Fee-for-service claims for services rendered in oversupplied areas will be paid according to the following table and are subject to the annual maximum set out below.

DISCOUNTED FEES FOR NEW PHYSICIANS

These discounts do not apply to "technical" fees, namely those listed in Bulletin 4291, pages 2 to 4. The 2.9% utilization reduction for 1995/96 does not apply to these claims.

* The 36 month period begins the first day a physician provides an insured service, or the day the physician begins working under an employment contract or any other remunerative arrangement that requires he or she to hold a certificate of registration under the Medicine Act, 1991. The period does not include services rendered by a physician holding a certificate authorizing postgraduate education or as part of a postgraduate medical education program in which he or she is enrolled.

Note :

Amounts paid to physicians under Alternate Payment arrangements are not subject to discounted fees or fee-for-service annual maximums.

Exemptions

Exemptions to the above discounted fee system apply to a physician :

• who entered into a binding arrangements on or before December 15, 1996 to practice in a designated oversupplied area;
• who has an agreement with an Academic Health Science Centre that includes a commitment to research, teach and/or carry out other academic activities of at least 20 hours per week;
• who falls within one of the domains of medical practice identified below :
• A psychiatrist who receives a majority of gross income from services provided to patients under 20 years old or 60 years or more, or in a mental health facility listed in Schedule 1, 2 or 3 of Regulation 741 under the Mental Health Act;
• A physician who routinely provides services to patients of provincial outpatient HIV clinics listed in Schedule 21 of Regulation 552 under the Health Insurance Act.;
• who for a period of at least six weeks under a written agreement provides services as a locum tenens in an oversupplied area, on behalf of a physician taking a leave of absence in relation to a birth or adoption and whose practice is not subject to discounted fees (for the period of the locum only).

Your local Ministry of Health office has information to respond to your enquiries.


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2. MANDATORY ADDRESS AND PRACTICE REPORTING

All physicians are required by regulation, to provide in writing to the Ministry of Health, an address for every place they regularly render insured services in Ontario to insured persons. In addition to each address, all physicians must indicate whether services are rendered at each such address as a locum tenens or whether the only services rendered are delegated procedures, as defined in the Schedule of Benefits.

Effective immediately, a physician must give the Ministry of Health at least 30 days advance notice of any changes to practice addresses. The Ministry may require supporting documentation to validate address information provided, and to request information on all other practice addresses. This information should be submitted to your local Ministry of Health district office upon request or in the event of a change to existing practice information currently on file with the Ministry.

Initially, only new applicants will be required to provide practice address information as prescribed by the new regulation.

The Ministry continues to work towards improving the currency and accuracy of the addressees it maintains. Physicians may be contacted to verify and/or update the address data currently on file with the Ministry.

To support the collection of better address information, mail will be forwarded to the physician's reported practice address or a primary address if multiple addresses exist, if a general mailing address is not provided to the Ministry.

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3. RE-ENTRY OPPORTUNITIES FOR ONTARIO GENERAL/FAMILY PHYSICIANS

The Ministry of Health is offering 10 third-year Family Medicine re-entry positions and 15 specialty re-entry positions for currently practicing Ontario general/family practitioners with independent practice certificates. These new positions are identified in the recent Ontario Medical Association/Ministry of Health Interim Agreement.

For the 10 family medicine positions, the Ministry is interested in general/family physicians wishing to pursue one year of residency to acquire advanced skills in emergency medicine, anaesthesia or care of the elderly. For the 15 specialty positions, the Ministry is interested in general/family physicians wishing to pursue residencies in general surgery, obstetrics/gynaecology, general internal medicine, or psychiatry. Specialty training will be for the duration necessary to meet the qualifications for Royal College of Physicians and Surgeons of Canada certifications.

Physicians accepted for re-entry must return service in an underserviced area, domain of practice, facility or agency acceptable to the Ministry, or as part of the new Medical Service Corps. They will be required to sign contracts agreeing to provide one year of full-time service for each year of training.

Re-entry positions will be available as early as July 1, 1997 for the 1997/98 academic year. Physicians accepted may attend the Ontario medical school of their choice, providing they meet admission criteria.

If you are interested in a re-entry positions, please write to the Ministry of Health by March 20, 1997. Please indicate :

• your current certification and type of practice
• the residency program you are interested in
• preferences for the community, domain of practice, facility or agency where you wish to return service.

Write to:

Shelly Barton
Health Human Resources Policy Unit
Ministry of Health
8th Floor, Hepburn Block
TORONTO ON M7A 1R3

Facsimile Number (416) 327-0167

Candidates will be contacted by April 1 about the application and selection process.

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4. NEW P.E.I. HEALTH CARD

Ontario providers who treat out-of-province patients are advised that Prince Edward Island (P.E.I.) has begun to issue new health cards and new health numbers to its residents. The card replacement process began in December 1996.

P.E.I.'s New Cards and Numbers

P.E.I.'s new plastic health cards have patient information including an individual health number on the front, and a magnetic stripe on the back.

On the front, the new cards feature a landscape scene that includes a lighthouse. The background colour is orange/red at the top, but lightens gradually to appear more yellow at the bottom. There are two colours of lettering.

In blue lettering: the P.E.I. Health and Community Services logo, and the word "Health." In gold lettering are: the patient's unique, 8-digit lifetime health number, his or her name, birth date, and sex, as well as the expiry date of the patient's card.

On the back, the magnetic stripe contains the same patient information that is shown on the front of the card.

What They Replace

New individual health cards are replacing P.E.I.'s family-based health cards, while 8-digit personal health numbers are replacing P.E.I. patients' social insurance numbers.

Claims Payment for P.E.I. Residents

For payment of claims for insured P.E.I. residents, "old" cards and numbers will be accepted until May 31, 1997. However, effective June 1, 1997, the new 8-digit P.E.I. health number must be used for claims payment.

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5. MALPRACTICE FEES PROGRAM

Further to Bulletin number 4297, dated January 31, 1997, regarding the reimbursement of malpractice fees, physicians should note the following:

• Based on the December 1996 Interim Agreement with the OMA and the results of the Dubin Report, the Ministry of Health will reimburse physicians for their Malpractice Fees based on the 1996 CMPA Schedule of Fees. Appropriate changes are being made to ministry systems to reflect this agreement.
• Physicians who have already received their 1996 reimbursement (or have recently received their reimbursements, prior to the above noted changes being implemented), based on the 1995 CMPA Schedule of Fees, will automatically receive adjustments for the difference in fees. It is anticipated that the adjustment payments will be forwarded within six weeks.