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 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
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
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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