Friday, the Federal Government issued correspondence to the provinces and territories regarding its newly introduced Canada Health Act Services Policy. As set out in this correspondence from the Minister of Health, the CHA Services Policy addresses the treatment out-of-pocket payments for services provided by regulated healthcare professionals offering medically necessary services to Canadians that would otherwise be provided by a physician and if so, considered an insured service.
The issuance of this new Policy was triggered by the recent expansion in scopes of practice for many regulated healthcare professionals (e.g. nurse practitioners, pharmacists, midwives) by provincial regulators in order to improve access to healthcare. As a result of these developments, these professionals are now permitted to deliver some of the same services that would normally be insured if provided by a physician.
Pursuant to the CHA Services Policy, patient charges for medically necessary services, whether provided by a physician or other health care professional providing physician-equivalent services, will be considered extra-billing and user charges under the CHA.
In order to give provincial and territorial governments sufficient time to review the administration of their health care plans and make any necessary adjustments, the CHA Services Policy will come into effect on April 1, 2026. As articulated by the Minister of Health, the federal goal of the CHA is not to levy penalties, but to ensure access to medically necessary care. Therefore, any deductions made under the policy will be eligible for reimbursement under the CHA Reimbursement Policy, once patient charges and the circumstances that led to them are eliminated.
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