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Rapporto annuale 2021 del Canada Health Act

Sep 18, 2023Sep 18, 2023

Scarica in formato PDF (9,9 MB, 416 pagine)

Organizzazione:Salute canadese

Data di pubblicazione:2023

Gatto.:H1-4E-PDF

ISBN:1497-9144

Pub.:220753

Health Canada desidera riconoscere il lavoro e lo sforzo necessari per produrre questo rapporto annuale. È grazie alla dedizione e all'impegno tempestivo dei seguenti dipartimenti della sanità e del loro personale che siamo in grado di fornirvi questo rapporto sull'amministrazione e il funzionamento del Canada Health Act:

Apprezziamo molto anche l'ampio sforzo di lavoro profuso in questo rapporto dal nostro team di produzione, inclusi editori desktop, traduttori, redattori ed esperti di concordanza, tipografi e personale di Health Canada.

Sono onorato di presentare al Parlamento e ai canadesi il Rapporto annuale 2021-2022 del Canada Health Act.

In qualità di Ministro federale della Sanità, una delle mie responsabilità principali è sostenere il Canada Health Act che garantisce che tutti i canadesi abbiano un accesso equo ai servizi sanitari essenziali in base alle loro necessità e non alla loro capacità, o volontà, di pagare. La mia lettera di mandato mi impegna inoltre a rafforzare il rispetto e a modernizzare l'interpretazione della legge. So che i canadesi rimangono giustamente orgogliosi del nostro sistema sanitario finanziato con fondi pubblici, ma il nostro sistema è anche sottoposto a una pressione significativa, che richiederà a tutti i livelli di governo di lavorare insieme per garantire che soddisfi le moderne esigenze dei canadesi.

Al fine di garantire la solidità a lungo termine del sistema sanitario, lavorando in collaborazione con province e territori, il nostro lavoro si concentrerà su aree prioritarie chiave; 1) migliorare l’accesso ai servizi sanitari familiari; 2) affrontare gli arretrati e sostenere, attrarre e trattenere gli operatori sanitari, 3) modernizzare il nostro sistema sanitario con dati sanitari e salute digitale, 4) migliorare l’accesso ai servizi di salute mentale e uso di sostanze e 5) aiutare i canadesi a invecchiare con dignità, più vicino a casa .

Medicare è un ottimo esempio di collaborazione federale-provinciale-territoriale poiché la salute è una responsabilità condivisa in Canada e, per ottenere risultati e soddisfare le esigenze di assistenza sanitaria dei canadesi, tutti i livelli di governo devono lavorare insieme. I governi provinciali e territoriali hanno la giurisdizione primaria nella fornitura e nell’amministrazione dell’assistenza sanitaria, mentre il governo federale definisce i requisiti nazionali che devono riflettersi nei piani di assicurazione sanitaria, ai sensi del Canada Health Act, che la maggior parte delle giurisdizioni non solo soddisfa ma spesso supera.

Nel corso della pandemia di COVID-19, abbiamo visto cosa si può ottenere quando tutti i livelli di governo lavorano insieme in collaborazione. Per soddisfare le esigenze di assistenza sanitaria dei canadesi, abbiamo assistito all’espansione dell’assistenza virtuale, della telemedicina e della portata degli operatori sanitari. Tuttavia, sebbene il nostro sistema sanitario pubblico universale sia stato parte integrante della risposta del Canada al COVID-19, la pandemia ha portato alla luce nuove sfide e amplificato quelle che già creavano stress al nostro sistema. A tal fine, le province e i territori hanno lavorato duramente nella lotta contro il Covid-19, per ridurre gli arretrati aggravati dalla pandemia e per reclutare e trattenere gli operatori sanitari.

Il nostro lavoro di collaborazione si estende anche al rafforzamento del sistema sanitario universale del Canada sostenendo gli standard del Canada Health Act. Da un punto di vista federale, stiamo lavorando duramente per garantire che, con l’evoluzione del nostro sistema sanitario, si evolvano anche l’interpretazione e l’amministrazione del Canada Health Act, per servire meglio i canadesi. Stiamo adottando misure per combattere le spese per i pazienti, comprese quelle per i servizi di aborto chirurgico, la diagnostica e altri servizi assicurati ricevuti in cliniche private; e, per la prima volta, nel marzo 2023, anche le province e i territori che consentono l’addebito di servizi diagnostici necessari dal punto di vista medico, dovranno affrontare detrazioni sui pagamenti del Canada Health Transfer. Lo scopo della legge non è imporre detrazioni, ma piuttosto collaborare con le province e i territori per garantire che i canadesi abbiano accesso alle cure di cui hanno bisogno senza barriere. In quanto tale, vorrei anche riconoscere diverse giurisdizioni per il loro lavoro di collaborazione volto a eliminare le spese per i pazienti nelle rispettive giurisdizioni e le circostanze sottostanti che le hanno portate. A Terranova e Labrador sono state completamente rimborsate tutte le detrazioni del trasferimento sanitario canadese dal 2019 e la Columbia Britannica ha ricevuto diversi rimborsi parziali in riconoscimento degli elementi del loro piano d'azione per il rimborso che sono stati implementati con successo. Copie dei rispettivi piani d'azione per il rimborso sono reperibili in questo rapporto. La Columbia Britannica ha anche assunto una forte posizione legale nel combattere le accuse dei pazienti nella provincia per quanto riguarda l’accesso all’assistenza sanitaria necessaria nelle cliniche private, nonché, più recentemente, per l’accesso alle cure virtuali. Questa azione incarna la posizione che condividiamo tutti, secondo cui nessuno dovrebbe essere lasciato indietro o negata l’assistenza sanitaria necessaria, in base alla sua capacità o volontà di pagare.

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$ NIL a) Name of applicable pieces of PT legislation that prohibit extra-billing and user charges (including facility fees). Please use as much space as needed below. b) Details about the process used to investigate extra-billing and user charges (e.g., proactive regular audits of provider billings; reactive investigations triggered by patient complaints, media reports or other sources). Please use as much space as needed below. c) A summary of any extra-billing and user charges investigations during the fiscal year including: Number of investigations Nature of each investigation (e.g., physician billing audits; patient triggered investigations; private clinic audits; third party report findings (e.g., Auditor General)) Confirmed cases and dollar amounts of extra-billing and user charges. Any amounts reimbursed to patients. Please use as much space needed bellow or add extra pages as necessary. d) Details on mechanisms to deter patient extra-billing and user charges (e.g., provider fines; plan payment withholding; provider/patient education initiatives; loss of facility accreditation). Please use as much space as needed below. CANADA HEALTH ACT FINANCIAL STATEMENT OF ACTUAL AMOUNTS OF EXTRA-BILLING AND USER CHARGES FOR THE PERIOD APRIL 1, 2019 TO MARCH 31, 2020 Total for extra-billing and user charges $ 0 a) Name of applicable pieces of PT legislation that prohibit extra-billing and user charges (including facility fees). Please use as much space as needed below. b) Details about the process used to investigate extra-billing and user charges (e.g., proactive regular audits of provider billings; reactive investigations triggered by patient complaints, media reports or other sources). Please use as much space as needed below. c) A summary of any extra-billing and user charges investigations during the fiscal year including: Number of investigations Nature of each investigation (e.g., physician billing audits; patient triggered investigations; private clinic audits; third party report findings (e.g., Auditor General)) Confirmed cases and dollar amounts of extra-billing and user charges. Any amounts reimbursed to patients. Please use as much space needed bellow or add extra pages as necessary. d) Details on mechanisms to deter patient extra-billing and user charges (e.g., provider fines; plan payment withholding; provider/patient education initiatives; loss of facility accreditation). CANADA HEALTH ACT FINANCIAL STATEMENT OF ACTUAL AMOUNTS OF EXTRA-BILLING AND USER CHARGES FOR THE PERIOD APRIL 1, 2019 TO MARCH 31, 2020 Total for extra-billing and user charges $ 0 a) Name of applicable pieces of PT legislation that prohibit extra-billing and user charges (including facility fees). Please use as much space as needed below. b) Details about the process used to investigate extra-billing and user charges (e.g., proactive regular audits of provider billings; reactive investigations triggered by patient complaints, media reports or other sources). Please use as much space as needed below. c) A summary of any extra-billing and user charges investigations during the fiscal year including: Number of investigations. Nature of each investigation (e.g., physician billing audits; patient triggered investigations; private clinic audits; third party report findings (e.g., Auditor General)). Confirmed cases and dollar amounts of extra-billing and user charges. Any amounts reimbursed to patients. Please use as much space as needed bellow. d) Details on mechanisms to deter patient extra-billing and user charges (e.g., provider fines; plan payment withholding; provider/patient education initiatives; loss of facility accreditation). Please use as much space as needed below. International and Intergovernmental Affairs Directorate CANADA HEALTH ACT FINANCIAL STATEMENT OF ACTUAL AMOUNTS OF EXTRA-BILLING AND USER CHARGES FOR THE PERIOD APRIL 1, 2019 TO MARCH 31, 2020 Total for extra-billing and user charges $ 6,560 a) Name of applicable pieces of PT legislation that prohibit extra-billing and user charges (including facility fees). Please use as much space as needed below. b) A summary of any extra-billing and user charges investigations during the fiscal year including: Number of investigations Nature of each investigation (e.g., physician billing audits; patient triggered investigations; private clinic audits; third party report findings (e.g., Auditor General)) Confirmed cases and dollar amounts of extra-billing and user charges. Any amounts reimbursed to patients. Please use as much space needed bellow or add extra pages as necessary. c) Details on mechanisms to deter patient extra-billing and user charges (e.g., provider fines; plan payment withholding; provider/patient education initiatives; loss of facility accreditation). Please use as much space as needed below. 21 Total # of Reviews Involving Confirmed EBUC (Including Facility Fees) Total Amount Charged and Reimbursed for Confirmed Reviews $19,474.49 $19,474.49 d) Details on mechanisms to deter patient extra-billing and user charges (e.g., provider fines; plan payment withholding; provider/patient education initiatives; loss of facility accreditation). Please use as much space as needed below. CANADA HEALTH ACT FINANCIAL STATEMENT OF ACTUAL AMOUNTS OF EXTRA-BILLING AND USER CHARGES FOR THE PERIOD APRIL 1, 2019 TO MARCH 31, 2020 Total for extra-billing and user charges $ 0 a) Name of applicable pieces of PT legislation that prohibit extra-billing and user charges (including facility fees). Please use as much space as needed below. b) Details about the process used to investigate extra-billing and user charges (e.g., proactive regular audits of provider billings; reactive investigations triggered by patient complaints, media reports or other sources). Please use as much space as needed below. c) A summary of any extra-billing and user charges investigations during the fiscal year including: Number of investigations Nature of each investigation (e.g., physician billing audits; patient triggered investigations; private clinic audits; third party report findings (e.g., Auditor General)) Confirmed cases and dollar amounts of extra-billing and user charges. Any amounts reimbursed to patients. Please use as much space needed bellow or add extra pages as necessary. d) Details on mechanisms to deter patient extra-billing and user charges (e.g., provider fines; plan payment withholding; provider/patient education initiatives; loss of facility accreditation). Please use as much space as needed below. CANADA HEALTH ACT FINANCIAL STATEMENT OF ACTUAL AMOUNTS OF EXTRA-BILLING AND USER CHARGES FOR THE PERIOD APRIL 1, 2019 TO MARCH 31, 2020 Total for extra-billing and user charges $ 0 a) Name of applicable pieces of PT legislation that prohibit extra-billing and user charges (including facility fees). Please use as much space as needed below. b) Details about the process used to investigate extra-billing and user charges (e.g., proactive regular audits of provider billings; reactive investigations triggered by patient complaints, media reports or other sources). Please use as much space as needed below. c) A summary of any extra-billing and user charges investigations during the fiscal year including: Number of investigations Nature of each investigation (e.g., physician billing audits; patient triggered investigations; private clinic audits; third party report findings (e.g., Auditor General)) Confirmed cases and dollar amounts of extra-billing and user charges. Any amounts reimbursed to patients. Please use as much space needed bellow or add extra pages as necessary. d) Details on mechanisms to deter patient extra-billing and user charges (e.g., provider fines; plan payment withholding; provider/patient education initiatives; loss of facility accreditation). Please use as much space as needed below. CANADA HEALTH ACT FINANCIAL STATEMENT OF ACTUAL AMOUNTS OF EXTRA-BILLING AND USER CHARGES FOR THE PERIOD APRIL 1, 2019 TO MARCH 31, 2020 Total for extra-billing and user charges $ 0 a) Name of applicable pieces of PT legislation that prohibit extra-billing and user charges (including facility fees). Please use as much space as needed below. b) Details about the process used to investigate extra-billing and user charges (e.g., proactive regular audits of provider billings; reactive investigations triggered by patient complaints, media reports or other sources). Please use as much space as needed below. c) A summary of any extra-billing and user charges investigations during the fiscal year including: Number of investigations Nature of each investigation (e.g., physician billing audits; patient triggered investigations; private clinic audits; third party report findings (e.g., Auditor General)) Confirmed cases and dollar amounts of extra-billing and user charges. Any amounts reimbursed to patients. Please use as much space needed bellow or add extra pages as necessary. d) Details on mechanisms to deter patient extra-billing and user charges (e.g., provider fines; plan payment withholding; provider/patient education initiatives; loss of facility accreditation). Please use as much space as needed below. CANADA HEALTH ACT FINANCIAL STATEMENT OF ACTUAL AMOUNTS OF EXTRA-BILLING AND USER CHARGES FOR THE PERIOD APRIL 1, 2019 TO MARCH 31, 2020 Total for extra-billing and user charges $ 13,275,823 a) Name of applicable pieces of PT legislation that prohibit extra-billing and user charges (including facility fees). Please use as much space as needed below. b) Details about the process used to investigate extra-billing and user charges (e.g., proactive regular audits of provider billings; reactive investigations triggered by patient complaints, media reports or other sources). Please use as much space as needed below. Beneficiary and Diagnostic Services Branch: Audit and Investigation Branch, Billing Integrity Program: c) A summary of any extra-billing and user charges investigations during the fiscal year including: Number of investigations Nature of each investigation (e.g., physician billing audits; patient triggered investigations; private clinic audits; third party report findings (e.g., Auditor General)) Any amounts reimbursed to patients. Please use as much space needed bellow or add extra pages as necessary. d) Details on mechanisms to deter patient extra-billing and user charges (e.g., provider fines; plan payment withholding; provider/patient education initiatives; loss of facility accreditation). Please use as much space as needed below. CANADA HEALTH ACT FINANCIAL STATEMENT OF ACTUAL AMOUNTS OF EXTRA-BILLING AND USER CHARGES FOR THE PERIOD APRIL 1, 2019 TO MARCH 31, 2020 Total for extra-billing and user charges $ 0 a) Name of applicable pieces of PT legislation that prohibit extra-billing and user charges (including facility fees). Please use as much space as needed below. b) Details about the process used to investigate extra-billing and user charges (e.g., proactive regular audits of provider billings; reactive investigations triggered by patient complaints, media reports or other sources). Please use as much space as needed below. c) A summary of any extra-billing and user charges investigations during the fiscal year including: Number of investigations Nature of each investigation (e.g., physician billing audits; patient triggered investigations; private clinic audits; third party report findings (e.g., Auditor General)) Confirmed cases and dollar amounts of extra-billing and user charges. Any amounts reimbursed to patients. Please use as much space needed bellow or add extra pages as necessary. d) Details on mechanisms to deter patient extra-billing and user charges (e.g., provider fines; plan payment withholding; provider/patient education initiatives; loss of facility accreditation). Please use as much space as needed below. CANADA HEALTH ACT FINANCIAL STATEMENT OF ACTUAL AMOUNTS OF EXTRA-BILLING AND USER CHARGES FOR THE PERIOD APRIL 1, 2019 TO MARCH 31, 2020 Total for extra-billing and user charges $ 0 a) Name of applicable pieces of PT legislation that prohibit extra-billing and user charges (including facility fees). Please use as much space as needed below. b) Details about the process used to investigate extra-billing and user charges (e.g., proactive regular audits of provider billings; reactive investigations triggered by patient complaints, media reports or other sources). Please use as much space as needed below. c) A summary of any extra-billing and user charges investigations during the fiscal year including: Number of investigations Nature of each investigation (e.Anywaysg., physician billing audits; patient triggered investigations; private clinic audits; third party report findings (e.g., Auditor General)) Confirmed cases and dollar amounts of extra-billing and user charges. Any amounts reimbursed to patients. Please use as much space needed bellow or add extra pages as necessary. d) Details on mechanisms to deter patient extra-billing and user charges (e.g., provider fines; plan payment withholding; provider/patient education initiatives; loss of facility accreditation). Please use as much space as needed below. CANADA HEALTH ACT FINANCIAL STATEMENT OF ACTUAL AMOUNTS OF EXTRA-BILLING AND USER CHARGES FOR THE PERIOD APRIL 1, 2019 TO MARCH 31, 2020 Total for extra-billing and user charges $ 0.00 a) Name of applicable pieces of PT legislation that prohibit extra-billing and user charges (including facility fees). Please use as much space as needed below. b) Details about the process used to investigate extra-billing and user charges (e.g., proactive regular audits of provider billings; reactive investigations triggered by patient complaints, media reports or other sources). Please use as much space as needed below. c) A summary of any extra-billing and user charges investigations during the fiscal year including: Number of investigations Nature of each investigation (e.g., physician billing audits; patient triggered investigations; private clinic audits; third party report findings (e.g., Auditor General)) Confirmed cases and dollar amounts of extra-billing and user charges. Any amounts reimbursed to patients. Please use as much space needed bellow or add extra pages as necessary. d) Details on mechanisms to deter patient extra-billing and user charges (e.g., provider fines; plan payment withholding; provider/patient education initiatives; loss of facility accreditation). Please use as much space as needed below. [Following is the text of the letter sent on June 18, 1985, to all provincial and territorial Ministers of Health by the Honourable Jake Epp, federal Minister of Health and Welfare. (Note: Minister Epp sent the French equivalent of this letter to Quebec on July 15, 1985.)] Public Administration Comprehensiveness Universality Portability Reasonable Accessibility Conditions Regulations [Following is the text of the letter sent on January 6, 1995, to all provincial and territorial Ministers of Health by the federal Minister of Health, the Honourable Diane Marleau.] [Following is the text of the letter sent on August 8, 2018, to all provincial and territorial Ministers of Health by the federal Minister of Health, the Honourable Ginette Petitpas Taylor.] Diagnostic Services Policy Reimbursement Policy Strengthened Reporting Reimbursement Policy for Provinces and Territories- Subject to Deductions under the Canada Health Act (the Reimbursement Policy) Background Time for a New Reimbursement Policy Current Process Working Together to Eliminate Patient Charges [Following is the text of the Newfoundland and Labrador Reimbursement Action Plan and January 2023 Status Update] [Following is the text of the Ontario's Reimbursement Action Plan and February 2023 Status Update] The timeline of the investigations The nature of the clinic-level service data requested by ON and provided by each clinic When the services described by this data were provided to patients The methodology used to analyze that data What was the nature of the fees charged by each clinic? How many patients were charged, and what proportion of patients at each clinic paid fees? Extra-billing and User Charges Patient information Summary Progress Report – Abortion Services in Ontario Action Timeline [Following is the text of the British Columbia Extra-Billing Elimination Action Plan and December 2022 Status Update] Health Human Resource (HHR) Strategy Continued Improvements in Seniors Care, Long-Term Care and Assisted Living Emergency Health Provider Registry (EHPR) Supporting our Nursing and Allied Health Staff Supporting Health Staff in BC's Northern Communities Supporting Internationally Educated Health Professionals New to Practice Incentives Workplace Violence Prevention and Cultural Safety/strong>