Alberta Health Care Insurance (Access Fees) Amendment Act, 2023

Summary#

This bill changes Alberta’s health insurance law to clearly ban “access fees” for publicly covered care and to make enforcement stricter. It aims to keep access to insured health services based on need, not on the ability to pay, and to match the principles of the federal Canada Health Act.

• Bans any private payment for insured services and bans paying for faster, preferred, or exclusive access to those services.
• Defines “access fee” to include membership or subscription fees, lump-sum or periodic payments, and any top-up beyond what the government pays for an insured service.
• Keeps the ability to charge for services that are not publicly insured, where allowed by law.
• Requires the Minister to take set enforcement steps for violations (warning, referral to the professional college, then stronger penalties).
• Lets the government recover illegal fees and reimburse the patient who paid them.

What it means for you#

• Patients

  • You should not be asked to pay to see a publicly funded doctor or dentist for insured care.
  • You cannot be charged to get in faster, get preferred booking, or get exclusive access for insured services. Paying a clinic membership or subscription for faster insured care would be banned.
  • If you are charged an access fee, the government can recover that money and reimburse you.
  • You can still be charged for services that are not covered by the public plan (for example, non-insured goods or services), if those charges are allowed by law.

• Physicians and dentists (who bill the public plan)

  • You cannot charge or collect access fees, including any extra amount on top of the public payment, or any fee that is a condition to receiving an insured service, or a fee for faster access.
  • First violation: the Minister must send a written warning. Second: must refer the matter to your professional college (regulator). Third or later: the Minister must deem you “opted out” of the public plan for a period (meaning you cannot bill the plan during that time).
  • If you know a patient is being charged an access fee, you will not be paid by the government for that insured service.
  • You can still charge for non-insured services where permitted, but you cannot make those payments a condition for receiving insured care.

• Clinics and companies that employ or contract physicians

  • You cannot charge access fees or offer paid faster, preferred, or exclusive access to insured services.
  • First violation: written warning. Second: notice that a third violation will end your agreement with the government. Third or later: the agreement is terminated.
  • If you know a patient was charged an access fee, you will not be paid for the insured services provided.

• General public

  • The bill does not change what is covered by the public plan. It clarifies that insured care cannot involve pay-to-access or pay-to-fast-track arrangements.

Expenses#

No publicly available information.

Proponents' View#

• Protects equal access: no one can buy their way to the front of the line for insured care.
• Aligns Alberta’s system with the Canada Health Act and its principles.
• Clear rules and mandatory penalties make enforcement consistent and deter violations.
• Reduces surprise bills and ensures patients get reimbursed if improper fees were charged.
• Prevents a two-tier path that could draw doctors and resources away from the public system.

Opponents' View#

• Limits patient choice for those willing to pay for convenience or faster service, without adding capacity to reduce wait times.
• Broad definition of “access fee” could create confusion and discourage legitimate, non-insured services or amenities.
• Mandatory penalties leave little room for judgment in unusual cases and could push some providers to leave the public plan.
• May add administrative work for clinics and government to monitor and enforce the rules.