Health Deputy Minister 22nd floor, Telus Plaza, North Tower 10025 Jasper Avenue , TSJ 1 S6 Telephone 780-422-0747 Fax 780-427-1016 www.health.alberta.ca

M.O. 613/2021

WHEREAS Section 18(2) of the Alberta Health Care Insurance Regulation authorizes the Minister of Health to establish by order a program to benefit one or more physicians or categories of physicians who are entitled to receive payment of benefits under the Alberta Health Care Insurance Plan;

WHEREAS the College of Physicians and Surgeons of Alberta requires every physician to possess and maintain liability insurance coverage in order to practice in Alberta;

WHEREAS such physicians generally obtain professional liability insurance from the Canadian Medical Protective Association (CMPA);

WHEREAS the Minister of Health wished to reimburse such physicians for a portion of their fees paid to the CMPA for liability insurance;

WHEREAS the Medical Liability Reimbursement Program was established by Ministerial Order 641 /2020 for the 2020 calendar year;

WHEREAS it is desirable to update the Medical Liability Reimbursement Program for the 2021 calendar year;

THEREFORE, I, LORNA ROSEN, Deputy Minister of Health, pursuant to section 21 (1 )(b) of the InterpretationAct, and pursuant to section 18(2) of the AlbertaHealth Care Insurance Regulation, do hereby:

1. repeal Ministerial Order 641 /2020; and

2. establish the Medical Liability Reimbursement Program for the 2021 calendar year in accordance with the attached Appendix A.

Classification: Public M.0. 613/2021

This Ministerial Order is effective upon signing.

DATED AT EDMONTON, Alberta, this 3'0.tlf day of a;vJ , 2021.

if-LLORNA) ROSEN DEPUTY MINISTER

Classification: Public M.O. 613/2021

APPENDIX A

MEDICAL LIABILITY REIMBURSEMENT PROGRAM - 2021

1. Definitions

a) "CMPA" means the Canadian Medical Protective Association.

b) "CMPA fees" means the annual amount (i.e., January to December in a given year) paid by a physician to the CMPA for medical liability insurance.

c) "MLR" means Medical Liability Reimbursement.

d) "MLR Program Application Form" means the form referred to in clause 4(a) of this Appendix A, as amended from time to time by Alberta Health.

e) "rural physician" means a physician, regardless of practice type or specialty, who is eligible for the MLR Program pursuant to clause 3(a) of this Appendix A and who practices and resides in a community listed in Schedule B to this Appendix A.

2. Purpose

a) The purpose of the MLR Program is to reimburse eligible physicians for a portion of CMPA fees in accordance with this Ministerial Order, at the rates set out in Schedule A to this Appendix A, which rates may be updated annually by Ministerial Order.

3. Eligibility

a) Subject to clause 3(b) below, a physician is eligible for reimbursement of a portion of CMPA fees through the MLR Program, in accordance with Schedule A, prorated for the portion of the calendar year during which the physician is:

i. a regulated member of the College of Physicians and Surgeons of Alberta (CPSA), holding a practice permit issued under the Health Professions Act;

ii. entitled to receive payment of benefits under the Alberta Health Care Insurance Plan pursuant to the Alberta Health Care Insurance Act (Act) and/or employed by or a party to a service agreement with a person under section 20.1 of the Act that enables the person to receive payment of benefits in respect of insured services provided by the physician under the employment or service agreement;

Classification: Public M.O. 613/2021

iii. providing insured services and/or other publicly funded medically required services;

iv. a member of the CMPA; and

v. determined by the CMPA to practice in Alberta as the physician's "primary province".

b) A physician is not eligible for reimbursement of CMPA fees through the MLR Program for any portion of a year during which the physician:

i. is a Provisional Register Postgraduate Trainee who is not registered with the CPSA as a Physician extender;

ii. . is opted-out of the Alberta Health Care Insurance Plan;

iii. has received or is entitled to receive reimbursement for CMPA fees from another government in Canada; or

iv. otherwise fails to meet all of the eligibility requirements in clause 3(a).

c) An eligible physician must notify Alberta Health as soon as possible if there are any changes in the physician's circumstances that may impact the physician's eligibility, as determined by Alberta Health.

4. Application

a) To apply to Alberta Health to participate in the MLR Program, a physician must complete and submit to Alberta Health the MLR Program Application Form, as updated by Alberta Health from time to time.

b) A physician must submit the MLR Program Application Form by December 31 in order to be reimbursed for a portion of that current calendar year's CMPA fees in accordance with Schedule A. If a physician misses this application deadline, the physician is deemed ineligible to participatein the MLR Program until the following calendar year.

c) If Alberta Health determines a physician meets the eligibility requirements referred to in clause 3(a), the physician will remain enrolled in the MLR Program and remain eligible to receive reimbursement of CMPA fees in accordance with this Ministerial Order until: i. the physician no longer meets the eligibility requirements; or

Classification: Public M.O. 613/2021

ii. the Minister of Health terminates the MLR Program in accordance with this Ministerial Order.

d) If Alberta Health determines the physician is ineligible for the MLR Program, Alberta Health will advise the physician of their ineligibility by email. The physician may reapply under clause 4(a) at any time.

e) If Alberta Health determines the physician is eligible for the MLR Program, Alberta Health will proceed to reimburse the physician's CMPA fees in accordance with this Ministerial Order without providing formal notice of eligibility in the MLR Program.

5. Annual Reimbursement Process

a) Upon receiving confirmation from CMPA that a physician has paid the entire amount of the physician's CMPA fees in full, and subject to clause 8 of this Appendix A, Alberta Health will reimburse the physician the full reimbursement amount set out in Schedule A by direct deposit into the account specified by the physician.

b) Failure by a physician to consent to the CMPA sharing information with Alberta Health for purposes of clause 5(a) above will prevent Alberta Health from reimbursing the physician's CMPA fees until the physician has provided all relevant information to Alberta Health.

c) Failure by a physician to provide banking information to Alberta Health for the purposes of clause 5(a) above will prevent Alberta Health from reimbursing the physician's CMPA fees until the physician has provided the banking information to Alberta Health.

6. Quarterly Reimbursement Process

a) Upon receiving confirmation from CMPA that a physician has paid the physician's CMPA fees monthly, and subject to clause 8 of this Appendix A, Alberta Health will reimburse the physician the amount set out in Schedule A in quarterly instalments by direct deposit into the account specified by the physician for the months that the physician paid CMPA fees, as confirmed by CMPA.

b) Failure by a physician to consent to the CMPA sharing information with Alberta Health for purposes of clause 6(a) above will prevent Alberta Health from reimbursing the physician's CMPA fees until the physician has provided all relevant information to Alberta Health. c) Failure by a physician to provide banking information to Alberta Health for the purposes of clause 6(a) above will prevent Alberta Health from reimbursing the physician's CMPA fees until the physician has provided

Classification: Public M.O. 613/2021

the banking information to Alberta Health.

7. Physician liability for over-payments

a) If Alberta Health reimburses a physician for CMPA fees for any period during which the physician does not meet the eligibility requirements of the MLR Program, or for which the physician is otherwise not legally entitled to receive reimbursement under the MLR Program:

i. the physician must repay the reimbursement amount provided for any period during which the physician did not meet the eligibility requirements; or

ii. the Minister may, as permitted by applicable laws, deduct the amount of any such over-payment from any other money owed or payable to the physician by Alberta Health.

8. Termination of MLR Program

a) The Minister may amend or terminate the MLR Program at any time upon providing physicians with 30 calendar days' notice by Alberta Health Care Insurance Plan Bulletin. Changes to the MLR Program Application Form are not amendments for the purpose of this clause.

9. Other

a) In the event of any inconsistency or ambiguity between this Ministerial Order and any other document, this Ministerial Order governs.

b) A physician may not apply to the MLR Program where the physician has already received reimbursement for CMPA fees from another government in Canada.

Classification: Public M.O. 613/2021

SCHEDULE A

Type of Description CMPA Fee Physician Alberta Health work Deductible Reimbursement codes Any Rural physicians Depends on $1,000 Remainder of type of work fee depending on type of work Residents and Fellows- With moonlighting/restricte 14 $1,800 $1,200 $600 d registration- Includes out-of- province electives Pathology- 21 $4,272 $2,500 $1,772 Anatomical or General Pathology- 23 $1,800 $1,200 $600 Hematological Biochemistry- 24 $1,800 $1,200 $600 Medical Microbiology- 25 $1,800 $1,200 $600 Medical Pathology- 26 $1,800 $1,200 $600 Neuropathology 27 Geriatric medicine $1,800 $1,200 $600 27 Palliative medicine $1,800 $1,200 $600 Physical medicine and 27 $1,800 $1,200 $600 rehabilitation Public Health and Preventative medicine 28 $1,800 $1,200 $600 (Community medicine) Clinical associates and hospitalists on a 31 $2,988 $1,800 $1,188 medical or surgical service 33 Assistance at surgery $1,800 $1,200 $600 Family medicine or General practice- Excluding anaesthesia, 35 $2,988 $1,000 $1,988 obstetrics (labour and delivery), shifts in the emergency department, and

Classification: Public M.O. 613/2021

surgery Psychiatry and 36 $2,988 $1,800 $1,188 addiction medicine Surgical 37 consultations/Office $2,988 $1,800 $1,188 surgical practice 38 Pain medicine $4,272 $2,500 $1,772 Obstetrics/Gynecolog 39 $4,272 $2,500 $1,772 y Clinical Immunology 42 $2,988 $1,800 $1,188 and Allergy 44 Dermatology $2,988 $1,800 $1,188 45 Diagnostic radiology $4,272 $2,500 $1,772 Endocrinology and 46 $1,800 $1,200 $600 metabolism 47 Gastroenterology $4,272 $2,500 $1,772 48 Genetics - Medical $1,800 $1,200 $600 50 Hematology $4,272 $2,500 $1,772 Occupational 51 $1,800 $1,200 $600 medicine 52 Infectious diseases $1,800 $1,200 $600 Critical/Intensive care 53 $4,272 $2,500 $1,772 medicine Internal medicine and 54 its subspecialties - $4,272 $2,500 $1,772 not elsewhere noted 55 Nephrology $2,988 $1,800 $1,188 56 Neurology $10,824 $4,000 $6,824 58 Nuclear medicine $1,800 $1,200 $600 59 Oncology - Medical $2,988 $1,800 $1,188 60 Ophthalmology $6,564 $2,500 $4,064 61 Pediatrics $6,564 $2,500 $4,064 62 Respirology $2,988 $1,800 $1,188 63 Rheumatology $2,988 $1,800 $1,188 64 Sportmedicine $2,988 $1,800 $1,188 Oncology- 65 $2,988 $1,800 $1,188 Radiation Neonatal-perinatal 66 $4,272 $2,500 $1,772 medicine 70 Cardiology $4,272 $2,500 $1,772 Family medicine or General practice - Primary professional 73 $2,988 $1,000 $1,988 work in family medicine including shifts in the

Classification: Public M.O. 613/2021

emergency department Otolaryngology (head 77 $10,824 $4,000 $6,824 and neck surgery ) Family medicine or General practice - Including obstetrics (labour and delivery), 78 $6,564 $1,000 $5,564 anaesthesia, surgery, and shifts in the emergency department Family medicine or General practice - Including anaesthesia, 79 $6,564 $1,000 $5,564 surgery and shifts in the emergency department 82 Emergency medicine $6,564 $2,500 $4,064 83 General surgery $10,824 $4,000 $6,824 84 Gynecologic surgery $10,824 $4,000 $6,824 85 Pediatric surgery $10,824 $4,000 $6,824 86 Plastic surgery $10,824 $4,000 $6,824 87 Thoracic surgery $10,824 $4,000 $6,824 88 Urology $10,824 $4,000 $6,824 89 Vascular surgery $10,824 $4,000 $6,824 90 Anaesthesiology $6,564 $2,500 $4,064 91 Cardiac surgery $10,824 $4,000 $6,824 92 Neurosurgery $20,844 $4,000 $16,844 93 Obstetrics $38,640 $4,000 $34,640 94 Orthopaedic surgery $20,844 $4,000 $16,844

Classification: Public M.O. 613/2021

SCHEDULE B COMMUNITIES BENTLEY BUFFALO HEAD PRAIRIE BERWYN BURDETT ACHESON BEZANSON BUSBY ACME BIG STONE ADEN BIG VALLEY CADOGAN AETNA ALBERTA BEACH BIRCH CLIFF BITTERN LAKE BLACK DIAMOND CALAIS ALDERSYDE BLACKFALDS CALLING LAKE ALHAMBRA BLACKFOOT CALMAR ALIX BLACKIE CAMP CREEK ALLIANCE BLAIRMORE CAMROSE ALSIKE BLOOMSBURY CANMORE BLUE RIDGE CANYON CREEK AMISK BLUEBERRY MOUNTAIN CARBON ANDREW BLUESKY CARCAJOU ANZAC BLUFFTON ARDMORE BODO CARMANGAY ARDROSSAN BON ACCORD CARNWOOD BONANZA CAROLINE ARROWWOOD BONNYVILLE CARROT CREEK ASHMONT BOTHA ATHABASCA BOW ISLAND CARSTAIRS ATIKAMEG BOWDEN CARVEL ATMORE BOYLE BALZAC BOYNE LAKE CASTOR BANFF CAYLEY BARNWELL BRANT CEREAL BARONS BRAZEAU NO. 77 GESSFORD BARRHEAD BRETON CHAMPION BASHAW BREYNAT CHARD BASSANO BROCKET CHATEH BAWLF BROOKS CHAUVIN BAY TREE BROSSEAU CHERHILL BEAR CANYON BROWNFIELD CHERRY GROVE BEAUMONT CHERRY POINT BEAUVALLON BRUCE BEAVERLODGE BRUDERHEIM CHINOOK BEISEKER BRULE CHIPMAN BELLEVUE BUCK CREEK CHISHOLM MILLS BELLIS BUCK LAKE CLAIRMONT BUFFALO CLAN DONALD COMMUNITIES (cont'd)

Classification: Public M.O. 613/2021

CLAR ESHOLM DEWBERRY FAUST DIAMOND CITY FAWCETT CLIVE DIDSBURY FENN CLUNY DIXONVILLE FERINTOSH CLYDE DONALDA FINNEGAN COALDALE FITZGERALD COALHURST DONNELLY FLATBUSH COCHRANE DOROTHY FLEET COLD LAKE DRAYTON VALLEY FOISY COLEMAN DRIFTPILE FOREMOST COLINTON DRUMHELLER FORESTBURG COLLEGE HEIGHTS DUCHESS COMPEER DUFFIELD FORT CONDOR DUNMORE FORT KENT CONKLIN EAGLES HAM FORT MACKAY CONSORT EAST COULEE FORT MACLEOD COOKING LAKE ECKVILLE FORT MCMURRAY CORONATION EDBERG COUTTS EDGERTON COWLEY EDSON FOX CREEK CRAIGMYLE EGREMONT FOX LAKE CRANFORD ELK POINT FROG LAKE CREMONA ELKWATER GADSBY CROOKED CREEK GAINFORD CROSSFIELD GALAHAD CYNTHIA ELNORA GARDEN RIVER CZAR EMPRESS GEM ENCHANT GIBBONS GIFT LAKE DARWELL DAYSLAND ENOCH GLEICHEN DE WINTON ENSIGN GLENDON DEAD MAN'S FLATS ENTWISTLE DEADWOOD ERSKINE GLENWOOD DEBOLT ESTHER DEL BONITA GOODFISH LAKE DELACOUR EUREKA RIVER GOODRIDGE DELBURNE EVANSBURG GORDONDALE DELIA GRAND CENTRE FAIRVIEW DENWOOD FALHER DERWENT FALLIS GRANUM DESMARAIS FALUN GRASSLAND

COMMUNITIES cont'd GRASSY LAKE INNISFREE LANGDON

Classification: Public M.O. 613/2021

GREEN COURT IRMA GRIMSHAW IRON RIVER LEGAL IRON SPRINGS LESLIEVILLE GROVEDALE IRRICANA LINDALE GUNDY IRVINE LINDBERGH GUNN ISLAND LAKE LINDEN GURNEYVILLE ISLAND LAKE SOUTH GUY ISLAY GWYNNE JAMES RIVER BRIDGE LODGEPOLE JARVIE LOMOND HALFMOON BAY JARVIS BAY LONE PINE HALKIRK JASPER LONGVIEW HANNA JEAN COTE LOUGHEED HARDISTY JENNER JOHN D'OR PRAIRIE HAY LAKES HAYS KANANASKIS MADDEN HAYTER KAPASIWIN MAGRATH HEATH MALES KEG RIVER MALLAIG HEISLER KEHEWIN MA-ME-O BEACH KELSEY MANNING HIGH PRAIRIE KEOMA MANNVILLE HIGH RIVER KIKINO HILDA KILLAM HILL SPRING KINGMAN HILLCREST MINES KINSELLA MARLBORO HILLIARD MARWAYNE HINES CREEK KIRRIEMUIR MAYERTHORPE HINTON KITSCOTY MCLAUGHLIN HOBBEMA MCLENNAN HOLDEN MCRAE HONDO MEANDER RIVER HOSELAW LAC DES ARCS HOTCHKISS LAC LA BICHE MEDLEY HUGHENDEN LAC STE. ANNE COUNTY HUSSAR LACOMBE HUXLEY LAFOND LAKE ISLE MILK RIVER HYTHE LAKE LOUISE IDDESLEIGH LAMONT MILLET INNISFAIL LANCASTER PARK MILLICENT

COMMUNITIES cont'd MILO PADDLE PRAIRIE MINBURN PARADISE VALLEY ROSALIND

Classification: Public M.O. 613/2021

MIRROR PARKLAND ROSEBUD MONARCH PATRICIA ROSEDALE STATION MONITOR PEACE RIVER ROSEDALE VALLEY MORINVILLE PEERLESS LAKE ROSEMARY MORLEY PEERS ROUND HILL MORRIN PENHOLD ROWLEY RUMSEY MOUNTAIN VIEW RYCROFT PICTURE BUTTE RYLEY MUNDARE PINCHER CREEK SADDLE LAKE MUNSON PINE LAKE MUSIDORA PLAMONDON SCANDIA MYRNAM POLLOCKVILLE SCHULER NACMINE PONOKA SEBA BEACH NAMAO PRIDDIS SEDALIA NAMPA PROVOST SEDGEWICK NANTON SEEBE RADWAY RAINBOW LAKE SEXSMITH NEVIS RAINIER SHAUGHNESSY RALSTON RANFURLY SIKSIKA RAYMOND SILVER VALLEY RED DEER COUNTY SKIFF RED WILLOW SMITH REDCLIFF SMOKY LAKE NOBLEFORD REDWATER SOUTH BAPTISTE REDWOOD MEADOWS NORGLENWOLD SPIRIT RIVER RIMBEY NORTH STAR RIVERCOURSE SPRING LAKE RIVIERE QUI BARRE CHATON ROBB OKOTOKS ROCHESTER SPUTINOW OLDS ST BRIDES ONEFOUR ROCHON SANDS ST ISIDORE ONOWAY ROCKY MOUNTAIN HOUSE ST LINA OPAL ST MICHAEL ORION ROCKYFORD ST PAUL OYEN ROLLING HILLS ST VINCENT

COMMUNITIES (cont'd) STAND OFF TOFIELD WARDLOW STANDARD TOMAHAWK WARNER STAR TORRINGTON WARSPITE

Classification: Public M.O. 613/2021

STAUFFER TROCHU WASKATENAU STAVELY TROUT LAKE WATER VALLEY STETTLER TSUU T'INA STIRLING STRATHCONA COUNTY TURIN WELLING STRATHMORE TURNER VALLEY WEMBLEY STREAMSTOWN WEST BAPTISTE STROME TWO HILLS SUNDRE WESTLOCK SUNNYBROOK VALLEYVIEW SUNNYNOOK VAUXHALL WHISPERING HILLS SUNSET HOUSE VEGA WHITE GULL SWALWELL VEGREVI LLE WHITECOURT SWAN HILLS VERMILION WHITELAW SYLVAN LAKE VETERAN WIDEWATER TABER VIKING WILDWOOD TANGENT VILNA WILLINGDON VIMY WIMBORNE TEES VULCAN WINFIELD THERIEN WABAMUN WINTER BURN THORHILD WABASCA WOKING THORSBY WAINWRIGHT WORSLEY THREE HILLS WALSH THRONE WRENTHAM TIGER LILY WANHAM YOUNGSTOWN TILLEY WARBURG

Classification: Public