Can radiologists provide (public) MRI’s outside the hospital

[-JAG-]

Are there any clinics in Canada that offer MRI’s covered by Medicare? Can radiologists bill for these services?

I couldn’t find anything in any provincial fee schedule on fees for the technical component of MRI’s, only interpretation. 

The only leads I could uncover were that the Quebec government was negotiating with the Fédération des Médecins Spécialistes du Québec on covering MRI and CT outside hospitals as early as 2016 yet even the 2019 fee schedule clearly states that radiologists cannot bill for these services outside a hospital, which leads me to think that negotiations have broken down.

In Ontario, I found this [https://insolvencyinsider.ca/filing/oxford-advanced-imaging/], which clearly states that someone was providing public MRI access outside hospitals,  but that the company has gone into insolvency. I can’t find any technical components for MRI’s on the OHIP fee schedule.

 

Does anyone have more information on this?

Thanks,

-JAG-

 

 

 

 

 

[-JAG-]

Posted this elsewhere but thought I may get more answers here.

Are there any clinics in Canada that offer MRI’s covered by Medicare? Can radiologists bill for these services?

I couldn’t find anything in any provincial fee schedule on fees for the technical component of MRI’s, only interpretation. 

The only leads I could uncover were that the Quebec government was negotiating with the Fédération des Médecins Spécialistes du Québec on covering MRI and CT outside hospitals as early as 2016 yet even the 2019 fee schedule clearly states that radiologists cannot bill for these services outside a hospital, which leads me to think that negotiations have broken down.

In Ontario, I found this [https://insolvencyinsider.ca/filing/oxford-advanced-imaging/], which clearly states that someone was providing public MRI access outside hospitals,  but that the company has gone into insolvency. I can’t find any technical components for MRI’s on the OHIP fee schedule.

 

Does anyone have more information on this?

Thanks,

-JAG-

[MilwaukeeProtocol]

Interested in this as well, any ideas for CT? Most also seem to be done in hospital...

[-JAG-]

On 3/28/2020 at 12:32 AM, MilwaukeeProtocol said:

Interested in this as well, any ideas for CT? Most also seem to be done in hospital...

There are, as with MRI, a small number of independent CT providers in Ontario, as shown on the last page of this document (http://www.auditor.on.ca/en/content/annualreports/arreports/en18/v1_308en18.pdf)

However, I can’t see how this is financially viable with the apparent lack of technical/facility fees for both CT’s and MRI’s in Ontario. A basic 64 slice CT machine can easily cost 500k CAD for even a used example, add to that qualified techs and special installations, I don’t see how it could be financially viable to run such a practice seeing as how you could make the exact same thing in a hospital without paying for any of this. Obviously there has to be something that I’m missing or that’s not public information because no one would run such an operation otherwise. They have an hourly rate, but this is kept secret and varies between facilities. Maybe they just get the hospital’s technical fee, which is 385/hr on top of interpretation, or maybe more, who knows.

On a related note, the director of the company that runs two of the facilities in Southern Ontario bills OHIP more than 3 million a year, yet a Thunder Bay address is listed under his CPSO profile. A quick google search also confirms that he heads some research program involving MRI’s at a hospital in Thunder Bay and that he also was pretty high up in large MRI tech company. This doesn’t add up with his independent facilities nor does it explain the fact that his company is providing these services outside a hospital and seem to be some of the only ones in Ontario to do so. 
 

[W0lfgang]

Can't bill privately in Ontario. The few outpatient MR and CT clinics in Ontario are operating under licences handed out many years ago, and none since. I believe the oxford group had two of these licences, which got bought by another group for many millions of dollars.

Quebec rads can bill private because of the Chaoulli v. quebec case, but, for some reason, that case did not set a precedent for the rest of Canada. The ongoing Cambie v. BC case looks like it will be precedent setting if ruled for the plaintiff. 

http://www.thecourt.ca/cambie-surgeries-v-bc-a-constitutional-right-to-access-private-heath-care/

https://thetyee.ca/Opinion/2019/12/03/Brian-Day-Court-Case-Ends/

[W0lfgang]

Merged. no double posting.

[-JAG-]

9 hours ago, W0lfgang said:

Can't bill privately in Ontario. The few outpatient MR and CT clinics in Ontario are operating under licences handed out many years ago, and none since. I believe the oxford group had two of these licences, which got bought by another group for many millions of dollars.

Quebec rads can bill private because of the Chaoulli v. quebec case, but, for some reason, that case did not set a precedent for the rest of Canada. The ongoing Cambie v. BC case looks like it will be precedent setting if ruled for the plaintiff. 

http://www.thecourt.ca/cambie-surgeries-v-bc-a-constitutional-right-to-access-private-heath-care/

https://thetyee.ca/Opinion/2019/12/03/Brian-Day-Court-Case-Ends/

Sorry for the double post. Any idea if the Ontario Ministry would issue new licenses for underserved regions (Sudbury, for example), especially for a facility willing to work on less funding than a public hospital. Also, do you know how this works in Alberta? There seems to be a number of private clinics offering publicly covered MRI and CT? (BGSA, EFW, for instance) What abut Quebec, it was one of Barrette's (a radiologist) main promises as Minister to cover these but nothing has happened since. The radiologists' association refused, but I don't see how this would have hurt them, especially in light of the Canada Health Act not really applying in Quebec (existing private clinics would be safe and would not be found to be violating it due to the previous ruling)

[W0lfgang]

No idea if they plan to issue any more licences. I don't believe they have for 20+ years.