Critical Condition Good Faith Coverage

The Saskatchewan Medical Association and the Ministry of Health have jointly developed a Critical Condition Good Faith (CCGF) Coverage Policy negotiated in the 2017-22 SMA/Ministry agreement. The purpose of the coverage policy is to minimize the risk of Saskatchewan practitioners not being paid for services provided to un-insured Canadian residents.

Physician Eligibility

To apply a physician must be licensed with the College of Physicians and Surgeons of Saskatchewan, be a resident in Saskatchewan and practicing on a fee-for-service basis at the time of service, providing eligible insured clinical services.

Service Eligibility

The policy only applies to treatment services provided on or after April 1, 2021, by eligible physicians to eligible patients in-hospital for emergent or urgent acutely critical conditions.

Services for conditions that are terminal but not acutely critical are not considered part of this policy. Treatment provided in clinics in the community is excluded. All services that are not medically required are excluded. Services provided to out-of-country visitors are excluded.

Patient Eligibility

The patient must be a resident of Canada eligible for provincial/territorial coverage at the time of service.

Note: Before applying for the CCGF coverage, physicians must hold billings for 180 days from the date of service and validate within this hold that the patient did not (re)establish their health coverage in Saskatchewan or elsewhere in Canada. If the patient has current coverage or (re)establishes coverage within 180 days, the physician must submit claims to Medical Services Branch.

Physicians interested in accessing the program are encouraged to first read the guidelines.

Validating patient eligibility requires access to the Person Health Registry System (PHRS) or the Shared Client Index (SCI). If you do not have access to the PHRS or SCI use this link to the alphabetized eHealth Forms Home page to request access.

For more details contact economics@sma.sk.ca.