Q-168 Response & Annex
Inquiry of Ministry
Prepare In English And French Marking "Original Text" Or "Translation"
Question No : Q-168
Rachael Thomas (Lethbridge)
June 12, 2025
Reply by the Minister of Immigration, Refugees and Citizenship
Peter Fragiskatos, M.P.
Question
With regard to the Interim Federal Health Program and its expenditures: (a) what were the total annual expenditures under the program, for each fiscal year from 2016 through 2024, broken down by (i) basic health services, (ii) supplemental health services, (iii) prescription drugs, (iv) dental services; (b) how many individuals were enrolled in the program or received the program coverage, for each fiscal year from 2016 through 2024, broken down by (i) basic health services, (ii) supplemental health services, (iii) prescription drugs, (iv) dental services; (c) what was the total number of individuals covered under the program, for each fiscal year from 2016 through 2024, further broken down by (i) province or territory of residence, (ii) gender, (iii) age group (under 18, 18-64, and 65+), (iv) country of origin; (d) what were the total payments made to health care providers under the program, for each fiscal year from 2016 through 2024, broken down by (i) physicians, (ii) hospitals, (iii) pharmacies, (iv) dental providers, (v) province or territory; (e) what were the total administrative costs of the program, for each fiscal year from 2016 through 2024, broken down by (i) costs associated with claims processing, (ii) costs associated with oversight and program management, (iii) fees paid to members of the Canadian Association of Blue Cross Plans; and (f) what measures have been implemented since 2016 to ensure transparency and accountability in the allocation and expenditure of funds under the program, including any audits, reviews or evaluations conducted, and what were the findings of such audits or reviews?
Reply
Insofar as Immigration, Refugees and Citizenship Canada (IRCC) is concerned:
With regard to the Interim Federal Health Program, please refer to Annex A and to details below for each point.
the total annual expenditures under the program, for each fiscal year from 2016 through 2024, broken down by health service type are summarised in Table 1 of Annex A.
the number of individuals who received program coverage for health services, for each fiscal year from 2016 through 2024, broken down by health service type is summarised in Table 2 of Annex A.
the total number of individuals who received program coverage for health services, for each fiscal year from 2016 through 2024, further broken down by (i) province or territory of residence, (ii) gender, and (iii) age group (under 18, 18-64, and 65+) is summarised in Tables 3a, 3b, and 3c of Annex A. (iv) The Department does not have a breakdown of the individuals who received program coverage for health services by country of origin.
the total payments made to health care providers under the program, for each fiscal year from 2016 through 2024, broken down by (ii) hospital, (iii) pharmacies (prescription drugs), (iv) dental providers (urgent dental services), and (v) province or territory are summarised in Tables 1 and 4 of Annex A. The Department is not able to provide a breakdown of payments to (i) physicians as a stand-alone in the medical category of care, for which expenditures are also provided in Table 1. Basic medical expenditures include all other provincially/territorially insured basic health care services not billed by hospitals directly (e.g., physician services, midwifery services, laboratory and diagnostic test, etc.).
the total administrative costs of the program, for each fiscal year from 2016 through 2024 for:
(i) costs associated with claims processing paid to Medavie Blue Cross, the contracted claims
administrator, is provided in Table 5 of Annex A;
costs associated with oversight and program management were as follows:
2016-17, $293,465; 2017-18, $747,531; 2018-19, $875,270; 2019-20, $834,646; 2020-21,
$1,260,438; 2021-22, $1,253,926; 2022-23, $1,114,890; 2023-24, $1,864,488; 2024-25, $2,031,766.
Fees are paid to Medavie Blue Cross, the contracted claims administrator for the program, for claims administration services [refer to e(i) above].
Several measures have been implemented since 2016 to ensure transparency and accountability in the allocation and expenditure of funds under the program.
Audits of Providers
As the claims administrator for the program, Medavie Blue Cross is contractually required to maintain a risk-based audit services and fraud prevention program. This includes verifying claims submitted for payment by registered health service providers to ensure compliance with program requirements as well as provincial/territorial acts and regulations, and requirements of professional regulatory bodies, and recovering ineligible payments when identified. Any ineligible payments that Medavie Blue Cross is unable to recover are then transferred to the department for further action (e.g., litigation) as appropriate. As required by the Treasury Board Secretariat, and as part of the Public Accounts exercises, the department reports all annual recoveries and losses related to provider overpayments through annual Public Accounts disclosure.
Audits of Medavie Blue Cross
A comprehensive third party compliance audit of the claims administrator contract with Medavie Blue Cross was completed in 2018-19 to assess Medavie Blue Cross’s compliance with its service standards, process controls, and administrative procedures, and to review a representative sample of claims processed. The audit report identified no issues of major concern or non-compliance, but did include six findings requiring follow-up actions in the following areas: recoveries, communication, operational dashboard, quality assurance report, stale-dated cheques, and client verification letters. These findings formed part of a Management Response Action Plan that was included in the final audit report and later implemented. In addition, the findings informed the development of the Statement of Work for the new claims administration contract initiated in 2020.
Evaluation of Immigration, Refugee and Citizenship Canada’s (IRCC) Migration Health Programs
The program is also subject to evaluations to ensure program effectiveness and was recently part of an evaluation of Immigration, Refugee and Citizenship Canada’s (IRCC) Migration Health Programs. The evaluation was conducted in fulfillment of the requirements under the Treasury Board Policy on Results and covered the fiscal years (FY) 2015/16 to 2022/23. The objective of the evaluation was to assess the performance of IRCC’s migration health programs, as well as contributions towards the achievement of associated program outcomes. IRCC’s health programming consist of three primary health programs: health screening, medical surveillance and notification and the Interim Federal Health Program (IFHP). Together the three programs aim to facilitate the entry of newcomers while protecting the health, safety and security of Canadians. Overall, the IFHP met its objectives, however clients experienced challenges in accessing some services. More details on the Evaluation Report, findings and associated Management Response Action Plan are available at Evaluation Report of Migration Health Programming - Canada.ca.
Q-168 - Annex A
With regard to the Interim Federal Health Program and its expenditures: (a) what were the total annual expenditures under the program, for each fiscal year from 2016 through 2024, broken down by (i) basic health services, (ii) supplemental health services, (iii) prescription drugs, (iv) dental services; (b) how many individuals were enrolled in the program or received the program coverage, for each fiscal year from 2016 through 2024, broken down by (i) basic health services, (ii) supplemental health services, (iii) prescription drugs, (iv) dental services; (c) what was the total number of individuals covered under the program, for each fiscal year from 2016 through 2024, further broken down by (i) province or territory of residence, (ii) gender, (iii) age group (under 18, 18-64, and 65+), (iv) country of origin; (d) what were the total payments made to health care providers under the program, for each fiscal year from 2016 through 2024, broken down by (i) physicians, (ii) hospitals, (iii) pharmacies, (iv) dental providers, (v) province or territory; (e) what were the total administrative costs of the program, for each fiscal year from 2016 through 2024, broken down by (i) costs associated with claims processing, (ii) costs associated with oversight and program management, (iii) fees paid to members of the Canadian Association of Blue Cross Plans; and (f) what measures have been implemented since 2016 to ensure transparency and accountability in the allocation and expenditure of funds under the program, including any audits, reviews or evaluations conducted, and what were the findings of such audits or reviews?
Organization : Immigration, Refugees and Citizenship Canada
- Data source: Interim Federal Health program (IFHP) Claims Reimbursement Database. The tables include approved and adjusted claims reimbursed to Interim Federal Health
program (IFHP) health care providers. Rejected claims are not considered.
- All fiscal years(FY) of Service include claims with reimbursement dates up until April 30, 2025. Interim Federal Health program (IFHP) service providers have up to 6 months to
submit claims for reimbursement. As such, please consider FY 2024-25 as being solely preliminary.
| Service | FY 2016–17 | FY 2017–18 | FY 2018–19 | FY 2019–20 | FY 2020–21 | FY 2021–22 | FY 2022–23 | FY 2023–24 | FY 2024–25 |
|---|---|---|---|---|---|---|---|---|---|
| Basic Health Services | $27,042,732 | $45,084,971 | $68,470,865 | $87,488,942 | $92,086,962 | $127,346,616 | $148,295,631 | $216,411,458 | $306,168,284 |
| HospitalNote 2 | $11,805,909 | $19,362,372 | $28,220,427 | $34,597,385 | $43,340,650 | $78,875,522 | $90,424,914 | $129,157,225 | $171,633,676 |
| MedicalNote 3 | $15,236,823 | $25,722,599 | $40,250,438 | $52,891,557 | $48,746,313 | $48,471,094 | $57,870,717 | $87,254,233 | $134,534,609 |
| Supplemental Health Services | $35,531,905 | $41,580,526 | $59,401,012 | $97,391,781 | $102,309,520 | $118,198,940 | $171,930,049 | $289,783,521 | $456,828,349 |
| Urgent Dental Services | $13,404,985 | $13,418,537 | $16,836,811 | $30,319,459 | $32,283,182 | $44,241,894 | $78,316,108 | $160,579,052 | $255,949,593 |
| Prescription Drugs | $15,125,565 | $19,981,930 | $29,828,724 | $43,140,012 | $45,735,143 | $44,531,976 | $50,286,212 | $70,723,711 | $106,867,410 |
| Other Supplemental Health ServicesNote 4 | $7,001,354 | $8,180,059 | $12,735,478 | $23,932,311 | $24,291,195 | $29,425,069 | $43,327,728 | $58,480,758 | $94,011,346 |
| In-Canada IMEs | $3,774,091 | $8,372,042 | $8,627,244 | $14,083,934 | $3,881,213 | $11,021,833 | $24,770,053 | $35,063,223 | $34,208,970 |
| Pre-Departure Medical Services | - | $11,431,978 | $17,892,135 | $15,658,175 | $4,355,123 | $21,970,474 | $29,290,638 | $28,474,242 | $23,989,945 |
| Service | FY 2016-17 | FY 2017-18 | FY 2018-19 | FY 2019-20 | FY 2020-21 | FY 2021-22 | FY 2022-23 | FY 2023-24 | FY 2024-25 |
|---|---|---|---|---|---|---|---|---|---|
| Basic Health Services | 50,782 | 78,036 | 114,556 | 146,013 | 111,441 | 118,654 | 166,623 | 249,475 | 330,893 |
| HospitalNote 3 | 11,683 | 21,020 | 31,915 | 39,296 | 36,126 | 37,059 | 49,154 | 72,583 | 101,351 |
| MedicalNote 4 | 39,099 | 57,016 | 82,641 | 106,717 | 75,315 | 81,595 | 117,469 | 176,892 | 229,542 |
| Supplemental Health Services | 94,047 | 96,091 | 132,293 | 192,396 | 132,712 | 147,434 | 261,934 | 380,610 | 497,421 |
| Dental Services | 24,999 | 21,083 | 25,859 | 35,259 | 28,685 | 33,047 | 60,283 | 103,744 | 141,049 |
| Prescription Drugs | 42,250 | 46,458 | 62,714 | 84,576 | 60,714 | 59,506 | 89,813 | 133,329 | 182,225 |
| Other Supplemental Health ServicesNote 5 | 26,798 | 28,550 | 43,720 | 72,561 | 43,313 | 54,881 | 111,838 | 143,537 | 174,147 |
| In‑Canada IMEs | 24,383 | 50,456 | 54,267 | 60,090 | 17,434 | 41,144 | 100,998 | 141,386 | 140,983 |
| Pre‑Departure Medical Services | - | 22,391 | 34,568 | 38,014 | 12,952 | 47,415 | 74,565 | 76,646 | 53,235 |
| Gender | FY 2016–17 | FY 2017–18 | FY 2018–19 | FY 2019–20 | FY 2020–21 | FY 2021–22 | FY 2022–23 | FY 2023–24 | FY 2024–25 |
|---|---|---|---|---|---|---|---|---|---|
| Female | 40,684 | 58,793 | 72,870 | 89,124 | 58,802 | 77,928 | 117,312 | 159,588 | 173,630 |
| Male | 43,502 | 64,473 | 78,866 | 96,682 | 61,125 | 84,854 | 141,154 | 201,147 | 228,428 |
| OtherNote 3 | 127 | 136 | 154 | 121 | 68 | 70 | 78 | 85 | 70 |
| Grand Total | 84,313 | 123,402 | 151,890 | 185,927 | 119,995 | 162,852 | 258,544 | 360,820 | 402,128 |
| Age Group | FY 2016-17 | FY 2017-18 | FY 2018-19 | FY 2019-20 | FY 2020-21 | FY 2021-22 | FY 2022-23 | FY 2023-24 | FY 2024-25 |
|---|---|---|---|---|---|---|---|---|---|
| Under 18 years | 28,472 | 38,779 | 46,901 | 55,590 | 29,257 | 43,075 | 68,992 | 82,490 | 82,511 |
| Between 18 and 64 years | 53,228 | 81,090 | 100,973 | 125,608 | 86,886 | 114,713 | 182,925 | 269,327 | 310,437 |
| 65 years and over | 2,618 | 3,538 | 4,028 | 4,735 | 3,855 | 5,086 | 6,656 | 9,033 | 9,195 |
| Grand Total | 84,318 | 123,407 | 151,902 | 185,933 | 119,998 | 162,874 | 258,573 | 360,850 | 402,143 |
| ProvinceNote 3 | FY 2016-17 | FY 2017-18 | FY 2018-19 | FY 2019-20 | FY 2020-21 | FY 2021-22 | FY 2022-23 | FY 2023-24 | FY 2024-25 |
|---|---|---|---|---|---|---|---|---|---|
| In-Canada | 84,967 | 106,588 | 129,999 | 162,169 | 111,560 | 129,119 | 214,418 | 308,240 | 373,516 |
| Alberta | 8,819 | 8,070 | 8,807 | 11,575 | 7,354 | 8,463 | 17,149 | 26,712 | 36,116 |
| British Columbia | 6,033 | 4,958 | 5,681 | 8,123 | 5,637 | 5,991 | 11,726 | 18,112 | 21,994 |
| Manitoba | 2,711 | 2,850 | 2,138 | 2,257 | 1,131 | 1,047 | 2,082 | 3,790 | 5,491 |
| New Brunswick | 1,614 | 680 | 584 | 653 | 319 | 423 | 1,136 | 1,626 | 1,467 |
| Newfoundland and Labrador | 422 | 304 | 316 | 387 | 267 | 311 | 654 | 903 | 775 |
| Nova Scotia | 1,632 | 870 | 923 | 1,219 | 725 | 774 | 1,588 | 2,208 | 2,143 |
| Northwest Territories | 4 | 0 | 6 | 6 | 8 | 9 | 5 | 16 | 27 |
| Nunavut | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | 6 |
| Ontario | 49,893 | 57,676 | 72,320 | 88,733 | 63,415 | 70,368 | 101,494 | 153,382 | 194,753 |
| Prince Edward Island | 246 | 120 | 131 | 94 | 63 | 78 | 112 | 113 | 180 |
| Quebec | 11,900 | 30,014 | 38,029 | 47,913 | 32,093 | 40,673 | 76,593 | 99,345 | 108,440 |
| Saskatchewan | 1,681 | 1,042 | 1,049 | 1,197 | 546 | 981 | 1,867 | 2,017 | 2,104 |
| Yukon | 12 | 4 | 15 | 11 | 1 | 1 | 12 | 16 | 20 |
| Outside of Canada (Pre-Departure Medical Services) | 0 | 22,391 | 34,568 | 38,014 | 12,952 | 47,414 | 74,565 | 76,643 | 53,234 |
| Grand TotalNote 4 | 84,967 | 128,979 | 164,567 | 200,183 | 124,512 | 176,533 | 288,983 | 384,883 | 426,750 |
| Province | FY 2016-17 | FY 2017-18 | FY 2018-19 | FY 2019-20 | FY 2020-21 | FY 2021-22 | FY 2022-23 | FY 2023-24 | FY 2024-25 |
|---|---|---|---|---|---|---|---|---|---|
| Alberta | $6,698,180 | $7,357,310 | $9,211,769 | $13,730,222 | $10,667,378 | $13,734,734 | $21,530,636 | $33,485,815 | $56,312,569 |
| British Columbia | $4,325,036 | $5,247,765 | $6,191,686 | $9,004,592 | $7,756,960 | $6,607,790 | $13,370,742 | $19,809,678 | $22,842,927 |
| Manitoba | $1,425,882 | $1,373,944 | $1,083,666 | $1,626,255 | $1,026,693 | $1,250,668 | $1,905,673 | $3,331,875 | $5,102,288 |
| New Brunswick | $991,482 | $415,161 | $221,531 | $408,503 | $129,291 | $301,765 | $806,850 | $1,654,216 | $1,392,932 |
| Newfoundland and Labrador | $212,755 | $194,086 | $184,346 | $241,708 | $144,446 | $242,796 | $409,371 | $708,310 | $701,561 |
| Nova Scotia | $1,447,842 | $680,145 | $704,434 | $911,039 | $979,252 | $915,710 | $1,665,074 | $2,775,758 | $2,270,894 |
| Northwest Territories | $932 | $0 | $1,024 | $5,970 | $7,621 | $2,782 | $4,997 | $10,332 | $10,989 |
| Nunavut | $0 | $0 | $0 | $101 | $1,477 | $0 | $0 | $0 | $7,932 |
| Ontario | $39,747,420 | $54,988,559 | $77,153,361 | $116,981,522 | $120,112,164 | $147,642,152 | $184,248,602 | $306,397,374 | $479,160,912 |
| Prince Edward Island | $155,734 | $42,865 | $44,802 | $28,244 | $27,988 | $46,869 | $45,866 | $70,262 | $91,092 |
| Quebec | $10,588,598 | $24,173,501 | $41,048,483 | $55,255,269 | $56,932,459 | $84,680,240 | $119,156,379 | $171,116,596 | $227,658,373 |
| Saskatchewan | $751,385 | $563,426 | $641,054 | $766,948 | $491,864 | $1,141,815 | $1,836,738 | $1,891,660 | $1,630,164 |
| Yukon | $3,480 | $778 | $12,966 | $4,284 | $101 | $67 | $14,804 | $6,325 | $22,971 |
| Grand Total (in‑Canada) | $66,348,728 | $95,037,540 | $136,499,122 | $198,964,657 | $198,277,695 | $256,567,389 | $344,995,732 | $541,258,202 | $797,205,603 |
| Type | FY 2016-17 | FY 2017-18 | FY 2018-19 | FY 2019-20 | FY 2020-21 | FY 2021-22 | FY 2022-23 | FY 2023-24 | FY 2024-25 |
|---|---|---|---|---|---|---|---|---|---|
| Costs associated with claims processing | $3,713,871 | $5,523,612 | $6,882,337 | $8,335,825 | $7,326,637 | $8,302,350 | $10,366,692 | $11,091,216 | $15,352,230 |