A public report entitled Prescription for Fairness - Special Report: Out-of-Country Health Services, has been issued pursuant to Section 28(2) of the Ombudsman Act.
The Alberta Ombudsman conducted an investigation, under his own motion, pursuant to Section 12(2) of the Ombudsman Act in response to a number of complaints brought to his attention. His investigation focused on whether Alberta Health and Wellness met the needs of Albertans in accessing out-of-country health services that are either not available in Canada or are not available in a reasonable timeframe.
The purpose of the investigation was to review the administrative fairness of the process, including:
- how Albertans are informed of the availability of funding for out-of-country health services;
- how medical practitioners are informed about the requirements and availability of the program;
- how out-of-country claims are reviewed;
- how decisions are made by the Out-of-Country Health Services Committee and the Out-of-Country Health Services Appeal Panel;
- how wait times factor into the decision making process; and
- how decisions are conveyed to Albertans.
All recommendations have been accepted and are being implemented.