Welcome to your daily briefing on healthcare developments in AB. Today we're covering 10 key stories including updates on alberta healthcare headlines, alberta healthcare updates, background & context. Let's dive in.
5 stories
Alberta Health has published a summary of the rules that govern and protect health information held by custodians.
Healthcare professionals in AB who serve as custodians must understand these rules to ensure compliance and protect patient information.
Albertans have the right to access their health records.
Healthcare professionals in AB should understand patient access rights to ensure compliant records management and support informed patient engagement.
Alberta's Interactive Health Data provides health statistics on demographics, mortality, disease, and more in data table, dashboard, or map formats.
AB healthcare professionals can leverage these visual tools for evidence-based planning, resource allocation, and population health management across the province.
Alberta Hospital Edmonton provides people and patients with access to information from their health records.
AB healthcare professionals can direct patients to this AHS service to support continuity of care and informed clinical decision-making.
The Centers for Medicare and Medicaid Services now mandates that nursing homes report employee turnover rates and weekend staffing levels for direct care staff.
AB healthcare professionals can use this newly public U.S. data to benchmark staffing challenges and inform local long-term care policy discussions.
Reach healthcare professionals
2 stories
The Provincial Provider Registry is a verified source of regulated health service provider information in Alberta.
Healthcare professionals in AB can rely on this registry for accurate, up-to-date information on regulated providers to support referrals, credentialing, and care coordination.
Healthcare professionals can request administrative health data for research, planning, and projects, and access online health data resources.
Reliable data access supports evidence-based decision-making for patient care and system improvements across AB.
3 stories
Covered entities must annually recertify their 340B eligibility through HRSA. Missing the recertification window pushes the entity to inactive status, which means immediate loss of 340B pricing and potentially diversion violations on previously dispensed drugs. Reinstatement requires a new application.
The discount value of 340B pricing for a covered entity often exceeds six figures annually. Letting the recertification lapse for paperwork reasons is one of the most expensive administrative errors in the regulation.
A vendor is a business associate if they create, receive, maintain, or transmit PHI on behalf of the covered entity. They are NOT a business associate just because they happen to be in a building with PHI or could conceivably access it. The functional test matters, not the proximity test.
Forcing BAA execution on vendors who do not meet the functional test creates contractual bloat and weakens the negotiating position with vendors who actually do. Failing to execute BAAs with true business associates exposes the covered entity to OCR enforcement.
Across most payors, the top-five denial reasons account for over 80% of prior-auth rejections: missing clinical documentation, wrong CPT/HCPCS code, service not in benefit plan, step-therapy not completed, and ordering provider not on the patient's plan. The same five repeat across plans because they are the easiest to deny on automation.
Practices that build a five-line pre-submission checklist around these reasons typically cut prior-auth denials by 40-60% within a quarter. The fix is process, not appeals capacity.
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