CEO of province's nurses and nurse practitioners association says similar cases have occurred before
Three years ago, a Colwood couple thought themselves fortunate to be patients of a nurse practitioner due to a lack of family doctors. However, they were horrified to learn that their insurance company won't pay for orthotics because it wasn't prescribed by a "physician."
According to a recent report by the Vancouver Sun, before Andrea Brown had to go to the Urgent and Primary Care Centre in Goldstream and was put in touch with nurse practitioner Sarah Adair, she and her husband Robert, both in their 70s, were without a primary-care clinician.
Over the years, the couple's insurer, Canada Life, has reimbursed them for the costs of their prescription medications. However, when it came to a $500 bill for Andrea's custom orthotics, which she needed to relieve hip and knee pain, the insurer said that under Brown's plan, that kind of prescription had to be written by a "physician, podiatrist, or chiropodist."
Read more: Senior, refused coverage by Manitoba Health, forced to pay for own knee braces
“They say nurse practitioners are not covered,” Andrea Brown, 75, told The Sun. “I think they should be covered.”
Nurse and Nurse Practitioners of B.C. reports that there are more than 800 nurse practitioners in the province, with about half of them working in family practice.
Robert Brown, a former professor at the University of Waterloo, has an extended health care plan that includes his wife.
Why Canada Life, which is owned by Power Corporation of Canada, would pay for much more serious drugs but not orthotics escapes him.
Robert Brown claimed he appealed, noting that "like a million other people in B.C., I did not have a medical doctor and probably would never have one," but Canada Life turned him down.
“Under the terms of your plan, custom made orthotics are covered when prescribed by a physician, podiatrist or chiropodist,” said the June 22 letter from Canada Life. “As a nurse practitioner is not eligible to prescribe custom made orthotics under your plan, we must maintain our decision to decline your claim.”
The Health Ministry stated that it was "discouraged" to learn that a nurse practitioner's prescription had been turned down.
“We encourage all insurance companies in the province to recognize nurse practitioners’ ability to prescribe, in order to connect more people with the care and services they need,” the ministry said in a statement.
Read more: Insurance policies falling behind as nurse practitioners gain importance
It's not the first time, according to Michael Sandler, CEO of Nurses and Nurse Practitioners of B.C., who said he doesn't understand why the insurance company wouldn't recognize a nurse practitioner's signature on a prescription for orthotics.
The BC Nurses and Nurse Practitioners, according to Sandler, wants to broaden nurse practitioners' scope of practice, which would help with problems like the one the Browns are having.
“That’s an inefficiency within the system that we advocate strongly to try and ameliorate based on the fact that nursing offers a multitude of solutions to some of the health-care delivery challenges the system is currently facing,” said Sandler.
