As previously reported, effective March 31, 2020, the Ministry of Health is making changes to the Schedule of Medical Benefits. Claims for Diagnostic Imaging (DI) services that are referred by a physiotherapist, chiropractor or audiologist are de-insured and no longer covered by the Alberta Health Care Insurance Plan.
The College of Physiotherapists of Alberta worked collaboratively with the Alberta College and Association of Chiropractors in efforts to discuss and inform Alberta Health how this change will negatively impact Albertans and will not result in the savings they have projected. Formal feedback was submitted. Meetings, multiple phone calls and letters were exchanged as well as last minute efforts to request these significant changes be postponed allowing all health-care professionals to focus on the needs of Albertans in response to the COVID-19 pandemic. Unfortunately, these efforts were unsuccessful.
The explanation provided was the rules of the Schedule of Medical Benefits do not allow physicians to be compensated for providing services which are uninsured or related to uninsured services. Because the physiotherapists, chiropractors or audiologists do not provide insured services, any DI referrals by these professionals are also considered uninsured. In efforts to find savings in the Physician Services Budget, Alberta Health identified rules that were not being followed and DI referrals was identified. This change means that patients are now responsible for payment of DI services ordered by a physiotherapist, chiropractor or audiologist.
This is very disappointing. The College of Physiotherapists of Alberta recognizes there are many questions that will need to be answered as we move forward and continue to provide safe, quality and effective care to Albertans. We will share all information as it becomes available. The Alberta Society of Radiologists have shared their common musculoskeletal price list.