Public Health Agency of Canada reviewing ‘the VISP experience,’ including users’ concerns
After a five-month investigation, Global News requested an interview with the Public Health Agency of Canada officials to discuss its Vaccine Injury Support Program.
The federal agency declined the request, asking for written questions instead.
Global News submitted an extensive letter with detailed questions about specific cases and facts.
PHAC sent us the following statement:
“In June 2021, the Government of Canada established a pan-Canadian no-fault Vaccine Injury Support Program (VISP) in consultation with the provinces and territories.
The VISP is a no-fault program that ensures that people who suffer a serious and permanent injury as a result of receiving a Health Canada-authorized vaccine administered in Canada, on or after December 8, 2020, have access to a financial support mechanism funded by the Government of Canada.
The need for a vaccine injury support program had been previously identified as a gap in Canada’s immunization system and recognized as an area of importance by all levels of government.
A number of countries have no-fault programs in place, including all G7 counterparts.
Building on the model in place in Québec for more than 30 years, the VISP was designed to support individuals in Canada who experience a serious and permanent injury as result of receiving a Health Canada authorized vaccine.
An open solicitation process took place in February 2021 to identify a third party administrator for the VISP.
The solicitation was open to Canadian not-for-profit and for-profit organizations and corporations.
Applicants had to demonstrate experience with:
- health claim adjudication
- injury causality assessments
- cost-effective delivery in administering payments
- managing personal information and
- providing program delivery at a national level in both official languages
PHAC received four proposals in response to the solicitation process.
A six-member Review Committee comprised of experts from inside and outside the Government of Canada in the areas of privacy, compensation programs, procurement, and medicine was established to review these four proposals.
After a comprehensive, transparent and ratings-based review of the submitted proposals by the Committee, Oxaro Inc. (formerly known as Raymond Chabot Grant Thornton Consulting Inc.) was unanimously identified as the successful applicant and selected as the 3rd party administrator of the VISP.
Oxaro was neither the lowest nor highest bidder in the process.
The VISP is currently being administered and delivered independently by Oxaro for the pan-Canadian VISP (and by Quebec for their longstanding Vaccine Injury Compensation program), with funding from PHAC.
As of December 31, 2024, a budget amount of up to $65.2 million over five years (2021-22 to 2025-26) was allocated to Oxaro for program operations and administration costs and claim payments through their Contribution Agreement. This does not represent payments made to Oxaro but rather the maximum amount available over the Contribution Agreement timeframe of five years.
As with all Contribution Agreements, only the actual costs (for both program administration and payments to claimant) are eligible. As such, as of December 31, 2024, Oxaro’s actual costs reported were $50.6 million.
(Global News reports that only $16.9 million of that $50.6 million sum went to injured Canadians.)
The VISP is a new and demand-based program with fluctuating costs based on the number of applications and appeals submitted by Canadians.
The cost to process and assess a claim is the same regardless of whether or not the claim is approved for financial support.
All eligible claims undergo a full and robust technical and medical assessment process based on the World Health Organization’s (WHO) guidance for causality assessment of an adverse event following immunization, regardless of the actual causality outcome and subsequent payment.
This process is conducted by a team of medical experts, which includes both general practitioners and specialists, as needed.
Administration costs are proportional to the number of claims received and processed.
Oxaro and its team of medical experts individually assess every claim.
This includes a review of all required and relevant medical documentation, as well as current medical evidence, taking into account the temporal relationship between the injury and the vaccine as well as existing population-based evidence for causality to determine if there is a probable link between the injury and the vaccine.
If there is a probable link, the medical experts will also assess the severity and duration of the injury. Oxaro uses this information to determine the types and levels of financial support awarded to the individual or their survivor(s).
The amount of financial support an individual will receive will be determined on a case-by-case basis, in accordance with the PHAC-approved benefit categories and maximum support amounts.
In addition, financial support provided by Oxaro must align with the Government of Quebec’s compensation program and other public and private sector injury compensation practices.
Timelines for a determination of eligibility and support depend on the nature and complexity of the claim (for example, time needed to collect medical records from provinces, territories, or medical institutions where the patient received care).
The average claim takes 12 to 18 months to process, but sometimes may take longer.
While PHAC set out the policy framework for the VISP, a committee of independent medical experts that follow WHO guidelines on causality assessment make decisions on individual claims.
PHAC is not involved in any individual case assessments or decision making and does not have access to personal information of the applicants. Furthermore, Oxaro is wholly responsible for the hiring and paying of both the program personnel and the physician consultants that it employs.
PHAC appreciates Global News’ interest in the VISP and takes the concerns raised by VISP claimants and beneficiaries seriously.
PHAC continuously and actively conducts analyses of the program to identify both shortfalls as well as opportunities to better support people in Canada who have experienced a serious and permanent injury after receiving a Health Canada-authorized vaccine.
PHAC is actively reviewing the VISP experience to date, including concerns raised by claimants and beneficiaries, and is working with experts to review the lessons learned and best practices from comparable international injury compensation programs.
This analysis and review will help ensure that the future program will effectively meet the needs of Canadians and is delivered in a fair, efficient and cost-effective manner.”
globalnews
