The new Canada Health Act (CHA) Services Policy came into effect on April 1, 2026. The Canada Health Act is federal legislation that allows Canadians access to medically necessary health care services without financial barriers like extra-billing and user charges. To receive federal funding, provinces and territories must comply with the criteria established in the CHA.
Currently, CHA coverage is limited to medically necessary hospital services and physician services. Coverage does not extend to important areas such as outpatient pharmaceuticals, dental care, long-term care, and many mental health services.
Physician-equivalent providers, such as nurse practitioners, already practise independently within their legislated scope of practice providing primary care services including diagnosing, treating, prescribing and referring patients to specialists as appropriate. Pursuant to the new CHA Services Policy, if the service is deemed medically necessary and within the “core basket of services”, it will be covered by provincial or territorial health plans. To comply with the CHA Services Policy, provinces and territories will need to establish funding models for these services.
These developments are expected to support the CHA’s objective of providing greater access to medically necessary care. This may help ease the strain on physicians through greater distribution of shared responsibilities. However, it may also introduce additional complexities for physician-equivalent providers, particularly in navigating the existing OHIP billing structure which requires strict documentation and compliance.
Once implemented, physician-equivalent providers like nurse practitioners will not be able to charge patients for medically necessary services as it will be considered extra-billing or user charges, which are prohibited under the CHA.
Additionally, under the new policy, provinces and territories will be required to report patient charges beginning in December 2028.
Notably, Ontario was not ready to meet the April 1, 2026, deadline. However, provinces will not incur penalties for non-compliance until April 2027.
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