2024-25 OHMEPA Government Relations Priorities
September 7, 2023
Government and Stakeholder Relations Focus for 2024-2025
- ADP Pricing
- Inflation: Supply chain pressures are easing, but increased costs and lengthy delays in delivery persist.
- New Device Approvals and Pricing: It is our understanding that the ADP price is set at 5% to 15% above the dealer cost submitted by the manufacturer, depending on the level of customization required. We will be working with ADP to better understand the approval and pricing process for new devices and to identify ways to streamline the process.This concern was echoed in a recent survey of authorizers initiated by the Vendor-Authorizer Task Force.
- Next Steps –
- Continue to focus on solutions with government to address rising costs. Continue to make the case for more realistic pricing for ADP-funded devices.
- Get explicit confirmation from the Ministry of Health that OHMEPA will have a formal role in future pricing reviews.
- ADP Audit Oversight
- Status – ADP has assured us verbally that although auditors have the authority to request client invoices, the provider may redact pricing/invoicing information for any non-ADP-funded items. In cases where it is not possible or practical to produce a signed client invoice, ADP will accept other options as long as the documentation provided by the provider allows them to do their due diligence.
- Next steps —
- Continue to emphasize the importance of allowing OHMEPA to provide input before any changes in policy or procedures take place.
- Monitor the audit experience for providers.
- ADP Audit Appeals
- Status – Some providers have advised us that they have experienced clawbacks during audit that were unfair because the disputed sale was an authorizer decision; the provider was simply dispensing the prescribed device. ADP has advised us that, if the provider has met all application requirements and has accurately dispensed what the authorizer has prescribed, and the issue at a provider audit is clearly an authorizer error, the provider should not be penalized.
- Next Steps – Continue to advocate with decision-makers to provide a third-party arbitrator so that providers have formal recourse when they dispute an audit’s findings. We are also seeking clarity of policies and clear direction on document retention to reduce the administrative burden of audits.
- Stakeholder Perception of Providers
- Status –
- OHMEPA has commissioned Strategy Corp, a leading government relations and strategic communications firm, to produce an Advocacy and Sustainability Strategy Report. This Report will validate through credible, third-party data the costs providers incur to take clients from the assessment to a properly fitted device, and the essential value these services provide to the client. The Report will help government stakeholders understand our industry business model, support changes to the approved ADP pricing structure, and include a strategy for government and stakeholder outreach.
- Next steps —
- Once completed in November, OHMEPA will launch an advocacy campaign to government using the Report as a cornerstone of our strategy.
- The completed Report will be distributed to members, the government, and stakeholders.
- Relationship Building with Decision-Makers and Influencers
- Status – We will continue to cultivate strong relationships with government stakeholders. Building on key takeaways from the authorizer survey we developed with the Ontario Society of Occupational Therapists, we are discussing with ADP how to increase the number of authorizers, particularly outside of the Greater Toronto Area.
- Next Steps – Increase our relationships with MoH, MCCSS, MS&A, Premier’s Office, MPPs and authorizers. Distribute key takeaways from the OSOT authorizer survey.
- Ontario Seniors Home Safety Tax Credit
- Status – we are advocating to make this credit permanent and universal; eligible to all. Our strategy is to focus on a grass roots campaign with MPPs.
- Next Steps – as soon as the Advocacy and Sustainability Report is ready, we’ll re-initiate the campaign in Q4-2023.