{"id":316183,"date":"2026-03-06T15:41:10","date_gmt":"2026-03-06T15:41:10","guid":{"rendered":"https:\/\/www.newsbeep.com\/nz\/316183\/"},"modified":"2026-03-06T15:41:10","modified_gmt":"2026-03-06T15:41:10","slug":"questions-remain-about-billing-for-primary-care-ahead-of-april-1-deadline","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/nz\/316183\/","title":{"rendered":"Questions remain about billing for primary care ahead of April 1 deadline"},"content":{"rendered":"

Angela McGraw is a nurse practitioner who specializes in women\u2019s health, treating more than one thousand clients out of her private clinic in Saint John’s north end.<\/p>\n

Most of her patients are in New Brunswick, but she\u2019s also licensed in Nova Scotia, Prince Edward Island and Ontario, providing virtual care to people in those provinces too.<\/p>\n

As an independent health-care provider, McGraw doesn\u2019t work for the local health authority. Instead, her patients are billed directly for their visits. <\/p>\n

Whether she can continue to offer primary care independently is a question.<\/p>\n

The Canada Health Act will expand on April 1 to include primary care provided by nurse practitioners, pharmacists and midwives, so patients aren\u2019t paying out of pocket for care.\u00a0<\/p>\n

It\u2019s just not clear yet what that will look like in New Brunswick or in the rest of Canada.\u00a0<\/p>\n

\u201cEach province is going to interpret it differently,\u201d McGraw said. But any health-care providers currently charging privately, could see \u201ca big barrier to their practice.\u201d<\/p>\n

WATCH | Flexible funding models needed, nurse practitioners say:\"\"<\/p>\n

Nurse practitioners unsure how big change in patient billing will work in N.B.<\/p>\n

A federal policy will add essential care by nurse practitioners, pharmacists and midwives to medicare coverage starting April 1. It\u2019s meant to \u200bkeep patients from \u200bhaving to pay out of pocket\u200b,\u200b but it\u2019s still unclear how\u200b the change will be applied in New Brunswick.<\/p>\n

The change to the Canada Health Act was announced<\/a> last year by former federal health minister Mark Holland to protect Canada\u2019s publicly funded health-care system.\u00a0\u00a0\u00a0\u00a0<\/p>\n

He said medically necessary services should be covered by a patient’s provincial or territorial health-care plan, whether it\u2019s provided by a physician or a physician-equivalent.\u00a0<\/p>\n

Starting April 1, any charges to patients will be considered extra billing, he said, and \u201cevery dollar wrongfully taken out of the pockets of Canadians will be deducted from the [provincial and territorial] health transfers.\u201d\u00a0<\/p>\n

Provinces, which have to implement measures to collect the information, are to start reporting patient charges in December 2028.<\/p>\n

\"AFormer health minister Mark Holland said nurse practitioners should be able to bill the public health-care system the same way doctors do. (Robert Holden\/CBC)<\/p>\n

CBC News requested an interview with the New Brunswick Health Department about the policy change. That request was declined.<\/p>\n

A statement from spokesperson Sean Hatchard, said the province has been in discussions over the past year and will continue to collaborate with federal, provincial, and territorial partners on the implications of the policy.\u00a0<\/p>\n

McGraw said people choose to pay for service from nurse practitioners, the same way they do for seeing a dentist, physiotherapist, psychologist or dietitian.\u00a0<\/p>\n

She\u2019s pleased to see health coverage expanded \u2014 but only if it\u2019s presented in a flexible way that allows people like her to continue operating independently. <\/p>\n

\u201cWe need to have more nurses at the table for all of these conversations,\u201d she said. <\/p>\n

\u201cThese are often decisions that are being made by people who aren’t working as a nurse or nurse practitioner, and often we are the last ones to be told after the decision has been made.\u201d<\/p>\n

Flexible funding needed<\/p>\n

Natasha Stephen, president-elect of the Nurse Practitioners of New Brunswick, said she hasn\u2019t been part of any discussions with the provincial government over funding models, but she would like to see the same flexibility that\u2019s offered to physicians.<\/p>\n

\u201cThere’s no expectation that all physicians practise in a certain way under the health authorities,\u201d she said. \u201cThey’re still able to have a solo practice if they wish. <\/p>\n

“They are able to be part of a collaborative health clinic if they wish. They’re able to work under the RHAs if they wish.\u201d<\/p>\n

\"ANatasha Stephen would like to see more flexible funding options for nurse practitioners. (Allyson McCormack\/CBC)<\/p>\n

As an example, Stephen said physicians who specialize in lactation consultation can operate their own private clinics and bill provincial insurance for those services. <\/p>\n

Stephen is also a lactation consultant, but she wouldn\u2019t be able to bill the province if she opened a similar clinic. She said her group would like to see that same liberty.<\/p>\n

\u201cLots of nurse practitioners have specialty areas of mental health or women’s health. There are so many examples where we could be great partners \u2026 and fill a huge gap here.\u201d<\/p>\n

With Canada-wide competition for physicians and nurse practitioners, Stephen said it\u2019s\u00a0 important New Brunswick match the flexibility being offered elsewhere in Canada.<\/p>\n

Still unable to order investigations<\/p>\n

There are about 10,000 nurse practitioners licensed in Canada, including more than 200 who live and work in New Brunswick. But for those in private health care, the ability to refer patients for diagnostics or to a specialist depends on where they practise.\u00a0<\/p>\n

\u201cIf I’m seeing clients in Ontario or P.E.I. virtually, there’s no issues there,\u201d McGraw said. \u201cI can order their blood work, I can order their ultrasounds, we can order CT scans if need be.\u201d<\/p>\n

That\u2019s no longer the case in New Brunswick.\u00a0<\/p>\n

A change<\/a> introduced under the Blaine Higgs government in 2021 meant any medical practitioner operating outside the public system would be billed by the regional health authority for any diagnostic or laboratory tests ordered.<\/p>\n

McGraw said she\u2019s now forced to jump through hoops to provide that same type of service, using other primary-care providers or telemedicine, to avoid those costs for her patients.\u00a0\u00a0<\/p>\n

She\u2019s hoping the new coverage rolling out next month will improve access to private nurse practitioners like her, and force a re-evaluation of how independent, non-salaried NPs are compensated for primary care services.<\/p>\n

New Brunswick pharmacists can do so much more to help patients- Heidi Liston, CEO, New Brunswick Pharmacists’ Association<\/p>\n

Heidi Liston, the CEO of the New Brunswick Pharmacists’ Association, calls the federal policy a \u201csignificant step toward more equitable, timely access to medically necessary health care.\u201d<\/p>\n

She said the association doesn\u2019t have any details yet on how the change will be applied in New Brunswick.\u00a0<\/p>\n

\u201cWhat we do know is New Brunswick pharmacists can do so much more to help patients in a timely manner,\u201d she said. \u201cThey can provide care for a growing list of common medical concerns, including assessing symptoms, performing basic physical exams and prescribing treatments, some of which are funded by government.\u201d<\/p>\n

Liston said funding more of these services can shift the treatment of minor medical conditions to a lower-cost, highly accessible community pharmacy setting.\u00a0<\/p>\n

That will free up physicians and nurse practitioners to focus on more complex patient needs, she said.<\/p>\n","protected":false},"excerpt":{"rendered":"Angela McGraw is a nurse practitioner who specializes in women\u2019s health, treating more than one thousand clients out…\n","protected":false},"author":2,"featured_media":316184,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[134,527,111,139,69],"class_list":{"0":"post-316183","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-health","9":"tag-healthcare","10":"tag-new-zealand","11":"tag-newzealand","12":"tag-nz"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/316183","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=316183"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/316183\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/316184"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=316183"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=316183"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=316183"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}