7Sep, 2023

2024-25 OHMEPA Government Relations Priorities

September 7, 2023|

Government and Stakeholder Relations Focus for 2024-2025

Priorities

  1. ADP Pricing
  • Status
    • 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.

 

  1. 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.

 

  1. 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.

 

  1. 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.

 

  1. 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.

 

  1. 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.
2Feb, 2023

2023-24 OHMEPA Government Relations Priorities

February 2, 2023|

Government and Stakeholder Relations Focus for 2023

Priorities

  1. ADP Pricing
    • Status
      • Pricing
        1. Supply chain pressures have resulted in increased costs and lengthy delays in delivery. We expect this to continue for at least the near to medium term.
        2. We made a formal case to the Ministry of Health for a 16% price increase across mobility devices. This was rejected by the Ministry. We will continue to focus on solutions with government to address rising costs.
        3. Many provider services are not accounted for in the current pricing model, and pricing reviews take place without stakeholder input. We have made a formal case to ADP to have OHMEPA included in future pricing reviews, and they are supportive of this. We may still need formal approval from the Ministry, but we have full support from ADP.
      • Next Steps
        • Continue to advocate to MoH and other ministries for increased funding.
        • Get confirmation from the Ministry of Health that OHMEPA will have a formal role in future pricing reviews.
  1. ADP Audit Oversight
    • Status – ADP stated in their January 12 memo that they want vendors to produce on request, manufacturers invoices for non-ADP funded items sold to clients. We have made a formal case to ADP that this is well beyond ADP’s mandate and jurisdiction, and that this opens a host of challenges including audit outcomes and client privacy. We are currently in discussion with ADP on this.
      • We have tentative agreement from ADP on the process which would allow ADP auditors to see client invoices, but vendors do not have to share the price at which they sell non-ADP-funded devices.
    • Next Steps
      • Continue discussion with ADP until we have full agreement on the audit scope.
  1. ADP Audit Appeals
    • Status – There is no third-party recourse for vendors who dispute an ADP audit finding.
    • Next Steps – Continue to advocate with decision-makers to provide a 3rd party arbitrator so that vendors have somewhere to turn 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.
  2. Stakeholder Perception of Vendors
    • Status – There is a lack of understanding amongst stakeholders of the critical role vendors play. This includes ADP and many authorizers.
      • Next Steps – Prepare and distribute a research paper to government and stakeholders. Emphasize the role vendors play in the delivery of essential healthcare products and services to Ontarians, regardless of size or location.
    • The target audience includes client advocacy groups, MPPs, MoH, MCCSS, MS&A, Premier’s office, ADP, and authorizers.
  1. Vendor-Authorizer Accountability
    • Status – Vendors experience clawbacks on audit if the client is deemed by the auditor to be ineligible for a device.
      • If the vendor has met all application requirements and has accurately dispensed what the authorizer has prescribed, there should be no fault ascribed to the vendor and no penalty.
      • We are advocating to ADP to provide clarity on where authorizer accountability ends, and vendor accountability begins.
    • Next Steps – Continue to work with ADP for clarity in audit policy.
  2. 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 – Prepare the research paper noted above in Q2 and launch campaign in Q3 2023.
  3. Relationship Building with Decision-Makers and Influencers
    • Status – We have strong government relationships which we will continue to nurture. We have also struck a Vendor-Authorizer Task Force to address mutual challenges in the vendor-authorizer partnership. We have the support of OSOT on the Task Force.
    • Next Steps – Increase our relationships with MoH, MCCSS, MS&A, Premier’s Office, MPPs and authorizers.

Tools and Tactics

MPP Mobilization

  • Use mobilization tactics for grass-roots support on key issues

Research

  • Produce a Research Paper demonstrating the role of vendors, costs, and margins on ADP-funded devices.

 

7Oct, 2022

OHMEPA Objectives 2022-23

October 7, 2022|

With your support, these are a few of the objectives OHMEPA is focusing on, to support a healthy and profitable vendor community.

 

  1. ADP Policy
    • Fair compensation for vendors
    • Recognition of vendor value
  2. ADP Audits
    • Ensuring audits do not extend to non-ADP-funded items
    • Creating a third-party arbitrator for vendors to appeal ADP audit results
  3. New Funding Sources
    • Vendor access to new sources of government funding for assistive devices and related services.
7Jul, 2019

Assistive Devices: Proactive Solutions for Ontario’s Seniors and Persons with Disabilities

July 7, 2019|

This report, Assistive Devices: Proactive Solutions for Ontario’s Seniors and Persons with Disabilities, illustrates the current and future impact of assistive devices on a changing population. Assistive devices will play an increasingly significant role in the health care industry.

Therefore,
(1) The assistive devices industry must be included in the policy decision making process.
(2) The funding and number of approved assistive devices must be reinstated to 2016 levels.

The government must update the product approval process and invest in innovation and technology for assistive devices.

Assistive Devices: Proactive Solutions for Ontario’s Seniors and Persons with Disabilities (2019)