The Ford government says it will not give nurse practitioners billing codes, but will work to bring them into the publicly funded health-care system as the federal deadline to ensure coverage for medically necessary services passes.
More than a year ago, the federal health minister wrote to Ontario, telling the province to come up with a policy to fund and regulate nurse practitioners by April 1.
Despite getting the clarity it had requested, the Ford government missed the deadline.
Health Minister Sylvia Jones said she felt the federal approach lacked uniformity and could download costs.
“There is no additional Canada Health Transfer. We are going to see inconsistency across provinces and territories, but Ontario will be in compliance,” she told reporters on Monday.
“I want to see nurse practitioners practise in our publicly funded system. I want them embedded in our multidisciplinary teams. I want them working in our hospitals.”
Jones said the province hadn’t “done a fiscal” analysis of how much bringing nurse practitioners into the public system would cost.
Nurse practitioners have said they are looking for flexible funding models, such as those for family doctors, who can bill OHIP on a fee-for-service basis or who are paid per patient enrolled.
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Jones said she has “no plans” to let nurse practitioners bill OHIP directly for services through the use of billing codes, saying that would have to be negotiated with the Ontario Medical Association.
The health minister did not say what approach she would take instead to bring nurse practitioners into the public system.
Liberal health critic Adil Shamji said it was a mistake to rule out billing codes before consulting with health-care experts.
“I think that there are many different ways that nurse practitioners could be publicly funded,” he told reporters.
“I’ve spoken to nurse practitioners; some are interested in that model, others are interested in other models altogether, whether they’re paid hourly wages or they’re brought on in a salaried model.”
Critics said it was “shocking” the government had missed the deadline — although Ontario won’t face penalties for non-compliance until next year.
“This government has been in power for eight years. They’ve now missed the deadline for the nurse practitioners’ agreement. And again, did she not have time to figure this out?”
Nurse practitioners in Ontario can assess patients, order and interpret tests, and prescribe medication and treatment. They work in a variety of settings, including family health teams and community health teams, hospitals and long-term care homes, as well as in more than two dozen publicly funded nurse practitioner-led clinics.
Two years ago, a proliferation of private subscription fee-based nurse practitioner clinics made headlines. Jones responded to opposition and media questions by putting the onus on the federal government to close a “loophole” that allowed them to operate.
“If there is a wedge that is allowing these clinics to happen, then perhaps the member opposite could pick up the phone and call their federal counterparts, because that’s what I’ve been doing,” she said in question period in March 2024.
The next month, Jones formally wrote to the federal government asking them to make the change.
While Ontario began funding 25 nurse practitioner-led clinics in 2011, the Ford government expanded the program by including an additional seven clinics under the funding envelope in the early 2020s.
In her letter in 2024, Jones asked the federal government to “work with provinces and territories on a Canada-wide solution to close this loophole, to guard against unintended consequences, and prohibit nonphysicians from charging for publicly funded services.”
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