For most of us, the holiday season was not celebrated with travel, large family gatherings, or going out for dinner or to parties. With pandemic restrictions promoting social distancing and limiting crowds many people bid farewell to a year they would prefer to forget. Here is hoping the year ahead is better than the one we left behind.
On an optimistic note, the long-awaited COVID-19 vaccine rollout started in Ontario December 15, 2020 and brings much needed hope for an eventual return to normality.
Congratulations to the OMA which was named one of GTA’s top employers for 2021! As well, the OMA was recognized by Twitter Canada as one of five Canadian health experts and organizations cited for “its masterful use of Twitter…with innovative approaches”.
So, without further ado, I would like to update you on the latest OMA news.
- ONTARIO BUDGET
- Doug Ford hopes “spending big” will help accelerate the province’s COVID-19 recovery!
- Nov 5, former Ontario Finance Minister Rod Phillips laid out the budget plan for 2020-21, including $45 billion over 3 years for necessary health resources, deliver critical programs and tax measures to support individuals, families and job creators impacted by the virus, and lay the groundwork for a robust economic recovery for the province.
- The budget proposes $30 billion in pandemic-specific spending.
- It comes with Ontario’s biggest-ever deficit, $38.5 billion.
- The government has committed to more than $7.5 billion in new health care spending.
- The province is spending $2.5 billion more in the hospital sector this year to help fight the pandemic.
- Hospitals were asked to anchor much of Ontario’s pandemic response, including running COVID-19 testing centres and assisting some long-term care homes.
- Hospitals also struggled with capacity issues through the second wave of the pandemic responding to a rise in cases while avoiding cancelling surgeries.
- MINISTRY EXTENDS LOAN REPAYMENT TIMELINE
- As you probably know, the OMA Board unanimously rejected the Advance Payment Program April 22, 2020, after asking the government repeatedly for appropriate relief for physicians – namely infrastructure costs and income stabilization.
- Nevertheless, this top-up to 70% of a physician’s normal billings was imposed upon us by government.
- The government planned to start to recover payments in February 2021.
- The OMA has been advised that the MOH is further deferring repayments of “loans” made to physicians under the Advance Payment Program to April 2021.
- Advance payments made in May, June and July last year will now be recovered from physicians’ billings in 6, equal monthly instalments (unchanged) beginning in April 2021 (instead of February).
- Comparison of Original vs. Revised Advance Payment Program
|Program Details||Advance Payment RAs||Recovery RAs|
|Original||May 2020 to July 2020||November 2020 to March 2021|
|Revised||May 2020 to July 2020||April 2021 to Sept 2021|
- Details, including options for earlier, voluntary repayments, are provided in OHIP INFOBulletin 210103.
- OMA will continue to advocate strongly for loan forgiveness and other income stability measures.
- EXPIRED HEALTH CARDS
- Some physicians have reported OHIP rejections of claims for services provided to pts with expired health cards.
- This is contrary to a previous Ministry of Health announcement OHIP InfoBulletin #4749 stating expired cards will remain valid until further notice for accessing insured health services.
- When validating a health card, response code 53 indicates the card has passed but is “expired”. These cards remain and OHIP will issue payments for claims submitted against them, unlike invalid cards (Lost, Stolen, Damaged or Voided).
- For patients without valid cards, services, like procedures and consultations, can only be billed to OHIP if the patient has a valid health card.
- Finally, patients without a valid health card can be billed for health services. If entitled to OHIP coverage on the date of service, the provider is required to reimburse the patient when the updated health card information is provided.
- 2021 OMA SUGGESTED FEES FOR UNINSURED SERVICES
- OMA Physician’s Guide to Uninsured Services: fees have been increased by 60% effective Jan. 1, 2021. i.e. Copying/Transmission of medical records, back to work note, sick note, insurance forms, CPP forms etc.
- OMA STATISTICS CANADA OVERHEAD PROJECT CONTROVERSY
- During the last round of arbitration, both OMA and MOH overhead estimates were criticized and the arbitrator decided “the parties must jointly collaboratively and comprehensively address this issue prior to their next PSA. An objective and professional study could actually determine what overhead costs were in different practice models and specialties.”
- The Statistics Canada (Stat Can) overhead project was first proposed in 2019, at OMA fall Council to provide anonymized and aggregated-by-Section overhead data on doctors in the province.
- Statistics Canada data is available to any researcher with appropriate approvals, including the Government of Ontario.
- Ontario Specialists Association (OSA) objected to the OMA launching theStat Can Overhead Project and although the concerns raised by the OSA were unfounded, they generated anxiety for many OMA members.
- The Stat Can project has been mischaracterized as the OMA having access to personal tax records through the CRA but does not involve the CRA.
- Only aggregate, at the OMA Section level, de-identified data on practice overhead would be obtained from Statistics Canada. The data will not allow the identification of any individuals or their practice.
- The project has been fully vetted, approved by Office of the Privacy Commissioner of Canada and the Privacy team at Statistics Canada.
- OMA would only use information about you that it collects for regular business purposes for which it has authority under its Privacy Notice— in this case, “Section” All other information that would be used is aggregate, de-identified data.
- The project would involve StatCan providing aggregated by “Section” anonymous arms-length overhead data.
- The Statistics Canada overhead study will preserve member privacy, support negotiations, and inform relativity models.
- This project has just recently been placed on hold by the OMA pending further consultations.
- OMA FALL COUNCIL DEBRIEF, NOVEMBER 28 AND 29
- Elected colleagues and OMA staff came together virtually in the last ever OMA Council meeting!
- Julie Kovacs and Dr. Philip Baer attended.
- OMA has fought to achieve Governance transformation since 2016 and this was approved at Fall Council.
- The OMA has undergone a significant transformation and reform since 2017.
- A new Board elected in 2017 and a new CEO (Allan O’Dette) appointed in 2018.
- Historic decisions were made in approving Governance Transformation to enable OMA to evolve into a world-class medical organization.
- The smaller, skills-based Board (physicians and non-physicians) with professional Directors will ensure a more nimble and effective organization that can pivot rapidly to efficiently deal with new threats to members’ well-being.
- There will be 125 Priority and Leadership Group Delegates that will meet a minimum of 2x/year.
- The goals of collaboration, representation, and diversity require that delegates to the Priority and Leadership Group reflect the broad diversity of the profession as a whole.
- All sections will have at least 1 allocated delegate.
- The OMA is made up of 49 Sections, 2 Fora, 11 Geographic Districts, 12 Medical Interest Groups. 11 Districts: 2 delegates per District = 22 Total Priority and Leadership Group
- 2 Fora (Academic and Rural): 3 Delegates per Forum = 6 Total Priority and Leadership Group
- 2 residents and 1 medical student attend the G.A as Delegates.
- To learn more about committees, contact the OMA Recruitment team at: email@example.com.
- Other Fall Council themes included working to close the “gender gap” and
- improve “equity, diversity and inclusion”, continuing to build upon the commitment and promises the organization has made to better advocate for ALL members.
- GOVERNANCE TRANSFORMATION CHANGES WILL HAVE A DIREST AFFECR ON THE “ELECTION” PROCESS
- You, the OMA membership will directly elect a skills-based Board of Directors and the President-elect.
- Nominations for all positions opened December 15 for 2021 election period.
- Given the new governance transformation model approved at Fall Council, there is an extended timeline to give members a chance to participate.
- Nominations close at 5 p.m. on February 9, 2021.
- Voting will take place between March 24-April 13
- Visit the OMA Elections page to learn more
- COVID-19 VACCINE ROLLOUT
- After independent and thorough scientific reviews for safety, efficacy and quality, Health Canada has approved two vaccines for use in Canada:
- Pfizer-BioNTech was approved on December 9, 2020.
- Moderna was approved on December 23, 2020.
- Both vaccines are manufactured in Belgium. After 2 doses, are expected to be 94-95% effective.
- Pfizer vaccine requires -80C temperature storage, administration recommended within 5 hours of reconstituting.
- The Canadian Rheumatology Association Position Statement on COVID-19 Vaccination Published on December 31, 2020; updated on January 21, 2021:
- The Canadian Rheumatology Association (CRA) provides the following updated recommendations regarding the COVID-19 vaccine for patients with rheumatic diseases:
- Individuals deemed eligible by Health Canada prioritization to receive the COVID-19 vaccine and who have an autoimmune rheumatic disease, or are immunosuppressed due to treatment, should receive the vaccine. They should be counselled about the unknown vaccine safety profile in these populations, in addition to the unknown effectiveness and the potential for lower vaccine response in those who are immunosuppressed. Even after vaccination, patients, particularly those who are immunosuppressed, will need to continue to follow all current public health guidelines to protect themselves against COVID-19.
- In addition to the above, individuals between 16 and 18 years of age will only be eligible for the Pfizer BioNTech COVID-19 vaccine. However, this vaccine will not be offered routinely to children below 16 years of age due to limited data. When Health Canada’s prioritization permits vaccination for those below 18 years of age, children with rheumatic diseases between 12-15 years of age may be offered the Pfizer vaccine on a case-by-case basis if they are deemed at high risk for COVID-19 exposure and disease, provided informed consent is obtained about the absence of data in this age group.
- There is currently no data to make a recommendation of whether DMARDs should be withheld at any point during the COVID-19 vaccination schedule. Studies on influenza vaccination have suggested that withholding 2 doses of methotrexate following vaccination improves vaccine response. It is unknown if this holds true for the COVID-19 vaccine or for other DMARDs. Concerns for potential disease flare should be considered when making these decisions.
Unfortunately, the initial NACI statement led to unintended inequities to access of the COVID-19 vaccine for some patients with rheumatic diseases. The CRA is optimistic that the updated NACI statement will allow for improved equity of access of the vaccine for patients with rheumatic diseases who wish to be vaccinated. Depending on the jurisdiction, a physician support letter for vaccination may be required but it is CRA’s expectation that this will not be necessary over time. Rheumatology patients should not be disadvantaged in receiving the COVID-19 vaccine because of diagnosis, treatment, where they live or because of an access issue due to a disability. The CRA shares the same goal as NACI and Health Canada in wanting to achieve equitable access to the COVID-19 vaccine and therefore highlights the importance of this issue.
- Jan 8, 2020, Dr. Philip Baer drafted a Vaccination Letter Template to authorize COVID-19 vaccination for your patients posted on the ORA website should it be required. Please see https://ca/members/existing-members .
- Toronto Public Health also has a vaccine authorization form: see https://www.toronto.ca/wp-content/uploads/2021/01/8da9-tph-confirmation-covid-vaccination.pdf
- December 15, 2020-March 2021
Who will be vaccinated:
- First phase: 1 million people will be vaccinated.
- residents, staff, essential caregivers (including family caregivers) & other employees in congregate living settings for seniors.
- health care workers, including hospital employees, staff who work or study in hospitals and health care personnel.
- adults in First Nations, Métis and Inuit populations.
- adult recipients of chronic home health care.
- The vaccine clinic locations in phase 1 include hospitals across the province.
- We are expecting to receive the following number of doses from the federal government:
- December 2020: 150,000
- January 2021: 350,000
- February: 600,000 was the initial estimate, however, Canada will not receive any Pfizer vaccine deliveries during the last week of January.
- Number of doses Canada will receive in the first two weeks of February has yet to be clarified.
- Despite this reduction, the government remains optimistic that Pfizer will be able to catch up after the delay, given that the delay is happening so Pfizer can boost its manufacturing capacity.
- Jan 8, 2021 OMA President’s Update: “At this time, there is only sufficient Pfizer and Moderna vaccine for acute (Hospital) & long-term care. However, due to some exceptional work and strong advocacy of OMA, as soon as supply becomes available, community physicians will be a priority.”
- The rollout in Ontario is very variable by region, in large part dependent on availability of the vaccines and challenges associated with storage and transportation.
- Some community physicians who provide services to patients attributed to a hospital may be extended eligibility for vaccination appointments during Phase 1.
- March-July 2021, depending on availability of vaccines.
Who will be vaccinated:
- Approximately 5 million people from the following groups will receive vaccines:
- Older adults, beginning with those ≥ 80 and decreasing in five-year increments over the course of the vaccine rollout.
- People who live & work in high-risk congregate settings (for example, shelters, community living)
- Frontline essential workers, including first responders, teachers and other education staff and the food processing industry.
- Individuals with high-risk chronic conditions and their caregivers.
- We are expecting to receive the following number of doses from the federal government:
- April: 5 million
- May: 5 million
- June: 5 million
- July: to be confirmed.
- August 2021 and beyond, depending on availability of vaccines.
Who will be vaccinated:
- Remaining Ontarians in the general population who wish to be vaccinated will receive the vaccine
- COVID-19 ALERT APP
- During the COVID-19 pandemic rapid and thorough contact tracing is essential in moving forward safely.
- If you haven’t already downloaded the App, the OMA would like you to consider doing so and encourage your social networks and patients to do the same. The COVID Alert app will work best if widely adopted.
- For those who can’t/won’t use the App, the OMA has a pocket journal to track movements and interactions daily; it’s far easier and more thorough than trying to recall 14 days’ worth of activity.
We will continue representing the Section on Rheumatology at Medical Assembly teleconferences and Assembly meetings, as well as all regular and special OMA Meetings.
New! COVID-related continuing professional development (CPD) and learning opportunities are now available. Follow this link for a list of COVID-CPD activities eligible for Maintenance of Certification (MOC) Program credit (Section 1 and Section 3).
You can monitor the MOHLTC website under the Health Professionals tab for new developments: http://www.health.gov.on.ca/en/pro/. There are links to OHIP Physician Bulletins: http://www.health.gov.on.ca/en/pro/programs/ohip/bulletins/ and to updates regarding the OPDP formulary, including new EAP listings:
You may also 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
Provided is a link to prior OHIP Bulletins http://www.health.gov.on.ca/en/pro/programs/ohip/bulletins/4000/bulletin_4000_mn.aspx
Online educational modules on billing, patient care, practice management and retirement planning are available through the OMA Education Network at:
As well, an online Privacy and Security Training Module is now available from OntarioMD:
Stay safe and be kind.