Court suspends a regulation that would have stopped them from billing OHIP as of next week.
Private physiotherapy clinics have won round one in a battle with the province after a court ruled the government must keep paying them to provide OHIP-covered services — at least temporarily.
The clinics’ victory creates an awkward situation for the province which must now fund two physiotherapy systems beginning next Thursday — the old OHIP one it had wanted to kill on July 31 and its replacement that comes into effect the next day.
“This is procedural. It will make implementation a little more complicated, but we are continuing to move forward with the changes,” Health Minister Deb Matthews said after Friday’s ruling.
In arguing against the suspension, the province’s lawyer, Lise Favreau, warned it would “create chaos” because the systems would overlap.
But Matthews said the province will monitor the situation to ensure no one takes advantage of it.
“We are going to be watching very, very closely to make sure there is no double billing for any individual or service,” she said.
The clinics ultimately want the court to quash a provincial regulation revoking their authority to bill the public health insurance plan. Ontario Divisional Court Justice Tom Lederer said the court needs more time to consider the complicated matter.
He asked the parties to return Aug. 21 when a three-judge panel will review of the matter. In the meantime, Lederer granted the clinics their request for interim relief by suspending the regulation.
A lot is at stake for the 91 clinics that have had exclusive rights to bill OHIP for physiotherapy for more than 50 years. (Only 43 are part of the court challenge.) Their owners and workers argue their livelihoods would be affected. The clinics billed OHIP for $213 million for the 2012-13 fiscal year, the court heard.
But Matthews said the new system will offer taxpayers better value and will more fairly allocate who gets provincially funded OHIP.
The 91 clinics are clustered in southern Ontario, mostly around the GTA and Hamilton. Northern Ontario has only two. While some patients under the OHIP system get 150 physio treatments a year, others in need get none.
There is a suggestion the old system was open to abuse and had turned into a cash cow for some of the clinics. Matthews said some had taken advantage of their unlimited ability to bill OHIP.
Under the new system, there will be 200 community physiotherapy clinics, more equitably distributed around the province. As well, physio will be offered in long-term care homes and through home care. Funding will flow from the province through transfer payments tied to patient volumes.
The clinics charge the province had an obligation to consult with them about the changes, but instead they were blindsided when the province announced the new regulation on April 18.
They argue they were purposely left out of discussions to mitigate opposition and political fallout.
About 140 clinic owners and workers protested outside the Eglinton Ave. E. offices of the Ontario Physiotherapy Association on Friday, arguing the association worked against them by supporting the province in the creation of the new system.
Theresa Boyle – The Star – 2013-07-26.
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