Correction - October 11, 2013: This article about a court case between the Ontario Ministry of Health and private physiotherapy clinics referred to four large companies that have purchased 35 per cent of the private clinics. In fact, one of the clinics, Family Physiotherapy Centres, which owns just two of the clinics, was not involved in the court case and should not have been mentioned with the other companies. The Star regrets the error. A group of private physiotherapy clinics is going to court Thursday in a last-ditch effort to stop the province from overhauling the way physiotherapy is provided to seniors. A group of private physiotherapy clinics is going to court Thursday in a last-ditch effort to stop the province from overhauling the way physiotherapy is provided to seniors.

They are pulling out all the stops in the days before the changes take effect Aug. 1, even demonstrating at all-candidates’ meetings for the five upcoming provincial byelections.

At stake is up to $200 million in taxpayers’ money that flows through the 91 clinics in question.

Forty-three of the clinics plan to ask the Ontario Divisional Court to quash a regulation that will force them to stop billing OHIP for physiotherapy.

“This regulation will delist (clinics) from OHIP and will have a catastrophic effect on (them) and their employees,” their factum argues.

“The delisting is coupled with a $46-million cut in public funding for physiotherapy services which will impair the health and well-being of Ontario residents currently receiving physiotherapy treatment from (the clinics),” it warns.

But Health Minister Deb Matthews stands by the changes , arguing they will bring more equity to a system that currently shortchanges much of Ontario. Most of the OHIP clinics are located around the GTA and Hamilton and there are only two in northern Ontario.

“It’s about getting best possible value for money. We are going through our spending and wherever we can get better value by doing things differently, we are doing it,” Matthews said.

There is a suggestion the current system is open to abuse. Many of the clinics run exercise classes in retirement homes, billing OHIP for each senior who attends.

“When we did an audit, we discovered many of these physiotherapy classes weren’t delivered by a physiotherapist but were being billed as one-on-one physiotherapy,” Matthews said.

Under the new system, provincially funded physiotherapy will be provided in 200 clinics that will be more equally distributed across Ontario. The 91 existing clinics can still provide physio, but the fee-for-service funding model will be replaced with one that involves transfer payment agreements with the health ministry.

Provincially funded physiotherapy will also be offered through home care, long-term care and primary care. As well, exercise classes for seniors will continue to be offered in retirement homes and other community settings.

Under the new model, the province maintains it is increasing the annual physio budget to $156 million from $146 million.

But the Designated Physiotherapy Clinics Association of Ontario, which represents the affected clinics, says the province is misrepresenting the changes, given that it actually spent $172 million in the 2011-12 fiscal year, an amount projected to hit $200 million in the current fiscal year.

“Incredibly, the province continues to call its cuts an expansion of physiotherapy services,” said Tony Melles, spokesperson for the group and president of Achieva Health, which owns and operates a number of the affected clinics.

The exercise classes the province is organizing for seniors should not come under the physio budget, the group contends.

But the province says the clinics have exceeded their budgets in each of the last three years, becoming the fastest-growing line in the health budget with demand driven by providers.

The province argues it’s high time to update an antiquated system that dates back to the 1960s and ’70s, when the clinics were given OHIP billing numbers. Since that time four large companies have purchased 35 per cent of the clinics.

They are Centric Health, Achieva, PT Health and Family Physio. Two-thirds of OHIP fee-for-service payments for physio go to clinics owned by these four companies, according to the province.

Matthews indicated the current system has been a cash cow for some.

Loading... Loading... Loading... Loading... Loading... Loading...

“No question about it. When you think about it, they run a 30-minute exercise class with say 30 people in it (and) they can bill for 30 one-on-one physiotherapy sessions. It is enormously profitable,” she said.

In court on Thursday, the clinics plan to argue they were blindsided when the province announced the changes in April and that the province had violated its own requirements for prior notice and consultation.

Matthews accused the clinics of fear-mongering: “They are telling people they are going to lose their physiotherapy. This just isn’t so. If they need physiotherapy they are going to get physiotherapy.”

Physiotherapy clinic locations

GTA: 49

Mississauga: 0

Northern Ontario 2

Hamilton: 9

Ottawa: 5