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Ontario auditor general finds province not properly overseeing doctor billings

Ontario's auditor general Shelley Spence speaks to the media following the release of her annual report at the Ontario legislature in Toronto, Tuesday, Dec. 3, 2024. THE CANADIAN PRESS/Chris Young. CHY/

Ontario’s auditor general has found that the province is not properly overseeing doctors’ billings, including in a few cases of physicians billing for more than 24 hours in a day.

Shelley Spence says in a series of health-related audits released today as part of her annual report that the Ministry of Health’s system that doctors use to bill OHIP for services provided to patients has limited ability to flag high-risk billings.

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She says an analysis of claims over the last three years found that in each year at least 59 doctors billed for more than 24 hours of service in a day, and the ministry hasn’t thoroughly reviewed those to determine reasons or if time-based fee codes need to be updated.

When it comes to connecting patients to family doctors, a key goal of the government, the auditor says very few physicians are participating in the province’s Health Care Connect system, leading to long wait times.

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The government has boasted of reducing the wait list by half, but the auditor says today that the number of people on that list is not representative of the true need for primary care, as only about 11 per cent of people without a family doctor have registered.

As well, the auditor found that the government’s plan to add 340 undergraduate and 551 postgraduate medical school seats with a focus on family medicine was based on an underestimate of how many people have no primary care provider.

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