Document name
Physicians
Document number
PRO 04/2020

Effective date: October 1, 2015

Approved date: October 7, 2020

Application: Applies to all physicians licensed to practice in Saskatchewan.

Policy subject: Health care services – providers

Purpose:

To provide guidelines for the implementation of fees for services provided by physicians.

BACKGROUND

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  1. The Workers’ Compensation Act, 2013 (the “Act”) directs that medical aid shall be furnished or arranged for by the Board as it may approve (Section 103(2)).
  2. The fees for medical aid furnished by any health care professional are determined by the Workers’ Compensation Board (WCB) (Section 104(1)).
  3. The Act directs the WCB to cover the costs of treatment or medical aid that may be required as a result of a work injury (Section 115(c)).

PROCEDURE

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  1. The WCB works in collaboration with the Saskatchewan Medical Association (SMA) regarding the treatment of injured workers, reporting to the WCB, and the remuneration of physicians.
  2. The WCB shall pay physicians the same rates as specified by the Saskatchewan Ministry of Health in the Saskatchewan Health Payment Schedule for Insured Services as amended from time to time.
  3. All service rates in the WCB’s fee schedule for physicians will be adjusted annually using the General Practitioner Composite Index (“GP index”), negotiated by the SMA and the Ministry of Health, for fee for service payment.
  4. The Chief Medical Officer (CMO) will ensure the fee schedules are updated annually to reflect the fees specified in the GP index. If increases to the GP index are unavailable at any annual date for adjustment, the adjustment will occur within 30 days of the index becoming available and communicated to the WCB by the SMA.
  5. When a claim is subsequently denied following the provision of services, the WCB will be responsible for the payment of physician services not specified in the Saskatchewan Ministry of Health’s Saskatchewan Health Payment Schedule for Insured Services provided by a Physician.

Policy references

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Legislative Authority

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The Workers’ Compensation Act, 2013

Sections 103, 104(1), 115(c)

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Document History

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(1) PRO 55/2015, Physicians (effective October 1, 2015 to September 30, 2020).

(2) References updated January 1, 2014 in accordance with The Workers’ Compensation Act, 2013.

(3) PRO 51/2009, Medical Fees – Physicians (effective January 1, 2008 to September 1, 2015). Amended February 1, 2012 to include fees effective April 1, 2011.

(4) PRO 53/2005, Medical Fees – Physicians (effective December 7, 2005 to December 31, 2007).

(5) PRO 04/98, Medical Fees – Physicians (effective April 1, 1998 to December 6, 2005).

(6) PRO 07/97, Medical Aid Fees for Professional Services Not Covered by MClB Payment Schedule (effective April 1, 1997 to March 31, 1998).

(7) PRO 01/97, Medical Fees - Physicians (effective April 1, 1997 to March 31, 1998)

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Complements

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