Relief Ahead for Claimants, Attendant Care Providers and Case Managers

Attendant Care

In April FSCO will release a bulletin clarifying insurer obligation to pay the total monthly benefit calculated on the Form 1 for Attendant Care, and that the Levels are merely an aid to calculation. Further, they are making a revision to the Attendant Care Rate Guideline, removing the language that says that insurers are not liable to pay for expenses related to attendant care costs rendered to an insured person that exceed the maximum hourly rates.  The Guideline change makes the Bulletin enforceable, so that claimants and provider will be better able get these disputes resolved or make complaints to Market Conduct.   In sum, we will have a FSCO-supported return to pre-LAT decision status quo.

Case Management

The April bulletin will also provide clarification to insurers intended reinforce the payment of Regulated Providers in accordance with the rate assigned to their discipline in the PSG for Case Management services. As above, this is an intended return to the pre-LAT decision.

With luck this Bulletin will see the light of day before mid-April.