Doctors are allowed to charge patients for services that are not covered by OHIP either

1. Item by item as these services are provided or
2. By a "Block Fee" to cover all uninsured (non-OHIP covered) services for a period of 3 – 12 months

Usually Block Fees are charged once per year and reportedly range from $100 - $250.These uninsured services include things like telephone advice & prescriptions, completion of forms and documents for medical assessments and some interviews with professionals re. patients.

Currently Block Fees are "self-regulated" by the professional body for doctors – the College of Physicians and Surgeons. The regulations specify that the payment of Block Fees are supposed to be the patient’s choice and doctors cannot refuse patients who do not agree to pay Block Fees.

The Medical Reform Group reports that the College of Physicians an Surgeons has received complaints including:

• A psychiatrist charging patients to review their daily logs
• Patients from one town being told their physicians would drop them from their practices if they did not pay the Block Fee
• Patients from one town being told that unless they paid a Block Fee their telephone messages would go unanswered

Recently a Globe and Mail story described two family doctors who are charging their patients an annual fee of $2,500 for a detailed medical work-up, customized health plans and 24/7 access. It is suspected that these physicians have structured the charges to avoid breaking the Block Fee policy of the College of Physicians and Surgeons.

In Bill 8 – the so-called "Commitment to the Future of Medicare Act", which has been introduced and is in consultations, the government has brought Block Fees into legislation and therefore out of "self-regulation" by the College of Physicians and Surgeons. This is an improvement. However, it leaves the regulation of them unspecified.

We are recommending that the government ban the use of Block Fees.