The Financial Services Regulatory Authority of Ontario (FSRA) published its third Health Service Provider Supervision Plan for 2024-2026, setting out supervisory priorities to strengthen compliance by licensed health service providers that bill automobile insurers for benefits under the Statutory Accident Benefits Schedule. FSRA notes that providers are licensed to receive direct payment from auto insurers, and that supervision initiatives over the past two fiscal years identified a high level of non-compliance despite efforts to raise awareness of regulatory obligations. The plan focuses on verifying compliance among top-billing health service providers in the Health Claims for Auto Insurance (HCAI) system that have never been reviewed by FSRA, examining how insurers and providers manage preferred provider network (PPN) agreements, and identifying providers with sanctioned practitioners on their HCAI rosters and reviewing potential unauthorized activity in HCAI. FSRA also states it is reviewing the Health Service Provider Framework in support of the Ontario Government’s commitments to improve the auto insurance system. Supervision activities under the 2024-2026 plan have already begun, and FSRA expects health service providers to review the plan and related publications to maintain awareness of, and comply with, regulatory requirements.

Original source View in tracker