Since August 1st 2025, the CISSS de l'Abitibi-Témiscamingue no longer manages the billing of medical services provided in Ontario. This decision is in line with interprovincial agreements and practices applied throughout Quebec. It aims to ensure regulatory compliance and responsible use of public funds, while continuing to support access to health care. The Canada Health Act remains in effect and allows any Quebecer to benefit from insured health services in a province other than their province of residence. Doctors practicing in Ontario who used the services of the CISSS de l'Abitibi-Témiscamingue to manage their billing have various options allowing them to claim their professional fees when providing care to a Quebec resident.
The CISSS de l'Abitibi-Témiscamingue understands the concerns raised by these changes and the impact they may have on the population. It is important to remember that this coverage of medical expenses, although paid for by the institution for several years, is not within the mandate of the CISSS de l'Abitibi-Témiscamingue. The associated costs were covered by the institution's funding, which is dedicated to providing health and social services in the Abitibi-Témiscamingue region.
For several years, actions and discussions have been undertaken with various partners and government bodies, and every effort will continue to be made. It is hoped that constructive discussions will continue, aimed at improving access to services, while respecting everyone's responsibilities.
The institution is aware that this situation is generating reactions, particularly from elected officials and citizens. It is essential that elected officials, citizens, health professionals, government bodies, and Ontario partners work together to find lasting and equitable solutions that respect everyone's responsibilities.
- Why does the CISSS de l’Abitibi-Témiscamingue no longer handle billing for services in Ontario?For several years, the CISSS de l'Abitibi-Témiscamingue acted as an intermediary betweenOntario doctors and the Régie de l'assurance maladie du Québec (RAMQ), also compensating, from the operating budget, the difference in rates between those defined by the RAMQ and those defined by the Ontario Health Insurance Plan (OHIP) for medical services. However, it is not the institution's responsibility to assume the remuneration of doctors, whether in Ontario or Quebec. The decision aims to regularize the situation, comply with standards of practice and focus financial resources on care provided directly in Abitibi-Témiscamingue.
- Does this change prevent access to care in Ontario?No. Ontario doctors can continue to provide services to residents of the Témiscaming-Kipawa area. However, they must now send their claim forms directly to the RAMQ or bill their patients directly, as some already do. However, doctors are under no obligation to accept or provide non-urgent care to Quebec residents.
Who decides on agreements between Quebec and Ontario or other provinces?
Reciprocal billing agreements between Canadian provinces regarding medical services are the responsibility of the provincial governments. Quebec has not adhered to these agreements. It is not within the jurisdiction of the CISSS de l'Abitibi-Témiscamingue to conclude such agreements regarding the billing and remuneration of doctors. Quebec has adhered to health insurance agreements regarding hospital care, ensuring that hospital services provided in another province are free for Quebec residents.
Will I have to pay more for medical services?
Urgent services will always be available to you at all times; this is a requirement for each province. You may subsequently receive a bill for medical fees. However, all hospital costs are assumed by the hospital that provides the services to you, and the RAMQ will reimburse them directly. This includes hospitalization costs and diagnostic tests.
For elective (non-urgent) services, the doctor decides whether to accept or provide medical services to a Quebec resident. When the doctor agrees to provide you with medical services, they can either bill you directly for their fees or claim them from the RAMQ. If you pay the fees directly, the RAMQ will reimburse you, but possibly at a lower amount; the difference could be covered by private insurance.
What alternatives are there to avoid additional costs?
- Confirm with your attending doctor in Ontario whether he agrees to forward his billing directly to the RAMQ using the form he previously sent to the CISSS de l'Abitibi-Témiscamingue;
- If your treating doctor decides to bill you directly for their fees, you can check with your private insurance coverage to see if the difference in fees for the medical services received is covered;
- Your attending doctor in Ontario can also, at his or her discretion, adjust his or her fees to what the RAMQ will reimburse you;
- Consult a health professional in Abitibi-Témiscamingue, in the various facilities of the CISSS de l'Abitibi-Témiscamingue with the possibility, when required, of telehealth care from the Témiscaming-Kipawa Multiservice Health and Social Services Center.Will the CISSS de l’Abitibi-Témiscamingue compensate Ontario doctors for accepting the RAMQ card?
No. The CISSS de l'Abitibi-Témiscamingue is not responsible for paying remuneration to doctors practicing in Ontario. Ontario doctors are responsible for billing their services according to interprovincial rules. Furthermore, the institution is not expected to cover the costs of services provided outside Quebec.
The establishment's financial resources are dedicated to care and services provided directly in Abitibi-Témiscamingue, and throughout the entire Témiscamingue region.
What if I have to travel for a service?
In some cases, Ontario services were more geographically accessible, and having to travel further can be a challenge for many residents. This is why the CISSS de l'Abitibi-Témiscamingue is committed to working with its partners to find solutions to limit the travel required to receive services.
The user travel policy, depending on the distance to be traveled to receive a service offered in another city in the region, allows for financial support associated with this travel.
What are the obligations of Ontario doctors who serve a Quebec citizen?
For non-urgent services, Ontario doctors are not required to serve residents of other provinces. The College of Doctors and Surgeons of Ontario provides procedures for terminating a therapeutic relationship with a patient. These procedures include the requirement that a doctor explain the termination of follow-up to the patient and the reasons for it, provide the required follow-ups if tests are underway, and address any urgent needs while awaiting treatment by another doctor. The doctor must also make available the contents of the medical record relevant to the continuation of care by another doctor.
How do I raise concerns or questions regarding a service interruption or continuity with an Ontario doctor?
If you had follow-up in Ontario for which an interruption occurred without a transfer to services in Abitibi-Témiscamingue being made or if you have questions or concerns related to a refusal of care in Ontario, we invite you to write to the following email address: transfertmedtk@ssss.gouv.qc.ca or by calling 819 627-3385, ext. 0.
Information about your needs will be forwarded to the relevant authorities at the CISSS de l'Abitibi-Témiscamingue to enable support in the region.
Who can I contact if I am dissatisfied?
People who are dissatisfied can contact the Complaints and Service Quality Commissioner .
Please note that the complaint may not be processed under the complaints review system since the mandate of the Regional Commissioner for Complaints and Quality of Services concerns the processing of dissatisfaction related to the quality of care and services provided by the CISSS de l'Abitibi-Témiscamingue. Anyone filing a complaint will receive a written response following its filing.
Do you have any questions?
Please do not hesitate to contact the Communications and Public Affairs team .
