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Alberta physiotherapists, chiropractors say not covering imaging will actually cost the government money

Edmonton Journal logo Edmonton Journal 2020-06-13 Ashley Joannou
a man wearing a suit and tie: Health Minister Tyler Shandro. File photo. © Darren Makowichuk Health Minister Tyler Shandro. File photo.

The associations representing Alberta physiotherapists and chiropractors say the government’s decision to no longer cover the cost of imaging, like x-rays, ordered by their members will end up costing the province money.

As of March 31, claims for diagnostic imaging services referred by a chiropractor, physiotherapist or audiologist were no longer covered by the Alberta Health Care Insurance Plan, meaning patients would have to pay out of their own pocket or through private insurance.

The government says physicians cannot be compensated for providing services which are related to an uninsured service like the ones provided by a chiropractor, physiotherapist or audiologist.

In a briefing memo written for the government in February and released by the Alberta NDP on Friday, the Alberta College and Association of Chiropractors and Physiotherapy Alberta said  while the change may save the government approximately $8 million a year upfront, a physician-only referral model for publicly funded imaging means overall costs will rise to $18 million.

That’s because instead of being able to go directly from their physiotherapist or chiropractor to get x-rays, patients who don’t want to pay out of their own pocket now have to have the tests ordered by their family doctor.

That means two visits to the doctor — one to order the test and one to review the results once they come in — on top of getting the tests done and going to see their physiotherapist or chiropractor.

“So there are extra steps and extra costs. It makes patients sometimes not even take those steps and not get the care that they actually need,” said Edmonton chiropractor Dr. Wendy Coburn.

Coburn said more barriers and red tape are being created.

“It may be two or three weeks in some cases before they start care, versus the same day or the day after,” she said. “And that can cause problems because it can lengthen the amount of time that they need care.”

Edmonton physiotherapist Jeffrey Begg said he’s been able to order tests directly for about the last eight years.

“This policy reversal is very difficult to understand in the sense of reason, logic or finances, and it’s going to create — in fact it’s already creating — quite a barrier to the proper care that we provide,” he said.

Begg said the government chose to apply an old rule that’s been on the books for a long time to reverse policy that has existed since 2012, “when obviously the right move would have been to maintain the good policy and rewrite the rule.”

Steve Buick, press secretary for Health Minister Tyler Shandro, said the change, which was announced last year, aligns Alberta with British Columbia and Ontario.

The government estimates it will save between $5 million and $8 million out of the total medical services budget of more than $5 billion a year.

When asked whether family doctors who order tests for those seeking chiropractic or physiotherapy care would also be breaking the rules around being compensated for uninsured services, Buick said: “Physicians should order publicly funded diagnostic imaging only in conjunction with insured services; they should not order it in conjunction with an uninsured service provided by the physician or on behalf of any other provider.”

Chris Nielsen, the NDP critic for red tape reduction, said this change goes against the UCP government’s promise to reduce red tape.

“That goes against the entire premise of the entire red tape reduction ministry. It was formed to make things more streamlined,” he said.

“It was supposed to make life better for Albertans and this change goes against both of those principles.”

ajoannou@postmedia.com


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