Bulletin

   
Bulletin Number
        2032
Date
        October 6, 2000
Direct inquiries to

         Ministry of Health
         Processing Office


(address below)
Distribution
       Independent Health Facilities
Subject      Changes to the Physician Schedule of Benefits
  1. Retroactive Payment: Discounted Fees
  2. Retroactive Payment: Physician Schedule of Benefits Increase
  3. After Hours Hospital Services Exempt from Threshold Calculations

The Ministry of Health and Long-Term Care (MOHLTC) and the Ontario Medical Association (OMA) reached a 4-year agreement in May 2000. The agreement is effective from April 1, 2000 to March 31, 2004 inclusive. Further to the July 1, 2000 implementation of changes, per Bulletin 4355, the following will be implemented on the effective dates specified for each item.

1. Retroactive Payment: Discounted Fees

Discounted fees for physicians who established practices in areas that were designated as over-supplied were eliminated effective January 1, 2000. A retroactive adjustment will be made for services provided between January 1, 2000 and July 1, 2000. The adjustment will account for the full amount of the reduction to all claims that were reduced by the discount. This adjustment will appear, if applicable, on your October 2000 Remittance Advice.

2. Retroactive Payment: Physician Schedule of Benefits Increase

The Schedule of Benefits has been revised to provide a 1.95% increase to all fees, except technical fees for diagnostic services, effective April, 1, 2000. Payments for services provided on or after April 1, 2000, and processed on or after July 1, 2000, have been paid at the new rate.

Retroactive payments will be made for eligible professional services provided on or after April 1, 2000 and processed before July 1, 2000. Due to the time required to process the volume of transactions, an estimated payment, if applicable, will appear on your November 2000 Remittance Advice as an accounting transaction. A final reconciled adjustment will be made early in 2001.

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