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4- The Oakville Beaver, Wednesday November 28, 2007 www.oakvillebeaver.com Doctors `block fees' spark privacy concerns DOC+OR By Dana Brown and Joan Walters SPECIAL TO THE BEAVER IS THERE A The Ontario Information and Privacy Commissioner has launched an investigation into the collection of personal information by a privatesector company that helps doctors collect fees. And the College of Physicians and Surgeons of Ontario says it will review its own regulations covering how doctors use hired companies for fees. The moves were announced after a Metroland West Media Group investigation published yesterday. It found that hundreds of thousands of Ontario patients have unknowingly been sending personal information to a Toronto-based corporation when signing up for extended coverage fee plans offered by their doctors. The involvement of the company, Healthscreeen Solutions Inc., is not disclosed to patients who receive letters over the signatures of their physicians. The college - the governing body for physicians - also will review whether it should be mandatory for doctors to tell patients an outside firm is involved. IN THE HOUSE? McMaster University professor Dr. Gordon Guyatt questions the propriety of a doctor failing to disclose the involvement of an outside billing agent. "I think that patients should have the right to know and the relationship between patient and physician is profoundly based on trust," said Guyatt, who publicly opposes block fees. "And the physicians have to be very careful not to abuse that trust. Patients are terribly vulnerable." Patients in Hamilton said yesterday they were uneasy about requests to pay block fees - charges imposed by doctors to cover uninsured services such as sick notes at $20 apiece and prescription renewals by phone for $15. Mary French, 77, a widow, said she felt she had to pay the annual fee of $95 suggested in her letter or risk being overwhelmed by individual charges. "What else could I do?" said French, who has had three heart attacks and suffers from a form of rheumatism. "I don't want to have to pay every time." Doctors are allowed to charge lump sum payments for services such as sick notes and telephone prescription renewals not covered by OHIP. But regulations covering the fees say patients must have a choice between paying for services one at a time, as they are needed, or paying one block fee annually to cover every- thing. Patients said they feel pressured to pay the annual fee or face higher costs when their doctors start charging individually for each thing they need. That's why NDP Leader Howard Hampton thinks the fees should be banned outright. He called on Health Minister George Smitherman to recognize that block fees are "open to manipulation and deception." "That's always wrong." Health Minister George Smitherman's office said he was not available for comment yesterday. But he told Metroland earlier this week he would consider reviewing how the fees are regulated if concerns are being raised. The newspapers' investigation prompted questions about transparency that See Privacy page 9 Collector of MD block fees says they are in compliance By Dana Brown SPECIAL TO THE BEAVER A company under scrutiny for failing to disclose its involvement in doctors' billing practices says it has contacted the Information and Privacy Commissioner for feedback. Justin Belobaba, president and CEO of Toronto-based Healthscreen Solutions Inc., says the company is "very confident" it is in compliance with all privacy regulations. "But at the same time we're open to whatever feedback that they have." The Ontario Information and Privacy Commissioner launched an investigation into Healthscreen's information collection practices as a result of a report by Metroland West Media Group. The investigation examined Healthscreen's involvement in helping doctors bill patients for uninsured services, which included lump-sum payments, or "block fees." Charging block fees is legal and voluntary for patients. The fees ranged from up to $95 for an individual to $140 for a family. Patients have the option of paying for services as they use them, such as sick notes at $20 a piece or telephone prescription renewals for $15. The investigation showed that patients were not told Healthscreen was involved in the billing process. Belobaba said yesterday he wanted to clarify that on a number of occasions, the company has disclosed its involvement at the request of the doctor. "That is a doctor-by-doctor decision that we leave to their discretion," he said. The College of Physicians and Surgeons of Ontario, the governing body for doctors, is also re-examining parts of its policy on block fees. 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