Alberta physicians want the provincial government to explain how it will assess patients’ eligibility for publicly funded health care as the province prepares for its Oct. 19 referendum and rolls out new health-care cards.
The Alberta Medical Association said uncertainty about a patient’s identity, residency or health coverage should not delay medically necessary treatment. The association added that physicians often must make urgent clinical decisions before a patient’s eligibility for coverage can be established.
The AMA is asking Premier Danielle Smith and the provincial health ministers to explain how the referendum questions and changes to health-care cards could affect patients and medical practices.
According to an AMA statement, physicians want assurances that the changes will not delay treatment, disrupt access to care or leave patients unsure where to turn for medical help. The association wants physicians to concentrate on assessing and treating patients rather than resolving questions about immigration status or health coverage.
The AMA is also seeking clarification on how federal immigration rules and provincial health coverage requirements would apply to different groups of residents. Those potentially affected could include permanent and temporary residents, refugees and asylum claimants.
The association wants guidance on how physicians should proceed when patients need medically necessary treatment but their eligibility for coverage has not been confirmed. It is also seeking clarity on how follow-up appointments and ongoing treatment would be handled in those circumstances.
The AMA also wants to know whether new eligibility procedures would increase the administrative workload for physicians and their staff. It is seeking clarification on whether doctors could submit claims for medically necessary treatment delivered during a lapse in coverage if a patient’s eligibility were subsequently reinstated.
The association argues that coverage verification should be handled through a separate administrative process that is reliable and timely.
Such a process would allow physicians to prioritize patient care while leaving eligibility decisions to the appropriate administrative authorities.
