Ministry Reports

External Review of the Ontario Health Insurance Plan's Out-of-Country Program

July 2007

In March 2007, an independent review of the Ministry of Health and Long-Term Care's Out-of-Country Program (Program) was undertaken on advice from Ontario's Ombudsman.  The review included an overall program evaluation that examined operational processes, legislative requirements, access to drug information and general communications.  It was completed in July 2007 and resulted in a number of recommendations. 

Twelve general observations provided the context for recommended program changes.  The review noted that the volume of applications to the Program are both increasing significantly and becoming more complex in nature.  As well, there are varying levels of program awareness among physicians and patients and legislative changes are required.

Recommendations of the External Review Committee have been categorized as follows :

• Increasing Public Awareness of the Program
• Supporting Applications & Decisions
• Assisting Physicians and Patients with the Process
• Clarifying the terms of O. Regulation 552
• Ensuring Equitable Access to Drugs
• Helping People do an Excellent Job
• Investing in Provincial Capability

The recommendations are expected to assist the ministry in strengthening the Program to ensure that acceptable and appropriate medical care is available to Ontarians when required. 

Since the report was presented to the ministry, a number of improvements to the Program have already been implemented.  They include :

• Dedicated website with links to other related programs
• Ministry participation in public forums to provide a better understanding of the Program
• Improvements to the processing of Prior Approval applications, and
• Better communication with physicians and the public

The Implementation Status Chart provides specific details relating to the external review's recommendations, the ministry's response and the implementation status of each recommendation.