May 27, 2014
Re: Duplicate licensing of regulated health professionals providing services to auto insurance clients
Dear Mr. Jim Wilson,
Recently the Financial Services Commission of Ontario (FSCO) confirmed that it is going ahead with its licensing scheme for healthcare practitioners (including regulated healthcare practitioners) and clinics that provide medical and rehabilitation services to Ontario citizens injured in motor vehicle accidents under the Insurance Act. FSCO is doing so despite Bill 171 dying on the Order Paper when the Ontario Legislature was dissolved for the election. FSCO also announced the fees it will charge practitioners and clinics to be licensed. See http://bit.ly/FSCOlicensing for more information.
All clinics will require licensing, including those owned and operated by regulated health care professionals. As a regulated health care professional, I believe strongly in initiatives to reduce fraud in auto insurance and to protect the public I serve. However I am very concerned that the system being implemented will achieve neither of these objectives. I wish to lodge my objection to FSCO requiring a “health service provider license” for physiotherapists and other regulated healthcare professionals (and clinics they own or control) for the following reasons:
- Missing The Target
The extent of fraud perpetrated in the auto insurance sector by clinics and healthcare providers has never been calculated or estimated. In particular, there is absolutely no evidence of significant fraud being perpetrated by regulated healthcare practitioners, or by clinics owned or controlled by regulated healthcare practitioners.
As Mike Colle, MPP stated during a session of the Standing Committee on General Government on April 30, 2014:
“Because, as I’ve said before, I think the registered health professionals are not the issue; it’s these characters who see money to be made in physiotherapy and they see accident victims as maybe their target audience.”
- Duplication of Licensing through FSCO
FSCO’s licensing scheme will create costly and completely unnecessary duplication with the regulatory Colleges set up by the government under the Regulated Health Professions Act (RHPA). Our College, the College of Physiotherapists of Ontario’s sole mandate is to protect the public and has standards of practice in place to address competency issues as well as business practices. In fact, it is professional misconduct under the Physiotherapy Act 1991 to submit a bill for services that is false or misleading. The College has a very effective auditing and investigation system in place that is intended to protect the public, including the insurance industry, from fraudulent business practices.
- Excessive cost of Licensing
A one-time license application fee of $337.00 plus an annual regulatory fee of $15.00 x the total number of claimants and $128.00 x the applicant’s total number of business locations are excessive. In many cases the FSCO licensing fee will be significantly more than the registration fee I pay to my College which is approximately $635/ year.
The fee of $15 per claimant is excessive, particularly from the perspective that current providers are and have been operating, for several years, in a business environment where:
1) Assessment costs are fixed;
2) The majority of treatment costs are fixed by FSCO;
3) Health care professional fees in the auto sector are fixed according to the Professional Service Guideline (PSG) set by FSCO. With respect to the latter, the reader is reminded that health care providers have never recovered their 1996 professional fee rate following a radical 30-50% decrease in 2003, and did not receive a cost of living increase to their fees in 2013/2014.
FSCO has always said that the licensing scheme has to be financially self-sustaining, but FSCO has provided no calculations or projections justifying these exorbitant fees.
Since FSCO “caps” fees payable, the cost of the licensing fees will be borne by the health care providers and clinics. This will mean that many providers and clinics, particularly sole practitioners and small provider groups, will not be able to afford licensing. As such, the licensing scheme and the fees discriminate against small businesses.
- Access to Insured Services
From an access to treatment perspective, this additional financial and administrative burden can be expected to reduce or even eliminate access to care/treatment by claimants, because a number of physiotherapistscan be expected to vacate this area of practice due to the licensing costs.
Recommendation:
Take a position against the duplication of licensing/regulatory systems, increased costs to the system and reduced access to post-accident care. Require licensing by only those clinics that are not owned or controlled by regulated health professionals or implement a tiered licensing/registration system that leaves the regulation of practitioners and clinics that are owned or controlled by regulated health professional in the hands of existing, statutory colleges.
It is my sincere hope that you, as a candidate for election in my riding will support my position that this is an unnecessary and costly duplication of regulation that will result in fewer physiotherapists providing services to clients in the auto insurance system and thereby deny or limit access to care for injured citizens who have purchased insurance to cover the cost of medical rehabilitation services and goods.
I ask that you contact the Minister of Finance on my behalf and urge him to reconsider the government’s position for the need for another layer of licensing for healthcare practitioners who are already regulated by a college under the RHPA.
Sincerely yours
Ryan Shea