2019 was an eventful year for the OMA and Ontario doctors. We saw the first ever arbitrated award for physicians in Ontario. We saw significant movement on relativity with the development of a new relativity model (FAIR model). A plan for transforming OMA Council was approved by the OMA Board. The profession united against the initial version of Bill 138 and worked on improving relationships with the government.
I invite you to catch up on some OMA News.
- Retroactive Compensation
As you know, last February, the Kaplan Arbitration Board released its Phase I decision, namely, the terms of our 4-year contract, April 1, 2017-March 31, 2021. Consequently, unilateral cuts (clawbacks) to physician’s salary ceased April 1, 2019. We are now in the process of implementing the normative compensation increases arbitrated for years 1-3 (2017/18-2019/20) of the Physician Services Agreement (PSA).
Recap of Rheumatology increases:
Year 1 (2017-2018), 0.8%
Year 2 (2018-2019), 2.1%
Year 3 (2019-2020), 2.6%
Years 1-3 (April 1, 2017-March 31, 2020), will be a series of one-time lump sum payments based on 0.8% of an individual physicians billing for year 2017-2018, 2.1% of an individual physicians billing for year 2018-2019, and 2.6% of an individual physicians billing for year 2019-2020.
The Ministry currently anticipates the following timelines for issuing the retroactive one-time lump sum payments:
1st year (2017-2018): Dec. 2019
2nd year (2018-2019): April 2020
3rd year (2019-2020): Fall 2020?
The one-time, retroactive payments for year 2017/18 were issued to most physicians in December 2019 RA under the accounting adjustment “2017-2018 Increase”.
The MOH is available to walk physicians through your actual payment calculation –at Service Support Contact Centre 1.800.262.6524
2) Year 4, April 1st increases
Also adjudicated as part of the Kaplan Phase 1 Binding Arbitration decision was the establishment of a formal bilateral fee setting body, the Medical Services Payment Committee (MSPC), to determine allocation of year 4 increases to the Schedule of Benefits.
Year 4 – (2020-2021) “New Money”, will be a permanent allocation of the cumulative, compounded, amount of 3.8% for rheumatology.
The 5 top OHIP grossing specialties will not receive increases (Ophthalmology, GI, Diagnostic Radiology, Cardiology, Radiation Oncology).
The process of permanently allocating fee increases to the Schedule of Benefits began at the end of July 2019 with surveys of Sections, and those results were only available in September 2019. Rheumatologists who responded to the August 23, 2019 Rheumatology Intra-Sectional Undervalued Fee Code Evaluation Survey overwhelmingly agreed that all rheumatology billing codes evaluated were undervalued. The deadline to submit Rheumatology’s proposal for fee code increases to the MSPC was October 14, 2019. With tight timeframes for the MSPC 2020 fee setting exercise, there was no appetite for creating new fee codes now. In order to have fee changes ready for implementation April 1, 2020, the MSPC needed to have its final recommendations completed by mid-November to bring to the PSC (Physician’s Service Committee) for approval. The PSC is a bilateral committee that provides a broad and structured process for regular liaison and communication between the MOHLTC and the OMA as required under the Representation Rights Agreement. PSC is tasked with activities related to implementation of a Physician Services Agreement.
I am pleased to inform you that the OMA Board approved the recommendations of the MSPC (Medical Services Payment Committee) on December 17, 2019 which met the MOH timeline to have recommendations in place, to begin the process of having OHIP computers reprogrammed in time for April 1, 2020.
What this means is … the majority of physicians can expect an increase in their fees on April 1st, 2020 without having to wait for a painfully slow retroactive payment schedule!
3) Bill 138
Nov. 6, 2019 the Government released its fall economic statement (FES) which maintained its commitment to balancing the budget by 2023-24 by making investments into critical public services and strengthening conditions for job creation. To legislate such promises, the Government introduced an omnibus Bill 138, Plan to Build Ontario Together Act, 2019.
The OMA was very concerned about the proposed changes to the Health Insurance Act (HIA), in Bill 138, and if passed, would have instituted an onerous new audit system for physicians:
1) Should a physician be audited and deemed to have billed incorrectly, the onus was on that physician to disprove the claim. Guilty of fraud until proven innocent!
2) Conduct inspections. Government could audit the physician’s billings and make that information public without recourse.
3) Government could arbitrarily recover funds for a 2-year period. Those funds will be directly recovered without opportunity to appeal first.
4) Government could introduce regulations to unilaterally amend and impose new terms on any existing agreement with physicians including all APPs and AFPs.
In Nov 2019, an email was circulated through the ORA asking rheumatology members to click on a link to send letters to the Health Minister, Finance Minister and Premier expressing our concerns about Bill 138. Thank-you to all those that took action and signed the petition to Queen’s Park! Minister Elliott subsequently pledged to work co-operatively with the OMA to find a fair and equitable solution.
Bill 138, Schedule 15 (= Health Insurance Act containing information about the new audit process for physicians) passed its third reading in December. All the amendments the OMA asked for were approved (Dec. 5)! A summary chart of amendments showing the before and after impact of the bill on physicians is available on the OMA website: Summary Chart. OMA clarified the intent of the legislation to focus on establishing an updated audit process that is fair and impartial, accountable and transparent.
4) CPSO Continuity of Care Policies
Just a brief reminder that September 20, 2019, the CPSO approved 4 NEW policies and one Advice to the Profession companion document that set out expectations related to continuity of care. The policies outline the mandatory regulations and the companion document suggests optional best practices and advice. The 30-day transition period set out by the College ended Sunday October 20, 2019!
Please read through the CPSO Continuity of Care New Policies carefully!
The OMA has developed a series of checklists to help physicians understand and implement the new policies. There is a comprehensive web page with great information. https://www.oma.org/member/section/practice-&-professional-support/continuity-of-care?type=subsections
5) OMA Elections
The Rheumatology Section slate was acclaimed December 2, 2019.
Chair, Dr. Carter Thorne
Vice Chair & Rheumatology Delegate, Dr. Julie Kovacs
Secretary & District 11 Chapter Centenary (Scarborough) Delegate, Dr. Philip Baer
The new 2-year terms commenced January 24, 2020.
6) New OMA Relativity tool… FAIR (Fee Adjusted Income Relativity) Approach
CANDI is the current OMA Relativity Tool. The Relativity Advisory Committee (RAC) was tasked with developing a new relativity tool because of dissatisfaction with existing and past approaches. At OMA Fall Council, November 22-24, 2019, the OMA Board endorsed the FAIR Approach. FAIR Model development is planned for November 2019-May 2020. Model recommendations will be presented at OMA Spring Council April 30-May 3, 2020.
7) OMA Advantages Retirement Program
The OMA has launched a retirement plan!
Are you preparing to retire? The Advantages Retirement Plan is a group retirement plan established exclusively for OMA members and their spouses/common-law partners, distributed by OMA Insurance Inc. Watch this short video to learn more.
| Watch the video |
The OMA will be hosting a Retirement Planning Seminar at Delta Hotels by Marriott in Mississauga Tuesday, March 31, 2020 4:00-8:00 p.m.
Topics Include: Winding Down Your Practice (Physician Presenter), Insuring a Financially Healthy Retirement (OMA Insurance), Top Estate Planning Mistakes and Financial Planning (MD Financial Management) and Legal Considerations when Closing a Practice (OMA Legal Counsel). Please register here, https://events.eply.com/OMARetirementPlanningSeminarMississauga3242014 if you are interested in attending.
You can keep up on OMA issues by reading the Ontario Medical Review (OMR), the OMA monthly magazine available in print and on the OMA website: www.oma.org
You can now access the OMA website using your email address — useful if you’re like me and have forgotten your membership number.
The Economics, Research & Analytics Department provides members with billing advice and assistance on OHIP, payable to physicians for insured medical services. The OMA publishes the Schedule of Fees, the Physician’s Guide to Uninsured Services, and the Scale of Grading and Remuneration to assist physicians in billing for uninsured services. https://www.oma.org/member/section/practice-&-professional-support/billings-and-fee-codes?type=subsections
Online educational modules on billing, patient care, practice management and retirement planning are available through the OMA Education Network at: https://learn.oma.org
As well, an online Privacy and Security Training Module is now available from OntarioMD:
https://www.ontariomd.ca/products-and-services/privacy-and-training-resources
