On March 11, 2015, France Gélinas, the NDP’s health critic, introduced Bill 78, the Transparent and Accountable Health Care Act, 2015. Bill 78 has since passed second reading in the Ontario legislature and was referred to the Standing Committee on Social Policy on March 26, 2015.
The Bill proposes to promote transparency and accountability in the funding of health care services in Ontario by:
- ensuring that certain persons and entities that receive public funds directly or indirectly are covered by legislative requirements relating to accountabi¬lity and transparency; and
- requiring annual reporting on payments made by the Ontario Health Insurance Plan (OHIP) to certain persons and entities.
Both physicians and major suppliers to Ontario’s public health sector would be particularly impacted by this proposed legislation.
Broadening the Reach of the BPSAA, PSSDA, Ombudsman and Auditor General
Bill 78 proposes to broaden the reach of Part II.1 of the Broader Public Sector Accountability Act, 2010 (BPSAA) and the Public Sector Salary Disclosure Act, 1996 (PSSDA) to major health sector organizations and publicly-funded suppliers – in other words, to all health-sector entities receiving more than $1 million in public funding annually, whether directly or indirectly.
Subject to limited exceptions, Part II.1 of the BPSAA prohibits compensation increases for designated executives and restricts performance pay for designated employers. Currently, the only health-sector entities subject to these prohibitions are public hospitals. The Bill expands the reach of the PSSDA, which established Ontario’s “Sunshine List”, to all major health sector organizations, requiring the publication of the salaries of all employees earning over $100,000 per year.
Additionally, the mandate of the Auditor General is broadened by authorizing its audits of major health organizations and publicly-funded suppliers. Such health-sector entities would also be subject to oversight by the Ontario Ombudsman.
OHIP Payments Publication
Bill 78 would also require the Ministry of Health and Long-Term Care to annually publish a disclosure statement of the total amount paid to a person or entity receiving at least $100,000 through OHIP billings. The disclosure statement would also include “cautionary language”, explaining that the figures do not represent a physician’s net income. The cautionary language proposed by the Bill is as follows: “Readers of this disclosure statement should understand that it provides only a record of gross payments. In some instances, the recorded figure is a payment for the services of a number of physicians. Physicians must pay the expenses of their practice out of this gross amount. No calculation of a physician’s net income can be made from such figures. Conclusions cannot be drawn from these figures about the relative net income of any physician since overhead varies greatly from physician to physician.”