bulletin

Bulletin Number
        4328
Date
        December 18, 1998
Direct inquiries to
         Ministry of Health
         Processing Office

(address below)
Distribution
        Physicians, Hospitals, Clinics, and Laboratories
Subject      OHIP FRAUD REPORTING

In support of the government's "zero tolerance" policy for health fraud, the ministry has implemented a new regulation. Effective April 24, 1998, Regulation 590/94 of the Health Insurance Act was replaced by Regulation 173/98.

Mandatory Reporting

Regulation 590/94 required physicians, certain members of their staff, as well as certain hospital and health facility staff to report, anonymously if preferred, specific incidents of health fraud to the ministry.

With the implementation of Regulation 173/98, the number of prescribed persons who are required to report specific incidents of health fraud is now extended to include:

  • registered nurses of the extended class (nurse practitioners), midwives, laboratory staff, schedule 5 physiotherapists, dentists, optometrists, podiatrists, chiropractors, and employees of these groups.

Under this new regulation, all prescribed persons listed above are:

  • required by law to report specific incidents of health fraud, as per subsection 43.1 (1);
  • permitted to take possession of a health card when it is surrendered voluntarily, per subsection 11.1 (2);

./2

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