Nfld. & Labrador

Faced with losing federal transfer money, N.L. reimbursing patients who paid for cataract surgery

The provincial government is ready to pay more than 60 cataract surgery patients as much as $1,100 each.

Provincial government ready to pay more than 60 people as much as $1,100 each

Health Minister John Haggie speaks at his office in Confederation Building in St. John's. (Mark Quinn/CBC)

The province is reimbursing patients who paid for cataract surgery in private Newfoundland and Labrador clinics, to avoid being fined for contravening federal health legislation.

Charging patients out of pocket for a publicly insured service contravenes the federal Canada Health Act and until provincial regulations were changed recently, it was forbidden to provide cataract surgery in a private clinic in Newfoundland and Labrador.

"We're asking for people who had cataract surgery performed outside a regional health authority facility prior to June of 2018 to identify themselves to the department because they may be eligible for reimbursement," said Health Minister John Haggie.

A cataract causes the normally clear lens of an eye to become cloudy. Cataract surgery removes the cloudy lens and replaces it with a clear one. It's estimated that more than 50 per cent of people develop cataracts by the time they turn 80.

An ophthalmologist drops medicine on the eye of a cataract patient. (Aaron Favila/The Associated Press)

In Newfoundland and Labrador cataract surgery is covered by the province's Medical Care Plan.

Haggie said if patients paid to have cataract surgery done in a private clinic they are eligible to be reimbursed at the MCP rate of $557 per eye.

Haggie said the province was facing a federal sanction — a loss of transfer payments — equal to the amount patients were charged for publicly insured services.

He said the province is aware of about 60 cases in which patients had the surgery in private clinics and it will contact them. The Health Department is also asking anyone else who believes they may be eligible for reimbursement to call 1-844-957-1401.

"The importance to us is that we have to report this to Health Canada and if people have paid out of pocket for an insured service, we, the government of Newfoundland and Labrador, get that money deducted dollar-for-dollar on our next year's health transfer," said Haggie.

The previous federal health minister was very keen on enforcing it.- John Haggie

At $557 per eye, 60 patients will be reimbursed a total of almost $67,000. That's the amount the federal government would have withheld from the province if it were not reimbursing the patients.

"The previous federal health minister was very keen on enforcing it but also giving provinces an opportunity to rectify the situation," said Haggie.

After 2018, provincial legislation was amended to allow private eye clinics to perform cataract surgeries and bill MCP for them.

"There was a loophole that we weren't aware of until we changed the regulation. So that provided the clarity that was needed on a go-forward basis and also allowed us to have a platform for formally introducing cataract surgery in private clinics," said Haggie.

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