Treasury Board and Finance - MEDICAL ASSESSMENT (MA) SERVICES

Care-First is Alberta’s new benefits-based automobile insurance model, established through the Automobile Insurance Act. The model shifts the system toward early access to treatment, recovery-focused benefits, and clear processes for insurers, healthcare providers, and Consumers. MAs, as outlined in the draft Benefit, Treatment and Care Regulation, form one component of this model. The Province is seeking information from Vendors capable of delivering MAs. Multidisciplinary Assessment Capability The MA service must be delivered through a multidisciplinary team of medical assessors that includes a physician and additional healthcare practitioners with expertise in assessing and treating automobile‑related injuries (e.g., physiotherapists, chiropractors). The Province is seeking information on how vendors currently access specialized physician expertise, including mental health–related specializations, in situations where such expertise is clinically required. Clinician Qualifications and Specialty Access All physicians and healthcare practitioners involved in MAs must: • be licensed in Alberta, • be qualified to assess bodily injury, • have no prior treating relationship with the Consumer, and • not provide any treatment to the Consumer following completion of the MA. Geographic Coverage The MA service must be available across Alberta through a combination of Vendors. Vendors are not required to provide province wide coverage; however, each Vendor must be able to reliably deliver in person assessments within the regions they serve and identify any geographic limitations. Vendors may also use mobile or virtual service models to expand access and support coverage in rural or remote areas. Telehealth Capability Telehealth capability is not mandatory. However, where clinically appropriate, the ability to conduct certain assessment components virtually is considered an asset. Any virtual delivery must meet applicable quality and clinical standards. Timeliness and Service Delivery Vendors must meet timelines for initiating and completing assessments, including scheduling, coordination of multidisciplinary components, specialist involvement where required, and timely submission of the final MA report to insurers. Data Handling, Reporting, and Technology Vendors must ensure secure two‑way information exchange with insurers, including encrypted transmission of MA reports and protection of confidential information. Internal privacy controls must comply with applicable legislation. Vendors may use emerging technologies, including AI, to enhance administrative or workflow processes, provided privacy and security requirements are met.