Ottawa plans to crack down on doctors charging for medically necessary health care

A rise in the number of companies offering Canadians faster access to health care at a price is prompting the federal government to launch a crackdown on the practice, CBC News has learned.

Health Minister Jean-Yves Duclos is telling the provinces to put a stop to patients being charged for medically necessary care — and warns that Ottawa will claw back federal health transfer payments if the charges continue.

"I am very concerned with the recent increase in reports of patient charges for medically necessary services," Duclos says in a letter sent Thursday to all provincial and territorial health ministers. Federal officials provided CBC News with a copy.

"No matter where in the country Canadians live or how they receive medically necessary care, they must be able to access these services without having to pay out of pocket."

Companies charging patients for virtual visits with a family physician are the chief targets of the federal crackdown, according to a senior government official.

Although the Canada Health Act prohibits charging "insured persons" for medically necessary services, there has been an explosion recently in the number of companies across the country offering online doctors' appointments and charging fees in the range of $50 to $100 per visit.

Companies that charge a fee get around the Canada Health Act prohibition by connecting the patient to a physician in a different province. Under the medicare rules in the province where the doctor practises, the patient technically would not qualify as an "insured person."

Some critics have called this a loophole in the Canada Health Act.

In his letter, Duclos says expanded access to health care using virtual platforms must remain "true to the spirit and intent of the Canada Health Act."

Duclos says he will give provinces and territories a document clarifying that charges for medically necessary services are not allowed, regardless of where the patient lives.

"The complexities of modern family health, virtual and surgical care, including its provision across jurisdictions, and expanding scopes of practice of health workers, should not be used to permit these charges," the letter says.

"As our health care system evolves, it must do so while respecting the Canada Health Act." 

One of the biggest players charging for virtual physician care is Maple, which describes itself as "Canada's top-rated virtual care app" and charges $69 or more for an appointment.

"We charge a fee for our services only when they are not covered by provincial health plans," says the company's website.