An Ontario judge has ordered the province to postpone changing the way it pays for physical therapy for seniors, throwing a wrench in a new regulation that the province claims will make services more equitable and reduce waste and abuse.
The regulation, which is to take effect Aug. 1, calls for the phasing in of 200 publicly-funded physiotherapy clinics that will be sprinkled across the province and bars private physiotherapy clinics, which currently corner the market on providing therapy to seniors in both retirement and long-term care homes, from billing the provincial health plan for their services.
The Designated Physiotherapy Clinics Association, which represents private clinics, argued in court the changes would thrust the system into chaos and leave 1,000 physiotherapists without a job and 35,000 seniors without care come next week.
Ontario Divisional Court Justice Tom Lederer on Friday ruled that the clinics could continue billing the Ontario Health Insurance Plan until a three-judge panel considers an application to review the entire regulation late next month.
“We’re happy,” the association’s executive director, Tony Melles, said after the court decision.
“It’s not like we won for the long term, but at least for the interim we have an opportunity to provide services and seniors won’t see a cut.”
The Ministry of Health and Long-term Care has acknowledged that implementing the changes would not be without hiccups, but insists the new system would lead to more seniors getting therapy and fewer taxpayers being ripped off by private clinics.
The ministry claims a recent internal audit revealed that nearly half of the bills private clinics submitted to the province for in-home therapy over the course of three months were bogus.
Among them were bills for physiotherapy that were not performed by a licensed physiotherapist, and charges for one-on-one sessions per senior who attended a standard exercise class.
The 91 private clinics with OHIP-billing privileges were paid $172-million by the province last year and are on pace to take in $200-million in the current fiscal year, according to the ministry.
The clinics could still provide services under the regulation, but their revenues would come in the form of transfer payments.
After the judge’s order, a defiant Health Minister Deb Matthews said the ministry intends to proceed next week with opening its new clinics. She conceded that would result in two physiotherapy funding models competing temporarily, but said rolling out the changes was critical.
“Of course I’m disappointed, but we are going to proceed,” Ms. Matthews said. “This is very important.
We want to expand access to physiotherapy and we’d like to do that as soon as possible.”
Physiotherapy is the fastest-growing line on the ministry’s budget, increasing somewhere between 18 and 20 per cent annually.
The ministry is earmarking $156-million this year, anticipating savings from the new funding model.