What is the Health Services Review Committee (HSRC)?
This arms-length panel reviews government decisions made on requests for out-of-province and out-of-country medical coverage, ensuring legislation, policy and guidelines are followed appropriately.
The Ministry of Health denied my request for coverage. Can I request a review?
Yes, if you are requesting coverage for out-of-province or out-of-country medical services (physician and hospital care) or community care programs (mental health, alcohol and drug, problem gambling, home care and rehabilitative services). This does not include other health programs such as prescription drug or ambulance coverage.
The Ministry will inform eligible applicants of their right to request a review by the HSRC.
What is the composition of the committee?
There are 22 members in total. Three members will review each request for coverage: a chair with legal or administrative expertise, a physician or other health professional, and a public representative. Several different members are appointed in each role to ensure availability and scheduling of timely reviews.
How do I apply to have my case reviewed by the committee?
Eligible applicants must submit a written application to the HSRC within 90 days after the date the Ministry made its coverage decision.
The application form is available online at the bottom of this web page.
Send a completed application to:
Health Services Review Committee
TC Douglas Building
3475 Albert Street
REGINA SK S4S 6X6
Phone : (306) 787-1910
Fax: (306) 787-3761
You may wish to submit to the HSRC additional information that was not previously provided to the Ministry in its coverage decision. This information will be forwarded to the Ministry to reconsider its decision.
If the additional information does not result in a change in the Ministry's coverage decision, the HSRC will schedule a meeting to review your request.
How long will it take for the committee to review my request?
We anticipate committee meetings will be scheduled on a monthly basis.
The Ministry will have 30 days from receiving your application to inform you of the date that the HSRC will consider your application. In cases of clinical urgency, the committee may be convened to conduct a review with a quicker turnaround time.
The committee will consider whether the legislation, policies and guidelines governing out-of province and out-of country coverage were followed by the Ministry in making its coverage decision. You do not attend the review, as it is closed to the public.
Following the review, the committee will provide you with its recommendation as soon as possible.
What types of requests for out-of-province or out-of-country health coverage will the committee not recommend for payment?
• Health services not covered by Ministry legislation, policies and guidelines;
• Services provided outside of Canada if the services are available in Canada;
• Services considered experimental or applied research; and,
• Cost of travel, accommodations or meals.
If the committee turns down my request, do I have any other option?
Yes, you may contact the Provincial Ombudsman.
What is the difference between the HSRC and the Provincial Ombudsman?
HSRC
- The HSRC is the first group you approach to request a review.
- The committee provides a timely review based on information presented to them.
- Decisions are based solely on whether the Ministry of Health followed legislation, policy and guidelines appropriately.
Provincial Ombudsman
- You can contact the Ombudsman if you have a concern about a decision of the HSRC.
- The Ombudsman not only reviews whether the Ministry followed policy appropriately, but also assesses the fairness and equity of the decision.
Will the committee be able to review past Ministry decisions?
No, the committee will only have the authority to make recommendations effective
July 13, 2011.
