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Could Anyone Provide A Really Brief Simple Summary Of The Psa?


Edict

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I find a lot of the discussion and debate on the PSA to be heavy in jargon and also I feel like it doesn't address things in a simple way because the simple way is not necessarily as nice to hear for the general public. Could anyone explain it in a bit more simple terms? Thanks! 

 

 

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A bit tough to do since the PSA is already very short, yet also complicated in what it agrees to, but here goes.

 

1) Physician Funding

 

The tPSA maintains a global cap on all physician billings. If physicians' billings exceed this cap, the government can clawback the money from physicians to keep their payments to physicians at the cap. The tPSA raises this cap above what the government had imposed on physicians for the past few years. It also imposes $200 million per year ($100 million/year starting in 2017, $100 million/year in 2019) in targeted fee reductions, to be negotiated at a later time between the OMA and the Ontario government with a third-party arbiter having the final say if no agreement is reached. The government also commits to increasing the cap if they add or expand services, or in the event of a significant disaster which would increase patient utilization (eg SARS), though no details are given on this point. Lastly, a small amount of money is set aside each year to be distributed to physicians each year as a one-time payment - however, if global physician billings exceed the cap, this money will be put towards the cap itself and not be distributed.

 

The sum of these efforts is that the Ontario government has provided funding roughly in line with the OMA's projections for what would be necessary to keep up with demand for physician services. They expect that aside from the $200 million/year in targeted fee reductions, physicians would not face additional clawbacks, or that they would be rather small. Billing codes would not be increased, so because of inflation, real physician income would still fall somewhat.

 

2) Negotiation Rights

 

The OMA's Charter Challenge regarding binding arbitration proceeds regardless of whether the tPSA is agreed to or not. With the tPSA, the OMA waives the right to seek damages from prior unilateral action. Negotiations on points agreed to in the tPSA - the $200 million in targeted fee reductions, any clawbacks, etc - will have a third-party arbiter.

 

3) Miscellaneous

 

The tPSA eliminates the New Graduate Entry Program in favour of restoring managed entry into FHO/FHNs for primary care providers. PARO and OMSA have secured assurances that any new programs would not target new graduates, though I do not believe this is officially part of the tPSA. The tPSA requires the MOHLTC to suggest some modifications to Bill 210, the Patients First Act.

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