FSRA Stakeholder Advisory Committee for Health Service Providers

1. Introduction

The Financial Services Regulatory Authority of Ontario (FSRA) is committed to an open, transparent and collaborative approach that involves stakeholders and ensures broad input and perspectives to inform its direction. 

Stakeholder Advisory Committees (SACs) will serve as consultative bodies to the Board on FSRA’s priorities and budget and other matters as the Board deems appropriate. They are an important part of FSRA’s stakeholder engagement process. 

These Terms of Reference relate to FSRA’s role in the Health Service Provider sector, which includes:

  • licensing service providers that bill auto insurers directly for medical and rehabilitation services provided to automobile insurance accident benefits claimants; 
  • regulating the business and billing practices of licensed service providers; and
  • collecting information about licensed service providers’ business systems and practices through an Annual Information Return (AIR).

These Terms of Reference are intended to inform the creation and operation of the Health Service Provider SAC.

2. Mandate of the Stakeholder Advisory Committee

The Health Service Provider SAC will:

  1. Inform FSRA’s annual business planning, with a focus on the Health Service Provider-related priorities and budget that will guide FSRA’s operations and regulatory activity, before FSRA’s annual business plan is delivered to the Minister of Finance;
  2. Provide feedback on the progress made by FSRA on its Health Service Provider-related priorities from the previous annual business plan; 
  3. Provide feedback to the FSRA Board on rule-making activity in the Health Service Provider sector where, the Board believes that given the complexity and importance of a specific rule and the issues identified by FSRA Management, the Board will benefit from direct engagement with the sector via the SAC;
  4. Upon request of FSRA, provide a forum for input on Health Service Provider sector issues, FSRA priorities and other initiatives or activities involving FSRA; and
  5. Have the opportunity for an in-camera session with the Board, at least annually, to raise any issues related to FSRA management and the Health Service Provider sector that the SAC wishes to discuss with the Board without the presence of FSRA management.

The Board may decide to convene a SAC meeting to discuss any other issue related to the regulation of the Health Service Provider sector, and may decide to combine SACs from different sectors for such a meeting.  

3. Nomination and Appointment of Stakeholder Advisory Committee Members 

Appointments to the Health Service Provider SAC will be made through an open nomination process posted online. Selections will be made by FSRA, based in part on the experience of the individuals who are put forward, their role in the sector they represent and other factors that FSRA may determine are relevant. 

The Health Service Provider SAC will have a target membership of fourteen stakeholder members, of which up to three are intended to be consumers and the remainder will represent regulated entities, associations of regulated entities or professionals working in regulated entities. FSRA can choose to add or remove any member of the SAC at any time and a SAC member may resign by giving written notice.

FSRA is looking for members for an initial one-year term commencing in November 2019 and this term may be renewed by FSRA for one additional year to allow membership to be staggered to provide continuity to the Committee.

FSRA will publish the names of the members of the Health Service Provider SAC on its website.

4. Members of the Stakeholder Advisory Committee

Stakeholder nominees to the Health Service Provider SAC should be senior members of their respective organizations or professions who can represent their organization or profession on relevant issues. In particular, FSRA is seeking members that have direct and extensive experience in Ontario’s auto insurance system both before and after the implementation of Health Service Provider licensing.

Industry members will be selected with an emphasis on ensuring adequate diversity by geography, organization size and background (e.g. treating clinician, assessment provider or business owner/administrator).

To ensure FSRA has a cross-section of views, we welcome consumer representation on the Health Service Provider SAC. Consumer members should have an interest in either health services or Ontario’s auto insurance system more broadly and will not be expected to have specialized knowledge of the Health Service Provider sector.

Responsibilities of Health Service Provider SAC members will include: 

  • reviewing background material in preparation for meetings
  • attending meetings (delegation is not permitted if a member is unavailable, but FSRA may appoint another Health Service Provider SAC member on an interim basis if a member is unavailable due to incapacity or other justifiable temporary cause)
  • providing advice, information and feedback to FSRA 
  • using best efforts to develop consensus and to identify any issues where stakeholder consensus does not exist, and the reasons for an absence of consensus
  • providing feedback to FSRA on the functioning of the Health Service Provider SAC 
  • working with FSRA management and other SAC members to prepare for Health Service Provider SAC meetings with the Board  

5. Public Process, Input from Others and Disclosure

The Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c.F.31, as amended, will generally apply to information and material provided to and prepared by or for the Health Service Provider SAC. 

Members of the Health Service Provider SAC are permitted to obtain assistance from co-workers or sector collaborators. However, members and those who assist them are required to maintain confidentiality of all information provided to the Health Service Provider SAC, or prepared by or for the Health Service Provider SAC for presentation or delivery to FSRA (with the exception of information made public by FSRA, including any submissions by the Health Service Provider SAC or its members as part of a public comment process sponsored by FSRA). 

6. Meetings, Agendas and Deliverables

It is expected that the Health Service Provider SAC will participate in at least one half-day meeting about FSRA’s business planning, tentatively scheduled for the week beginning Monday, November 25, 2019, and another priorities meeting in fall 2020. There may be additional meetings as per the terms of reference.

For those selected to participate on the SACs, FSRA will not be providing any remuneration. However, consumers residing outside of the Greater Toronto Area are entitled to be reimbursed for reasonable travel expenses they may incur in attending meetings in accordance with FSRA approved Travel, Meal and Hospitality Directive.

Members may be asked to prepare material for consideration by FSRA or for presentation to the Board.

FSRA management shall endeavour to provide meeting agendas and related materials at least one week in advance of each regular meeting. FSRA management shall prepare a summary of each SAC meeting with the Board and distribute it, including any accompanying written submissions, to members, typically within three weeks following a meeting. FSRA also intends to publish a high-level summary of the Health Service Provider SAC’s work on FSRA’s website within approximately three weeks of each meeting with the Board.