Alberta Health Care Insurance Regulation

(Consolidated up to 291/2025) ALBERTA REGULATION 76/2006 Alberta Health Care Insurance Act ALBERTA HEALTH CARE INSURANCE REGULATION Table of Contents 1 Definitions Part 1 Interpretation 2 Insured oral and maxillofacial surgery services 2.1 Insured podiatric surgery services 3 Temporarily absent from Alberta 4 Information under section 22 of the Act 5 Deemed residents from outside Canada 6 Resident under section 22 of the Act 7 Dependants deemed residents 8 Resident who establishes permanent residence elsewhere Part 2 Health Services and Benefits 9 Benefits payable re basic health services 10 Benefits payable re extended health services 11 When entitlement commences 12 Services not considered basic or extended health services 13 Diagnostic imaging services Part 3 Claims 14 Extra billing 15 Information to be provided by practitioners 16 Minister to notify Alberta Cancer Board Part 3.1 Administrative Penalties 16.1 Notice of administrative penalty 16.2 Amount of administrative penalty 16.3 Time for payment 16.4 Interest and late payment penalty 16.5 Collection of administrative penalty 16.6 Appeal of administrative penalty Part 4 Reciprocal Payments 17 Ministers re reciprocal payments Part 4.1 Physician Resource Planning 17.1 Committees 17.2 Setting of number of additional physicians Part 5 Program Costs 18 Program and program benefits Part 6 General 19 Health Insurance Supplementary Fund (Canada) 20 Contract or self‑insurance plan allowed under section 26 of Act 21 Repeal 21.1 Expiry Definitions 1 (1) In this Regulation, (a) “accredited educational institute” means a high school, college, university or any other educational institution recognized as such by the Minister for the purposes of this Regulation; (b) “Act” means the Alberta Health Care Insurance Act ; (c) “child” includes a foster child and any other person in respect of whom a resident or other person stands in the place of a parent. (2) In Part 1 of the Act and this Regulation, “dependant” means, in relation to any person, (a) the spouse or adult interdependent partner of that person, (b) each unmarried child under the age of 21 years who is wholly dependent on that person for support, (c) each unmarried child less than 25 years of age who is in full‑time attendance at an accredited educational institute, and (d) each unmarried child 21 years of age or more who is wholly dependent on that person by reason of mental or physical infirmity. AR 76/2006 s1;291/2025 Part 1 Interpretation Insured oral and maxillofacial surgery services 2 Those services that are provided by a dentist in the field of oral and maxillofacial surgery for which benefits are payable under the Oral and Maxillofacial Surgery Benefits Regulation are hereby specified as insured health services for the purposes of section 1(n)(ii) of the Act. AR 76/2006 s2;291/2025 Insured podiatric surgery services 2.1 The services referred to in section 1(b)(v) of the Act for which benefits are payable under the Podiatric Surgery Benefits Regulation are hereby declared to be insured health services for the purposes of the Plan. AR 128/2006 s2;291/2025 Temporarily absent from Alberta 3 (1) For the purposes of this Regulation and section 5(2) of the Act, a person is “temporarily absent from Alberta” if the person (a) stays in another province or territory for a period that will not exceed 12 consecutive months, or (b) stays outside Canada for a period that will not exceed 6 consecutive months, and the person intends to return to and maintain permanent residence in Alberta on the conclusion of the stay outside Alberta. (2) The Minister may extend any period referred to in subsection (1) for a further period of time that the Minister considers proper, (a) if the person provides evidence satisfactory to the Minister that the person intends to return to and maintain permanent residence in Alberta after the extended period of time, or (b) if, in the opinion of the Minister, there are unforeseen and extenuating circumstances. Information under section 22 of the Act 4 For the purposes of section 22 of the Act, “residents’ registration information” includes (a) any information necessary to identify or contact a personal representative, guardian, trustee or other legal representative of a resident, and (b) in the case of a person who is deemed to be a resident under section 6, any information that the Minister requires or receives regarding the person that would constitute residents’ registration information if required or received from any resident. Deemed residents from outside Canada 5 (1) Subject to subsection (2), the following persons whose ordinary place of residence is outside Canada are deemed to be residents of Alberta for the purposes of Part 1 of the Act: (a) a person who is in Alberta under a work assignment, contract or arrangement and applies for registration under the Plan; (b) a person who is in full‑time attendance as a student at an accredited educational institute in Alberta; (c) a person who is registered under the Health Insurance Premiums Act as a dependant of the person referred to in clause (a) or (b). (2) Subsection (1) applies only if a person referred to in subsection (1)(a), (b) or (c) (a) has been lawfully admitted to Canada, (b) has established residence in Alberta, and (c) intends to remain in Alberta for 12 or more consecutive months. AR 76/2006 s5;291/2025 Resident under section 22 of the Act 6 A person whose ordinary place of residence is outside Alberta is deemed to be a resident of Alberta for the purposes of section 22 of the Act if that person receives health services in Alberta pursuant to any policy, program or arrangement for which the Department of Hospital and Surgical Health Services or the Department of Primary and Preventative Health Services. (a) makes payment directly or indirectly, or (b) provides or arranges any funding or administrative services. AR 76/2006 s6;170/2012;158/2025 Dependants deemed residents 7 (1) When a child is born outside Alberta to parents who are both temporarily absent from Alberta and are both registered under the Health Insurance Premiums Act , the child is deemed to be a resident of Alberta for the purposes of Part 1 of the Act. (2) If a dependant of a resident is (a) within Canada on a vacation or visit of not more than 12 months’ duration, or (b) in full‑time attendance as a student at an accredited educational institute, with the intention to become a permanent resident of Alberta on the conclusion of the vacation, visit or attendance as a student at an accredited educational institute, that dependant is deemed to be a resident of Alberta for the purposes of Part 1 of the Act. AR 76/2006 s7;291/2025 Resident who establishes permanent residence elsewhere 8 (1) A resident who leaves Alberta for the purpose of establishing permanent residence in another province or territory of Canada is entitled to continue the resident’s coverage under the Plan for the period beginning on the day the resident ceases to be a resident of Alberta and ending on the last day of the 2nd month following the month of arrival in the new province or territory, unless extended under subsection (3). (2) Notwithstanding subsection (1), if a resident leaves Alberta for the purpose of establishing permanent residence outside Alberta and the spouse or adult interdependent partner of the resident (a) maintains a home in Alberta, (b) is not living apart from the resident pursuant to a court order or separation agreement or otherwise, and (c) intends to join the resident, the resident is entitled to continue coverage under the Plan for a period not exceeding 12 months beginning on the day the resident ceases to be resident in Alberta. (3) If the resident informs the Minister that vacation or travelling time will be taken in conjunction with the move referred to in subsection (1), the Minister may extend the duration of the coverage under the Plan for a further period not exceeding one month, except that under no circumstances may the total duration of the coverage under the Plan extend beyond the last day of the 4th month following the month of leaving Alberta, unless extended under subsection (4). (4) If a resident, while travelling between Alberta and the province or territory of Canada in which the resident intends to establish permanent residence, is hospitalized, the resident remains entitled to continuing coverage under the Plan while the resident is continuously hospitalized for up to 12 months from the date the resident first became hospitalized. (5) Subject to subsection (7), if a resident is establishing permanent residence outside Canada and notifies the Minister that the resident wishes to continue to be covered under the Plan, that resident is entitled to be covered under the Plan for the period beginning the day that resident ceases to be a resident of Alberta and ending one, 2 or 3 months, as prescribed by the Minister, following the month the resident ceases to be a resident of Alberta, unless the period is extended under subsection (6). (6) Subject to subsection (7), if a person requires continuing coverage under the Plan while en route from Alberta to establish permanent residence outside Canada, the Minister may, in a particular case in which the Minister finds that unforeseen and extenuating circumstances so warrant, extend the duration of the continuing coverage under the Plan for a further period not exceeding 12 months. (7) A resident is not entitled to continuing coverage under the Plan until the resident has paid (a) all arrears of premiums, and (b) the premiums applicable to the period of the continuing coverage pursuant to the Health Insurance Premiums Regulation (AR 217/81). Part 2 Health Services and Benefits Benefits payable re basic health services 9 The benefits payable by the Minister in respect of basic health services are the benefits specified in the regulations under section 17 of the Act. Benefits payable re extended health services 10 The benefits payable in respect of extended health services pursuant to section 3(2) of the Act are (a) for those goods and services provided by a dentist, a denturist, an optometrist or an optician that are listed in the Extended Health Services Benefits Regulation , and (b) subject to any terms and conditions that may form part of an agreement made under section 20 or 40 of the Act. When entitlement commences 11 (1) Entitlement to benefits for extended health services pursuant to section 3(2)(b) of the Act shall commence (a) on the date on which the registration under the Health Insurance Premiums Act becomes effective, if the resident is receiving a widow’s pension at that time, or (b) on the date the resident becomes eligible for a widow’s pension, if that date occurs after the effective date of registration. (2) Entitlement to benefits for extended health services pursuant to section 3(2)(b) of the Act shall cease (a) at the end of the 2nd month following the month in which the death of the resident who was receiving the widow’s pension occurs, or (b) at the end of the 2nd month following the month in which the resident becomes ineligible for the widow’s pension, whichever occurs first. Services not considered basic or extended health services 12 (1) For the purposes of this section, a service is available in Canada if a resident could have obtained the service in Canada within the time period generally accepted as reasonable by the medical or dental profession for any resident with a similar condition. (2) Unless otherwise approved by the Minister, the following services are not basic health services or extended health services: (a) medical‑legal services, including (i) examinations performed at the request of third parties in connection with legal proceedings, (ii) giving of evidence by a practitioner in legal proceedings, or (iii) preparation of reports or other documents relating to the results of a practitioner’s examination for use in legal proceedings or otherwise and whether requested by the patient or by a third party; (b) advice by telephone or any other means of telecommunication and toll charges or other charges for telephone calls or telecommunication services except as provided for in the Schedule of Medical Benefits under the Medical Benefits Regulation ; (c) transportation services, including ambulance services for (i) transportation of a patient to a hospital or to a practitioner elsewhere, or (ii) transportation of a practitioner to a hospital or to a patient elsewhere, whether the costs of those services are by way of charges for distance or charges for travelling time; (d) examinations required for the use of third parties; (e) services that a resident is eligible to receive under a statute of any other province or territory, the Health Facilities Act , Part 2 of the Alberta Health Care Insurance Act , any statute relating to workers’ compensation or under any statute of the Parliament of Canada, including (i) the Aeronautics Act (Canada), (ii) the Civilian War‑related Benefits Act (Canada), (iii) the Corrections and Conditional Release Act (Canada), (iv) the Government Employees Compensation Act (Canada), (v) the Merchant Seamen Compensation Act (Canada), (vi) the National Defence Act (Canada), (vii) the Pension Act (Canada), and (viii) the Royal Canadian Mounted Police Act (Canada); (f) services not provided by or under the supervision of a practitioner, except as provided for in the Schedule of Medical Benefits under the Medical Benefits Regulation ; (g) services for which a patient would not be liable to pay in the absence of benefits for health services; (h) services that the Minister, on review of the evidence, determines not to be health services because the services (i) are not required, or (ii) are experimental or applied research; (i) services in connection with group immunizations against a disease or services in connection with group examinations by a practitioner; (j) services provided by a practitioner to the practitioner’s children, grandchildren, siblings, parents, grandparents, spouse or adult interdependent partner or any person who is dependent on the practitioner for support; (k) laboratory and diagnostic imaging services provided in Alberta in a facility that does not meet the criteria for registration under the Alberta Health Care Insurance Plan and that is not registered with the Alberta Health Care Insurance Plan or for which benefits are not payable under the Medical Benefits Regulation , the Podiatric Surgery Benefits Regulation , the Podiatric Benefits Regulation or the Oral and Maxillofacial Surgery Benefits Regulation ; (l) services provided outside Canada that are available inside Canada (other than services provided in the case of an emergency resulting from an acute and unexpected illness, disease, condition or injury that requires medically required treatment without delay outside Canada); (m) services provided outside Canada that are not available inside Canada unless approved by the Out‑of‑Country Health Services Committee or the Out‑of‑Country Health Services Appeal Panel under the Out‑of‑Country Health Services Regulation ; (n) drugs, casts, surgical appliances and special bandages, except as provided for in the Schedule of Medical Benefits under the Medical Benefits Regulation , the Schedule of Podiatric Surgery Benefits under the Podiatric Surgery Benefits Regulation or the Schedule of Podiatric Benefits under the Podiatric Benefits Regulation ; (o) non‑hospital facility fee charges associated with any health services provided in a non‑hospital facility outside of Alberta; (p) services for substance abuse, eating disorders or other addictive disorders provided outside of Alberta. AR 76/2006 s12;128/2006;136/2009;193/2019;148/2020;291/2025 Diagnostic imaging services 13 (1) If benefits are paid or payable with respect to diagnostic imaging services provided to a resident, the practitioner who provided the services shall, as soon as is reasonably practicable after a request is made by the resident, make the resulting diagnostic images available to any other practitioner designated by the resident. (2) A practitioner who receives diagnostic images under subsection (1) (a) may make copies of the images, and (b) shall, as soon as is reasonably practicable after the images have served the purpose for which they were required, return the original images to the practitioner who made the images available. (3) If a practitioner fails to comply with a request under subsection (1), (a) the Minister may withhold the benefits payable to the practitioner with respect to the diagnostic imaging services provided to the resident, or (b) if benefits have already been paid to the practitioner or resident with respect to those services, the practitioner is liable for and shall repay to the Minister the benefits paid in respect of the services. (4) If the practitioner fails to repay benefits under subsection (3)(b), the Minister may withhold the amount of the benefits from any other benefits payable to the practitioner. (5) If a practitioner fails to comply with subsection (2)(b), the Minister may withhold from benefits payable to the practitioner an amount equivalent to the benefits paid or payable with respect to the diagnostic imaging services provided by the practitioner who made the diagnostic images available. (6) If benefits are withheld by the Minister under subsection (3)(a), (4) or (5) or a practitioner repays benefits to the Minister under subsection (3)(b), the practitioner is not entitled to collect any amount from any person in respect of the services involved. Part 3 Claims Extra billing 14 (1) Except as provided for in section 21 of the Act, a practitioner must not submit an account for payment to a resident or to another Government department or agency if the practitioner has submitted or intends to submit a claim for benefits to the Minister. (2) A person who contravenes subsection (1) is guilty of an offence. (3) To avoid any doubt, for the purposes of Part 1 of the Act and the regulations made under that Part, any good or service provided by a practitioner that is listed in the Schedule of Medical Benefits under the Medical Benefits Regulation , the Schedule of Podiatric Surgery Benefits under the Podiatric Surgery Benefits Regulation or the Schedule of Oral and Maxillofacial Surgery Benefits under the Oral and Maxillofacial Surgery Benefits Regulation is an insured health service, whether the cost of that good or service is greater than or less than the maximum benefit payable for the good or service provided. AR 76/2006 s14;128/2006;291/2025 Information to be provided by practitioners 15 (1) A practitioner must, in a form approved by the Minister, provide to the Minister any information that the Minister may require regarding the practitioner’s training, the type of practice the practitioner is engaged in or any other related information. (2) If a practitioner provides goods or services to a resident of Alberta, the practitioner must retain the original documentation relating to the goods or services provided for a period of not less than 6 years and must, on request, make the documentation available to the Minister. (3) If a practitioner or a person referred to in section 20.1 of the Act claims benefits in respect of diagnosis or treatment of cancer on behalf of a resident, the practitioner or person, from time to time, must report to the Alberta Cancer Board, in writing, on forms established by that Board, any information that the Board requires concerning the claim, including the name of the person in respect of whom the services were provided, the nature of the illness and particulars of the services. AR 76/2006 s15;106/2021 Minister to notify Alberta Cancer Board 16 (1) If requested to do so by the Alberta Cancer Board for any specific resident, the Minister shall notify the Alberta Cancer Board whenever a claim for benefits is paid in respect of any services provided to that resident that may relate to cancer. (2) If benefits for services are paid by the Minister before the practitioner complies with section 15(3) in respect of the reports, the College of Physicians and Surgeons of Alberta or the Alberta Dental Association and College, as the case may be, may, on being notified to do so by the Alberta Cancer Board, request, in writing, the practitioner to submit the reports to the Alberta Cancer Board. (3) If a practitioner, on being requested by the College of Physicians and Surgeons of Alberta or the Alberta Dental Association and College under subsection (2) to submit the reports under section 15(3) fails to do so, the practitioner is liable for and shall repay to the Minister the benefits paid to the practitioner in respect of the services and the amount of such benefits constitutes a debt payable to the Crown. (3.1) If benefits for services are paid by the Minister before a person referred to in section 20.1 of the Act complies with section 15(3) in respect of the reports, the Minister may, on being notified to do so by the Alberta Cancer Board, in writing, request that person to submit the reports to the Alberta Cancer Board. (3.2) If a person referred to in section 20.1 of the Act, on receiving a request under subsection (3.1), fails to submit the reports to the Alberta Cancer Board, the person is liable for and shall repay to the Minister the benefits paid to the person in respect of the services and the amount of such benefits constitutes a debt payable to the Crown. (4) If the practitioner or person referred to in section 20.1 of the Act fails to repay benefits under subsection (3) or (3.2), the Minister may withhold the amount of the benefits from any other benefits payable to the practitioner or person. (5) If a practitioner or a person referred to in section 20.1 of the Act repays benefits to the Minister under subsection (3) or (3.2) or the benefits are withheld by the Minister under subsection (4), the practitioner or person is not entitled to collect any amount from any person in respect of the services involved. (6) Subsections (3), (3.2), (4) and (5) cease to apply when the practitioner or person referred to in section 20.1 of the Act complies with section 15(3) in respect of the reports. AR 76/2006 s16;106/2021 Part 3.1 Administrative Penalties Notice of administrative penalty 16.1 (1) A notice of administrative penalty issued under section 28.1 of the Act must contain the following information: (a) the name of the person on whom the administrative penalty is imposed; (b) the provision of Part 1, Division 1 of the Act, or of the regulations made under that division, that the person has contravened or failed to comply with; (c) a description of the nature of the contravention or failure to comply identified under clause (b); (d) the amount that the person is required to pay and the manner in which the amount was determined; (e) the date by and manner in which the amount must be paid; (f) the right to appeal under section 28.2 of the Act. (2) The Minister shall serve a notice of administrative penalty on a person on whom an administrative penalty is imposed by personal service at, or by registered mail addressed to, the person’s last known address. AR 289/2025 s2 Amount of administrative penalty 16.2 (1) Where, as a result of a contravention of or failure to comply with Part 1, Division 1 of the Act or the regulations made under that division, any person has charged, collected or received an amount in addition to or in excess of benefits that are payable by the Minister, the amount of the administrative penalty that the person who is served the notice of administrative penalty respecting the contravention or failure to comply must pay is, (a) if the contravention or failure to comply is the person’s first contravention or failure to comply, $5000 or 10% of the amount charged, collected or received, whichever is greater, (b) if the contravention or failure to comply is the person’s 2nd contravention or failure to comply, $10 000 or 25% of the amount charged, collected or received, whichever is greater, or (c) if the contravention or failure to comply is the person’s 3rd or any subsequent contravention or failure to comply, $25 000 or 50% of the amount charged, collected or received, whichever is greater. (2) Where a contravention of or failure to comply with Part 1, Division 1 of the Act or the regulations made under that division has not resulted in the charging, collecting or receiving by any person of an amount in addition to or in excess of benefits that are payable by the Minister, the amount of the administrative penalty that the person who is served the notice of administrative penalty respecting the contravention or failure to comply must pay is $5000 per such contravention or failure to comply up to a maximum of $1 000 000. (3) Notwithstanding subsections (1) and (2), the Minister may, where the person who is served the notice of administrative penalty is not a practitioner, determine that the amount of the administrative penalty that the person must pay is, (a) if the contravention or failure to comply is the person’s first contravention or failure to comply, $25 000, (b) if the contravention or failure to comply is the person’s 2nd contravention or failure to comply, $50 000, or (c) if the contravention or failure to comply is the person’s 3rd or any subsequent contravention or failure to comply, $100 000. AR 289/2025 s2 Time for payment 16.3 (1) Subject to subsection (2), the Minister may determine the date by which a person who is served a notice of administrative penalty must pay an amount under section 16.2. (2) A date determined under subsection (1) must be at least 30 days after the day on which the person was served the notice of administrative penalty. (3) The Minister may extend the date determined under subsection (1) (a) on the request of the person served with the notice of administrative penalty, or (b) for any reason that the Minister considers appropriate. AR 289/2025 s2 Interest and late payment penalty 16.4 (1) If a person who is served a notice of administrative penalty does not pay the full amount that the person is required to pay under section 16.2 by the date determined under section 16.3, the Minister may, by issuing a notice to the person, (a) charge simple interest with respect to the amount at a rate the Minister determines but not exceeding 8% per year, and (b) charge a late payment penalty equal to no more than 10% of the amount that is unpaid. (2) Subject to subsections (3) and (4), a person who is issued a notice under subsection (1) must, on being issued the notice, pay the interest and late payment penalty that the person is charged. (3) The person may, within 30 days of being issued the notice, make a request to the Minister to have the interest and late payment penalty that the person is charged waived. (4) On receiving a request under subsection (3), the Minister may waive some or all of the interest and late payment penalty that the person making the request was charged if the Minister considers it appropriate to do so. AR 289/2025 s2 Collection of administrative penalty 16.5 (1) The Minister may collect from a person who is served a notice of administrative penalty any portion of the amount of the administrative penalty that the person must pay, and of the interest and late payment penalty that the person is charged, that is not paid in accordance with section 16.3 or 16.4, as applicable, (a) by withholding an amount equivalent to the portion from any benefits payable to the person, (b) by proceedings on a certificate registered with the Court of King’s Bench under subsection (2), or (c) under an agreement between the Minister and the person providing for the payment of the portion. (2) The Minister may certify the portion as an amount payable to the Minister by the person after (a) the expiry of the appeal period under section 16.6(1), if no notice of appeal is submitted, or (b) the day on which the appeal is discontinued or the appeal panel established to hear the appeal confirms or varies the notice of administrative penalty, if a notice of appeal is submitted. (3) A certificate under subsection (2) shall, on production to the clerk of the Court of King’s Bench at the judicial centre closest to the place where the person resides or has an office according to the records of the Minister’s Department, be registered in the Court as a judgment of the Court and when registered has the same force and effect, and all proceedings may be taken on it, as if the certificate were a judgment obtained in the Court for a debt in the amount specified in the certificate. (4) Any fees payable by the Minister for the registration of a certificate under subsection (3) or for the filing of a writ of enforcement under the Land Titles Act may be included in the amount specified in the certificate. (5) Where, on appeal under section 18(9) of the Act, a reassessment of a claim for benefits is vacated, the Minister shall vacate any notice of administrative penalty issued in respect of that claim. AR 289/2025 s2 Appeal of administrative penalty 16.6 (1) A notice of appeal submitted under section 28.2(1) of the Act must be submitted no later than 15 calendar days after the person submitting it was served with a notice of administrative penalty. (2) A notice of appeal must be in the form and contain the content prescribed by the Minister. (3) An appeal panel established under section 28.2(2) of the Act to hear an appeal shall consist of one to three members, one of whom the Minister shall designate as the chair. (4) The chair may decide to conduct an appeal by (a) written submission only, or (b) an oral hearing held (i) in person, (ii) by electronic means, or (iii) by a combination of the methods referred to in subclauses (i) and (ii). (5) The chair shall set the date by which a written submission must be filed with the appeal panel in the case of an appeal conducted by written submission only. (6) The chair shall set the date, time and location of the hearing where the appeal is to be conducted by oral hearing. (7) Members of the appeal panel who are not employees of the Government of Alberta may be paid remuneration and may receive reasonable travelling and living expenses while away from their ordinary places of residence in the course of their duties as members of the appeal panel, at the rates prescribed by the Minister. AR 289/2025 s2 Part 4 Reciprocal Payments Ministers re reciprocal payments 17 (1) The Minister is authorized under the Plan as defined in Part 1 of the Act to make payments to a physician in respect of insured health services provided by the physician to non‑residents from another province or territory of Canada if (a) the making of those payments is the subject of an agreement between the Crown as represented by the Minister and the government of the other province or territory as represented by the appropriate Minister of that province or territory, and (b) the agreement provides that those payments are recoverable from the provincial or territorial health authority of the other province or territory. (2) A sector Minister is authorized under the Plan as defined in Part 2 of the Act to make payments to a hospital services facility operator in respect of insured hospital services provided by the hospital services facility operator to non‑residents from another province or territory of Canada if (a) the making of those payments is the subject of an agreement between the Crown as represented by the sector Minister and the government of the other province or territory as represented by the appropriate Minister of that province or territory, and (b) the agreement provides that those payments are recoverable from the provincial or territorial health authority of the other province or territory. AR 76/2006 s17;170/2012;218/2022;158/2025;291/2025 Part 4.1 Physician Resource Planning Committees 17.1 (1) The Minister may establish any committees that the Minister considers necessary for the purposes of physician resource planning. (2) The Minister may, with respect to any committee established under this section, (a) appoint or provide for the manner of the appointment of its members, (b) prescribe the term of office of any member, (c) designate a chair, vice‑chair and secretary, and (d) authorize, fix or provide for the payment of remuneration and expenses to its members. (3) Remuneration and expenses referred to in subsection (2) must be determined (a) in accordance with any applicable regulations under the Alberta Public Agencies Governance Act , or (b) by the Minister if no regulations under the Alberta Public Agencies Governance Act are applicable. (4) A committee established pursuant to this section may, with the approval of the Minister, make rules governing the calling of its meetings, the procedure to be used at its meetings, the conduct of business at its meetings, reporting and any other matters as required. (5) A committee established pursuant to this section may exercise the powers and shall perform the duties and functions that the Minister approves or confers or imposes on it. (6) The Minister may require any person appointed to a committee established under this section, before beginning the person’s duties, to take an oath that the person will not, except as authorized by the Minister, divulge any information received by the person in the course of the person’s duties as a member of the committee. AR 136/2017 s2 Setting of number of additional physicians 17.2 (1) Each year, the Minister may, by order, set out the number of additional physicians needed to provide insured health services in Alberta. (2) In making an order under subsection (1), the Minister shall take into account the following: (a) any advice provided by a committee established under section 17.1; (b) existing health resources; (c) Albertans’ health needs; (d) the affordability and sustainability of paying benefits for insured health services provided by the number of additional physicians to be set out in the order in view of the financial resources allocated for the payment of benefits; (e) short, medium and long‑term planning for allocation of physician resources; (f) any other matter the Minister considers appropriate. (3) The Minister may amend an order made under subsection (1) at any time. (4) The Minister shall, on or before April 1, 2018, make an order under subsection (1) to take effect April 1, 2018, but is not required to make a subsequent order. AR 136/2017 s2;291/2025 Part 5 Program Costs Program and program benefits 18 (1) In this section, (a) “program” means a program established under subsection (2); (b) “program benefit” means the benefit referred to in subsection (2). (2) The Minister is authorized to establish by order or enter into an agreement with a person for the establishment of a program to benefit one or more physicians or categories of physicians who are entitled to receive payment of benefits under the Plan. (3) The order or agreement establishing a program must (a) provide for the basis on which eligibility for program benefits is determined, (b) provide for the basis on which the rates for program benefits are determined, (c) prescribe the manner in which program benefits are to be paid and the persons to whom program benefits are to be paid, the conditions of payment, if any, and the information required to be submitted in connection with claims for program benefits, (d) provide for the term or manner of termination of the program, (e) provide for the payment of costs, if any, to administer the program and the person to whom the costs are to be paid, and (f) include such other provisions as the Minister considers appropriate in respect of the program. (4) The Minister is authorized to pay the administration costs and program benefits of a program under the Plan. Part 6 General Health Insurance Supplementary Fund (Canada) 19 The Minister may participate in the Health Insurance Supplementary Fund (Canada) in respect of persons of Alberta who through no fault of their own have ceased to be entitled to benefits or are not eligible for benefits. Contract or self-insurance plan allowed under section 26 of Act 20 (1) Pursuant to section 26 of the Act, an insurer shall not enter into or issue a contract or initiate a self‑insurance plan covering indemnification for the cost of basic health services or extended health services provided within Alberta except as otherwise provided in this section. (2) An insurer may enter into or issue a contract or initiate a self‑insurance plan under which a resident is indemnified for (a) repealed AR 136/2009 s3, (b) the cost of podiatric services provided to the resident by a podiatrist in excess of the amount that is payable in respect of each service under the Podiatric Benefits Regulation , (c) the cost of optometric services provided to the resident by an optometrist in excess of the amount that is payable under the Optometric Benefits Regulation , or (d) the cost of extended health services provided to the resident where those services are outside the limits prescribed in the Extended Health Services Benefits Regulation . (3) Repealed AR 20/2020 s2. (4) Notwithstanding subsection (2), nothing in this Regulation prevents an individual from receiving indemnity for the cost of extended health services where the individual was eligible to receive such indemnity through some other plan provided by a private insurance carrier before the individual or the individual’s dependants became eligible for extended benefits. AR 76/2006 s20;136/2009;20/2020 Repeal 21 The Alberta Health Care Insurance Regulation (AR 216/81) is repealed. Expiry 21.1 For the purposes of ensuring that this Regulation is reviewed for ongoing relevancy and necessity, with the option that it may be repassed in its present or an amended form following a review, this Regulation expires on March 31, 2031. AR 106/2021 s4 22 Repealed AR 4/2016 s1.