The Ministry of Finance is proposing to amend O. Reg. 7/00 to make it an unfair or deceptive act or practice (UDAP) for a person who provides or offers to provide goods or services for the benefit of a person who claims statutory accident benefits to communicate any false, misleading or deceptive information regarding their business or billing practices, services provided, or any other matter related to licensing.
This UDAP is intended to apply to both licensed and unlicensed service providers. An unlicensed service provider may not advertise that they are a licensed provider. A licensed provider that has had their licence suspended or revoked may not continue to advertise that they are licensed. This amendment would ensure that consumers can identify licence holders and avoid confusion about what licence holder status means. This will also discourage inaccurate claims about what a licence signifies.
In addition, the Ministry is proposing regulatory amendment to allow the Superintendent to apply variable administrative monetary penalties (AMP) to deal with significant contraventions of the regulations that can involve or potentially lead to improper billing practices. The service provider would have the opportunity for a hearing before the Financial Services Tribunal on the proposed AMP.
The Ministry is also proposing to amend O. Reg. 90/14 (Service Providers – Standards for Business Systems and Practices) to introduce a duty to report accurately to the Superintendent of Financial Services, in the periodic return established under section 288.4(5) of the Insurance Act, all information necessary to calculate any applicable fees established pursuant to section 121.1 of the Insurance Act.
The Ministry is proposing to amend O. Reg. 89/14 (Service Providers – Listed Expenses) to prohibit licensed service providers from invoicing claimants directly – they will receive direct payment from insurers. The proposed amendment will allow licensed service providers to seek payment for outstanding accounts directly from claimants in prescribed situations (where a full and final settlement has been reached and signed between the insurer and the insured person that includes these amounts).
Finally the Ministry is also proposing to amend O, Reg. 34/10 (SABS) to require claimants who go to unlicensed service providers to obtain specified billing information from their service provider and submit this information to their insurer when seeking reimbursement.
The SABS would also be amended to require insurers to provide HCAI the billing information when they reimburse a claimant for a “listed expense”. These amendments will ensure the continuity of robust and more complete data collection by HCAI. It will avoid possible loss of data that may otherwise occur when claimants are invoiced directly by service providers who are not licensed to be paid directly through the central processing agency.
The Ontario government’s Regulatory Registry is inviting stakeholders and interested parties to provide comments on these proposed regulations (that have yet to be made public). The deadline for comments is November 6, 2014.
Ontario’s Regulatory Registry provides information on new proposed regulatory initiatives that could affect Ontario businesses and recently approved regulations that affect business. Regulations are approved by the provincial Cabinet.
Once a regulation is approved, a plain language summary of the regulation is posted on the Registry website, with a link to the regulation posted on the Government of Ontario’s e-Laws website.