Ottawa – Mark Holland, Minister of Health, announced Canada Health Act (CHA) deductions and reimbursements for this year. The mandatory Canada Health Transfer (CHT) deductions, totalling over $79 million, are in respect of patient charges levied that represented out of pocket costs for Canadians during 2021-2022, for medically necessary services that should be accessible to patients at no cost. The majority of the deductions (over $72 million) were taken due to patient charges for diagnostic imaging services at private clinics.
Under the CHA’s Reimbursement Policy, mandatory CHT deductions may be reimbursed if the implicated province or territory carries out a Reimbursement Action Plan to eliminate the patient charges as well as the circumstances that led to them. Full reimbursement (if all patient charges have been eliminated) or partial reimbursement (if some, but not all, patient charges have been eliminated), can occur anytime up to two years after the original deduction was made.
In recognition of efforts by provinces to eliminate these patient charges, six provinces (British Columbia, Alberta, Manitoba, Ontario, Quebec and Newfoundland and Labrador), received reimbursements totalling over $90 million. This includes reimbursement of deductions taken under the Diagnostic Services Policy (DSP) totalling over $83.2 million for actions taken to eliminate patient charges for medically necessary diagnostic services, as well as reimbursements totalling $6.9 million for actions taken to eliminate patient charges for other medically necessary services (e.g., surgical abortions, cataract and other surgical procedures).
The Canada Health Act Annual Reports include Reimbursement Action Plans that outline what PTs have done to eliminate patient charges. The most recent Annual Report (2022-23) was published in February 2024. Should PTs take additional action to eliminate charges for medically necessary services, they could be eligible for additional reimbursements.
The reimbursements issued in March 2024 demonstrate the successful implementation of both the DSP and Reimbursement Policy, to encourage provinces to improve access to medically necessary services and to ensure patients are not charged to access these services.
| Deductions | Reimbursements | |||
|---|---|---|---|---|
| Diagnostic | Other | Total | Total | |
| British Columbia | $11,270,216 | $6,848,5051 | $18,118,721 | $22,405,749 |
| Alberta | $20,450,175 | – | $20,450,175 | $20,538,796 |
| Saskatchewan | $1,084,513 | – | $1,084,513 | 0 |
| Manitoba | $650 | – | $650 | $354,477 |
| Ontario | – | $32,8002 | $32,800 | $43,296 |
| Quebec | $36,014,132 | – | $36,014,132 | $46,728,814 |
| New Brunswick | $1,794,635 | $109,2753 | $1,903,910 | 0 |
| Nova Scotia | $1,794,635 | – | $1,794,635 | 0 |
| Newfoundland and Labrador | – | $1,2554 | $1,255 | $1,255 |
| TOTALS | $72,408,956 | $6,991,835 | $79,400,791 | $90,072,387 |
| 1 For patient charges levied for medically necessary surgical services. 2 For patient charges levied for medically necessary abortion services. 3 For patient charges levied for medically necessary abortion services. 4 For patient charges levied for medically necessary cataract surgery. | ||||
Note that reimbursement amounts listed in the table above are greater than deduction amounts (except Newfoundland and Labrador) as they represent reimbursements in respect of multiple years of deductions, which vary by province:
- Reimbursement amounts to British Columbia and Ontario represent partial reimbursements of their March 2022, 2023 and 2024 deductions in recognition of their efforts to eliminate patient charges for medically necessary diagnostic and surgical services (BC) and medically necessary abortion services (Ontario).
- Reimbursement amounts to Alberta and Quebec represent partial reimbursements of their March 2023 and 2024 deductions in recognition of their efforts to eliminate patient charges for medically necessary diagnostic scans.
- The amount reimbursed to Manitoba represents full reimbursement of its March 2023 deduction and an immediate reimbursement of its March 2024 deduction for successfully eliminating patient charges being levied for medically necessary diagnostic scans.
The amount reimbursed to Newfoundland and Labrador represents an immediate and full reimbursement of its March 2024 deduction for successfully eliminating patient charges being levied for medically necessary cataract surgeries.