Who pays for what on Maple? Company acknowledges some people charged improperly

Some Prince Edward Islanders have been reluctantly paying to be seen by a health professional through the Maple virtual care platform even though they believe it should be free as part of Canada's publicly fundedmedical system.

Now the company is offering refunds to people who consulted doctors online and were charged due to what it calls "a configuration error."

Cornwall, P.E.I., resident Margaret Simpson recently paid about $70 for a virtual care appointment through the platform.Earlier this year, she was suffering from a lung infection. She has a family doctor but couldn't get an in-person appointment, so she decided to use Maple.

Simpson was eventually connected with a health professional who issued her some prescriptions.

"It might not be a great system for someone who's older and not computer-literate, but I thought it was great," she said.

"It gave me my drugs and within a couple of days, I was feeling better. SoI fully loved the system."

Thousands of Islanders use Maple for free

P.E.I. residents on the waiting list for a family doctor or nurse practitioner to provide primary careare supposed to be able to access the service for free as part of a program that's been in place since the COVID-19 pandemic began.

As of March 27, there were 29,056 people on the province's patient registry, with 410 of thosehaving a family doctor but wanting a different one.

While she personally has a doctor, Simpson pointed out that many Islanders in that position are not able to access their primary caregivers when they need them.

"I didn't mind paying it just to get better. But I don't think, as a P.E.I. resident, that I really should have had to pay," she said.

"We have health coverage ... I can't get into the doctor when [I'm] sick. There aren't enough clinics for people."

Maple's CEO told CBC News recently thatwhether you have a doctor or not, you should not be charged for seeing one on its platform because that's set up as a publicly insured service.

As It Happens6:31CEO of Canadian virtual health-care company defends charging for services

Dr. Brett Belchetz is the CEO of Maple, a virtual health-care company that charges for some services. The federal government wants the provinces to crack down on companies like his. But Belchetz says Maple operates entirely within in the confines of Canadian law. He spoke to As It Happens host Nil Kksal.

CEO defends charging for services

On March 10, federal Health Minister Jean-Yves Duclos issued a letter warning provinces that the federal government would be cracking down on private companies that charge Canadians out-of-pocket for medically necessary health care including virtual care platforms because that's against the spirit of the Canada Health Act, which aims to protect public health care in the country.

Maple CEO Dr. Brett Belchetzsaid he doesn't think the company is charging for medically necessary services as governments define it.

"[A] great example of that is something like dental care. We all understand dental care is pretty necessary; it's really important to our health. But provinces have decided not to cover it, and thus it is something that dentists can charge privately for," he said in an interview with CBC News: Compass last week.

"This is absolutely part of the way that healthcare functions in this country. And so the things that we charge for on Maple just like when the dentist charges youare the things that the government has chosen not to cover."

Belchetzsaid he would love to see more thorough public coverage of Maple's offerings, and would like to see the province's program expanded to cover virtual care for all citizens, not just those on the patient registry.

Nurse practitioners not on public system

Belchetzsaid in most cases where Islanders with a family doctor havehad to pay for using Maple, they were matched up with nurse practitioners. Unlike doctors, nurse practitioners aren't set up to provide virtual care through the publicly fundedsystem.

"For the most part across Canada, there are actually no billing codes that a nurse practitioner can bill to actually see a patient on their own," he said. "So that is outside of a specific setting that is actually an uninsured service.

There's lots of nurse practitioners that we can tap into that can provide help to Canadians that aren't able to access care when they need it. And there's no way to get those nurse practitioners paid using the public health care system. And as a result of that, that is a privately paid-for service."

But Simpson ended up seeinga doctor through the system, not a nurse practitioner.

Error now fixed, company says

Maple confirmed there was a "configuration error" with its system that resulted in a "handful" of out-of-province doctors with P.E.I. licences being matched with P.E.I. patients who had to pay out of pocket.

...Asmall number of patients were inadvertently charged for their virtual care consultations. The error has now been fixed. Statement from Maple

"As a result, a small number of patients were inadvertently charged for their virtual care consultations. The error has now been fixed," the company said in a statement.

"We are clarifying with Health P.E.I. whether these visits can be reimbursed under provincial billing codes, and in the meantime we would be happy to refund any patient that was inadvertently charged during this time."

In a statement, Health P.E.I. saidit is the responsibility of private physicians to ensure they're following appropriate processes, adding that how private companies bill for service is "outside the purview of Health P.E.I."

Simpson said she'll gladly take a refund from Maple for her virtual appointment with a doctor. Yet shethinks care provided by nurse practitioners should also be part of the system.

"They're seeing patients, they're providing care, so why shouldn't that be reimbursed too?"