virtual health care? We want to hear from you. Send an email to [email protected]

For example, until last December the Ontario Health Insurance Plan (OHIP) covered the cost of virtual or phone consultations when the patient had an ongoing relationship with the doctor. “Virtual walk-in clinic” visits – visits with a doctor the patient has not seen face-to-face – are not covered.

That switch disrupted the business model of another company offering virtual appointments — Rocket Doctor, which now charges $55 for a doctor’s visit.

The company’s website says, “Virtual primary care and urgent care services are unfortunately no longer a service that patients can access for free on Rocket Doctor.”


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