There have been no changes to lab tests covered under the Ontario Health Insurance Plan that may have led to a patient being billed, a Ministry of Health spokesperson has confirmed.
Bill Campbell issued the statement in response to multiple claims on social media that some Ontario patients are being given bills for lab tests that they believe were previously covered by OHIP.
Natalie Mehra, executive director of the Ontario Health Coalition, a healthcare advocacy group, said her organization has heard from several hundred people with concerns about the issue. But, after investigating, they were unable to find any evidence that medically necessary tests previously covered by OHIP are no longer covered.
“So far I haven’t found any evidence that this is real,” she said.
“They really do believe this is a new thing, but a lot of them haven’t had this test before and they are being charged and they think they shouldn’t,” Mehra said.
One patient, though, said he was changing medication for mental health issues and had to get some blood work done and a stool sample analysed.
“The last time I did tests was back in early 2018. I don’t recall ever taking out my wallet to pay for anything beyond parking,” said the man from Guelph who asked only to be identified as John.
This time, he said, he received a bill for $26 for the blood work and $126 for the stool analysis, in addition to parking.
“It felt very demoralizing, the whole experience,” he said. “Gas in my tiny car cost me nearly $100 and then I had to shell out $180 just to see what is wrong with my health.”
Some treatments that were previously covered by OHIP have been delisted in recent years as part of an effort by the provincial government and physicians to try to cut back on medically unnecessary procedures.
But LifeLabs, which was the focus of many of the claims, said there have not been any laboratory tests de-listed in the last five years under the Ontario Health Insurance Plan schedule of benefits for laboratory services.
“Our services are governed by partnerships with the provincial government which dictate scope, service-level, funding and standards of care,” LifeLabs said in a statement. “LifeLabs cannot bill individuals with OHIP coverage for tests that are covered by OHIP,” said LifeLabs in a statement.
Ottawa family physician Dr. Nili Kaplan-Myrth said that, although the tests are getting a great deal of attention, “they aren’t our biggest problem.”
She suggested a bigger threat to public health care can be seen in expanding support by the provincial government for private long-term care homes and issues such as people having to pay for COVID-19 PCR tests.
She noted that there are numerous other ways in which the health system is being privatized, chiefly when it comes to mental health services.
Kaplan-Myrth said patients in need of mental health care are commonly forced to pay for it themselves.
“That is why I do so much primary mental health care. If they don’t have benefits for private care, they have no other means of getting help.”
And she said she has seen other cases where patients end up paying for services they badly need. In one case, a severely anemic patient didn’t qualify to get an iron infusion covered by OHIP at the hospital because her hemoglobin levels were slightly higher than the cutoff.
The patient was told to go to a private infusion clinic, which would have cost “hundreds and hundreds of dollars” for each of what would have to be multiple treatments.
“Most people don’t have $1,000 to drop on a basic medical necessity.”
Kaplan-Myrth said it was the first time she had received such a note suggesting a patient go to a private clinic for the infusion.
Kaplan-Myrth also noted that private clinics that offer virtual family medicine services are becoming more common.
“The privatization of family medicine it going to creep in where we are going to see private virtual services either your company pays for or you pay out of your pocket,” she said.
“This is what our colleagues in Alberta have been warning us about.”
As for the numerous patient claims that they are being charged for lab services, Kaplan-Myrth said there are requirements for some tests that forms be filled out by a physician to verify they are medically necessary in order for them to be covered.
Patients who feel they have been charged for a service that is insured can call the Commitment to the Future of Medicine Act program at 1-888-662-6613.