Keeping Health Care Providers informed of payment, policy or program changes

To: Homeless Shelter Agreement (HSA) Physicians (Inner City Health Associates, Shelter Health Network, Sherbourne Physicians Group)
Published by: Negotiations Branch, Ministry of Health
Date Issued: April 24, 2020

The Ministry of Health (ministry) and the Ontario Medical Association (OMA) have been working together to implement the compensation adjustments on eligible physician payments outlined in Section 21(a) of the Binding Arbitration Framework (BAF) in accordance with the 2019 Kaplan Board of Arbitration Award (Award).

Increases to physician compensation have been implemented, in part, through a Health Insurance Act regulation change effective April 1, 2020.

Relativity increase

Year 4 (2020-2021) of the Award provides for a permanent 3.5446% compensation increase on physician payments effective April 1, 2020. The distribution of the total compensation increase across physician specialties is subject to the relativity adjustments agreed to between the ministry and the OMA in the Interim Relativity Process Agreement dated November 7, 2017.

Effective April 1, 2020, the following payment elements under your funding agreement will be increased by 25.0000% and will be reflected on your May 2020 Remittance Advice (RA) payment.

  • Medical Director Sessional Fee-Q301A
  • Primary Care Sessional Fee-Q302A
  • Psychiatric Services Sessional Fee-Q303A
  • Internist Services Sessional Fee-Q304A
  • Primary Care After-Hours Services Sessional Fee-Q305A

Also, effective April 1, 2020, the Fee Schedule Master (FSM) will be updated to reflect the increases to fee-for-service (FFS) codes as agreed to between the ministry and the OMA at the Medical Services Payment Committee (MCPS). Claims processed through the Medical Claims Payment System (MCPS) with a service date on or after April 1, 2020 will reflect these increases and will be reported on the May 2020 RA.

For further information regarding the determination of the relativity increase rates by physician specialty please contact your OMA representative.

For inquiries related to payments or payment processing timelines please contact the Service Support Contact Centre at 1-800-262-6524.