Ontario 'asking questions' about Ottawa clinic charging membership fee, health minister says

Ontario's health minister says the Ontario government and Ministry of Health will shut down any clinic charging for services covered by OHIP, as a clinic in Ottawa's south end is under scrutiny for charging a $400 membership fee to access a nurse practitioner.

CTV News Ottawa first reported last week that the South Keys Health Center is charging clients a membership fee for access to a nurse practitioner, not a doctor.  The health minister says the ministry is now investigating the clinic, although the clinic says the fee is legal.

"OHIP funded services cannot be charged in the province of Ontario. As soon as we learned that there may have been something happening in the Ottawa region, we opened a report and are asking questions," Health Minister Sylvia Jones told reporters at Queen's Park.  

"If it is happening, then the practice will be shut down. I want to be very clear, our government has always said OHIP funded service will always and continue to be funded by your OHIP card."

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Under provincial health laws, it is illegal for doctors to charge a fee for services that are covered by OHIP. The Ontario Medical Association says nurse practitioners cannot bill OHIP but they, or those who employ them, can charge patients for health-care services.

The South Keys Health Center clinical director Osman Nur told CTV News Ottawa last week that the $400 per person a year fee for access is, "called rapid access and it's perfectly legal."

"Nurse practitioners are the ones seeing you. They can do prescriptions, they can do a lot of health information, they can send you to a specialist."

A nurse practitioner can diagnose, order and interpret diagnostic tests, prescribe all medications and perform medical procedures. According to the Nurse Practitioners' Association of Ontario, nurse practitioners work in hospitals, community health centres, family health teams, nurse practitioners led clinics, doctors' offices and public health units.

The Ontario government funds numerous nurse practitioner positions, such as in about two dozen provincial nurse practitioner-led clinics functioning as primary health care.

Jones told reporters that the Ontario government is looking to "close those loopholes" if patients are being charged for health care services covered by OHIP.

"I've made it very clear, OHIP funded services must be covered by OHIP, cannot be charged. We opened an investigation and started asking questions last Thursday when we heard about this and we will shutdown that practice if it is occurring."

The Ontario Liberals are calling on the government to end the practice of charging subscription fees to access a doctor or a nurse practitioner.

"The problem is the ability to charge a subscription fee exists in Ontario and if one person is going to try to take advantage of that, others will," interim Liberal leader John Fraser said at Queen's Park.

"So you need to ban that practice, number one. Number two, nurse practitioners or primary care, whether it's delivered by a nurse practitioner or a physician, should be covered by the publicly funded OHIP system, full stop."

The Ontario Medical Association wouldn't comment on the legalities of the South Keys Health Center.

"Like most of Ontario, Ottawa needs more doctors. Every Ontarian, no matter where they live, should be connected to an interprofessional care team of primary care givers led by a family doctor," an OMA spokesperson said in a statement.

"Even one person is too many, but a recent study shows more than 2.2 million people do not have a family doctor. Addressing Ontario's doctor shortage is one of the pillars of our Prescription for Ontario: Doctors' 5-Point Plan for Better Health Care."

The Ontario Liberals want the Ontario government to ensure primary care is always covered by OHIP, whether you are seeing a primary care physician or a nurse practitioner, end subscription fees in primary care and fully fund primary care.

"Charging a subscription fee, or a membership fee, for the right to access services that are supposed to be provided to you as a citizen is wrong," Fraser said.

"I think that any government, and it should happen right now with this government, if they believe that people should only have to use their OHIP card, they should ban this practice and do it right now."

On Tuesday, CTV News Ottawa reported two Ottawa doctors discovered their bios on the South Keys Health Center website, despite never working there or having any contact with the walk-in clinic. Dr. Sonam Maghera of the Ottawa Orthopaedic Centre on Woodroffe Avenue said she was alerted to the posting by calls from patients asking if she had changed her practice location.

"There's lots of questions about this specific situation, which is not good," Fraser said.

A spokesperson for the Ministry of Health told CTV News Ottawa last week it reviews all possible violations that come to its attention.

"We will not tolerate any clinic charging for services," the spokesperson said. "While at this time, services delivered by nurse practitioners who are not part of a nurse practitioner led clinic, are not covered by OHIP, we are taking steps to review this and shut down bad actors taking advantage of patients."

CTV News Ottawa's Leah Larocque reached out to the clinic on Wednesday for an interview.

"We have nothing more to say. The story has been covered by the media multiple times. We have now declined all interviews, with or without a camera," Idil Ahmed, operation manager for South Keys Health Center, said in a statement.

With files from CTV News Ottawa's Leah Larocque and The Canadian Press