Expansion of the Spectrum of Care for Infertility Treatments

There are 2 issues related to topic "Expansion of the Spectrum of Care for Infertility Treatments".


Topic

Expansion of the Spectrum of Care for Infertility Treatments

Case number

Description

During the review of a recent grievance concerning the reimbursement of costs relating to in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatments, the Board noted that, in 1997, IVF was added to the Spectrum of Care (SoC) for Canadian Forces (CF) members with bilateral tube blockage for a maximum of three cycles, which mirrored the Province of Ontario's coverage at that time. As well, as a result of a Federal Court decision, the CF added ICSI to its coverage under certain conditions in 2008. These benefits for CF members stand true today. However, in August 2010, the Province of Quebec expanded its coverage to include IVF and ICSI up to a maximum of three cycles, no matter what the cause of infertility. On 18 April 2011, the SoC Review Committee met to review this new development, but decided to support the status quo and did not expand CF coverage.

The stated intent of the SoC is to provide CF members with comprehensive health care "comparable" to that guaranteed to other Canadians, and to ensure that public funds are used to provide access to a standard of health care comparable to that received by Canadians under provincial health care plans. In fact, concerning IVF, up to August 2010, the Board concluded that the CF’s approach vis-à-vis the notion of providing “comparable” health care was to provide “identical” or “as good as” provincial care.

However, in the Board's opinion, the CF refusal to update its health care so as to be "comparable" to the most recent changes in Quebec is not in line with its commitment under the SoC. The result is that, if it wasn't for the fact that the person was a member of the CF, IVF and ICSI, up to a maximum of three cycles, no matter the cause of infertility, would be available to a CF member posted in Quebec.

Furthermore, according to regulations, reservists on Class "A" or "B" service who are in need of medical care not related to CF duty benefit from provincial health care, as well as CF medical care. Therefore, reservists in Quebec have access to three cycles of IVF and ICSI no matter the cause of infertility, but Regular Force members or reservists on Class "C" service or serving outside the Province of Quebec do not. This, in the Board's view, is patently unfair.

Recommendation

The Board recommended that the Chief of the Defence Staff (CDS) direct that the SoC coverage for IVF and/or ICSI be expanded to include three cycles of treatment, regardless of the infertility cause, effective 18 April 2011, the date the last SoC review took place.

The Board also recommended that the CDS direct that the SoC be amended to reflect this new coverage.

Final Authority Decision

Pending


Topic

Expansion of the Spectrum of Care for Infertility Treatments

Case number

Description

The Committee understands that the CAF has an obligation to be accountable for its use of public funds and has budget constraints. Nonetheless, given the current infertility coverage received in Quebec, Ontario and by RCMP members, the Committee reiterated its previous systemic recommendation that the SoC be expanded to cover a broader range of fertility treatments than it currently does.

Recommendation

The Committee recommended that the SoC be expanded to include a broader range of fertility treatments than it currently provides to CAF members.

Final Authority Decision

Pending

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