Private surgery in Alberta: the legal framework after Bill 11
Alberta's Bill 11 lets certain physicians bill patients directly for defined dual-practice surgeries. Whether a specific facility may charge for a specific service in Alberta still depends on three separate legal layers: the physician's participation status, CPSA accreditation, and chartered surgical facility contract status.
Last verified
2026-09-14
Sources
Jurisdiction
Alberta
surgical facility
Editions as of
2026-09-14
Key takeaways
- Bill 11 (Health Statutes Amendment Act, 2025 (No. 2), SA 2025 c21) rewrote section 8 of the Alberta Health Care Insurance Act into three physician categories: participating, flexibly participating, and non-participating, replacing the old opt-in or opt-out choice.
- The dual-practice provisions were proclaimed in force on June 18, 2026, the tranche containing s.1(12), which substitutes sections 8 to 8.5 of the Act; later tranches on July 2 and September 1, 2026 cover other subsections, and the fall 2026 program rollout is a separate, media-reported timeline.
- Alberta's dual-practice page lists eligible categories including orthopedic, cataract, gynecological, ophthalmology, select ear, nose and throat, dermatology, plastic surgery, and minimally invasive general surgery, while cancer and emergency or urgent surgeries stay fully public.
- Whether dual-practice billing is limited to chartered surgical facilities and hospitals, or open to any CPSA-accredited surgical facility without a contract, is not resolved by any Alberta.ca page as of September 2026.
- CPSA's existing Standard of Practice on charging for uninsured professional services still governs every private fee: reasonable cost basis, disclosure before the service, and a written block-fee or per-service choice.
- The federal Canada Health Act's extra-billing and insured-person definitions sit above Alberta's rules; Health Canada recorded Canada Health Transfer deductions from Alberta for diagnostic-imaging patient charges in 2023 and 2024.
- Budget 2026 attributes $525 million over three years to chartered surgical facility capacity toward a stated 50,000-procedure target; that is a funding commitment, not a legal requirement.
Scope: This guide covers Alberta-wide legislation and regulator positions on privately paid surgery for non-hospital surgical facilities: the Alberta Health Care Insurance Act as amended by Bill 11, Alberta's dual-practice program, Acute Care Alberta's chartered surgical facility contract requirements, CPSA's billing standards, and the federal Canada Health Act overlay. It does not cover municipal permits, safety codes, or the CPSA accreditation process itself, which live in the surgical facility pillar and the accreditation guide. It describes what the instruments say; it is not legal advice.
Why the legal layer matters before you design
Clinical accreditation Operational readinessAlberta's private-surgery landscape now stacks three distinct legal layers, and a facility project that treats them as one concept risks designing for the wrong rules. Acute Care Alberta's chartered surgical facility contracts require every contracted clinic to meet College of Physicians and Surgeons of Alberta accreditation standards, which shows that contract status sits on top of, not instead of, non-hospital surgical facility accreditation.[13] Budget 2026 attributes $525 million over three years to expanding chartered surgical facility capacity toward a stated target of 50,000 additional procedures, underscoring how much provincial policy now depends on the contracted-facility model.[5] None of that funding commitment changes what an individual facility may lawfully charge a patient: that question turns on separate legislation (the Alberta Health Care Insurance Act as amended by Bill 11) and on CPSA's own standards of practice, covered in the sections that follow. This page describes those layers; it does not predict how any regulator will apply them to a specific project.
The reason to settle the legal layer early is that it shapes the business case before it shapes the building. A facility built for a contract revenue model and a facility built for private-pay surgery may look the same on a drawing, but they answer to different instruments, and the second model has only had a statutory footing in Alberta since mid-2026. Reading those instruments before committing a program of rooms is cheaper than reading them after.
Three layers: NHSF accreditation, CSF contract, physician participation status
Clinical accreditation Operational readinessThree separate approvals govern who may operate and bill for surgery outside a public hospital in Alberta. First, CPSA accreditation: a physician who wants to open a non-hospital surgical facility needs an assessment and CPSA accreditation before opening,[12] at a cost of $300 plus GST to register a new facility,[12] with CPSA developing best-practice standards, conducting an on-site assessment when the facility opens, and reassessing accredited facilities on a four-year cycle.[12] Second, the chartered surgical facility contract: Acute Care Alberta requires every contracted clinic to meet CPSA accreditation standards,[13] to follow the Health Facilities Act and its Regulation on the sale of enhanced medical goods and services,[13] and to meet physician-qualification standards under Alberta Health Services' Medical Staff Bylaws.[13] Third, physician participation status under the Alberta Health Care Insurance Act: every physician is by default a participating physician unless they elect flexibly participating or non-participating status.[1] A facility can hold CPSA accreditation without a contract, and a physician's participation status is independent of both.
The terminology matters because the public conversation blurs it. Non-hospital surgical facility, or NHSF, is the CPSA accreditation credential. Chartered surgical facility, or CSF, is the label Acute Care Alberta uses for the facilities it contracts to deliver publicly insured surgeries. BuildMedi did not locate a statutory definition of chartered surgical facility in the Health Facilities Act during research, so this guide uses the term only in the contract sense that Acute Care Alberta itself uses.[13] Every contracted facility must be an accredited NHSF; the reverse is not true.
| Layer | Instrument and issuer | Who it binds | What it decides |
|---|---|---|---|
| Facility accreditation | CPSA non-hospital surgical facility program (College of Physicians and Surgeons of Alberta) | Any facility performing surgery outside a hospital | Whether the facility may open and keep operating; assessed at opening and every four years[12] |
| Contract | Acute Care Alberta chartered surgical facility agreements | Facilities that deliver publicly insured surgeries under contract | Adds CPSA accreditation, Health Facilities Act compliance on enhanced goods and services, and AHS Medical Staff Bylaws compliance as contract conditions[13] |
| Physician participation | Alberta Health Care Insurance Act s.8, as amended by Bill 11 (Alberta King's Printer) | Each physician individually | Whether the physician bills the Plan, bills privately, or both, and for which services[1] |
What this means for the project. The three layers have three different owners: the College, a provincial agency, and the individual physicians who will practise in the building. A project that has resolved only one of them has not resolved its revenue model. The accreditation guide covers the first layer's process in detail; this page stays on the second and third.
What Bill 11 changed: participation categories before and after
Operational readinessBefore Bill 11 (Health Statutes Amendment Act, 2025 (No. 2), enacted as SA 2025 c21), the Alberta Health Care Insurance Act deemed every physician to have opted into the Plan by default, and a physician who wished to opt out had to give 180 days' written notice plus published and posted notice; that historical mechanism no longer describes current law.[2] Bill 11 repealed the former section 8 in full and substituted a new framework[2] defining three categories: participating physicians (the default), flexibly participating physicians (who provide both insured and non-Plan services[1] and may decide case by case which status applies to a given service[1]), and non-participating physicians (who provide only non-Plan services).[1] The consolidated Act's own amendment footnotes confirm this substitution was enacted as 2025 c21, s.1(12).[1] Alberta's proclamations list shows the core dual-practice provisions came into force June 18, 2026, with certain related subsections not in force until September 1, 2026, a distinct date from any later program rollout.[3]
The Act's own words for the two new categories are short enough to quote. The definition of a flexibly participating physician reads:
"flexibly participating physician" means a physician who provides insured health services and non-Plan services;
Alberta Health Care Insurance Act, RSA 2000, c A-20, s.1(l.1)[1]
And the non-participating category:
"non-participating physician" means a physician who provides non-Plan services and does not provide insured health services;
Alberta Health Care Insurance Act, RSA 2000, c A-20, s.1(o.2)[1]
The case-by-case election is the mechanical heart of dual practice:
A flexibly participating physician may decide on a case-by-case basis whether to provide a service described in section 2(2)(a), (b) or (c) as a non-Plan service or an insured health service.
Alberta Health Care Insurance Act, RSA 2000, c A-20, s.8(5)[1]
CPSA, the regulator that will oversee physicians practising under the new categories, summarized the change the day after Royal Assent:
This Bill amends the Alberta Health Care Insurance Act, creating a "dual practice" model in Alberta, allowing physicians to work concurrently in both the public and private systems and charge patients out-of-pocket for certain services.
CPSA, Medical Matters: Healthcare legislation overview, December 12, 2025[10]
| Before SA 2025 c21 | After SA 2025 c21 (in force June 18, 2026) | |
|---|---|---|
| Default status | Deemed opted into the Plan[2] | Deemed a participating physician[1] |
| Alternative statuses | Opted out entirely, after 180 days' written notice plus published and posted notice[2] | Flexibly participating (insured and non-Plan services) or non-participating (non-Plan only)[1] |
| Mixing public and private work | Not provided for; the choice was all or nothing | Flexibly participating physicians decide service by service[1] |
| Ministerial control | Not applicable to this question | The Minister may order restrictions on non-Plan services by type or specialty, with at least 90 days' notice unless a shorter period is found appropriate[1] |
Who a facility may charge: insured services, non-Plan services, residents and non-residents
Operational readinessThe Act's extra-billing prohibition applies by its terms to participating physicians, participating dentists and flexibly participating physicians, who may not charge a person an amount in addition to the benefits payable by the Minister for an insured health service;[1] BuildMedi reads this as structurally not extending to a non-participating physician, who provides no insured health services for the prohibition to attach to, but this is BuildMedi's inference, not a regulator ruling, and should be confirmed with counsel before it informs a billing model. The Minister may also order restrictions on which non-Plan services flexibly participating or non-participating physicians may provide, and any such order must be published and cannot take effect for at least 90 days unless the Minister finds a shorter period warranted.[1] Separately, the Act's definition of resident, the class eligible for insured services, excludes tourists, transients and visitors;[1] how that intersects with billing an out-of-province Canadian patient is not addressed in the sources reviewed and should not be assumed either way.
The prohibition itself is one sentence, and it is worth reading in the Act's own words because everything else on this page is an inference from it:
physician who provides insured health services to a person shall not charge or collect from any person an amount in addition to the benefits payable by the Minister for the insured health services.
Alberta Health Care Insurance Act, RSA 2000, c A-20, s.9(1) (extract)[1]
Notice what the sentence turns on: an insured health service, provided to a person, by a physician in one of the named categories. A flexibly participating physician who elects to provide a given surgery as a non-Plan service is, on the face of s.8(5), not providing an insured health service in that instance.[1] A non-participating physician provides no insured health services at all.[1] That is the structural reading; it is not a statement that any particular fee is lawful, and the Minister's order power under s.8.1 can narrow the field of non-Plan services at any time.[1]
The resident definition is the other half of the question. The Act's definition of the people the Plan insures ends with an exclusion:
but does not include a tourist, transient or visitor to Alberta or a person assumed under the Health Insurance Premiums Act no longer to be a resident;
Alberta Health Care Insurance Act, RSA 2000, c A-20, s.1(x) (extract)[1]
Owners sometimes summarize the pre-2026 position as "you could only operate privately on out-of-province patients." The sources reviewed for this page support a narrower statement: the extra-billing prohibition is framed around insured health services to insured people, and visitors to Alberta are not residents for Plan purposes. How a patient from another province is treated, given the reciprocal arrangements that exist between provincial plans, is not covered by any instrument BuildMedi reviewed, and this guide makes no claim about it.
Two exclusions apply regardless of the physician's status. Alberta's dual-practice page states that surgeries for life-threatening conditions, including cancer, and emergency or urgent procedures will remain entirely publicly funded,[4] and CPSA's own bulletin says the same in its own words:
Certain health services, like cancer surgeries and life-threatening conditions, must remain entirely within the publicly funded system to protect patient safety and ensure access.
CPSA, Understanding dual practice, July 10, 2026[9]
The dual practice program: eligibility, eligible procedures, approved settings
Operational readiness Clinical accreditationAlberta describes dual practice as allowing eligible physicians to provide publicly funded surgeries in the public system and privately paid surgeries in approved private settings,[4] with CPSA describing the model as limited to surgical procedures accredited as safe for non-hospital surgical facilities[9] and requiring that a physician apply to and be approved by the Government of Alberta before participating.[9] Alberta's program page lists eligible categories including orthopedic, cataract, gynecological, ophthalmology, select ear, nose and throat, dermatology, plastic surgery, and minimally invasive general surgery procedures,[4] and states family physicians are generally not eligible except those holding a subspecialty in anesthesia or surgical assistance.[4] Where dual practice may physically occur is unresolved: one part of Alberta's program page describes accredited chartered surgical facilities and hospitals,[4] while another describes approved private settings more broadly, and no ministerial order or regulation naming the scope of approved settings was located. A standalone CPSA-accredited facility without a contract should not be assumed eligible for dual-practice billing without direct confirmation from Alberta Health or CPSA.
CPSA's framing deserves its own line, because it ties the program back to the accreditation layer rather than to the contract layer:
Dual practice is limited to surgical procedures accredited as safe for non-hospital surgical facilities.
CPSA, Understanding dual practice, July 10, 2026[9]
Read carefully, that sentence is about procedures, not about which buildings qualify. It says the private half of dual practice is confined to the kind of surgery CPSA already accredits for the non-hospital setting. It does not say that every accredited NHSF is an approved setting for the program, and Alberta's program page, which is the government's own description rather than a legal instrument, uses two different phrases for the setting question. That is the gap a facility owner without a contract needs closed before building a private-pay business case.
| Question | What the sources say | Source and status |
|---|---|---|
| Who decides eligibility | Physicians apply to and must be approved by the Government of Alberta[9] | CPSA bulletin, July 2026 |
| Which physicians | Family physicians generally excluded, except those with a subspecialty in anesthesia or surgical assistance[4] | Alberta.ca program page; paraphrased |
| Which procedures | Orthopedic, cataract, gynecological, ophthalmology, select ear, nose and throat, dermatology, plastic surgery, minimally invasive general surgery[4] | Alberta.ca program page; the list is program guidance, changeable by ministerial order[1] |
| What stays public | Cancer, life-threatening, emergency and urgent surgeries[4][9] | Alberta.ca and CPSA agree |
| Where | "accredited chartered surgical facilities and hospitals" in one passage;[4] "approved private settings" in another[4] | Unresolved; no instrument located |
CPSA obligations that still apply to private billing
Specialized standardsIndependent of Bill 11, CPSA's existing Standard of Practice on charging for uninsured professional services continues to govern how any Alberta physician, including one billing under dual practice, sets and discloses a fee. It requires that fees charged for uninsured professional services reasonably reflect the physician's professional costs, administrative costs and the patient's ability to pay;[11] that patients be directly informed of any fee before the physician performs the uninsured professional service;[11] and that physicians allow patients the choice between paying a block fee or paying for each individual professional service, provide the block-fee option in writing, and ensure the patient has sufficient information to make an informed choice.[11] CPSA has also said it will review related standards and Advice to the Profession documents as it implements dual-practice oversight,[9] including a dedicated Dual Practice Standard of Practice that remained in draft, not finalized, as of CPSA's July 2026 bulletin; its eventual content should not be treated as settled until CPSA finalizes and publishes it.
The uninsured-services standard predates Bill 11 by years and is not specific to surgery; it applies to any fee a physician charges for a service the Plan does not cover. That is exactly why it matters here: a privately paid surgery under dual practice is, from the College's side, an uninsured professional service with a fee attached, and the standard's three requirements follow it. In CPSA's bulletin language:
Fees charged for uninsured professional services must reasonably reflect the physician's professional costs, administrative costs and the patient's ability to pay.
CPSA, Physicians charging for uninsured professional services, July 28, 2023[11]
Patients must be directly informed of any fee before the physician performs the uninsured professional service.
CPSA, Physicians charging for uninsured professional services, July 28, 2023[11]
What this means for the project. Fee disclosure is a workflow, and workflows occupy space. A facility expecting private-pay volume should plan for consultation and consent rooms where a fee conversation and a written block-fee choice can happen before the day of surgery, not at the pre-operative desk. The building should also assume that CPSA's dual-practice standard, once final, will add documentation expectations that the current draft status leaves unknown.
The federal overlay: Canada Health Act definitions and the deduction record
Operational readinessAbove Alberta's own rules sits a federal layer. The Canada Health Act defines extra-billing as billing an insured person for an insured health service in an amount in addition to any amount paid or to be paid for that service by a provincial plan,[6] a federal description running parallel to, but legally distinct from, Alberta's own section 9(1) prohibition. It defines an insured person as a resident of the province, subject to exclusions including Canadian Forces members, federal penitentiary inmates and residents still within a province-set waiting period of up to three months,[6] a federal analogue to Alberta's own tourist, transient and visitor exclusion. This layer has real financial consequence: Health Canada's published Canada Health Transfer deduction data record Alberta being deducted for patient charges under the Diagnostic Services Policy for fiscal 2023[7] and fiscal 2024, with a partial reimbursement recorded for 2024 tied to progress eliminating the charges.[8] These figures describe diagnostic-imaging charges, not dual-practice surgical billing, and should not be conflated with it.
The federal layer binds the province, not the facility. A private clinic is not a party to the Canada Health Act; Alberta is. What the Act does is condition federal cash transfers on the province's plan meeting its criteria, and the extra-billing definition is the term through which patient charges for insured services become a provincial compliance problem.[6] Whether Alberta's dual-practice model will be treated as extra-billing at the federal level is a live political and legal question that this page does not attempt to answer; the point for a facility owner is that provincial policy in this area can move in response to federal pressure, and the Minister's order power in s.8.1 is the mechanism through which it would move.[1]
| Concept | Alberta Health Care Insurance Act | Canada Health Act |
|---|---|---|
| Who is insured | A resident, excluding a tourist, transient or visitor to Alberta[1] | An insured person: a resident of the province, with exclusions for Canadian Forces members, penitentiary inmates, and residents within a waiting period of up to three months[6] |
| Charging beyond the plan | A participating or flexibly participating physician may not charge or collect an amount in addition to the Minister's benefits for an insured health service[1] | Extra-billing: billing an insured person for an insured health service in an amount in addition to any amount paid or to be paid for that service[6] |
| Who bears the consequence | The physician (status and billing) | The province (federal cash contribution) |
Health Canada's deduction releases show the federal lever in use. The March 10, 2023 release records a deduction of $13,781,152 from Alberta's transfer under the Diagnostic Services Policy, for patient charges levied for medically necessary diagnostic imaging services.[7] The March 21, 2024 release records a further deduction of $20,450,175 and a reimbursement of $20,538,796.[8] The reimbursement is larger than that year's deduction because, in Health Canada's own description, the Alberta and Quebec reimbursements are partial reimbursements of their March 2023 and 2024 deductions together, in recognition of efforts to eliminate the patient charges. Both figures are Health Canada's, quoted from its releases.
What the province has signalled: Budget 2026
Operational readinessBudget 2026 states the government is committing $525 million in additional funding to deliver 50,000 more surgical procedures over the next three years by leveraging chartered surgical facilities to expand operating-room capacity and reduce surgical wait times.[5] That is a government funding announcement and a stated volume target, not a legal instrument, and it does not itself create or expand any physician's or facility's authority to bill privately; that authority still depends on the Alberta Health Care Insurance Act's participation categories,[1] CPSA accreditation,[12] and any applicable contract,[13] covered earlier on this page. Read alongside the province's separate dual-practice program, Budget 2026 signals where public capital is expected to flow, toward chartered surgical facility capacity specifically, which is relevant context for a facility project's revenue mix and timing assumptions, but the figures are attributed to the government's own announcement and should not be presented as a BuildMedi projection, an assured result, or a schedule commitment for any individual project.
The signal, in plain terms, is that the province is funding the contract layer, not the private-pay layer. A facility whose model is built on contract volume is aligned with where Budget 2026 says the money goes; a facility whose model is built on dual-practice private fees is relying on a statutory permission that exists as of June 2026 and a program whose settings rule is still unwritten. Both are legitimate planning positions. They are not the same risk.
What this means for a facility project
Clinical accreditation Operational readinessFor a project team, these layers imply that CPSA accreditation of a non-hospital surgical facility, requiring an assessment before opening,[12] is a distinct step from securing a chartered surgical facility contract with Acute Care Alberta, which in turn requires that accreditation standards be met;[13] BuildMedi infers this ordering from Acute Care Alberta's contract requirements, and no procurement or RFP process page was located confirming it as a stated sequence. Separately, the Minister's power to order restrictions on non-Plan services, and the requirement that any such order be published at least 90 days before taking effect, means the scope of billable non-Plan services is not fixed indefinitely and should be re-checked close to project milestones.[1] Because SA 2025 c21 came into force in tranches, with the dual-practice subsection in the June 18, 2026 one,[3] while program rollout has been reported separately in the media, a project's timeline assumptions should distinguish in force from operational and confirm both against current Alberta Health and CPSA sources rather than this page's publication date.
Three practical consequences follow for the feasibility stage, which the feasibility guide covers in its own terms:
- Model the revenue layers separately. Contract revenue depends on winning and keeping an Acute Care Alberta agreement and meeting its hospital-equivalent conditions.[13] Private-pay revenue depends on physicians holding flexibly participating or non-participating status[1] and on the unresolved settings question. A pro forma that adds the two without separating their assumptions hides the risk.
- Treat the eligible-procedure list as a variable. The categories Alberta lists today are program guidance,[4] and the Act gives the Minister a published-order mechanism to narrow them with 90 days' notice.[1] A specialty-specific facility is more exposed to that mechanism than a multi-specialty one.
- Keep the accreditation clock separate from the legal clock. CPSA's assessment is triggered by readiness and repeats every four years;[12] the legal permission to bill privately dates from the June 2026 proclamation.[3] Neither clock waits for the other.
The Alberta Surgical Group case study shows what a purpose-built facility on the contract layer looks like in the public record; it is an example, not an endorsement, and it makes no claims about that project's revenue or contract terms.
Questions to ask counsel and CPSA
Operational readiness Specialized standardsGiven the unresolved points identified in researching this page, a facility project should put specific questions to legal counsel and, where appropriate, directly to CPSA and Alberta Health before finalizing a billing or facility model. These include: whether a CPSA-accredited non-hospital surgical facility without a chartered surgical facility contract is an approved private setting for dual-practice billing, since Alberta's own program page uses both a narrower phrase, accredited chartered surgical facilities and hospitals,[4] and a broader one, approved private settings,[4] without resolving which governs; what content CPSA's dedicated Dual Practice Standard of Practice will ultimately contain once finalized, since it remained in draft as of CPSA's July 2026 bulletin;[9] how the extra-billing prohibition's apparent non-application to non-participating physicians should be treated in a specific fee structure;[1] and how an out-of-province Canadian patient's eligibility for insured services, and any resulting billing treatment, should be assessed given Alberta's resident definition.[1] None of these questions has a confirmed answer in the sources reviewed for this page.
A short list to take into the first meeting:
- Is this facility, without an Acute Care Alberta contract, an approved private setting for dual practice, and where is that written?
- Which of our physicians will elect flexibly participating status, and what does the election process require of each of them?
- Which procedures on our program are on Alberta's current eligible list, and how would we learn of a ministerial order under s.8.1 narrowing it?
- What will CPSA's finalized Dual Practice Standard require of our consent, disclosure, and scheduling workflows?
- How should we treat out-of-province Canadian patients, and what documentation supports that treatment?
- What does the Health Facilities Act and its Regulation require of us regarding enhanced medical goods and services, whether or not we hold a contract?
Frequently asked questions
- What is Bill 11 in Alberta?
- Bill 11 is the Health Statutes Amendment Act, 2025 (No. 2), enacted as SA 2025 c21. It repealed section 8 of the Alberta Health Care Insurance Act and substituted a dual-practice framework, which CPSA describes as allowing physicians to work in both the public and private systems and charge patients out of pocket for certain services.
- What does Bill 11 allow doctors to do?
- It creates a flexibly participating physician status, defined as a physician who provides both insured health services and non-Plan services, and lets that physician decide case by case whether a given service is provided as a non-Plan service or an insured health service. A non-participating physician provides non-Plan services only.
- What is dual practice in Alberta healthcare?
- Alberta describes dual practice as allowing eligible physicians to provide publicly funded surgeries in the public system and privately paid surgeries in approved private settings. Every physician is deemed participating unless they elect flexibly participating or non-participating status under the Act.
- What is a chartered surgical facility in Alberta?
- It is the label Acute Care Alberta uses for the facilities it contracts to deliver publicly insured surgeries. Those contracts require CPSA accreditation and compliance with the Health Facilities Act and its Regulation on the sale of enhanced medical goods and services.
- What is the difference between a chartered surgical facility and a non-hospital surgical facility?
- A non-hospital surgical facility is the CPSA accreditation category; a facility needs an assessment and CPSA accreditation before opening. A chartered surgical facility is an Acute Care Alberta contract status, and every contracted clinic must meet CPSA accreditation standards, so a chartered facility is always an accredited NHSF while an NHSF need not hold a contract.
- Can Alberta doctors charge patients directly for surgery?
- Under the amended Act, a flexibly participating physician may provide a service as a non-Plan service on a case-by-case basis, and a participating or flexibly participating physician may not charge beyond the Minister's benefits for an insured health service. Whether a particular fee is lawful depends on the physician's status, the service, the program's settings rule, and CPSA's standards; obtain legal advice.
- Can out-of-province patients pay for surgery in Alberta?
- The Act's definition of resident excludes a tourist, transient or visitor to Alberta from the people the Plan insures. How that applies to a patient from another Canadian province, given interprovincial arrangements, is not addressed in the sources reviewed for this page and should be confirmed with counsel.
- Does Bill 11 violate the Canada Health Act?
- That is contested and this page does not answer it. The Canada Health Act defines extra-billing as billing an insured person for an insured health service in an amount in addition to what the provincial plan pays, and defines an insured person as a resident of the province with listed exclusions; whether dual practice meets those definitions is a question for Health Canada and the courts, not a facility guide.
- Has Alberta had federal transfer payments clawed back for extra billing?
- Health Canada's March 2023 and March 2024 releases record Canada Health Transfer deductions from Alberta under the Diagnostic Services Policy for patient charges at private diagnostic imaging clinics, with a partial reimbursement in 2024. Those deductions concern imaging, not surgery, and predate the dual-practice provisions.
- When does Bill 11 dual practice come into effect?
- Alberta's proclamations page shows the dual-practice provisions in the June 18, 2026 tranche of SA 2025 c21, the one containing section 1(12), which substitutes sections 8 to 8.5 of the Act. Later tranches on July 2 and September 1, 2026 cover other subsections. The operational start of the government's program has been reported in the media as fall 2026; that is a program date, not a legal one.
Disclaimer: This page describes what Alberta's Health Statutes Amendment Act, 2025 (No. 2) (Bill 11, SA 2025 c21), the Alberta Health Care Insurance Act, the Health Facilities Act, CPSA's standards of practice, and the federal Canada Health Act say about physician participation status, private billing, and chartered surgical facility contracting, as confirmed as of the review date. It is not legal advice and not a prediction of how Alberta Health, CPSA, Acute Care Alberta, or Health Canada will apply these instruments to any specific facility or physician. The dual-practice program and CPSA's dedicated Dual Practice Standard of Practice were still changing at the time of writing. Readers planning a facility should obtain legal advice and confirm current status directly with CPSA and Alberta Health before relying on this page.