Uninsured Services: Billing and Block Fees – General Consultation

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    The deadline to provide feedback is May 1, 2017

    Our Process

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    The College’s Block Fees and Uninsured Services policy is currently being reviewed. The policy sets out expectations for physicians who charge for uninsured services and/or offer patients the option of paying for uninsured services by way of a block fee. An updated and newly titled Uninsured Services: Billing and Block Fees draft of the policy has been developed and is being circulated for external consultation.

    View the draft policy

    We are inviting feedback from all stakeholders, including members of the medical profession, the public, health system organizations and other health professionals on the revised draft policy. Comments received during this consultation will assist in developing a final policy which will be considered for final approval by Council.

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    We want to hear your thoughts on the draft policy…

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    Background

    The College’s current Block Fees and Uninsured Services policy sets out expectations for physicians who charge for uninsured services and/or offer patients the option of paying for uninsured services by way of a block fee. In particular, the policy requires that physicians charge ‘reasonable’ fees for uninsured services, requires physicians who offer patients a ‘block fee’ to give patients the option of paying for services individually at the time they are provided, and requires that patient decisions regarding how to pay for uninsured services must not affect their ability to access care.

    Key Features of the Draft

    Overall, the draft policy retains the key content and central principles of the current policy. However, updates have been made in order to strengthen existing expectations or to address issues currently not addressed by the policy. These changes were made in response to research (including a jurisdictional review), feedback obtained through the preliminary consultation, and trends observed in the context of the College’s regulatory work.

    The key revisions being proposed to the policy are set out below (this list is not exhaustive):

        • Additional clarity and expectations regarding the reasonableness of fees has been provided, including the requirement that physicians consider the patient’s ability to pay (an expectation that is comparable to positions set out by the Ontario Medical Association, Canadian Medical Association, and other Canadian medical regulatory authorities).
        • New expectations regarding communicating fees have been added, including requirements for when uninsured and insured services are being proposed or provided together or when uninsured services are being offered as an alternative to insured services.
        • While physicians continue to be permitted to bill for missed appointments or appointments cancelled without proper notice, new content has been added setting out the specific requirements that must be in place in the physicians practice before the patient can be billed.
        • Additional clarity and expectations regarding the offering and management of block fees have been provided, including strengthened or new expectations regarding how block fees are offered or described to patients.

    Have Your Say

    We would like to hear your thoughts on the draft policy. In particular, we are interested to know:

        • Does the draft policy provide useful guidance?
        • Are there issues not addressed in the draft policy that should be addressed? If so, what are they?
        • Are there other ways in which the draft policy could be improved?

    Please provide your feedback by May 1, 2017

    Next Steps

    The College is committed to ensuring that the Uninsured Services: Billing and Block Fees draft policy reflects current practice issues, embodies the values and duties of medical professionalism, and is consistent with the College’s mandate to protect the public. The feedback obtained during this consultation will be carefully reviewed and used to evaluate the draft. While it may not be possible to ensure that every comment or suggested edit will be incorporated into the final policy, all comments will be carefully considered.

    Final decisions regarding policy revisions are made by College Council. Once a final draft has been approved, a copy will be posted on this page as well as the College’s website.

    To ensure transparency, the College will post all consultation feedback in accordance with our posting guidelines.

    We value your feedback and thank you again for participating in our policy review process.  _____________________________________________________________________________

    View feedback

    View the feedback received to date

    Send us your feedback by mail:

    College of Physicians and Surgeons of Ontario 80 College Street Toronto, Ontario M5G2E2 Attention: Policy Department