OHMEPA Government Relations Priorities

Priorities

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.

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.

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.
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.

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.
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.
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

Research

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