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Relatório Anual da Lei de Saúde do Canadá 2021

Sep 18, 2023Sep 18, 2023

Baixe em formato PDF (9,9 MB, 416 páginas)

Organização:Health Canada

Data de publicação:2023

Gato.:H1-4E-PDF

ISBN:1497-9144

Bar.:220753

A Health Canada gostaria de reconhecer o trabalho e o esforço despendidos na produção deste Relatório Anual. É por meio da dedicação e do compromisso oportuno dos seguintes departamentos de saúde e suas equipes que podemos apresentar a você este relatório sobre a administração e operação da Lei de Saúde do Canadá:

Também apreciamos muito o extenso esforço de trabalho que foi colocado neste relatório por nossa equipe de produção, incluindo editores eletrônicos, tradutores, editores e especialistas em concordância, impressores e funcionários da Health Canada.

Tenho a honra de apresentar ao Parlamento e aos canadenses o Relatório Anual da Lei de Saúde do Canadá 2021-2022.

Como Ministro Federal da Saúde, uma de minhas principais responsabilidades é defender a Lei de Saúde do Canadá, que garante que todos os canadenses tenham acesso equitativo a serviços essenciais de saúde com base em suas necessidades e não em sua capacidade ou disposição de pagar. A minha carta de mandato também me compromete a reforçar o cumprimento e a modernizar a interpretação da Lei. Sei que os canadenses continuam justificadamente orgulhosos de nosso sistema de saúde com financiamento público, mas nosso sistema também está sob pressão significativa, o que exigirá que todos os níveis de governo trabalhem juntos para garantir que atenda às necessidades modernas dos canadenses.

A fim de garantir a solidez do sistema de saúde a longo prazo, trabalhando em parceria com as províncias e territórios, o nosso trabalho centrar-se-á nas principais áreas prioritárias; 1) melhorar o acesso aos serviços de saúde da família; 2) lidar com atrasos e apoiar, atrair e reter profissionais de saúde, 3) modernizar nosso sistema de saúde com dados de saúde e saúde digital, 4) melhorar o acesso a serviços de saúde mental e uso de substâncias e 5) ajudar os canadenses a envelhecer com dignidade, mais perto de casa .

O Medicare é um excelente exemplo de colaboração federal-provincial-territorial, pois a saúde é uma responsabilidade compartilhada no Canadá e, para alcançar resultados e atender às necessidades de saúde dos canadenses, todos os níveis do governo precisam trabalhar juntos. Os governos provinciais e territoriais têm jurisdição primária na prestação e administração de cuidados de saúde, enquanto o governo federal define os requisitos nacionais que devem ser refletidos nos planos de seguro de saúde, de acordo com a Lei de Saúde do Canadá, que a maioria das jurisdições não apenas atende, mas frequentemente excede.

Ao longo da pandemia do COVID-19, vimos o que pode ser alcançado quando todos os níveis de governo trabalham juntos em colaboração. Para atender às necessidades de saúde dos canadenses, vimos a expansão do atendimento virtual, da telemedicina e do alcance dos profissionais de saúde. No entanto, embora nosso sistema de saúde público universal tenha sido parte integrante da resposta do Canadá ao COVID-19, a pandemia trouxe à tona novos desafios e ampliou aqueles que já criam estresse em nosso sistema. Para isso, as províncias e territórios têm trabalhado arduamente na luta contra o COVID-19, para reduzir os atrasos agravados pela pandemia e recrutar e reter profissionais de saúde.

Nosso trabalho colaborativo também se estende ao fortalecimento do sistema de saúde universal do Canadá, mantendo os padrões da Lei de Saúde do Canadá. Do ponto de vista federal, estamos trabalhando muito para garantir que, à medida que nosso sistema de saúde evolua, o mesmo aconteça com a interpretação e administração da Lei de Saúde do Canadá, para melhor atender os canadenses. Estamos tomando medidas para combater as cobranças de pacientes, incluindo as de serviços de aborto cirúrgico, diagnósticos e outros serviços segurados recebidos em clínicas privadas; e, pela primeira vez, em março de 2023, as províncias e territórios que permitem cobranças por serviços de diagnóstico médicos necessários também enfrentarão deduções em seus pagamentos da Canada Health Transfer. O objetivo da Lei não é cobrar deduções, mas sim trabalhar com as províncias e territórios para garantir que os canadenses tenham acesso aos cuidados de que precisam sem barreiras. Como tal, também gostaria de reconhecer várias jurisdições por seu trabalho colaborativo para eliminar cobranças de pacientes em suas respectivas jurisdições e as circunstâncias subjacentes que levaram a elas. Newfoundland and Labrador foi totalmente reembolsado por todas as deduções do Canada Health Transfer desde 2019 e British Columbia recebeu vários reembolsos parciais em reconhecimento aos elementos de seu Plano de Ação de Reembolso que foram implementados com sucesso. Cópias de seus respectivos Planos de Ação de Reembolso podem ser encontradas neste relatório. A Colúmbia Britânica também adotou uma forte posição legal no combate às cobranças de pacientes na província em relação ao acesso aos cuidados de saúde necessários em clínicas privadas, bem como, mais recentemente, ao acesso a atendimento virtual. Esta ação incorpora a posição que todos compartilhamos, de que ninguém deve ser deixado para trás ou negado os cuidados de saúde necessários, com base em sua capacidade ou disposição de pagar.

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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>
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