Alberta moves to allow private diagnostic tests without a doctor’s referral

Albertans could soon pay out of pocket to get private diagnostic testing, without a doctor’s referral.

Bill 29, if passed, would allow Albertans to self-refer to private clinics later this year. Primary and Preventative Health Services Minister Adriana LaGrange said it will free up the public system and help identify medical conditions early. 

“It’s about giving Albertans more control over their health while maintaining the strong public health-care system that we all rely on,” LaGrange said at a news conference Monday.

She said early detection can save lives and puts less pressure on the system.

Details on criteria and which tests will be included will be revealed later this year. 

The changes had been mentioned in Premier Danielle Smith’s 2025 mandate letter to LaGrange and were previously announced in a government video last year. 

In that video, LaGrange said Albertans will be able to buy any diagnostic or screening test they want including MRIs, CT scans and full body scans.

LaGrange said the legislation would permit “lifestyle testing” done in countries like Japan and South Korea — citing bloodwork to check vitamin or hormone levels as an example.

But she said the government may take a phased approach, starting with one or two kinds of tests.

“Being the first in the country to do this, we want to be able to walk before we run.” 

“We’re looking to make sure that the public system is protected first and foremost, that we are able to deal with those referral tests that are already in the system and make sure that those are prioritized,” she said.

Last year’s announcement of self-referred tests prompted some doctors to warn about a shortage of skilled technologists.

LaGrange said it’s about adding capacity to the system, not taking away.

“People are paying for these tests themselves, there will be a market, a private market, that will step in to meet that capacity demand.”

NDP Primary and Preventative Health Services critic Sharif Haji said he believes it will increase inequity, and contribute to two-tiered healthcare.

“The ones who pay out of pocket will have access,” he said.

“It will not be based on need but will be based on who can pay first.”

Dr. Brian Wirzba, the president of the Alberta Medical Association, said the bill poses an increased risk of false positives and incidental findings.

“We are very concerned about what will happen with all of those extra findings as far as follow-up, further testing and consultations generated from those findings that will further burden our health-care system,” he said.

Tom McIntosh, a political science professor who studies health policy at University of Regina, said the details of what kinds of tests are allowed will have big implications.

“Can you self-refer yourself for a colonoscopy because you just think it would be a good idea to get one every year?”

McIntosh also noted there’s a rising demand for unnecessary tests, which he says could crowd referrals that are medically necessary.

“People with very high incomes want all sorts of medical, quasi-medical kinds of things that they don’t necessarily need, but they just want it and they can afford it,” he said.

Who pays?

Some private clinics and health facilities already provide preventive testing services, but most still require provider referrals.

There are also publicly funded self-referral screening programs delivered through private clinics, including for mammograms, with no out-of-pocket costs.

In last year’s video Smith said that if a private self-referred test reveals a significant or critical condition, the cost would be reimbursed. 

But at Monday’s news conference LaGrange said the government would be the “payer of last resort,” and private insurers would be billed first for those who have it.

McIntosh said he’s not sure insurers would do that.

“Even if it’s deemed medically necessary after the fact because it discovered something, I would say that if I were a private insurer, I’m not paying for that,” he said.

Access to addiction treatment

The bill also would allow health care prescribers like doctors and nurse practitioners to keep a limited supply of addiction treatment medications on site, and is designed to improve access in rural and Indigenous communities. It would only apply to a limited list of low risk opioid agonist drugs.

It would only apply to a limited list of low risk opioid agonist drugs.

Currently, pharmacists can only dispense these drugs with a prescription for a named patient, which the government said can lead to delays in timely treatment in some parts of the province.

Other small technical changes in the legislation would complete the final phase of the province’s health-care restructuring, LaGrange said.