Summary#
Bill 85, the Transparent and Accountable Health Care Act, 2025, would create a new Act; it does not amend the existing Acts it refers to. It would extend three existing accountability laws and the Ontario Ombudsman’s reach to certain health organizations and suppliers receiving public money. Its stated goal is to promote transparency and accountability in health-care funding; that goal is not a guaranteed result.
- A health-sector organization receiving at least $1 million from the Ministry of Health in a qualifying fiscal year would be covered. The bill lists examples including hospitals, long-term care homes, Ontario Health organizations, and group purchasing organizations.
- A supplier receiving at least $1 million, directly or indirectly, from covered organizations or other covered suppliers would also be covered. The threshold includes payments for goods or services, fee-for-service arrangements, loans, and loan guarantees.
- Covered organizations and suppliers would be treated as designated employers under the Broader Public Sector Executive Compensation Act, 2014, governmental organizations under the Ombudsman Act, and employers under the Public Sector Salary Disclosure Act, 1996.
- The Auditor General could audit any aspect of a covered organization’s or supplier’s operations, subject to the bill’s fiscal-year limits.
- The thresholds apply to fiscal years beginning on or after April 1, 2027. The Act itself would start on Royal Assent.
What it means for you#
- Health organizations and suppliers: If you meet the relevant $1 million threshold, the bill would bring you under the named laws and allow the Auditor General to audit your operations. For executive-compensation and Ombudsman coverage, the bill says coverage begins in the first qualifying fiscal year and continues in every fiscal year after that. Salary-disclosure coverage and the Auditor General’s audit power apply only in fiscal years when the threshold is met.
- For-profit organizations and suppliers: The bill expressly includes businesses that operate for profit.
- Patients and the public: The bill does not directly change health-care services, eligibility, fees, or funding for patients. It aims to extend accountability rules to more recipients of public money, but does not guarantee a particular public disclosure or audit.
- Taxpayers: The bill does not create a new tax, fee, fine, or benefit.
Money#
No cost information is in the available material.
- The bill gives the Auditor General authority to audit covered organizations and suppliers, but provides no estimate of audit costs or added staffing.
- Covered organizations and suppliers may face costs from complying with the named laws; the bill provides no estimate.
- The bill does not appropriate a stated amount of money.
What is unclear#
- The texts of the three existing Acts are not provided, so their current coverage and the exact requirements that newly covered organizations and suppliers would face cannot be verified here.
- The bill defines “public funds” by reference to another Act, which is not provided. The precise scope of that term is therefore unclear.
- The bill does not set out how recipients’ funding would be tracked through indirect payments, or how disputes about meeting the threshold would be handled.
- It does not specify an application, review, appeal, or reporting process for deciding whether an organization or supplier meets the threshold.
- The bill allows regulations to be made, but does not say what rules may be made or whether any will be.
Case for#
- The bill appears intended to extend accountability requirements beyond organizations funded directly by the Ministry of Health, to suppliers receiving public money through the health sector.
- Including payments for goods and services, loans, and loan guarantees could make the rules cover more than grants or transfer payments.
- Applying the rules to for-profit recipients could reduce gaps based only on an organization’s business structure.
- Giving the Auditor General authority to examine any aspect of covered operations could allow scrutiny beyond a narrow set of financial records.
Case against#
- The bill does not explain how recipients would determine or prove whether direct and indirect funding reaches the $1 million threshold.
- A supplier could face added legal and administrative requirements even though it is not itself a health-care provider; the bill gives no estimate of those costs.
- The Auditor General’s authority to audit “any aspect” of operations is broad, while the bill does not set out a process or specific limits for such audits.
- Executive-compensation and Ombudsman coverage would continue in every fiscal year after an organization or supplier first meets the threshold, even if its funding later falls below $1 million.