Insurers: What You Need to Know

The College is committed to working with investigators from all major insurance providers with a goal of increasing coordination on health insurance fraud investigations.

The public interest depends on the integrity of the profession. Protecting the integrity of the profession demands zero tolerance of inappropriate business practices.

About the College

The College of Physiotherapists of Ontario is responsible for protecting the public interest by licensing physiotherapists, setting the standards of the profession and ensuring that they're followed, and investigating concerns or complaints. Depending on the findings of these investigations, the College has the power to add terms, conditions or limitations to a physiotherapist's registration, or to suspend or revoke their license. 

The College is one of 26 health regulatory colleges in the province. A complete list is available on the Ontario Health Regulators website.  

Rules That Physiotherapists Must Follow 

There are a number of rules that are applicable to physiotherapists practicing in Ontario. While some rules are dictated by provincial or federal legislation, the College is also responsible for creating and enforcing rules (also called standards) that ultimately contribute to high-quality, ethical patient care. 

Some of these rules are unique to physiotherapy and may differ from other regulated health professions, like doctors. The College also investigates the professional conduct of PTs who may not be following the rules and anyone is permitted to make a complaint about a physiotherapist.

There are certain rules that are frequently referenced in health insurance fraud investigations including: 

  • Fees, Billings and Accounts Standard
  • Supervision Standard
  • Working with Physiotherapist Assistants Standard
  • Record Keeping Standard
  • Professional Misconduct Regulation
  • All Rules and Standards

    Review Real Cases

    Stay up to date with the Case of the Month - this is a great opportunity to see the rules in action. Each month the College blogs about a real case where a concern or complaint was raised about a physiotherapist. Key identifiers may be changed or omitted to maintain confidentiality. 

    There are a number of Case of the Month postings that are directly related to fraud and inappropriate financial/billing practices: 

  • Pilates Problems
  • Caught Up in the Cryo Hype
  • Financial Irregularities
  • False Records: Case of the Physiotherapist and the Fake Massage Therapist
  • PTs Fight Back Against Shady Clinic
  • Concealing Fraudulent Acts

  • All Cases 
     

    Have Questions About the Rules? 

    Contact our Physiotherapy Information Advisor for free, confidential advice. 

    Phone: 1-800-583-5885 extension 241
    Email: advice@collegept.org

    College Tip Line

    Please contact us if you would like to share information regarding the practice of a physiotherapist in Ontario. If you believe a physio is not following the rules and practicing unethically it is important that you inform us so that we can follow up as required. 

    If you have questions about the investigations process or would like to share a tip, please contact: 

    Peter Ruttan, Manager of Investigations, Professional Conduct
    pruttan@collegept.org or 
    (416) 591-3838 extension 226

    CLHIA Tip Line

    Suspect Health Care Fraud? 

    Report It!

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