Backgrounder: New Canada Health Act Initiatives (August 2018)

The Government of Canada is moving forward with three new initiatives related to the Canada Health Act. In August 2018, the Minister of Health issued letters to the provinces and territories outlining the Diagnostic Services Policy, a new Reimbursement Policy, and requirements for strengthened reporting.

Diagnostic Services Policy

One of the overarching objectives of the Canada Health Act is to ensure that Canadians have access to medically necessary care based on their health needs and not their ability, or willingness, to pay.

The federal position has always been that patients should not face charges for medically necessary hospital and physician services―including diagnostic services―regardless of where the service is provided.

The Diagnostic Services Policy is aimed at eliminating patient charges for medically necessary diagnostic services (such as MRI and CT scans). It clarifies that the Canada Health Act will be enforced and that evidence of patient charges will result in a mandatory dollar-for-dollar deduction from Canada Health Transfer payments.

The Government acknowledges that it may take time in some jurisdictions to align provincial and territorial systems with the Diagnostic Services Policy. This policy will not take effect until April 1, 2020 and reporting on any patient charges for diagnostic services will begin in December 2022 (for the fiscal year 2020-21). That means that any Canada Health Transfer deductions would only be made in March 2023. 

Reimbursement Policy

Under this policy, those provinces and territories facing deductions will be eligible to have them reimbursed if they eliminate patient charges in a timely manner.

When Health Canada informs a province or territory that it will be subject to a deduction, it will outline the conditions for a possible reimbursement. This includes working with the jurisdiction to determine the extent of patient charges and the steps needed to eliminate them.

To be eligible for a reimbursement, a province would be required to submit a report to Health Canada that provides:

• an account of the steps taken to meet the conditions;
• a statement of any patient charges levied in the jurisdiction and how these charges have been addressed; and
• an attestation as to the completeness and accuracy of the information submitted.

If the Minister is satisfied that the conditions have been met and that patient charges have been eliminated, the jurisdiction would then be reimbursed.

Strengthened reporting requirements

The Government is phasing in strengthened and standardized reporting requirements from provinces and territories to Health Canada. This will help provide a clearer picture of how the public health care insurance plans across all the provinces and territories are operating.

The Government of Canada is committed to working with provinces and territories to protect and strengthen Canada’s health care system and to ensure the enforcement of the Canada Health Act.