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CBC
5 days ago
- Health
- CBC
Ontario doctors don't get paid when they treat uninsured patients. Here's how that might change
Several times a week, a man facing homelessness and mental health issues comes to the busy emergency department in downtown Toronto where Dr. Bernard Ho works, and doctors there treat him despite not being paid to do so. That's because the man doesn't have a valid health card — and he's not the only one. Ho said many doctors are forced to bear the cost of caring for people in need who can't prove they have health insurance. "We see them all the time. And unfortunately, we're not paid for them," Ho told CBC Toronto. Currently, most doctors across the province can't invoice the Ontario Health Insurance Plan (OHIP) for patients who can't prove they have coverage. The Ontario Medical Association is hoping to change that and is working to finalize a new compensation deal with the provincial government that includes the reintroduction of what it calls a "good-faith" payment policy, first scrapped in 1998. What is a 'good-faith' payment policy? During the COVID-19 pandemic, Ontario revived a version of 20th-century "good-faith" payment policy, creating a stream of funding to ensure doctors got paid whenever they treated someone, even when the patient was not insured. The policy was scrapped again in 2023. The Ministry of Health told CBC Toronto in a statement it's unable to comment on specific proposals while in active bargaining with the OMA. If the proposal is approved, the "good-faith" payment system would kick in under three scenarios, according to the OMA: Newborn patients experiencing glitches or delays while they await a permanent health card. People who are OHIP-eligible but don't have valid documentation or valid coverage, a category which could include people experiencing homelessness, mental health issues or other barriers to documentation. Uninsured patients presenting in critical conditions, who are unable or don't have someone available to provide documentation. The category could include undocumented residents, temporary residents experiencing lapses in coverage, uninsured travelers facing medical emergencies, and individuals facing complications or emergencies after elective health or birth tourism. 'Free for all' not the goal, OMA president says It's that third scenario, in which doctors would bill for care for uninsured patients, that could face pushback, the OMA noted in a 2024 report. "The Ministry may indicate that this is simply not their problem to manage … Some members of the public may feel similarly," the report says. Under the proposed policy, hospitals would need to make reasonable attempts to verify someone's coverage, said OMA president Dr. Zainab Abdurrahman. But if that's not possible, she believes the doctors caring for them should still get paid. "Our real focus is really the OHIP-eligible. Could someone [ineligible] slip in there? There's always a possibility," Abdurrahman said. "We're being very specific and very intentional … to help allay the fears that this is just going to be a free-for-all for everyone to come and get Ontario taxpayer-paid health care," she said. "That's not our goal." When the policy was in place during the pandemic, the OMA found that 7,000 Ontario physicians provided 400,000 instances of care to patients without insurance. Similar programs exist across Canada: OMA It's unclear whether bringing back the policy could incentivize more medical tourism, said Boriana Miloucheva, an assistant professor of health economics at the Dalla Lana School of Public Health. "The option to get medical services and not pay [the bill] already exists," she said. "It's a good-faith program, but there should be reviews about who is actually billing and what they're actually billing," she said. Other provinces, such as B.C., Alberta, Saskatchewan, and Quebec, do provide similar payment options for emergencies, according to the OMA. Some of them allow retroactive billing or accept mailing addresses from homeless shelters as proof of residency for those without a health card. A similar policy was also recently implemented in Manitoba. Ontario doctors are close to a new compensation deal. Here's what it includes 7 days ago The Ontario Medical Association is hoping to strike a new deal with the province that would change the way family physicians are compensated. CBC's Dale Manucdoc has more on what the proposed deal includes. Ultimately, says Dr. Ho, this is about more than getting compensated for work. He says it's a health equity issue for the province's most vulnerable populations, who might delay care or turn down prescriptions they can't pay for because they can't prove they're eligible for OHIP. Ho says the policy could end up saving the province money, since people postponing care could face more serious health issues that need treating later on. "We do need to reduce these barriers to care and … create fair processes for these patients because they are disproportionately affected by this," he said. Abdurrahman said she's hoping for an update on the proposed policy this fall.
CTV News
06-08-2025
- Health
- CTV News
Ontario's family doctors could soon have a new compensation system. Here is how it will work
Ontario family doctors could soon be subject to a new compensation system as part of the province's efforts to incentivize physicians to work as general practitioners. Ontario Medical Association CEO Kimberly Moran tells CTV News that negotiations on the new system are ongoing but that she believes a deal can be reached within months. She said that while the matter is still under an arbitration board's review an agreement has already been reached with the Ontario government on 'most of the elements.' The focus of the new system would be to pay doctors for the time they spend doing administration, as well as the time they spend providing medical care, Moran says. Right now, family doctors are not compensated for the time they spend working on administration or with specialists on behalf of their patients. Instead, doctors operate under both a fee-for-service model, in which they are reimbursed under the Ontario Health Insurance Plan (OHIP) for every service they provide a patient and an enrollment system, in which they are paid a set amount per patient, regardless of how many times they see them. 'What this incentivized compensation model does is that it recognizes the work that's done by doctors that they have talked about as very challenging and that is a lot of critical administration,' Moran said of the new proposed model. 'It directly compensates that for them, so for example if you need referral to a specialization or if the family doctor needs to talk to your specialist about something, like none of that time is compensated. But now its going to be, so that's great.' Ontario has long had a shortage of family doctors. The provincial government has pledged to make sure that every Ontarian has a family doctor by 2029 and Moran said she is hopeful the new system will convince more physicians to enter family medicine. The OMA represents 31,500 practicing physicians in Ontario. 'The hope is that it will attract new physicians to the field, keep those who are practicing now and entice other doctors who have moved away from that kind of medicine back to practice medicine there,' she said. Ontario is short on doctors of all sorts but Moran emphasized the importance of family doctors right now. Right now, 2.5 million Ontarians are without a family doctor. 'What we wanted to do with this model was incentivize family doctors, those who have chosen family medicine,' she said. 'To have improved compensation is one of the ways we recruit and retain family doctors. It is going to be important over the next decade to make sure we have enough doctors through all of our specialties. But for this time, right now, where attachment to a family doctor is so critical, we wanted to focus here.' Moran said that under the existing payment system doctors were not compensated for the total time they spent with a patient who may come in 'with four, five, six different things to do.' She said that the new system 'means that if the doctor has to spend 45 minutes with a person who has lots of complexity, its going to be compensated properly.' Minister of Health and Deputy Premier Sylvia Jones was asked about the ongoing negotiations during an unrelated press conference on Wednesday but declined to comment, only offering that there were 'very positive movements' and that progress was being made. 'So, as we expand primary care clinicians, opportunities in communities, we want to make sure that those physicians, those clinicians, those nurse practitioners are well supported and we're doing that work with the OMA. I can tell you to date it has been very positive,' she said.
Hamilton Spectator
31-07-2025
- Health
- Hamilton Spectator
Rocket Doctor's Virtually-Enabled Emergency Department Diversion Program Reduces Strain on Overwhelmed Hospitals
Vancouver, BC, July 31, 2025 (GLOBE NEWSWIRE) — AI Inc. (CSE: TRUE, OTC: TREIF, Frankfurt: 939) ('Treatment') and its wholly owned digital health platform and marketplace, Rocket Doctor, are providing a scalable response to Canada's emergency department crisis with a data-backed diversion program. The program uses smart triage, provider infrastructure, and AI-enabled care to safely keep appropriate patients with low-acuity healthcare concerns out of overcrowded hospitals, while getting them the comprehensive out-patient care that they need, faster. Across Canada, hospitals are facing unprecedented strain. Since 2019, emergency departments have experienced more than 1.14 million hours of closure , the equivalent of 47,500 lost days of emergency care. Ontario and Alberta have been hit especially hard, with rural ER closures and care disruptions becoming a regular occurrence. This reality has left communities with few options and patients in critical need of safe, timely alternatives. British Columbia is equally seeing regular ER closures throughout 2025, causing challenges for patients, healthcare systems and especially rural communities: BC is not Alone – Rural ER Crisis across Canada – BC Rural Health Network While in many cases a virtual-only system is not a replacement for in-person emergency care, Rocket Doctor's ED diversion program is helping to support hospitals and patients to fill a void in accessible care. The platform enables hospital systems to allow patients to self-select to reroute themselves to clinically appropriate, out-patient consultations, leveraging customized intake forms, real-time triage, and a flexible physician network, either from independent MDs on Rocket Doctor's platform, or the hospital's own staff. At Georgian Bay General Hospital in Ontario, the results speak for themselves. Between June 2022 and December 2024, more than 3,065 patients have been successfully managed through MDs on Rocket Doctor's platform, with 97% of patients treated virtually and only 1% redirected to the ER. Patients waited an average of just 20 minutes to connect with a physician. The estimated system savings totaled $1.4 million, based on an average $475 cost per diverted ER visit multiplied by the total number of patients seen. All visits were covered under OHIP, with no additional fees to patients. In Alberta, Rocket Doctor has seen similar success across its broader platform, with over 12,000 patients seen in the past 3 months alone, entirely funded by provincial health insurance. More than 98% of these visits were resolved without requiring in-person care, and less than 1% were sent to the ER. 'We see so many patients in our rural, remote and even urban communities going to ED, often when they recognize that they could be seen outside the hospital.' Said Dr. William Cherniak, CEO of Rocket Doctor. 'There has been a lot of good content from the Canadian Association of Emergency Physicians (CAEP) to recognize that we need to support patients to access healthcare where they see most appropriate. We often see patients choose an ED with low-acuity issues simply because of a lack of access to family doctors, or other accessible out-patient choices.' By leveraging smart triage and other digital tools, Rocket Doctor's ED Diversion Program and broader platform pairs patients with the right physician based on their needs, empowering physicians to order labs, imaging, make specialist referrals, or escalate care to in-person options when clinically necessary (although rare). Patients can also rebook with the same physician to ensure continuity of care, improving outcomes and reducing unnecessary visits. 'We are filling that gap by empowering physicians in a team-based cloud-enabled model of care with technological support to work at the top of their license within their clinical competencies digitally.' said Dr. Cherniak. 'We're building a system that gives patients a smarter entry point and gives physicians the tools to work independently, safely, and efficiently.' As staffing shortages and rural hospital disruptions continue to affect patients across Canada, Rocket Doctor and AI are offering hospitals and provincial systems a deployable, proven solution; one that reduces backlog, lowers system strain, and drives meaningful outcomes at scale. About AI Inc. AI is a company utilizing AI (artificial intelligence) and best clinical practices to positively improve the healthcare sector and impact current inefficiencies and challenges. With the input of hundreds of healthcare professionals globally, AI has built a comprehensive, personalized healthcare AI engine - the Global Library of Medicine (GLM). With more than 10,000 expert medical reviews, the GLM delivers tested clinical information and support to all healthcare professionals as well as providing recommended tests (physical and lab), imaging and billing codes. The GLM helps healthcare professionals (doctors, nurses or pharmacists) reduce their administrative burden; creates more time for needed face-to-face patient appointments; and enables greater consistency in quality of patient support. AI's GLM platform, through supporting healthcare professionals, allows for the inclusion of disenfranchised communities. Learn more at or contact info@ . About Rocket Doctor Inc. Rocket Doctor is a technology-driven digital health platform and marketplace that is breaking down obstacles that limit access to quality, comprehensive and cost-effective healthcare. Our proprietary software equips doctors with the tools to run practices in virtual and hybridized in-person/virtual models of care, enabling them to provide tailored care to patients in rural and Northern communities across Canada and on Medicaid in the United States. Leveraging large language models, AI/ML and wireless medical devices, Rocket Doctor is bridging the healthcare divide, connecting patients to equitable and accessible virtual healthcare services regardless of age, location, or financial status. To learn more about Rocket Doctor's platform and services, visit (Canada) or (U.S.), or contact media@ . FOR ADDITIONAL INFORMATION, CONTACT: Dr. Essam Hamza, CEO, AI Email: ehamza@ Call: +1 (612) 788-8900 / Toll-Free USA/Canada: +1 (888) 788-8955 Dr. Bill Cherniak, CEO, Rocket Doctor Email: bill@ Media inquiries: media@ Cautionary Statement This news release contains forward-looking statements that are based on AI's expectations, estimates and projections regarding its business and the economic environment in which it operates, including with respect to the implementation of its shareholder communications initiative and the timing thereof. Although believes the expectations expressed in such forward-looking statements are based on reasonable assumptions, such statements are not guarantees of future performance and involve risks and uncertainties that are difficult to control or predict. Therefore, actual outcomes and results may differ materially from those expressed in these forward-looking statements, and readers should not place undue reliance on such statements. These forward-looking statements speak only as of the date on which they are made, and undertakes no obligation to update them publicly to reflect new information or the occurrence of future events or circumstances unless otherwise required to do so by law. The Canadian Securities Exchange does not accept responsibility for the adequacy or accuracy of this release.
Hamilton Spectator
18-07-2025
- Hamilton Spectator
A Toronto woman was hurt in a violent hit-and-run in Texas. Now she's facing $100k in medical bills
A 22-year-old Toronto woman is recovering from a brazen hit-and-run in Dallas, Texas — stuck in the United States with a shattered foot, emotional scars and more than $100,000 in medical bills. Tesnim Hussein says she did not have travel insurance. She never thought about needing it. 'I was really stressed,' she told the Star. 'It's a lot of money to have to pull out of nowhere. We came for just a quick trip, to see our family, to have fun, and now I'll end up staying here for a month.' On July 1, Hussein travelled south for the 27th annual Harari Sports and Cultural Festival, a weeklong celebration of her Harari culture, community and history, held in different cities worldwide. The event is something she looks forward to each year, a chance for her to connect with her roots and catch up with family. This year, the timing made it extra special — Hussein and her cousin had just graduated from university, and she'd recently been promoted to manager at the fast-food restaurant where she works. 'I had a week of training left before I went for my vacation,' she said. But on the night of July 3, the course of that trip — and her summer — changed dramatically. After a soccer game at the University of Texas (UT) at Dallas campus, Hussein and her cousin, Khadija Ahmed, 22, said they were struck in the nearby parking lot by the driver of a white sedan. Before they could react, the women were thrown onto the hood and then slammed onto the pavement. As the car drove off, multiple passengers — they appeared to be teenagers — rolled down the windows and 'recklessly' launched fireworks into the crowd, according to Hussein and three other witnesses. A spokesperson for the UT Dallas police department said the driver, a 17-year-old boy, has been arrested and charged with failing to stop and render aid at an incident resulting in serious bodily harm. The investigation is ongoing. The incident left Hussein with a crushed left foot, four dislocated bones, a fracture and bruising and scars along the side of her body. She has undergone two surgeries and requires a third in the coming months. Doctors have told her she cannot fly home to Toronto until the end of July because it's too risky — she could develop blood clots. The physical toll is one thing, but the financial burden adds another challenge for Hussein and her family. As a Canadian citizen, Hussein said her Ontario Health Insurance Plan (OHIP) does not come close to covering every dollar of her U.S. hospital care. Without travel insurance, she and her family are now responsible for more than $100,000 (U.S.) She said her situation is an unfortunate reminder of the importance of buying additional protection when travelling abroad. 'Not buying travel insurance was a mistake I think a lot of people make, not because we're careless, but because you just don't expect the worst to happen,' she said. Hussein said she's travelled plenty before without any issues, and thought she'd be fine this time, too. 'It never crossed my mind that something so serious could happen.' By sharing her story, she hopes it helps others think twice and protect themselves. 'But more than that,' she said, 'I hope people can understand how quickly life can change and how much support really matters when it does.' Will McAleer, executive director of the Travel Health Insurance Association of Canada, described the U.S. as 'the most expensive place on the planet' for receiving medical care. He said a Code Blue emergency, which usually means a patient is having a cardiac or respiratory arrest, can cost as much as $10,000 a day or even per hour. OHIP's Travellers Program can cover some out-of-country emergency services, but it's limited. According to its website, the treatment or service must meet specific criteria, including being medically necessary and received at a licensed hospital or health facility. The plan says it will reimburse outpatient visits at $50 Canadian each day or the amount billed by the hospital, whichever is less. It can also pay up to $400 Canadian each day for in-hospital services, depending on the level of care required. Even if a patient is eligible for that higher payment, McAleer said the coverage amounts to a very small portion of the total costs incurred in places like the U.S. It also takes a long time to get reimbursed, he said. 'We know that, on an average, you might get three to five per cent of the cost of a medical emergency,' subject to that cap, McAleer said. Hussein was discharged from the hospital last week and is recovering at a relative's home in Dallas until she can return to Toronto. Recounting the events that unfolded the night of July 3, she told the Star she doesn't remember certain parts. She's looked to Ahmed and other witnesses to help fill in the gaps. It was around 11:30 p.m. Dozens of people had finished watching the final match in a soccer tournament and were headed to their cars. Hussein and Ahmed were chatting with other attendees while their cousins went to get the car. Just as the women were walking to meet them, a white sedan with tinted windows started trailing slowly behind them. 'I thought maybe they were trying to manoeuvre around the people,' Hussein said. 'It was a little crowded.' Her cousin, Ahmed, noticed the glare from the headlights. 'Oh my god,' she recalled thinking. 'This car is so bright.' That's when the car bumped them. Just as Ahmed turned around, she said the car accelerated again. This time, it was much faster. She and Hussein rolled onto the hood and hit the windshield, but the driver didn't stop. 'They just kept going,' she said. Suddenly, the driver slammed on the brakes 'really hard,' said Sara Ali, 22, who was watching the incident unfold from her car just metres away. Before Ali could do anything, she said passengers in the sedan launched 'huge fireworks' from the windows into the crowds. At this point, Ahmed said she was on the ground. Her hijab had come off. She remembers looking up and seeing the headlights. Worried the driver was going to strike again, she said she screamed at Hussein to 'get up' and ran for cover behind another vehicle. Hussein couldn't move; she was 'screaming in pain' recalled Ahmed. The driver of the sedan then reversed and sped off. Bystanders immediately called police and rushed to help Hussein. Weeks later, Hussein and Ahmed said they are still in shock, unable to comprehend why the suspects would do such a thing — and why she and her cousin were the targets. 'Just throwing fireworks is one thing, and then to hit someone (with a car) and keep on going. There was no remorse,' Ahmed said. Hussein said she hopes justice is served to prevent a similar incident from happening. 'If they could do that to us, they can do that again.' In the wake of the incident, Hussein's family has organized a GoFundMe page to help offset the rising medical bills. It raised more than $55,000 as of Wednesday afternoon. In the message on the fundraiser page, the organizer stated that the donations would help cover the costs of surgeries and medical procedures, the hospital stay, post-operative recovery and mobility support, including crutches and therapy. 'Tesnim didn't ask for this,' the message reads. 'She was a victim of a reckless, public act — something no one should ever have to go through. Her story has been witnessed by many, and now we ask you to be a part of her healing journey.' Error! Sorry, there was an error processing your request. There was a problem with the recaptcha. Please try again. You may unsubscribe at any time. By signing up, you agree to our terms of use and privacy policy . This site is protected by reCAPTCHA and the Google privacy policy and terms of service apply. Want more of the latest from us? Sign up for more at our newsletter page .
Yahoo
30-06-2025
- Health
- Yahoo
Ontario to invest in community surgical centres
Canada's Ontario Government has announced an investment of C$155m ($113.47m) over two years to establish 57 new community surgical and diagnostic centres across the province. As part of Your Health: A Plan for Connected and Convenient Care, this initiative is expected to enhance access to publicly funded procedures for 1.2 million people. It will accelerate the delivery of MRI and CT scans, as well as gastrointestinal (GI) endoscopy services. Ontario premier Doug Ford said: 'It's all part of our plan to protect and improve our health-care services, all while ensuring people always receive the care they need with their OHIP card.' Starting this summer, 35 newly licensed centres will begin offering MRI and CT scan services, following a call for applications. This expansion is set to connect up to 828,000 more individuals to essential diagnostic imaging, surpassing the province's initial target by more than fourfold. The new centres will play a crucial role in lessening wait times and ensuring that patients receive scans within the recommended time. For GI endoscopy services, 22 additional licensed centres will be introduced, aiming to perform up to 420,000 procedures over two years. This marks a threefold increase over the original goal set by the province, and guarantees timely access to GI endoscopy procedures for all patients within Ontario. The announcement regarding funding was made at the Schroeder Ambulatory Centre in Richmond Hill, which has been allocated C$14m to provide MRI and CT scans, along with GI endoscopy services, to more than 115,000 patients over two years. The names of the other recipient centres will be disclosed in the following weeks. New centres are mandated to present detailed staffing strategies to maintain stability at public hospitals, report into the province's wait times information system, and engage in regional central intakes where available. In addition, all community surgical and diagnostic centres will fall under the remit of Accreditation Canada's recently introduced programme for quality assurance. This initiative enforces the same stringent standards as public hospitals. "Ontario to invest in community surgical centres" was originally created and published by Hospital Management, a GlobalData owned brand. The information on this site has been included in good faith for general informational purposes only. It is not intended to amount to advice on which you should rely, and we give no representation, warranty or guarantee, whether express or implied as to its accuracy or completeness. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of the content on our site. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
