Ontario Health Insurance Plan

INFOBulletin

Year 3 Kaplan Board of Arbitration Award Physician Increases

Laboratory medicine physician compensation increases were paid in February and March 2021.


To: All Physicians, Hospitals and Independent Health Facilities
Category: Physician Services, Primary Health Care Services
Written by: Claims Services Branch, Ontario Health Insurance Plan Division
Date issued: May 18, 2021
Bulletin Number: 210502


Background

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 in accordance with the 2019 Kaplan Board of Arbitration Award (Award).

The ministry and the OMA have come to an agreement that increases to physician compensation should be applied to laboratory medicine fee schedule codes (L800 series) listed in the Schedule of Benefits for Physician Services (Schedule).

These payments were made on the February and March 2021 Remittance Advice (RA).

Retroactive Increases to Physician Laboratory Fees billed through Community Labs

Year 3 (2019-2020) of the Award provides for a 1.00% compensation increase on physician payments for the period of April 1, 2019 to March 31, 2020 with 0.50% of the increase applied to remove the payment discount under the 2012 Physician Services Agreement. Together with the 0.75% increase awarded in Year 1 (2017-2018), and the 1.25% increase awarded in Year 2 (2018-2019), the total cumulative compensation increase that will be applied to physician payments for Year 3 is 2.5194%.

Claims for eligible laboratory services billed through community labs received the Laboratory Medicine increase of 1.6986% for Year 3. A summary accounting transaction was made on the February RA for eligible providers. If the provider received any other Year 3 compensation increases (as per INFOBulletin 210107) on their February RA, all compensation increase payments were reported under one (1) accounting transaction.

Retroactive payments for the Year 1 (2017/18) and Year 2 (2018/19) compensation increases were made on the March RA. The increases applicable to these payments are:
Laboratory Medicine Group (L8XX)

Year

Compensation Increase

Year 1 (2017/18)

0.5051%

Year 2 (2018/19)

1.3548%

Reporting

Please see INFOBulletin 210107 titled ‘Year 3 Kaplan Board of Arbitration Award Physician Compensation Increases’ for details on the reporting of this increase.

On the February RA, the summary total was displayed and laboratory compensation increases reported with a Percentage Increase of 1.6986%.

On the March RA, summary totals for each year were displayed, and on the two associated reports (one for 2017/18, and another for 2018/19, payments were identified based on the Percentage Increase amounts reported above.

Keywords/Tags

Kaplan Award; Arbitration; Year 3; physician compensation increase; laboratory medicine

Contact Information

For further information regarding the determination of the relativity increase rates by physician specialty not covered in INFOBulletins #4732/11218, Appendix B-“Method for the Implementation of 2017/18 Compensation Increases in the 2019 Ministry of Health (ministry) and Ontario Medical Association (OMA) Arbitration Award” please contact your OMA representative at negotiations@oma.org.

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

Find INFOBulletins online on the Ministry of Health website.

For More Information

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TTY 1–800–387–5559.
In Toronto, TTY (416)327–4282
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