Regulation - LGIC

Improving Physiotherapy Access, Value and Accountability. Amendments to Regulation 552 of the Health Insurance Act (HIA).

Regulation Number(s):
Instrument Type:
Regulation - LGIC
Bill or Act:
Health Insurance Act
Summary of Decision:
Approval was given by the Legislation and Regulations Committee to remove all non-hospital physiotherapy services as insured services from the Ontario Health Insurance Plan (OHIP) effective August 1, 2013.
Further Information:
Proposal Number:
Posting Date:
Summary of Proposal:
Currently, OHIP funds physiotherapy services prescribed under Regulation 552 of the HIA.

Effective August 1, 2013, all non-hospital OHIP insured physiotherapy services will be removed from the HIA. However, access to publicly funded physiotherapy and exercise and falls prevention classes will be increased across the province making the services available to more Ontarians in more locations. The changes will also improve value and accountability for the provision of these services.

Beginning in August, funding for physiotherapy will be provided:
-Directly to Long-Term Care (LTC) homes in order that they can manage the physiotherapy needs of their residents according to their plan of care;
- Directly to Community Care Access Centres (CCACs so that they can treat more patients needing physiotherapy in their home (including retirement homes)
-To community based physiotherapy providers across Ontario (under contracts); and
-In family health care settings, such as Family Health Teams, Community Health Centres, Aboriginal Health Access Centres and Nurse Practitioner-Led Clinics.

Additionally, funding will also be provided, through Local Health Integration Networks, for the expansion of exercises and falls prevention classes in communities across Ontario. Funding will also continue in Long-Term Care Homes for exercise classes as well.

These amendments are being proposed in support of recommendations made by the Walker Report in 2011, the Drummond Commission on the Reform of Ontario's Public Services and Dr. Sinha's 2012 report 'Living Longer, Living Well'.

The changes will ensure value and accountability to the public for the use of scarce health care dollars and is another measure in the province's commitment to ensure that patients receive the right care in the right place at the right time.

These programs were not possible, or had limited use/availability when physiotherapy services were insured under OHIP. Only a limited number of physiotherapy providers, primarily in the Greater Toronto Area, had access to bill OHIP for physiotherapy services, and regardless of the service provided (e.g. group exercise class in senior's homes, post-surgical rehabilitation), each service was valued and paid at the same amount.
Contact Address:
Ministry of Health and Long-Term Care
Health Services Branch
Fee-For-Service Programs
370 Select Drive
Kingston ON K7M 8T4
Effective Date:
August 1, 2013