Alberta ombudsman to examine out-of-province health funding program
04.12.2008 03:26
Health
- Source: cbc.ca
 Emerald Raho said Tuesday her claim for out-of-province medical coverage for her twin daughters was rejected by the province. (CBC)Complaints from people who've been denied funding by Alberta's out-of-province health program prompted Alberta ombudsman Gord Button to launch an investigation Tuesday. Button said at a news conference Tuesday he's received about a dozen complaints from people whose requests for funding were turned down without any reasons given as to why. "A department in delivering such a service has a responsibility to explain their decisions and explain their actions to citizens when they're asked those questions," Button said. "That's what we are finding in all of these investigations is sorely lacking." How it works The Out-of-Country Health Services Regulation allows Albertans to apply for funding to pay for insured health services obtained outside of Canada, as long as the procedures qualify under Alberta health insurance, are not available anywhere in Canada, and are not considered experimental or applied research. Emerald Raho from Red Deer is still looking for answers she said the government failed to give her when her $7,000 claim was rejected by the province. Her twin daughters, now five, each had a condition three years ago that caused them to bang their heads, preventing them from sleeping through the night. The children were put on a two-year waiting list for a sleep study in Alberta. "I felt that a two-year waiting list was quite lengthy," she said, so she researched what was available for her girls in Canada. "We didn't have anybody here in Canada that could actually deal with this extreme head banging …so I made a decision, found a doctor in Chicago who specialized in this area and they were in to see him within a week and a half." The girls stopped banging their heads, and started sleeping normally within a month, Raho said. Raho made her claim based on the fact her girls were facing a two-year wait, and the medical expertise to treat her daughters was not available in Canada. "My children at the time were two, and sleep is so important in regards to them developing …and it would have been a detriment for them to wait two years," she said. When Raho's claim was denied, Alberta health officials told her treatment was available in Canada, but did not tell her where. Button tried to get provincial officials to review Raho's case, but his requests have been denied. As part of his investigation, Button is asking anyone who's had similar experiences with the program to contact his office. Health Minister Ron Liepert said his ministry will co-operate with Button's investigation. The ombudsman's investigation will focus on how claims are reviewed by Alberta Health and how decisions are made by the committee and the appeal board that evaluates the claims. It will also look at how wait times are factored into decisions, and how the reasons for decisions are given to claimants. Button expects to release his findings in spring 2009. Story Tools: E-MAIL | PRINT | Text Size: SMLXL | REPORT TYPO | SEND YOUR FEEDBACKHealth HeadlinesHealth care often inaccessible to Inuit: reportInuit have far less contact with doctors than the average Canadian, particularly in the northern communities where few have hospitals, a new Statistics Canada report says.Self-embedding of objects in body a puzzling teen disorderSome teens are wounding themselves and embedding objects such as paper clips and glass to cope with disturbed thoughts and feelings, say U.S. doctors who are looking for ways to remove the objects safely.Add sleep break for doctors in training: reportDoctors training at hospitals should limit how long they work without a sleep break to reduce the chances of fatigue-related medical errors and improve their learning environment, an expert panel in the U.S. recommended.Canadians eating less lunch meat after listeriosis outbreak: studyLast summer's listeriosis outbreak has caused Canadians to re-examine their eating habits, a University of Guelph survey suggests.Online stem cell therapies 'not ready for prime time,' study cautionsA Canadian study says consumers should be wary of web-based clinics that offer unproven stem cell therapies for numerous diseases. Health FeaturesWEEKLY CHECKUPPutting kids firstLessons from Madonna and GuyIN DEPTHCholeraNUTRITIONTrans fatsGirl Guides moving away from 'bad' fats FOOD SAFETYJuice boxes Reports of leaks prompt CFIA investigationVIDEODodaAddictive poppy derivative poses challenge to police (2:18)CAMPUS CRACKDOWNDrunken studentsA problem that is well past the tippling pointPeople who read this also read …
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