West Scarborough Community Legal Services
Response in PDF format.
Don Valley Community Legal Services (DVCLS)
Peterborough Community Legal Centre (PCLC)
Good afternoon,
Please consider the attached stakeholder submissions regarding the College of Physicians and Surgeons of Ontario’s “Uninsured Services: Billing and Block Fees” Policy.
Ontario Medical Association (OMA)
Community Legal Services of Ottawa (CLSO)
Dear CPSO consultation team,
Please find attached a submission from Community Legal Services of Ottawa (CLSO) in response to your consultation on the Uninsured Services: Billing and Block Fees Policy and Advice to the Profession: Uninsured Services.
As a community legal clinic serving low-income residents in Ottawa, we are particularly concerned about the impact of out-of-pocket medical fees on individuals applying for public disability benefits and navigating other critical legal processes.
We appreciate the opportunity to contribute to this important consultation and would be happy to discuss our submission further.
Willowdale Community Legal Services (WCLS)
To whom it may concern,
Please find attached Willowdale Community Legal Services’ submissions regarding the consultation on CPSO's uninsured services policy.
Professional Association of Residents of Ontario (PARO)
Dear CPSO Policy Department,
Thank you for the invitation to provide feedback on the Uninsured Services: Billing and Block Fees CPSO draft policy. We have reviewed the document, and overall find that it provides clear guidance.
We are wondering if the policy should provide guidance about how physicians can accept payment for uninsured services. For instance: is a physician required to accept credit/debit and cash as payment options, or are they permitted to limit transactions to credit/debit only if they have no way of managing cash/change in their clinic setting?
Once again, we truly appreciate being included in the CPSO's consultative process.
Income Security Advocacy Centre (ISAC)
Note: Some content has been edited in accordance with our posting guidelines.
Hello,As a mature member of the public, living in [redacted], after reading the background documents and comments, my opinion is based on my observations including:Note: because doctors in Ontario (along with my optometrist) are not especially well compensated for their professional services, I support billing for uninsured services.About missed appointments, our physiotherapists, dentists and others already bill for missed appointments.2009-2010 I was power of attorney supporting an ill family member whose new general practice doctor was asked to complete his disability documents as required by Canada Revenue Agency. I was present at his appointments due to his health status, cognition and eventual terminal illness. By chance this Family Health Team (FHT) group practice accepting new patients had recently offered a $75.00 annual fee for uninsured services. This form alone required time and detail so I was in agreement with this new annual fee.Since 2003 and continuing, I have been a patient of a doctor at a different and mature FHT in [redacted]. The website for this practice lists uninsured fees and cost for each in detail. Although I have not had reason to request an uninsured medical service, in future I would expect to pay a fee on request.With respect to an annual fee for unanticipated future uninsured services, I might not be receptive to that option. Depending on individual patient health status and needs, I understand this option might suit some patients.Thank you for considering this perspective from [redacted].
I declined to pay 'extra costs' to get my prescriptions renewed by my doctor at an Ottawa health clinic. The alternative has been to set up appointments for which OHIP is being billed. That should not happen. It is costly in terms of my time and money as I don't drive. Used to be that I could just phone my doctor who never billed to renew prescriptions.I find block 'fees' for prescription renewals to be absurd.
I tried to complete your survey. As a patient there was no way for me to fully understand the policy and what would be expected of physicians. There needs to be a separate survey that can allow patients to share their experiences of using uninsured services.I have had to have quite a few forms filled out that aren’t covered in the “block fee”. I’ve never paid for it for this reason. Even if I had, I would be paying even more for services. The block fee should have to cover everything that’s uninsured or it should not be allowed.Also there are many things drs are required to do that they are not compensated for- that is also unacceptable. Given that they have so many legal requirements to meet and such a burden if they aren’t they deserve to be fairly compensated for their time.A true consultation needs to be accessible to everyone who participates and their participation needs to be meaningful. This survey does not fulfill either of these objectives.
Ontarians should make their voices heard as CPSO holds public consultations on block fees and other patient charges.Many Ontarians are also being asked to pay annual “block fees” of $150 or more to cover these types of services. These changes are being considered following a rise in complaints from patients who feel pressured or unable to afford the extra costs.This is about fairness and protecting access to health care.“Ontarians are already struggling with rising costs of living under this government, and Doug Ford is quietly pushing Ontario toward a two-tier American-style system, where if you have money, you get better care, and if you don’t, you’re left behind. These block fees and extra charges are just another form of upselling that has no place in the public health system.
It's important to note that the CPSO is not asking whether individuals agree with block fees, but rather requesting feedback on the policy guide that informs physicians in their professional responsibilities.I believe the policy guide is fair and well written. It provides thorough guidance for family practice, which represents a significant portion of your membership. However, I encourage you to also consider the diverse roles that other members hold—these are the areas where additional clarity and guidance may be most needed.I also want to acknowledge and appreciate the thoughtful work that went into the sections on Setting Reasonable Fees and Communicating with Patients. The accompanying guide was detailed and clear, and I have no further feedback on those sections.
Inform Patients to get a “Receipt” when paying Uninsured Services Fees and include the cost as a Medical Expense on Line 33099 on their T1 — Annual Income Tax Return. This will permit low income individuals to claim a modest Tax Credit and will offset the cost of these fees.
Is it legal to charge for referring a patient to a Specialist? My friend is being charged for this
[redacted]
This raises a few issues [about block fees].
1. Consistency -- My ophthalmologist who prescribed me eye drops for my glaucoma does not charge me a block fee. He send to the pharmacy a prescription with multiple renewals and told me if I run out to have the phramacy call his office and he will extend the prescription.
2. Cost. 150 dollars (cash) cannot be redeeed by my insurance coverage and there appears to be no option for couples. With an aging population a couple can be paying 300 yearly for coverage. We already pay [redacted] Health Charge.
3. For those who do not pay and therefore do not take meds they will end up in emergency and therefore costing the health care system more. It is better for the province to pay the doctor to do this task.
I do not fault my doctor though I am frustrated as this puts a strain on our relationship and with a shortage of GP's I am not in a postion to do more. My take is that this is a result of underfunding and poor administration by individuals in so called goverment leadership positions (Health Minister and Premier) who lack the education and experience to address this matter in a responsible manner.
The policy is largely focused on administrative fees (e.g., forms, missed appointments) and lacks clarity on how uninsured aesthetic procedures should be communicated or managed.The policy cautions against requiring payment before services are rendered unless fully disclosed. In aesthetics, bundled or pre-paid services (e.g., laser packages) are routine. I would ask the CPSO to clarify that prepayment for aesthetic packages (e.g., laser series or injectable bundles) is permitted provided patients receive clear terms, including refund or rescheduling conditions.Current policy requires each uninsured service to be explained and consented to individually. I would propose allowing use of general consent forms or service menus (digital or printed), especially in large practices with multiple routine uninsured services.Many clinics use e-commerce or practice management platforms to display services, manage bookings, or process payments. I would ask the CPSO to explicitly support the use of secure third-party systems (e.g., Shopify, Jane, TouchMD) for managing uninsured services billing, provided patient information and consent are appropriately documented.These changes would better align the policy with modern dermatology practices while maintaining patient protection.
