The provincial government claims an oversight led to 141 communities being removed from Alberta’s Rural Remote Northern Program — which compensates doctors working in under-served areas with flat-fee payments and variable fee premiums — according to a statement released Sunday.
Several Indigenous communities, Banff, Canmore and High River were among the 141 on the list stripped of their rural designation.
The RRNP assesses communities and awards isolation points based on “the extent to which the community is medically isolated.”
“The greater the medical isolation, the higher the points, and the greater the financial incentives for physicians,” the Alberta Medical Association’s website said.
The list omission comes after the Health Ministry made changes to the way rural doctors bill for services in an effort to keep them from re-locating — lifting the cap on variable fee payments.
On Friday, Health Minister Tyler Shandro said the changes totalled $81 million and included cash top-ups to doctors in rural areas.
Massive potential impact, NDP says
The NDP Opposition questioned whether or not physicians in those communities would still be considered rural doctors and included in the changes.
NDP health critic David Shepherd called it a sweeping change with a massive potential impact, noting that it takes away the incentive for doctors to move to remote communities.
Shepherd called Shandro a liar, saying he did not communicate clearly.
“The minister clearly lied when he was asked to define. He knew he was changing that definition on Friday. His bulletin says he has changed that definition,” he said.
Government apologizes for ‘oversight’
Shandro tweeted Sunday that no communities were being removed from the list and it would be corrected.
Steve Buick, Shandro’s press secretary, said the 141 communities are the least-isolated ones, according to the formula used by the program.
“The variable fee premium rate in these communities is zero per cent; so a doctor who works in one of those communities but doesn’t live there would receive no payments under the program, and, in fact, only 29 of those communities last year had a doctor who did,” he said in an emailed statement.
“The RRNP list does not apply to any other program; the list has no meaning outside the program.”
Buick said Shandro approved consulting on the list and removing the flat-fee amount when he uncapped the variable rates.
“Most of those communities only qualify for the flat [rate], so to the department, removing the flat rate meant, ‘OK, take them off the list.’ No, we should’ve decided on that separately, and the decision is leave them on,” he said.
“Doctors get one payment or the other: if you don’t get the variable premium, you get the flat rate instead. But remember, there’s a big scale and these are the least-isolated communities. The amounts are small and most of the doctors there don’t qualify at all. The difference between on the list and not on it is actually $0 for most of them.”
Alberta Health tweeted Sunday, saying the list, Med Bulletin 227, was published with incorrect information.
“Out of the 141 communities identified on social media as communities that were previously listed, only 29 had physicians who claimed that flat fee,” it said.
“Physicians who had previously been receiving this fee and new physicians who apply in these communities will continue to be able to receive this fee.”
The government apologized for the “oversight,” saying it will revise the bulletin and community list on Monday.
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