OHC: Participate in Open Consultations on Uninsured Services and Block Fees
Please note that the Ontario Health Coalition is not affiliated with the College of Physicians and Surgeons of Ontario. We are sharing about these consultations so Ontarians can make their voices heard about the care you receive and the fees you are being charged.
Open Consultations on Uninsured Services and Block Fees
The College of Physicians and Surgeons of Ontario (CPSO) is the organization that regulates medical doctors in Ontario. All physicians must register with the CPSO in order to practice medicine in the province. One mandate of the CPSO is to ensure that physicians provide quality care. Another is to serve the public interest.
The CPSO is currently holding open consultations to receive feedback on policies that they are updating or amending. One of the policies they plan to update is their policy on uninsured services and block fees. If you have a family doctor or have gone to a walk-in clinic, you may have been charged for services like telephone prescriptions, sick notes, driver’s medical examinations, or more. These are uninsured services, i.e., they are not covered by OHIP. You may also have been charged $150 to cover all these uninsured services for one year. This is an example of a block fee.
The deadline to provide feedback is Friday, August 1 at 11:59 p.m. (ET).
Click here to find the current CPSO policy on uninsured services and block fees.
Keep reading below to learn more about block fees, why the Ontario Health Coalition opposes them, and how to provide feedback to the CPSO.
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Ontario Health Coalition
What Are Block Fees?
Doctors are allowed to charge patients for services that are not covered by OHIP either:
- Item by item as these services are provided, or;
- By a “block fee” to cover all uninsured (non-OHIP covered) services for a period of 3 to 12 months.
Uninsured services (i.e. services that are not covered by OHIP) include: telephone advice and telephone prescriptions (not to be confused with in-person prescriptions for which you cannot be charged a fee), completion of forms and documents for medical assessments for work or camp, sick notes, and more.
Usually, block fees are charged once per year and reportedly range from $100 to $250.
Since user fees for medically needed health care are not allowed, technically, the physician should have to return the unused portion of any block fee (or somehow roll it over to the next year) if the patient does not use the full cost of the block fee in medically unneeded services. However, we have never heard of anyone returning the unused portion of the block fee. This should not be happening.
Why Oppose Block Fees?
- They confuse patients. Patients think they have to pay the block fee. (They do not, it is optional.)
- Patients think that they will not get as good care, or will lose out on preferential appointments if they cannot afford to pay or choose not to pay.
- They have, in fact, facilitated the creation of a two-tier system in which those who pay a block fee or a fee for “enhanced” but medically unnecessary care get better, faster care while those who cannot pay face discrimination. These block fees have been used to sell annual “memberships” to certain physicians’ clinics for thousands of dollars per year. Ostensibly the block fee is for medically unnecessary things, but without question, those clinics are selling enhanced access to medically needed care for CEOs, executives and the wealthy.
- They are difficult to control and regulate — people are hesitant to complain about our doctors, especially when there are no options for getting another doctor due to the shortage. Already, the fees are going up and people are reporting that they do not feel they have a choice in paying them. Others have reported that they were required to pay block fees in order to receive care which is illegal.
- They are unnecessary — physicians can already charge item by item for these uninsured services.
A note about “uninsured” services
- Some “uninsured” services are medically necessary and should not be subject to user fees. For example, telephone prescription renewals should be covered by OHIP rather than charging patients for them. Prescription renewal is medically necessary and if the family doctor determines it to be safe and effective, it should be covered whether the doctor sees the patient in person or by telephone (or other technology). (Note: We are not advocating that for-profit online virtual care physicians without any relationship to the patient and with no continuity of care be enabled to rack up OHIP billings by renewing prescriptions). Similarly, the transfer of patient records, if medically needed, should not be subject to user fees. OHIP should cover these services.
- As many of you know, we have done extensive work on the for-profit clinics charging patients who go in for cataract surgeries, endoscopies, MRIs, colonoscopies and other surgeries or diagnostic tests. Often the clinics claim that they are charging for “uninsured” services, though often the patient is manipulated into paying. Please share your feedback on these practices with the CPSO also.
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How to provide feedback to the CPSO consultation about uninsured services and block fees
You can provide feedback in three ways:
- Post a comment by clicking here, scrolling down, and clicking on the blue/green button that says “COMMENT”
- Email the CPSO at consultations@cpso.on.ca
- Fill out an online survey by clicking here
The deadline to provide feedback is Friday, August 1 at 11:59 p.m. (ET).
The CPSO posts all feedback anonymously on their website. According to their posting guidelines, “Names of individuals are not posted with their feedback and reasonable efforts are made to remove personal identifiers prior to posting.”
Questions for the CPSO about the consultation?
If you have questions about the consultation, please email the CPSO at policydepartment@cpso.on.ca.
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