What it is: A private member’s bill to amend Alberta’s Health Care Insurance Act
What it would do: Bar primary care doctors in certain practices from choosing case by case whether to bill the province or charge patients
What changes: The “flexibly participating” billing status would no longer be available in prescribed primary care practices
Why it matters: Benefits insurers and group plan administrators may see shifts in how supplementary coverage interacts with Alberta’s public system
Where it stands: Introduced in the Alberta legislature; has not passed second reading
Some Alberta doctors can decide, patient by patient, whether to bill the province or charge the person sitting across from them.
Bill 214 would end that arrangement in primary care.
The private member’s bill, introduced by Member Hoffman, would amend the Alberta Health Care Insurance Act to stop doctors in certain primary care practices from opting into a billing category called “flexibly participating.” That status currently lets a doctor choose, one visit at a time, between putting a service through the public plan or billing the patient directly.
Right now, a doctor with that designation looks at each appointment and decides: public plan or private invoice. Bill 214 would close that middle ground for primary care. Doctors in prescribed practices simply could not elect the case-by-case billing option. The bill does not bar them from opting out of the public plan altogether - it targets the ability to toggle between public and private on a visit-by-visit basis.
The bill would also simplify the definition of “non-Plan services.” The current wording ties the term to specific service categories. The replacement is plainer - any service that is not an insured health service. And for doctors who do hold that case-by-case status outside prescribed practices, the bill adds a new restriction: they could not reclassify a publicly covered service as non-Plan and bill the patient for it.
The policy shift is spelled out in the preamble. The existing Act says the government “supports individuals having a choice in how they access care.” Bill 214 would replace that with language about “preventing the creation of financial barriers” and ensuring access “regardless of an individual’s income, place of residence or personal circumstances.”
One disclosure requirement would disappear too. Doctors who bill case by case currently must tell patients they could get the same service through the public plan from another doctor. The bill would scrap that rule.
If passed, the changes would take effect April 1, 2027. For benefits insurers and group plan administrators, the bill is worth tracking - any shift in how primary care billing works in Alberta could ripple into how supplementary health plans interact with the public system.
The bill has been introduced but has not passed second reading. Its provisions have not been debated or amended by the legislature.
