Tag Archives: Cardiac Rehab

New Ontario hotline for complaints about extra billing

Have you been illegally charged for a public health service that should have been insured under the Ontario Health Insurance Plan (OHIP)?

Yesterday the Ontario government launched a phone line and e-mail address for complaints about extra billing.

In its release, the government says there were 189 new investigations into illegal billing in 2010/11. Since 2007, about $1.3 million in illegal billing has been recovered either through reimbursements or cancellation of charges. This is on a $47 billion a year public health system.

For the average patient, figuring out whether their service should be covered or not will be a challenge, with health care providers deciding what is medically necessary and what is theoretically voluntary.

In the examples the government gives on its web site, it suggests that block fees are acceptable if payment is voluntary, does not cover insured services, and must be for a specific period of time. Users must also be given the option to pay for services that are not insured on a per-use basis.

The Ontario Health Coalition issued a release yesterday applauding the crackdown on extra billing.

“We are asking each of the provincial political party leaders to make a clear commitment to roll back the expansion of for-profit clinics and institutions, the majority of which charge patients illegal fees and undermine public Medicare in Canada,” says Natalie Mehra, Director of the Ontario Health Coalition.

Recently OPSEU raised the question of Rouge Valley Health System charging a block fee of $500 for patients in their cardiac rehab program who wish to continue past six months. The fee is not broken out by type of service, such as access to the indoor track and exercise equipment, stress tests or ongoing counselling.

Under the Canada Health Act, hospital services are insured health services. The Act defines hospital insured services as services provided to in-patients or out-patients at a hospital, if the services are medically necessary for the purpose of maintaining health, preventing disease or diagnosing or treating an injury, illness or disability. It would be difficult for a hospital to maintain that cardiac rehab is not medically necessary for the purpose of maintaining health.

It is particularly difficult for Rouge to maintain these are not covered services when its new partner in the program is Lakeridge Health, which provides a year-long cardiac rehab program.

Will the government order Rouge Valley to reimburse the $500? We can only wait and see.

To access the phone line: Call 1-888-662-6613

Or e-mail complaints to: protectpublichealthcare@ontario.ca

Rouge Valley doubles parking costs for cardiac rehab patients

Where do you draw the line when it comes to user fees at hospitals?

At Rouge Valley Health Centre participants in the cardiac rehab program are upset that the hospital is changing the rules on parking. Whereas it used to cost $8 per day for cardiac rehab patients, it will now double to $16 per day.

This is on top of $500 per year they pay to continue in the program past six months. That $500 does cover access to the hospitals indoor track and exercise machines, but it also covers access to a dietician, stress tests, and other health-related activities. The hospital will likely argue that the $500 covers the exercise portion, but given it charges for the entire program, this would appear to be a direct violation of the Canada Health Act.

Recently Rouge Valley’s cardiac rehab program merged with Lakeridge Health’s program. At Rouge they charge beyond the six month period. At Lakeridge it is covered. The question is, are they also going to merge policies, forcing patients in Durham to now pay for what was once covered?

Under the Canada Health Act, hospitals are not allowed to charge for health services.

The cardiac rehab program is a successful model that dramatically reduces the mortality rate for patients who are coping with heart disease. By placing a fee for these services and doubling parking fees, this discourages patients of limited means from continuing on with the program. With parking, continuing past six months means a cost of $1300 per year. Given many of these individuals are elderly and on a fixed income, this is a hefty price to pay.

For those who come three times a week for cancer treatments, this change in parking fees also means a jump to $52 per week.

The government talks a good line when it comes to preventative care. But if hospitals are going to place considerable obstacles to participating in preventative programs like this, then it will cost us all much more in the long term.

Rouge Valley should not be trying to balance its budget on individuals battling heart disease and cancer.