admin Federal Health Minister Mark Holland has announced that provincial and territorial health plans will begin covering primary care services provided by nurse practitioners, pharmacists, and midwives.
From 1 April 2026, regulated health professionals other than doctors will be able to bill the government for medically necessary services typically provided by physicians. Holland stated this policy shift is part of a new interpretation of the Canada Health Act, aiming to address issues where patients are paying out of pocket for essential care, including at private nurse practitioner clinics.
Holland emphasised that charging patients for these services is inconsistent with universal health care. Instead, nurse practitioners will be allowed to bill the health-care system in the same manner as doctors. However, the changes will take effect next year to allow provincial and territorial governments sufficient time to adapt their health insurance plans.
The directive was outlined in an “interpretation letter” sent to health ministers on Thursday and released publicly on Friday. Holland expressed concern about patients being charged for public health-care services, stating, “This certainly isn’t in the spirit of the Canada Health Act, and this interpretation letter shuts that down.”
The new policy empowers non-physician health professionals to deliver the full range of care they are qualified to provide, alleviating the burden on primary care physicians and the broader health-care system. Nurse practitioners, in particular, are seen as key to addressing pressures within the system.
In his letter, Holland noted the expanding scopes of practice for professionals such as nurse practitioners, pharmacists, and midwives, enabling them to utilise their full competencies, knowledge, and skills to improve access to care.
The changes will be enforced through federal health transfer payments, which may be reduced if patients are charged for medically necessary services. Holland’s directive follows concerns raised nearly two years ago by his predecessor, Jean-Yves Duclos, about patients paying out of pocket for essential treatments.
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