Ottawa to offer one-year grace period before new rules on nurse practitioner services are enforced

As new rules requiring public healthcare plans to cover nurse practitioner services are set to take effect next month, Ottawa is giving provinces and territories a one-year grace period before it imposes penalties for non-compliance.Last Friday, federal Health Minister Marjorie Michel’s office confirmed to the Canadian Healthcare Network that the new interpretation letter of the Canada Health Act (CHA) will take effect on April 1, 2026, as planned under the previous Liberal government.The new interpretation letter requires provinces and territories to allow certain non-physician healthcare providers to bill public healthcare plans for “physicians-equivalent services” that are covered under the CHA’s “core basket of services,” intended to close a loophole that enabled nurse practitioner clinics to charge patients out-of-pocket for medically necessary primary care services. However, the Globe and Mail reported Sunday that penalties for failure to implement this directive will not take effect until April 1, 2027, citing a letter sent from Michel to provincial and territorial health ministers that has not been publicly released.In addition, the letter clarifies that this directive only applies to services from nurse practitioners, midwives and pharmacists—but Michel also reassured her counterparts that the new policy will not impact any decisions to expand the scope of practice for healthcare professionals.“Some provinces and territories have raised concerns that the CHA Services Policy could negatively impact decisions to expand the scope of practice of health care professionals in the future,” Michel wrote in the letter, as reported by the Globe. “Specifically, there are concerns that these changes might automatically fall under the Policy. I assure you that this is not the case.”Michel has also ruled out issuing a similar interpretation letter for billing on virtual care—something that continues to be charged for out-of-pocket in many provinces.“I reiterate my commitment that there will not be a virtual care policy interpretation letter,” she said in the letter.Meanwhile, Alberta, which has been expanding options for privately paid healthcare through Bill 11, has long opposed Ottawa’s efforts to rein in out-of-pocket charges for medically necessary care. “While the federal government has offered a one-year waiver of financial penalties, that is not sufficient,” a spokesperson for Adriana LaGrange, Alberta Minister of Primary and Preventative Health Services, told the Globe. “Using ‘interpretation letters’ to change how the Canada Health Act is applied bypasses proper federal–provincial collaboration and creates confusion, risk, and costs for Alberta’s health system.”

Ottawa to offer one-year grace period before new rules on nurse practitioner services are enforced

Register for free access or login.

Related Topics