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Frustrated by an impasse in talks, Health Minister Eric Hoskins revealed last week that more than 500 doctors billed the province more than $1-million each in 2015.

Kevin Van Paassen/The Globe and Mail

Ontario's doctors have been without a contract for two years, and haven't formally met with the government for more than a year, but on Tuesday indicated they are now prepared to meet to set some preliminary ground rules.

This small concession – and it's still unclear if it will even be accepted by the government – came amid a flurry of letters between the Ontario Medical Association (OMA), which represents the province's 33,000 doctors, and Health Minister Eric Hoskins over resuming contract negotiations.

It comes after much political gamesmanship, including a remarkable news conference last Friday during which Dr. Hoskins, frustrated by the impasse, divulged that more than 500 doctors billed the provincial health-insurance program more than $1-million each last year.

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In an interview Tuesday, Dr. Hoskins said the strategy behind his news conference was to try to get the doctors back to the negotiating table – and to point out the "inherent unfairness" that exists in the physicians' fee schedule, one that allowed a single doctor, according to Dr. Hoskins, to bill $6.6-million last year.

He says he wants to work with the OMA on the fee codes to even out some of the disparities – there are 7,300 different procedures for which a doctor can bill.

OMA president Mike Toth characterized the Friday news conference as an "attack" on doctors and a tactic to divide them.

However, he says he wants to work on the billing issues, too, but first, he needs to ensure the government agrees to their request for binding arbitration.

"I think there is an obvious power imbalance between the government and the physicians in Ontario and binding … arbitration is a way of righting that imbalance," he said in an interview.

Later Tuesday, in a letter to Dr. Hoskins, Dr. Toth said they are trying to work out a time to meet to "establish the terms of reference for mediation/arbitration."

"As is common with negotiations across the Ontario public sector, success hinges on setting out fair and clear rules for the negotiations process in advance of formal talks," he wrote.

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Dr. Hoskins, meanwhile, has repeatedly said that the government is willing to "discuss mediation/arbitration as part of formal negotiations."

In a statement released to the media Tuesday evening, Dr. Hoskins's press secretary said that the OMA has told them they are not available to meet this week.

"We remain hopeful that the OMA will accept our offer and resume formal negotiations on a new agreement that includes a predictable budget, allows us to invest in other areas of the health-care system," Shae Greenfield wrote.

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