Bill 160, the Strengthening Quality and Accountability for Patients Act, 2017 (the “Act”) became law on December 12, 2017, bringing some significant changes to many areas of the health industry. While some discrete portions of the Act came into force on the date of Royal Assent, most of the Act, along with supporting regulations, will come into force on a day to be named by proclamation of the Lieutenant Governor.
1. Health Sector Payment Transparency Act, 2017
The stated intention of this legislation is to strengthen transparency and increase patient trust in the health care system. The Act makes Ontario the first Canadian province or territory to require the reporting of certain transfers of value by the pharmaceutical and medical device industry to recipients such as health professionals and hospitals. Specified information must be reported to the Minister of Health and Long-Term Care for analysis and publication in an online database.
“Payors” will be required to report information about direct and indirect transfers of value over a prescribed threshold. Transfers of value are defined broadly in the legislation and could include meals and hospitality, travel expenses, financial grants, and fees paid for consulting on speaking events, among other things.
Payors are persons and entities that provide a transfer of value to a recipient in relation to “medical products”, which are defined as drugs, medical devices, or other prescribed products used in the health care system. Payors include:
- a manufacturer that sells a medical product under its own name or trademark, or a name or mark that is owned or controlled by the manufacturer;
- a person who fabricates, produces, processes, packages or labels a medical product on behalf of a manufacturer;
- wholesalers, distributors, importers or brokers facilitating the sale of medical products;
- marketing firms and individuals performing activities to market or promote a medical product;
- persons who organize continuing education events for members of a health profession on behalf of a manufacturer; and
- any prescribed person or entity.
Recipients are prescribed persons or entities that receive a transfer of value from a payor. Both payors and recipients are required to retain records of transactions. The Ontario government has investigation and enforcement authority with respect to the legislative requirements.
2. Oversight of Health Facilities and Devices Act, 2017
The Oversight of Health Facilities and Devices Act, 2017 (the “Oversight Act”) establishes a regulatory system for the licensing and operation of community health facilities (CHFs) and energy applying and detecting medical devices (EADMDs).
Specific EADMDs that require licensing will be set out in regulation. They may include devices that are manufactured, sold, or represented for use in diagnosing or treating individuals or for restoration of body structures or functions, as well as devices used to apply or detect acoustic, electromagnetic, or particle radiation.
The definition of CHFs is expected to be clarified by regulation, and will include facilities formerly licensed under both the Private Hospitals Act and the Independent Health Facilities Act (provided certain prescribed requirements are met).
The Oversight Act requires operators of CHFs and EADMDs, including hospitals, to obtain a license, and enhances the enforcement tools available to inspectors in an effort to improve patient safety. Lastly, the Oversight Act sets out powers to inspect CHFs and the use of EADMDs.
3. Medical Radiation and Imaging Technology Act, 2017
The Medical Radiation and Imaging Technology Act, 2017 replaces the Medical Radiation Technology Act, 1991. Under this legislation, the College of Medical Radiation Technologists of Ontario is continued and expanded to become the College of Medical Radiation and Imaging Technologists of Ontario, which is reflective of its full membership. The scope of practice statement of medical radiation and imaging technology has been amended to include the application of soundwaves, which incorporates the practice of diagnostic medical sonographers.
In addition to the above, Bill 160 makes consequential amendments to numerous other acts. Some highlights which will directly affect the health industry are as follows:
- The Ambulance Act has been amended to give wide scope to the Minister to issue operational and/or policy directives wherever it is in the public interest to do so. Among other things, these directives will allow paramedics to transport individuals by ambulance to destinations other than hospitals, and provide on-scene care, as required. Further, the legislation broadens inspectors’ and investigators’ powers of investigation to include examination and inspection of ambulances, vehicles, supplies, equipment, workplaces or records; and making inquiries of any person.
- Amendments to the Long-Term Care Homes Act, 2007, Retirement Homes Act, 2010, and Health Care Consent Act, 1996 will address gaps in the legislation related to the use of restraints and confinement, particularly provisions relating to “secure units”, which never came into force. Instead, new amendments set out the circumstances in which it is permissible for a resident or patient to be restrained or confined, and address a consent-based system. In addition, s. 70 of the Retirement Homes Act, 2010 regarding permitted confinement (which has yet to be proclaimed) has been amended to clarify a licensee’s obligations with respect to resident rights.
- Further amendments to the Retirement Homes Act, 2010 give increased oversight powers to the Retirement Homes Regulatory Authority at the direction of the Minister with the stated purpose of strengthening the protection of seniors.
We note that the above summarizes just some of the many changes implemented by the Strengthening Quality and Accountability for Patients Act, 2017. We invite you to contact us if you have any questions about the new legislation or how its implementation may impact your organization.
 The Act amends the following legislation:
- the Ambulance Act;
- the Excellent Care for All Act, 2010;
- the Health Protection and Promotion Act;
- the Long Term Care Homes Act, 2007;
- the Health Care Consent Act, 1996;
- the Ontario Drug Benefit Act; and
- the Retirement Homes Act.
 The Act repeals the following legislation:
- the Ontario Mental Health Foundation Act;
- the Medical Radiation and Imaging Technology Act, 1991;
- the Independent Health Facilities Act;
- the Healing Arts Radiation Protection Act; and
- the Private Hospitals Act.