Government of Canada Announces Deductions and Next Steps to Curb Private Health Care Paid Out-of Pocket

News release

March 10, 2023 | Ottawa, ON | Health Canada

Universal, accessible, and publicly funded health care is a point of pride for Canadians and a priority for the Government of Canada. Under the Canada Health Act, it is made clear that no Canadian should be paying out of pocket for medically necessary services. Upholding the Canada Health Act (CHA) remains critical to protecting our health care system and ensuring Canadians have access to necessary care, regardless of their ability to pay.

Today, the Honourable Jean-Yves Duclos, Minister of Health, announced mandatory Canada Health Transfer (CHT) deductions totalling over $82 million in respect of patient charges levied during 2020-21 for medically necessary services that should be accessible to patients at no cost. He also announced next steps to curb private medically necessary health care being paid out-of-pocket by Canadians, with a focus on virtual care and other medically necessary services that Canadians are being asked to pay for.

This includes the first deductions taken under the Diagnostic Services Policy (DSP), totalling over $76 million for patient charges levied for medically necessary diagnostic imaging services. An additional $6 million was also deducted for other patient charges, including those levied for insured services provided at private surgical clinics and for access to insured abortion services.

The goal of the CHA has never been to levy penalties, but rather to ensure patients are not charged for the insured services they have already paid for through their taxes. If a province or territory permits patient charges for medically necessary health services, a mandatory deduction must be taken from the jurisdiction’s CHT payments.

The Minister of Health has also sent a message to his PT colleagues reiterating our collective responsibility in ensuring Canadians’ ability to access medically necessary services without having to pay out of pocket, no matter where they live in the country or how care is delivered. The COVID-19 pandemic created a need for our health system to adapt and provide alternative ways for Canadians to continue accessing health care, in particular virtual care. While there are benefits to these new approaches, there has also been an increase in reports of patient charges to access medically necessary care, that would otherwise be covered if provided in-person by a physician. It is critical that access to medically necessary services, whether provided in-person or virtually, remains based on medical need and free of charge.

As our health care system and the nature of care evolves, the federal interpretation and administration of the CHA must evolve with it, so Canadians can have continued access to care without financial barriers. The Government of Canada will not tolerate and will take action to address patient charges, including those for surgical abortion services, diagnostics, as well as other insured services received in private clinics.

Canadians and their families deserve timely access to health care services they need, and they expect their governments to work together to find immediate and longer-term solutions to these challenges. The federal government will continue working closely with PTs to help ensure all Canadians have equitable access to medically necessary care based on their needs, not their ability to pay.


“No Canadian should be paying out of pocket for medically necessary services and our government will not tolerate it. As the nature of care evolves, we must protect Canadians’ ability to access medically necessary services free of charge - no matter how or where care is delivered. We will continue to work with provinces and territories to improve our healthcare system in a manner that strengthens its public, accessible, and universal nature.”

The Honourable Jean-Yves Duclos
Minister of Health

Quick facts

  • Since 2015, over $188 million has been deducted from CHT payments for non-compliance with the Canada Health Act (CHA).

  • On March 9, the Minister of Health sent a letter to provincial and territorial Ministers of Health on the importance of upholding the CHA to protect Canada’s publicly funded health care system.

  • Under the Canada Health Act Extra-billing and User Charges Information Regulations, provinces and territories are required to report annually to Health Canada on extra-billing and user charges levied in the fiscal year two years prior to the current fiscal year. As such, the current reporting cycle pertains to those levied during fiscal year 2020-21. 

  • Mandatory CHT deductions for patient charges under the Diagnostic Service Policy (DSP) were required for British Columbia, Alberta, Saskatchewan, Manitoba, Quebec, New Brunswick and Nova Scotia. 

  • Provinces and territories (PTs) that face mandatory deductions have the opportunity to be reimbursed through the CHA Reimbursement Policy if they work collaboratively with Health Canada to develop an action plan and take the necessary steps to eliminate patient charges as well as the underlying circumstances which led to them. Through this process, a reimbursement of over $15 million was made to British Columbia under the Policy this March. This amount represents a partial reimbursement from its March 2021, March 2022, and March 2023 deductions.

  • CHT deductions taken in March 2023 for patient charges that occurred during the 2020-21 fiscal year, and any reimbursements issued will be included in the 2022-23 Canada Health Act Annual Report, which will be tabled in February 2024. 

Associated links


Guillaume Bertrand
Senior Communications Advisor and Press Secretary
Office of Honourable Jean-Yves Duclos
Minister of Health

Media Relations
Health Canada and Public Health Agency of Canada

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