need your help.
Why Ontario’s doctors are concerned
Guilty until proven innocent
The Ontario government tabled proposed legislation called Bill 138 on Nov. 6, 2019 to address concerns the Ministry of Health says it has about a small percentage of doctors and how they bill under OHIP. Ontario doctors support releasing physician
billing information with proper context, but as it stands now, this bill goes far beyond what is needed to address these concerns. Here’s why:
- Bill 138 will put all of Ontario’s doctors under a cloud only to address the small percentage—100 of 31,577 practicing physicians—whom we understand the Ministry of Health has concerns with over OHIP billing.
- Among its many flaws, it treats every doctor in Ontario as guilty until proven innocent, extends the presumption of guilt over a long time period, and recoups money before even allowing appeal.
The onus is on the physician to prove that he or she did nothing wrong.
It removes rights that every Canadian enjoys, allowing the government appointees to unilaterally cancel or change contracts and to claw back funds without a proper hearing.
- It gives people with no medical background the right to decide whether or not a procedure was appropriate.
We have a permanent solution – Update the Schedule of Benefits
Doctors use the Schedule of Benefits to bill the government for patient care. It’s complex, confusing, and outdated, and mistakes and inaccurate billing sometimes occur as a result. That solution is to update the Schedule, which contains more than 7,000 different billing codes. It is not a detailed document designed to be interpreted literally. Many of these codes are vague and open to interpretation.
What doctors now face
Imagine if the Canada Revenue Agency (CRA) told you that you had made a mistake on your taxes. Because of that, CRA automatically assumed you had made the same mistake for the past two years and ordered you to pay the money back without being able to tell your side of the story or appeal. This is what Ontario’s physicians now face.
We can work together on an OHIP billing solution
Ontario’s doctors have a positive working relationship with government for the first time in more than 10 years. We want that to continue, and we want to work with elected officials to improve Ontario’s healthcare system for all Ontarians.
The OMA Supports:
The work the government is doing to transform the health care system and we believe physician-led Ontario Health Teams will help end hallway medicine.
The release of billing information as long as the proper context is provided. The government is doing this and making it clear that OHIP billings are not salaries, but rather gross billings out of which each physician must pay all the overhead costs to run their practice. Taxpayers should know where their money is going and we endorse this initiative.
The elimination of the old red and white OHIP cards to prevent fraud.
Ontario doctors support an OHIP billing system that is accountable, fair and transparent. We agree that nobody should be inappropriately billing.
What we are asking for today
The first priority of Ontario’s doctors is the health and safety of their patients. We are fully committed to work with the government to create a fair, transparent and accountable billing system.
Bill 138 tabled on Nov. 6, 2019 is more than a distraction from that priority. It is about fundamental fairness and trust. Doctors can only work with patients—and government—when there is a foundation of trust.
The OMA is concerned that Bill 138 will threaten its current positive working relationship with government and undermine health system transformation efforts.
We have provided a summary of the issues with the bill and proposed changes that would allow us to support it. We are asking the government to change Bill 138 so that we can work together to come up with a solution that works for everyone.