This bulletin provides an important reminder and information regarding the upcoming recoveries under the COVID-19 Advance Payment Program

To: All Physicians, Hospital-based Dentists, Optometrists, Podiatrists
Category: Physician Services, Dentist Services, Optometrist Services, Podiatrist Services
Published by: Claims Services Branch, Ontario Health Insurance Plan Division
Date Issued: January 8, 2021

COVID-19 advance payment program

As per INFOBulletins 4754, 9142, 8161, and 7130 on April 22, 2020, the Ministry of Health (the ministry) established a three-month advance payment program to provide payments to eligible health care providers to address any cash flow issues that may have arisen during the initial stages of the COVID-19 outbreak.

The COVID-19 Advance Payment Program provided monthly, interest-free, automated advance payments that will be recovered from future OHIP payments to individual providers. Providers who were eligible for advance payments automatically received these payments on their solo Remittance Advices (RAs) in May, June and July, 2020 unless they notified the ministry of a request to opt out of the program.

Advance OHIP payment recoveries

By accepting the advance payment, providers were deemed to agree with the terms and conditions regarding set off against future OHIP payments. As the number of COVID-19 cases have continued to rise and due to the province wide shutdown and restrictions that are in place, the ministry would like to advise you that once again it is revising the timing and recovery period for the advance payments as follows:

  • Recovery of advance payments will be applied by setting off these amounts against a provider’s future OHIP payments beginning with the April 2021 RA (instead of February 2021).
  • The total amount of the advance payments will continue to be recovered in six equal installments from monthly OHIP payments beginning on the April 2021 RA and ending with the September 2021 RA (instead of February - July 2021 RA).
  • No interest will be charged.

NOTE: Advance payments will be automatically recovered from the provider’s solo RA. The recovery will report as a deduction on the RA under Accounting Transactions, as follows: ‘EMERG ADVANCE (COVID19) RECOVERY’.

Cheque repayment

Providers who wish to return the advance payments prior to the recovery period starting in April 2021 were previously advised that they may submit a cheque. Cheques for early advance repayments must be received by the ministry by February 22, 2021; following that date, cheques will only be processed at the end of the recovery period to ensure accurate payment amounts.

Negative balances

If a provider does not have sufficient earnings on their solo RA to set off the recovery, the RA will show a negative balance (amount owing).

Negative balances will not accumulate interest and cannot be deducted directly from the provider’s bank account. When a negative balance is generated on the solo RA, it will carry over to the following month’s RA and any payments on that RA will automatically be applied against the negative balance. This will continue until the negative balance has been repaid.

A provider in a negative balance at the end of the recovery period may send a cheque to return the remaining balance owing to the ministry. Once payment recoveries have started in April 2021, providers are asked to wait for the September 2021 RA before sending a cheque to ensure that it reflects the correct repayment amount. Any cheques received after February 22, 2021 and before the September 2021 RA is issued will not be processed by the ministry.

Further instructions regarding cheque repayments will be communicated prior to September 2021.

No further action will be required by a provider who is not in a negative balance at the end of the recovery period.

Providers with group earnings

Providers who anticipate that they will not have sufficient earnings on their solo RA in the months of April 2021 to September 2021, but anticipate having earnings through a group source and would like the recoveries made from their group earnings can have their group administrator contact the ministry’s Service Support Contact Centre or call 1-800-262-6524.

Automated recoveries will only be made from a provider’s solo RA; however, requests for recoveries of the advanced payments from a group source made by the group’s administrator will be reviewed on a case-by-case basis.

Requests must be made by the group administrator, not an individual group member, in order to qualify for consideration. Once they have contacted the ministry, the group administrator will be sent an indemnification form that they will need to complete in order to allow the ministry to process the request. Administrators may request repayment on behalf of all or some group members.

Keywords/tags

COVID-19; Advance Payment Program; APP; EMERG ADVANCE; negative balance

Contact information

Do you have questions about this INFOBulletin? Email the Service Support Contact Centre or call 1-800-262-6524.