Your sector news: the 2017 AIR, new ‘desk reviews’, the OCF-21 and more

Service Providers eNewsletter – Issue #21


Have you filed your 2017 Annual Information Return yet?


All principal representatives of service providers with a FSCO licence as of December 31, 2017 are responsible for submitting the Annual Information Return (AIR) in their FSCO Account and paying the annual regulatory fee by March 31, 2018 – even if they did not do any business in 2017. 


Last year, more than 96 per cent of principal representatives filed their AIR with FSCO. Those who did not file faced enforcement action including fines, licence suspension and/or licence revocation. Take 30-60 minutes today and file your AIR in your FSCO Account so you can stay compliant.


Desk reviews are here!


FSCO has expanded its oversight of the service provider sector by introducing a new monitoring activity called ‘desk reviews.’ Similar to on-site examinations but less intrusive, desk reviews are conducted through email and telephone exchanges with service providers.


FSCO will use them to assess service providers’ compliance with the Insurance Act and Regulations. This includes confirming that service providers’ contact information and Health Claims for Auto Insurance (HCAI) rosters are up-to-date.


They do not replace examinations or other monitoring activities. Under sections 442.1 (2) and 443 of the Insurance Act, FSCO has the legal authority to inquire into or examine matters related to service providers.


If FSCO selects you for a desk review, you will be notified by email. This year, FSCO is focusing on facilities with 10 claimants or fewer per year. You will have 15 business days to provide the information requested in the email. If you do not respond to FSCO’s request by the deadline, you could be subject to an on-site examination and/or regulatory action.


Once your desk review is completed, FSCO will email you about the results. Depending on the outcome, you may be subject to a further on-site review.


Report any changes to your business information – it’s the law!


Any changes to the service provider’s business information must be reported to FSCO within five business days, as per section 20 of Ontario Regulation 90/14. This includes changes to its mailing address, email address, telephone number, fax number, principal place of business location, or any facility, branch, office or location in Ontario.


Take two minutes and make sure all of your information is up-to-date in your FSCO Account. This will help you stay compliant with the law and will make sure you get important messages from FSCO. This is also one of the areas FSCO will be looking at during desk reviews.


Has your service provider’s management team changed? Here’s what to do.


Principal representatives have a responsibility to provide FSCO with the names of a corporation’s officers and/or directors, or the partners in a partnership. Principal representatives must also report to FSCO when there has been any change in a corporation’s officers and/or directors, or the partners in a partnership.


Reporting is easy and online – just login to your FSCO Account and submit the “Add/Remove Director, Officer or Partner” application.


When a director, officer or partner has been added to the business, the principal representative must provide FSCO with the new person’s contact information (including name and email address).


Note: new directors, officers or partners SHOULD NOT create a FSCO Account before they receive instructions from FSCO. They will receive an email from us with instructions on how to create a FSCO Account and how to complete a declaration/attestation. If they don’t wait, they might not be able to access the appropriate declaration/attestation.


Keeping your HCAI roster up-to-date


As a reminder, you must remove health professionals from your roster in HCAI as soon as they are no longer employed with you in order to stay compliant with your licence requirements. This is one of the areas FSCO looks at when conducting desk reviews.


The rules around signing the OCF-21


Failure to sign the OCFs continues to be one of the most common issues of non-compliance found by FSCO during examinations.


The OCF-21 must be signed by the regulated health professional who is providing treatment to the claimant. The regulated health professional can also designate an “authorized signatory” to sign the OCF-21 on their behalf if the regulated health professional has provided his or her consent. Your facility must keep a copy of the signed OCF-21 on file. This can be either the original paper version, or an electronic copy saved in PDF format.


Attention all nurses and occupational therapists!


Starting on October 1, 2018, all participating facilities in HCAI must submit the Assessment of Attendant Care Needs Form (Form 1) to insurers electronically, through HCAI or software that is integrated with HCAI. Furthermore, as of October 1, 2018, all insurers must communicate the approval or rejection of the Form 1 through HCAI. This will allow users to propose, approve and track benefit amounts with ease electronically. Read the bulletin for more information.


FSCO’s Service Providers Market Conduct Symposium


Preparations are underway for FSCO’s next market conduct symposium for the service provider sector. Stay tuned for more information in the coming months.


Ninety-two per cent of last year’s symposium attendees found the presentations informative and relevant. The program emphasized the importance of proper billing and business practices, including strong policies and procedures and complete record keeping. Participants were able to gain a better understanding of FSCO’s compliance expectations.


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