In accordance with the 2019 Kaplan Board of Arbitration Award, the Ministry of Health and the Ontario Medical Association have implemented compensation adjustments to eligible physician payments. These payments are outlined in Section 21(a) of the Binding Arbitration Framework.
Laboratory medicine fee schedule codes (L800 series) have been increased according to an agreement between the ministry and the OMA. These payments are listed in the Schedule of Benefits for Physician Services and were paid on your February and March 2021 Remittance Advice (RA).
Retroactive Increases to Physician Laboratory Fees billed through Community Labs
There was a 1.00% compensation increase on physician payments between April 1st, 2019 and March 31st, 2020 with 0.50% of the increase applied to remove the payment discount under the 2012 Physician Services Agreement is provided by Year 3 (2019-2020). The total cumulative compensation increase applied to physician payments for Year 3 is 2.5194%, with a combined 0.75% increase awarded in Year 1 (2017-2018), and the 1.25% increase awarded in Year 2 (2018-2019).
The Laboratory Medicine increase of 1.6986% for Year 3 applies to claims for eligible laboratory services billed through community labs. Eligible providers received a summary accounting transaction on the February RA. If on your February RA you received any additional Year 3 compensation increases (as per INFOBulletin 210107) then you’d have seen all payments reported under one accounting transaction.
The March RA received retroactive payments for the Year 1 (2017/18) and Year 2 (2018/19) compensation increases. The increases applicable to these payments are:
Laboratory Medicine Group (L8XX)
|Year 1 (2017/18)||0.5051%|
|Year 2 (2018/19)||1.3548%|
For details on the reporting of this increase, see INFOBulletin 210107 ‘Year 3 Kaplan Board of Arbitration Award Physician Compensation Increases’.
The summary total was displayed on your February RA along with laboratory compensation increases reported with a Percentage Increase of 1.6986%.
Summary totals for each year were displayed on the March RA, and on the two associated reports (one for 2017/18, and another for 2018/19). Payments were adjusted based on the Percentage Increase amounts in the chart above.
If you have any questions about these increases, feel free to reach out to our team to help answer any questions.
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
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