Ontario doctors wage legal fight against billing information disclosure

Practitioners are arguing that payments should be considered private information

Ontario doctors wage legal fight against billing information disclosure
Resisting an order to publicly disclose the identities and amounts received by Ontario’s highest-billing doctors, two groups of doctors and the Ontario Medical Association (OMA) have taken their fight to the courts.

The order was issued last year by the information and privacy commissioner, who ruled that payments to the taxpayer-funded Ontario Health Insurance Plan (OHIP) are business-related, according to the Toronto Star. Since transparency is important for government expenditures, the ruling said, the top billers’ identities and amounts billed should be revealed.

The OMA and two groups of doctors — referred to in court submissions only as “several physicians affected directly by the order” and “affected third-party doctors” — are seeking a judicial review, hoping that the order would be quashed by a three-judge panel in Divisional Court.

The case originated from a freedom of information request from the Star, asking the Ontario Health Ministry for physician-identified data on the top 100 billers. The ministry provided information on payments and medical specialties, but did not release names due to privacy concerns.

The Star appealed the decision successfully, arguing that it’s in the public’s interest to reveal the names. In its factum for the current case in Divisional Court, the publication noted that health spending takes up nearly half of the provincial budget, and payments to doctors under OHIP comprises a substantial portion of that spending.

Based on data from the ministry, the top 100 billers in 2012-13 raked in a combined $191 million, with the highest biller alone claiming $6 million. Nineteen doctors each received more than $2 million in payments.

Other provinces already disclose such information annually, and Ontario already publicizes the names and salaries of practitioners in the public sector who earn more than $100,000. Still, public practitioners represent only a small fraction of the 29,000 physicians working in Ontario.

In his June 2016 ruling, John Higgins, adjudicator at Ontario’s information and privacy commissioner, said that OHIP payments count under physicians’ gross revenue, which is different from personal income and is therefore not protected under privacy provisions.

The appealing doctors argued against Higgins’ decision, saying that it was not consistent with previous rulings by the privacy commissioner. They also claimed that the privacy watchdog did not handle the case objectively: they cited a 2014 Star article where the previous adjudicator, Brian Beamish, said an appeal would be a good opportunity to take a fresh look at transparency of information concerning government expenditures.

The OMA’s contention is that doctors are not government employees with defined and secure benefits, and should therefore be granted greater confidentiality. “Quite simply, revenue [from OHIP billings] is not income,” the group’s factum stated.

The group also noted “huge overhead costs” shouldered by private physicians such as rent, equipment costs, and payments to dozens of support staff and allied health professionals. Because of that, they argued, physician billing information isn’t comparable to the salaries of public servants.

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