Diagnostic imagery ordered by chiropractors, physios won’t be covered in Alberta

Click to play video: 'Edmonton Health Matters Feb. 25: Diagnostic imaging rule changes'
Edmonton Health Matters Feb. 25: Diagnostic imaging rule changes
WATCH ABOVE: Soon, Alberta will no longer cover diagnostic imaging ordered by certain health professionals. According to Alberta Health, this change puts the province in line with Ontario, Quebec and B.C. Su-Ling Goh tells us how it will impact you. – Feb 25, 2020

As of March 31, diagnostic imaging services like X-rays, ultrasounds, bone scans and MRIs ordered by certain practitioners will no longer be covered by the Alberta Health Care Insurance Plan.

The province terminated the master agreement with the Alberta Medical Association and will implement new physicians funding framework and 11 consultation proposals, which include the de-insuring of diagnostic imaging services referred by physiotherapists, the Physiotherapy Alberta College and Association said in an email.

The funding change, announced Feb. 20, includes claims referred by chiropractors, physiotherapists and audiologists, in non-AHS facilities.

“In the past, if I felt it was necessary to send someone for an X-ray or an ultrasound, I could do so just in the clinic,” said physiotherapist Mira Jindani.

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“I could just give them a requisition and send them right away.

“Now… I’ll have to send the patients back to their general practitioner, they’ll have to make an appointment to do that, go for the imaging. I won’t have direct access to that imaging, so I’ll have to request it from the doctor — we don’t have access to Netcare, so I’d have to request it through the doctor — they’d have to follow up for the results from the doctor and we’d be able to go forward from there.”

She worries this change will increase the burden on family doctors.

“We’re also impacting the health-care system further… Essentially, the doctor is busier with these cases that we could have been dealing with ourselves.”

The association says another impact of the change would be patients paying out-of-pocket for these services or accessing third-party insurance benefits to avoid delays in treatment.

“Their pain could increase, further degeneration, different things,” said Jindani. “Time off work. If somebody is needing surgery, or some interventions, it delays that step too.”

She stressed that images are not ordered lightly and not all physiotherapists have the ability to order them. It requires a specific course.

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“This announcement is incredibly disappointing as we know this will negatively affect patient care while increasing costs to the health-care system,” the Physiotherapy Alberta College and Association said in a statement.

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“We encourage you to contact your local MLA and the minister of health to emphasize the unintended consequences of this announcement.”

In a statement, a spokesperson for the ministry of health said it’s “acting to make insurance coverage consistent across providers and consistent with other provinces, including Ontario, Quebec and B.C.”

WATCH BELOW (Feb. 21): Alberta’s health minister says ending an agreement between the province and its physicians is the right move but some doctors say it could devastate their bottom line, especially in rural Alberta. Nicole Stillger reports.

Click to play video: 'Some rural doctors concerned about changes being made by Alberta government'
Some rural doctors concerned about changes being made by Alberta government

“This change adds barriers to access and also creates out-of-pocket costs for patients, which is difficult to understand given the Alberta economy,” said Dr. Brad Kane, president of the Alberta College and Association of Chiropractors, in a statement to Global News. “This is the wrong move for Albertans, and chiropractors are significantly concerned about the unintended consequences for patients.”

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Dr. Mailie Harris said she’ll now have to send patients back to their medical doctor to ask for the requisition, which could create delays in treatment and barriers to access it.

“Travel times, days of work and getting appointments at busy medical doctors offices… With the health-care system being so backed up right now, now they have to go through another series of obtaining an appointment, getting there and getting the requisition.”

Harris said medical imaging helps chiropractors determine the best course of treatment.

“In the past, chiropractors were able to order things like bone scans, MRIs, X-rays, ultrasounds, and those things help us look at the bones and visualize the soft tissues and tendons and help us diagnose things.”

An Alberta government bulletin, dated Feb. 20, explained “diagnostic imaging (DI) services that are referred by a chiropractor, physiotherapist, or audiologist are de-insured and no longer covered by the Alberta Health Care Insurance Plan.”

The notice added that these health professionals can still order DI services, but paying for them “will be the patient’s responsibility” as of March 31.

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The province the new funding framework will maintain the government’s current level of spending on physicians at $5.4 billion and will “avoid $2 billion in cost overruns by 2022-23.”

The new framework will be developed with consultation with the AMA, the province said. It will include implementing changes proposed during negotiations to prevent cost overruns, aligning benefit programs and administrative fees with those of comparable provinces, improving services for patients.

In its statement to Global News, the health ministry said it’s maintaining health spending at $20.6 billion, which it describes as the highest level ever and highest per capita of all provinces (age adjusted.)

The changes are being made to bring Alberta’s costs in line with other provinces, Alberta Health said.

WATCH BELOW (Feb. 20): An independent review of Alberta Health Services is looking for ways to reduce costs and improve performance. As Emily Olsen reports, it could lead to some surgeries being deprioritized.

Click to play video: 'AHS review highlights surgeries with ‘limited clinical value’'
AHS review highlights surgeries with ‘limited clinical value’

The government said patients currently pay for services provided by practitioners like chiropractors, audiologists and physiotherapists and, as of March 31, covering diagnostic imaging referrals from those practitioners will also be the patients’ responsibility.

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The changes do not affect practitioners’ scopes of practice or their ability to order imaging services; only who pays for them, the province said.

It added that imaging ordered by a physician or nurse practitioner will still be covered by the Alberta Health Care Insurance Plan.

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