Ontario Health Insurance Plan
OHIP Bulletins
INFOBulletin
Keeping Health Care Providers informed of payment, policy or program changes
To: Family Health Group and Comprehensive Care Model
Published by: Negotiations Branch, Ministry of Health and Long-Term Care
Date Issued: March 6, 2019
Bulletin Number: 11204
Re: Reminder: Preventative Care Bonus letters will be discontinued
Posted Electronically Only
As previously communicated on October 30, 2018 in INFOBulletin # 11200.
All signatory physicians who are active with an eligible Patient Enrolment Model (PEM) on March 31st of each fiscal year are eligible for the Preventive Care Bonuses for that fiscal year.
Family Health Group (FHG) and Comprehensive Care Model (CCM) physicians must meet the minimum roster size as of March 31st of the fiscal year in order to be eligible for the bonuses.
Requirements for Family Health Group (FHG) and Comprehensive Care Model (CCM) minimum roster sizes
The requirements for Family Health Group (FHG) and Comprehensive Care Model (CCM) minimum roster sizes are as follows:
- Eligibility is based on a physician’s roster size on March 31st of the current bonus year.
- In each bonus year, a physician must have a minimum roster size of 650 enrolled patients on March 31st of the bonus year being claimed.
- New Graduates in their first year of practice with a FHG or CCM will be required to have a minimum roster size of 450 enrolled patients on March 31st of the bonus year being claimed.
The Target Population Service Report has been automated from a manual process. Physicians will receive their semi-annual reports (April & September) via Medical Claims Electronic Data Transfer (MCEDT).
The ministry will continue to provide paper reports for those providers who continue to receive paper Remittance Advices.
Family Health Group (FHG) and Comprehensive Care Model (CCM) physicians who do not meet the minimum roster size will receive a Projected Target Population Service Report (TPSR) to identify enrolled patients that meet each the five bonus payment categories for the fiscal year.
Preventative Care Bonus letters will be discontinued for FHG and CCM physicians who have not met the minimum size roster
A letter previously sent to Family Health Group (FHG) and Comprehensive Care Model (CCM) physicians each April advising them of their minimum roster size and encouraging them to continue to enroll patients will no longer be produced.
Where to find your Roster Size
The Roster Capitation Reconciliation Report included in the monthly reporting to Family Health Group (FHG) and Comprehensive Care Model (CCM) providers via Medical Claims Electronic Data Transfer (MCEDT) includes a count of “previous month – total patients” and the “current month – total patients”.
For any inquiries please contact the Service Support Contact Centre at 1-800-262-6524.To view Portable Document Format PDF files, you will need to have Adobe Acrobat® Reader installed on your computer. You can download this free software from the Adobe website.
Public Information
