Private clinics illegally charging patients: report

Many private clinics in Ontario often violate the Canada Health Act by charging for procedures that should be fully covered by the Ontario Health Insurance Plan, says a new report by the Ontario Health Coalition.

“We found a significant number of private clinics are both billing OHIP and charging patients fees on top,” said Natalie Mehra, the Ontario Health Coalition's executive director.

The Ontario Health Coalition, which was established with the mandate to protect single-tier health care, had six university student researchers call 135 private clinics and hospitals in Ontario to find out whether they charged patients fees on top of billing OHIP for medically necessary services. There are 960 private clinics across the province.

The private clinics and hospitals they contacted offer services and procedures also covered by public hospitals.

To increase community care, the province has offloaded some procedures to private clinics. Around 600,000 colonoscopies are performed in Ontario hospitals every year, for example, but the Ministry of Health and Long-Term Care wants to move 200,000 to clinics.

But the Ontario Health Coalition’s student researchers found some patients were charged fees up to $3,500 for procedures like cataract surgeries and colonoscopies, that should be covered by OHIP.

According to the report, some clinics also charged $50 administrative fees for things such as snacks and access to patient records.

Mehra said more than 90 per cent of private eye surgery clinics they contacted charged for cataract surgeries.

In addition, Mehra said patients they contacted were afraid to challenge their physicians on various fees, out of fear they could lose out on a needed procedure.
Ontario Health Minister Deb Matthews told media in Queen's Park that private community clinics have been a benefit to the health-care system.

“It's easier for patients and it brings down wait times,” Matthews said.

Patients charged for procedures that should be covered by OHIP are encouraged to contact the Ministry of Health and Long-Term Care, Matthews said.

“It's illegal to charge people for insurance services,” she said. “If people feel that they are being charged for insurance services, we really need to know about that, because it's not acceptable.”

Nickel Belt MPP France Gélinas, the NDP's health critic, said the province needs to take a more active role in enforcing the law with regards to private clinics.
“The only enforcement (Matthews) is willing to do is when people complain,” Gélinas said.

Both Gélinas and the Ontario Health Coalition said clinics should fall under the control and administration of hospitals, which falls under the Public Hospitals Act.

“I'm not against care in the community,” she said. “But it has to be done with strong oversight to protect the public, and this is where (Matthews) falls flat.”