Recent Case Sheds Light on OHIP Billing Amendments: 1582235 Ontario Limited v Ontario, 2020 ONSC 1279

  • 15 octobre 2020
  • Joshua Lerner, Rosen Sunshine LLP

Bill 138, the Plan to Build Ontario Together Act, received Royal Assent in December 2019. Far-reaching in scope, the Bill included amendments that touched on a variety of sectors in the province. Included in this broad mandate were amendments impacting the health sector, and in particular the Ontario Health Insurance Plan (“OHIP”) and the process through which Ontario’s physicians submit their billings.

The resulting effect on the province’s healthcare regime has already been interpreted by the Ontario Superior Court in a recent decision that sheds light on the practical implications of some of these amendments and how they may impact ongoing disputes related to a physician’s billings.

The decision in 1582235 Ontario Limited v Ontario, 2020 ONSC 1279 ("1582235 Ontario Limited"), is reviewed below; however, it is prudent to first provide a high-level overview of both the OHIP billing process in general as well as some of the relevant amendments implemented by the passing of Bill 138 in December 2019.