This committee reviews government decisions made on requests for out-of-province and out-of-country medical coverage, ensuring legislation, policy, and guidelines are followed appropriately.
Services and programs may be reviewed
The Ministry of Health informs eligible applicants of their right to request a review by the HSRC upon denial of their out-of-province or out-of-country coverage request.
You can request a review by HSRC only if your coverage request was for:
- Out-of-province medical health services;
- Elective out-of-country medical services (physician and hospital care); or
- Community care programs (mental health, alcohol and drug, problem gambling, and rehabilitative services).
HSRC does not review the following services:
- Emergency medical services provided outside of Canada;
- Other health programs such as prescription drug or ambulance coverage;
- Denial of coverage administered by another Ministry or agency of government, a regional health authority, a community-based organization or other entity;
- Coverage or benefits unrelated to Medical Services Branch or Community Care Branch;
- A patient is concerned with the manner in which he or she was treated by Ministry officials; or
- Cost of travel, accommodations or meals.
HSRC does not recommend payment for the following services:
- Health services not covered by Saskatchewan legislation, policies, and guidelines;
- Services provided outside of Canada if the services are available in Canada; or
- Services considered experimental or applied research.
Apply for review
Eligible applicants must submit a completed Health Service Review Committee Request for Review Application to the HSRC within 90 days of the date of the Ministry of Health's letter advising of its coverage decision.
Send your completed application to:
Health Services Review Committee
TC Douglas Building
3475 Albert Street
Regina SK S4S 6X6
You may wish to submit additional information to the HSRC for reconsideration of your coverage decision. The committee process indicates any additional information that is received with an application is required to be sent to Ministry of Health officials for their consideration. If the additional information does not result in a change in the coverage decision by the Ministry, the HSRC will schedule a meeting to review your request.
HSRC meetings are scheduled as necessary and as soon as possible. The Ministry of Health has 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 conduct a review with a quicker turnaround time.
HSRC will consider whether the Ministry of Health followed the legislation, policies and guidelines governing out-of-province and elective out-of-country coverage in making its decision.
Please note only committee member will be in attendance at your review. Review meetings are closed to outside participants and Ministry staff, and you will not be asked to attend. Following the committee's initial meeting, a comprehensive review may take several weeks to complete. The committee will notify you with their recommendation as soon as the comprehensive review is complete.
Composition of HSRC
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.
Another option for review
If your case is ineligible for HSRC or if HSRC upholds the Ministry's coverage decision, you may contact the Provincial Ombudsman for another review.
Differences between the HSRC and the Provincial Ombudsman
- Contact first to request a review of coverage for out-of-province health service;
- Provides a timely review based on information presented to them;
- Makes its decisions solely on whether the Ministry of Health followed legislation, policy, and guidelines appropriately; and
- Has the authority to make recommendations effective July 13, 2011.
- Contact the Ombudsman if you have a concern about a decision of the HSRC; and
- Reviews whether the Ministry of Health followed policy appropriately, and may also assess the fairness and equity of the decision.