Canada: Amendments To The Independent Health Facilities Act Proposed By Private Members’ Bill

Last Updated: July 10 2012
Article by Cathi Mietkiewicz

Bill 41, entitled "Reducing Automobile Insurance Premiums by Eliminating Fraud Act, 2012" (the "Bill"), was introduced by Liberal MPP Amrit Mangat.  The Bill proposes an amendment to the Independent Health Facilities Act (the "IHFA") with respect to the licensees of Independent Health Facilities ("IHFs").

IHFs are facilities that receive funding from the government to perform certain OHIP-insured procedures that would ordinarily only be performed in hospitals as they are too costly or complex to perform without the support of a hospital global budget.  The IHFA provides, among other things, a funding and licensing model for these facilities. Examples of IHFs include facilities that provide services such as diagnostic imaging, pulmonary function or sleep study tests, or ambulatory care facilities that provide certain surgical and therapeutic procedures.  In order to establish or operate an IHF, a licence must be obtained from the Director of Independent Health Facilities (the "Director"). 

The IHFA permits the Minister of Health and Long-Term Care to authorize the Director to request one or more proposals for the establishment and operation of one or more independent health facilities by sending a request for a proposal to one or more specific person or by publishing a notice in a newspaper in Ontario. According to a fact sheet published in August 2011 by the Ministry of Health and Long-Term Care (the "Ministry"), in order to become a licensee of an IHF, a person (or other entity) submits a proposal in response to an RFP issued by the Ministry for the establishment and operation of an IHF.  The Director then determines whether the proposal meets the specified criteria in the RFP.  Criteria may include that the quality and standards of the IHF and the services to be provided in the facility will comply with the regulations made under the IHFA, that the licensee will operate the IHF competently and with honesty and integrity, and that the licensee will establish and maintain a system to ensure the monitoring of the results of the services provided in the IHF.

The Bill proposes that in the future, a licensee would be required to be a health practitioner 1 in order to establish an IHF.  In the case where a corporation is the licensee, all of the shares of the corporation would have to be legally and beneficially owned, directly or indirectly, by one or more health practitioners.  Existing IHFs would not be affected where a licence was issued prior to the amendment coming into force and the requirement would not apply to the renewal of an existing IHF licence.

The impetus for the introduction of Bill 41 was to combat auto-insurance fraud that occurred as a result of health professionals at IHFs filing false medical reports in automobile insurance claims.  As such, the Bill was put forth with the intention of increasing awareness to the issue of such fraud on the part of health professional colleges. It is unclear whether these changes are required, as it is already professional misconduct for health practitioners to file false reports and a health professional who did so would be subject to disciplinary action by his or her regulatory college.

According to MPP Mangat, the specific amendment regarding licensees is intended to combat the proliferation of unregulated facilities.  However, while requiring licensees to be health practitioners ensures the owners of IHFs are accountable to the professional colleges that govern them, it will not affect the number of unregulated facilities.  There are a limited number of IHFs in existence and no new licences have been issued in approximately ten years. However, hundreds of health care facilities, such as physiotherapy and other rehab clinics are not IHFs and therefore are not caught by the Act.  Since these amendments will not apply to existing IHFs or to non- IHF clinics, the force of the proposed amendments is questionable. In order to truly regulate health care facilities, legislation would need to require any facility that provides health care to be subject to a regulatory regime.

The Bill is currently before the Standing Committee on General Government.  Subsequent to the Standing Committee's review, any amendments will be brought back to the legislature for a third reading.  Only if the bill is passed at a third reading will it come into force as law.


1 Under the Bill, "health practitioner" is defined as a member of a College as defined in the Regulated Health Professions Act, S.O. 1991, c.18

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