Self-Referral Tests and Health Funding Changes

Summary#

• Bill 29 changes several Alberta health laws. Its main goal is to create a new, defined set of preventative health tests that people can access without a doctor’s referral, and to set clear payment rules for those tests.

• It also lets certain health professionals buy some prescription drugs for use in their practice through a “written order,” with limits set by the Minister. The bill updates hospital and health agency rules and adds a repayment rule for some severance pay.

• Some parts take effect later, after the government sets a start date.

• Key changes:

  • Creates “preventative health testing services” and allows self-referral (no doctor referral needed) if you meet rules the Minister sets.
  • The Minister decides which tests qualify and how much the public plan will pay for them.
  • For these tests, you must claim private insurance first. The public plan pays last and there is no appeal if a claim is denied.
  • Lets the Ministry collect some personal health information to decide if benefits are payable.
  • Allows regulated health professionals to buy certain prescription drugs for patient care through written orders; pharmacies must keep detailed records.
  • If a former health agency worker who got severance is hired by the Alberta government during their severance period, they must repay up to the amount they earn in that period.
  • Updates terms and funding tools for hospitals and health agencies as part of system changes.

What it means for you#

• Residents and patients

  • You may be able to book certain screening or lab tests on your own, without seeing a doctor first, if the Minister lists them and you meet the rules.
  • The public plan can pay for some of these tests, but only after your private plan (if you have one) pays or denies the claim.
  • If your claim for these tests is denied, there is no appeal process for that denial.
  • You may be asked to share personal health information so the Ministry can decide if a benefit is payable.

• People with private health insurance

  • You must submit your claim for these preventative tests to your private insurer first. The public plan pays only what is left unpaid and only up to the government-set rate.

• Regulated health professionals (who can prescribe)

  • You can buy certain Schedule 1 drugs for use in treating your patients through a written order to a pharmacy, if the Minister authorizes those drugs.
  • You must follow limits on which drugs, how much you can order, and any procedures the Minister sets. Written orders are not prescriptions to a specific person.

• Pharmacists and pharmacies

  • You may sell certain prescription drugs to regulated health professionals if you receive a proper written order.
  • You must keep added records, including copies of written orders and details of drugs sold under those orders.
  • New standards for handling written orders will be set and must be followed.

• Hospital patients and operators

  • The law updates terms around “hospital services facilities” and clarifies when patients may be charged for non-insured services.
  • The Minister still must pay for insured hospital services. Grants to hospital operators are now at the Minister’s discretion, which could change how funding is delivered.

• Employees in health agencies

  • If you received severance from a regional health authority, provincial health agency, or provincial health corporation and then take a job with the Alberta government during your severance period, you must repay up to the amount you earn in that period (but not more than your severance).
  • Agencies must share certain severance details with the oversight Minister when asked.

Expenses#

No publicly available information.

Proponents' View#

• Makes it easier and faster for people to get key screening tests, which can catch health problems early.
• Gives people more choice in how they access care while keeping costs in check by letting the Minister set covered tests and payment rates.
• “Payer of last resort” and no-appeal rules help protect public funds and reduce drawn-out disputes.
• Allowing written orders helps clinics have needed medicines on hand, speeding up treatment.
• Strong pharmacy record-keeping supports patient safety and prevents misuse.
• The severance repayment rule prevents people from being paid twice for the same period, saving taxpayer dollars.
• Updates align laws with the new health system structure.

Opponents' View#

• The Minister has broad power to decide which tests are covered and how much is paid, which could limit access or create uneven coverage.
• No right to appeal a denied claim for these tests may feel unfair to patients.
• Requiring private insurance to pay first could delay reimbursement and add paperwork for families.
• Collecting identifiable health information to assess claims raises privacy concerns.
• New pharmacy record rules and written order processes add administrative work for pharmacies and clinicians.
• Changing grants to hospital operators from “must” to “may” could create funding uncertainty for hospitals.
• The severance repayment rule could discourage experienced health workers from returning to government roles.