Reimbursements for medical scans in Alberta was an AHS policy before it was scrapped last year

The provincial government cancelled a policy to reimburse Albertans for medical scans and procedures in 2025 - a framework that many patients seeking care didn't know about.

Alberta Health Services (AHS) discontinued a reimbursement policy where it offered compensation to Albertans early last year for medical scans, after what it says was “low uptake.”

“Due to the Alberta government’s incoming policy changes related to preventative testing, combined with inefficiencies and low uptake of the previous program, the preventative testing reimbursement program through (AHS) was discontinued in 2025,” read a statement from AHS.

Albertans could have many of their scans paid for if they qualified for reimbursement.

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“It is important to note that the AHS policy was narrow in scope and strictly limited to urgent imaging cases,” the statement read.

“Patients were required to complete multiple steps before receiving reimbursement, and the program was not widely used. Approximately five applications met the eligibility criteria each year.”

However, AHS would not say how many people used it, who those people were and how many were successful in being reimbursed.

It’s also unclear on how long the program ran.

Reporting from CBC News, found documents through an Alberta’s Access to Information Act that showed AHS officials asking the CEO to discontinue the policy where refunds for MRI`s, CT and PET/CT scans were paid out.

Earlier this month, Alberta’s Hospital and Surgical Health Services department announced the dual practice model will launch in September, that will allow physicians to deliver both publicly funded and privately paid elective surgeries in the province.

The surgeries include orthopedic procedures, hip and knee replacements, cataract surgery, select ear, nose and throat procedures, gynecological surgeries, dermatology, plastic surgery, and minimally invasive general surgeries such as hernia repair.

Krista Fordham had been waiting years to get on the list for a new right hip.

Her first MRI was nearly two years ago. A follow up MRI took nearly 18 months later with wait times for surgery between 20-26 months.

“I ended up in the system where I wasn’t able to get in the queue because my imaging wasn’t strong enough at that time, although I was in chronic pain for two years,” said Fordham.

Fordham then decided to pay privately for surgery, out of pocket and out of country.

She spent $20,000 for a new hip in Lithuania.

“The people that are getting private help and we’re getting replacements out of country, out of province, these aren’t wealthy people. I mean, these are people that are struggling to refinance or restructure, I mean, this is a very difficult financial decision, most of them being retirees as well,” she said.

Fordham says she would have liked to be compensated for MRIs before her surgery if she had known about the previous AHS policy.

“We were offered no compensation whatsoever. That makes no sense to me. I mean, we’re doing it out of personal desperation, but at the same time, there’s thousands of us that are doing this that can’t wait,” she said.

“We just can’t wait. Our quality of life is depreciating too much.”

Fordham says she’s encouraged by the new dual model, believing it will help alleviate strain on the public system.

“I mean, if we are able then to have access to more privatized care here, I mean, I just can’t see how that can’t benefit the system entirely,” she said.

“I don’t understand the opposition to that.”

But Friends of Medicare believe this AHS policy had too many loopholes, with little transparency.

“Who were the people that learned about it? How were they accessing it, even those who were attempting to access it, the vast majority got denied, and it’s not really clear what was going on,” said Chris Gallaway, executive director with Friends of Medicare.

“And now we have a government that’s canceling the program without really saying why or what was happening. So, there has been basically no transparency since this program started.”

Gallaway says many in Alberta’s medical field had no idea the reimbursement program even existed.

“There was never a fulsome communication to the AMA (Alberta Medical Association) or health practitioners or so on, so it was a very quiet program,” he said.

“Yet some people were getting money, just skipped the queue really to get their MRI quicker for medically necessary diagnostics.”

A spokesperson for Primary and Preventative Health Services would not address the cancellation of the AHS policy, deferring CTV News to AHS, but pointed to the new dual practice model.

“Rising demand for diagnostic imaging is putting real pressure on the system and impacting timely access to care,” read the statement.

“Despite significant investments, MRI and CT wait times in Alberta continue to increase, which is why our government recently passed legislation that will establish a clear path to expanded access for elective testing, screening and other diagnostic scans.”

The ministry says next steps will be known in the coming weeks.

“As always, with this government and their health-care policy, they’re making it up as they go along,” said NDP leader Naheed Nenshi.

“There’s no guidelines. There are no restrictions. They’re just kind of throwing it up in the air and hoping it works. And it’s very clear that the old policy created by an old conservative government, was working so poorly that most people didn’t even know it existed.”

Nenshi says he still has many questions about the old AHS policy, that was around when his predecessor Rachel Notley was premier in Alberta.

“Approximately five people per year got reimbursed for their private MRIs and their private X-rays,” said Nenshi.

“So, there’s some very open questions to who knew about this, who was benefiting from it, and who was being hurt by this policy.”

The Alberta NDP told CTV News that Notley’s health minister, Sarah Hoffman, did not know about the policy.

CTV News asked Education Minister Demetrios Nicolaides about the policy change, but he deferred to Minister Adriana LaGrange for comment on the decision.

“We are of the view and of the opinion that, if an individual wants to avail themselves of some of those opportunities, that they shouldn’t be limited to be able to do that,” said Nicolaides on Monday.

“That’s a lot of the primary rationale to help facilitate those policy changes, which is ultimately based on a desire to help ensure that Albertans are getting access to health care as quickly as possible, so that we can help improve our health care system.”

Nicolaides adds that “every Albertan expects their health-care system to be there for them when they need it.”