Compensation increases for hospital-based services under the PHSUP funding for the period of April 1, 2021 to March 31, 2022 will be paid in November 2023.

To: All Physicians
Category: Physician Services
Written by: Health Insurance Branch, Health Programs Delivery Division
Date issued: November 10, 2023
Bulletin Number: 231107

Physicians compensation increase for hospital-based services through Physician and Hospital Services for Uninsured Persons (PHSUP) funding

The Ministry of Health and the Ontario Medical Association have been working together to implement physician compensation increases in accordance with the 2021 Physician Services Agreement (PSA).

Year 1 increase

Year 1 (2021-2022) of the PSA provides for a one per cent across-the-board compensation increase to physician payments for the period of April 1, 2021 to March 31, 2022. This applies to payments made as part of the PHSUP funding, which concluded on March 31, 2023.

The ministry has calculated the compensation increase owing for payments made to physicians for providing hospital-based services through the PHSUP funding for Year 1 and will pay this amount as lump sum payments to the hospitals at the end of November  2023.

Year 2 increase

Year 2 (2022-2023) of the PSA provides for 2.01 per cent compensation rate increase to physician payments effective April 1, 2022. The Year 2 compensation increase of 2.01 per cent was applied on a go-forward basis and has already been paid for claims submitted for services rendered during the period of April 1, 2022 to March 31, 2023.

Compensation increase reporting

As per the regular convention for uninsured patient payments under the PHSUP funding, hospitals will receive an Allocation Summary Report that will specify the total payment amount to the hospital. This payment will be identified as the “2021-2022 Compensation Increase” on the report.

To assist in the distribution of funds, hospitals will also be issued a report, which details the amount payable to individual physicians at the hospital.

Appeals process

The compensation increase has been calculated based on the percentage and methodology agreed to between the ministry and the Ontario Medical Association outlined in the PSA.

As such, there is no appeal process for physicians who received a compensation increase payment and are disputing the percentage or methodology used in calculating the payment that they received.

The methodology is as follows, a lump sum equivalent to a 1.0 percent increase to all physician payments set out in Section 21(a) of the Binding Arbitration Framework (BAF), except hospital technical fees and Ontario Medical Association Priority Insurance Program.

Questions about PHSUP

For further PHSUP information, please see the previous INFOBulletins on March 25, 2020: 4749 and May 5, 2020: 4756.

For inquiries specific to this reimbursement notice, as well as all other inquiries about PHSUP claims payments, please contact the ministry at: uninsuredpatientsfunding@ontario.ca.

Keywords/Tags

Physician Services Agreement; PSA; physicians; payments; reimbursement; PHSUP; Physician and Hospital Services for Uninsured Persons;

Contact information

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