Alberta doctors say province seeks to cut $400M in billing fees

A doctor examines a patient during an appointment. (CTV News Edmonton)

The Alberta government wants to cut more than $400 million in the fees it pays to doctors, according to a confidential memo obtained by The Canadian Press.

The Feb. 18 memo, sent by Alberta Medical Association head Dr. Shelley Duggan to member physicians, says Alberta’s health ministry seeks cuts to more than 800 physician billing codes to save $400 million because of budget pressures.

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Those codes lay out how much money is paid for specific procedures, sometimes based on the amount of time that a doctor spends with a patient.

“What has become clear in the last few months is that Alberta Health is looking to address its budget shortfalls through the physician services budget,” Duggan writes.

“While we hope Alberta Health will reconsider its current approach, we wanted to advise members that it’s highly likely the (issue) will proceed to arbitration.”

Duggan says the government move breaks an agreement to jointly review the billing changes because the province has not left enough time for a proper evaluation before a March 31 deadline.

If the two sides can’t reach a deal by then, the next steps would be mediation followed by binding arbitration, if necessary, later in the spring.

The association, known as AMA, declined to speak to Duggan’s memo, citing confidentiality requirements of their 2022 master agreement with the province.

Health Minister Adriana LaGrange’s office, in a statement, also declined to discuss specifics but said they remain committed to the agreed-upon joint review process.

It also noted overall government spending on physicians has been rising, going up by $1 billion since 2022-23.

“This year alone the government is on track to spend far more than the $6.7 billion that was budgeted on physician compensation for Alberta’s approximately 12,000 physicians,” it said.

Alberta NDP Opposition health critic Sarah Hoffman said the proposed billing cuts are another step in a larger government plan to undermine public health care and steer more patients to privatized services.

“I’m hearing from a lot of doctors (about) growing mistrust, growing anxiety and growing stress about the future of their practice and what the future of public health care is going to be,” Hoffman said.

“They know that the government is focused on undermining them and all public services, and they don’t feel respected in this process.”

The dispute is set against a background of red ink, controversy and structural upheaval in health care.

Premier Danielle Smith’s government has introduced a budget for the upcoming year that forecasts a $5.2 billion deficit, citing uncertainty over U.S. tariffs and expected declines in oil revenue.

The AMA has said the budget shortchanges physician compensation and development by about $600 million.

“It is unclear how government plans to balance the probable 2025-26 expenditures for physician compensation and development against an insufficient budget,” the association said after the budget was tabled Feb. 27.

The AMA had said it would be inappropriate for the government to fund the shortfall by making changes to billing codes.

The health system is currently undergoing foundational restructuring of how it’s organized.

It is also dealing with a lawsuit, a scandal, and an RCMP investigation into allegations of sweetheart contracts, favouritism and high-level political arm-twisting on multimillion-dollar health procurement deals.

This report by The Canadian Press was first published March 13, 2025.

Lisa Johnson, The Canadian Press