Canadian Health Plan Under Investigation

Expedited medical treatment insurance sold by the British Columbia Automobile Association to its 800,000 members is under scrutiny for possibly violating the Medicare Protection Act.

The medical access insurance, also called “wait list insurance,” is being supplied to the association by Acure Health Corp., a Calgary, Alberta, company that the Medical Services Commission determined in July to be providing services inconsistent with the act. The commission manages the medical services plan that pays for health care in British Columbia on behalf of the government.

The insurance being offered to the association’s members allows them to seek expedited medical treatment in private clinics in British Columbia or the U.S. if they are put on a treatment waiting list that exceeds 45 days.

The Medical Services Commission said the Acure policies that allegedly violated provincial statutes ignored a provision prohibiting private insurance policies that pay for services that are covered by the medical services plan and are performed by doctors enrolled in the plan, according to a spokeswoman from the Ministry of Health Services in Victoria, British Columbia.

The commission is seeking more specific details regarding Acure’s plan for the association to determine its legitimacy, the spokeswoman said.
Acure provides insurance to several employers in British Columbia.

Jim Viccars, president of Acure, said the company’s plans comply with state and federal statutes. He said that although the commission sent the company a letter in July informing it of compliance issues, the commission has yet to ask Acure for copies of its policies or to ask any specific questions about its policies.

“We wouldn’t have spent time and money developing this insurance unless we believed we were fully in compliance,” Viccars said.

Filed by Kristin Gunderson Hunt of Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

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