Remaining payments for Year 2 of the 2021 PSA to be processed January 2024

To: All Physicians
Category: Primary Health Care Services, Physician Services
Written by: Physician Relations & Contract Oversight Branch
Date issued: February 8, 2024
Bulletin Number: 240201

Background

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

Year 2 (2022-2023) of the 2021 PSA provided a 2.01% across-the-board compensation increase on physician payments for the period of April 1, 2022 to March 31, 2023.

Due to the nature of how certain payments are calculated and paid, a number of payments have yet to receive the 2.01% increase as agreed to in Year 2 of the PSA.

Please note: no action is required on the part of physicians.

Remittance advice

For physicians and groups that receive a monthly Remittance Advice (RA) through the Medical Claims Electronic Data Transfer (MCEDT), the Accounting Adjustment will reflect the 2022-2023 Compensation Increase payment value at the solo physician or group level based on how the compensation increase payment was processed.

The “Compensation Increase Report” will be delivered to the physician via MCEDT. Physicians will be required to provide permission to their appropriate designees for reviewing and/or downloading this report, if they have not already done so.

Solo report

The solo report will detail the Total Payments, Percent Increase and Compensation Increase for each Clinic Code under which the physician provided services and received a payment in 2022-2023.

Group report

The group report will detail the Total Payments, Percent Increase and Compensation Increase for each Payment Element (example: Preventive Care Bonus Payment) under which the group received a payment in 2022-2023.

The group report will also show the Total Payments, Percent Increase and Compensation Increase for each physician affiliated to the group during the 2022-2023 fiscal year.

Further information

The following payments will receive a 2.01% increase for the period of April 1, 2022 to March 31, 2023:

  • Group Management Leadership Payment (GMLP)
  • Preventive Care Bonus Payment
  • Special Premium Payments
  • Office Practice Administration (OPA)
  • Administration payments in the following agreements:
    • Toronto Palliative Care Agreement (TPCA)
    • General Practice Focus Practice groups
    • Homeless Shelter Agreements
    • After Hours On-Call Payments for General Practice Focus Practice groups and TPCA
    • Human Immunodeficiency Virus (HIV) Compensation level Premium
  • Rurality Gradient Premiums

Payment dates for the final payments of year 2 of the PSA

  • The ministry will process the one-time final payments in January 2024 for payment in the month of February 2024.
  • Physicians and groups who receive a remittance advice will see the payment deposited on or about February 14, 2024. The payment will be reported on the RA under accounting adjustment “2022-2023 Compensation Increase”.

Final payments for year 2 of the 2021 PSA payments to retired or deceased physicians

  • The ministry will deposit the compensation increase payments to the solo bank account on file where the bank account has remained open.
  • Where bank account details are not available, a cheque will be issued payable to the solo physician or to the “Estate of” in the event the physician is deceased.
  • Cheques will be sent to the same address on file with the ministry that was used for the remittance advice.

No changes to the Schedule of Benefits

The final payments for Year 2 of the 2021 PSA are one-time payments and do not increase physician compensation amounts in funding agreements or fee code values in the Schedule of Benefits.

Appeals process

The percentage increase and the compensation increase payments have been calculated based on the methodology agreed to between the ministry and the OMA in accordance with the PSA.

As such, the agreed-to methodology between the ministry and the OMA does not provide for an appeal process for physicians who received a compensation increase payment and are disputing the amount of the payment that they received.

The methodology is as follows, A lump sum equivalent to a 2.01 percent increase [reflecting the 1 percent increase for 21/22, and a further 1 percent for 22/23, compounded] to all physician payments set out in Section 21(a) of the Binding Arbitration Framework (BAF).

Keywords/Tags

Physician Services Agreement, PSA, physicians, payments, GMLP, Preventative Care, Special Premium Payments, Office Practice Administration, TPCA, GPFP, HSA

Contact information

Do you have questions about this INFOBulletin? Email the Service Support Contact Centre or call 1-800-262-6524. Hours of operation: 8:00 a.m. to 5:00 p.m. Eastern Monday to Friday, except holidays.