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Compliance for providers and suppliers

The WSIB’s approach towards compliance is to educate, communicate, assist and, only as a last resort, use enforcement.

We want to ensure that all suppliers are:

  • billing for services and goods that were actually provided
  • billing for medically necessary services only
  • submitting accurate and up to date statements

If you suspect that anyone involved in a WSIB case (patient, employer, supplier or another health care practitioner) is not dealing honestly with us, you can use our toll-free action line at 1-888-SI-LEADS (1-888-745-3237), Monday to Friday, 7:30am to 5:00pm or email us at sileads@wsib.on.ca anytime to report your suspicions anonymously.

You are not required to provide your name and we do not capture email addresses and will take every reasonable effort to protect your personal identity.

Convictions under the Workplace Safety and Insurance Act or under the Criminal Code of Canada will bring hefty fines and possible jail time. The WSIB will notify the appropriate regulatory body and it could affect your licence to practice.

If you want to get involved in preventing fraud in our health care environment, the Canadian Health Care Anti-Fraud Association acts on behalf of public and private sector healthcare organizations.

What steps are taken to protect your identity?

We protect your privacy:

  • when reporting fraud or non-compliant behaviour you are not required to provide your name, address, or any other information that may identify you
  • under the Freedom of Information and Protection of Privacy Act and the Workplace Safety and Insurance Act any information you provide (other than information that identifies you) may be released to people including, but not limited to, the worker, the employer and their representatives
  • we do not capture your email address if you send us a message through sileads@wsib.on.ca . However, if you send us an email from your own email account, we will have your email address.
  • if you have concerns about Internet security you can always use our toll-free action line: 1-888-SI-LEADS (1-888-745-3237) between 7:30am and 5:00pm, Monday to Friday.

What constitutes an offence in dealing with WSIB?

It is an offence when a health care provider or supplier intentionally does any of the following:

  • Bills for services or goods that are not actually provided
  • Falsifies any aspect of billing submitted (for example, bills for more expensive service than the one actually provided)
  • Bills for services that are medically unnecessary

What is the penalty for submitting false or misleading statements?

Conviction can result in the following penalties:

  • For an individual:
    A fine not to exceed $25,000 and/or a jail term of up to six months
  • For a corporation:
    A fine not to exceed $100,000

    (Sec.158 (1) of the Act)

The court may also order restitution of the full amount of money obtained by commission of the offence (Sec.149 (5) of the Act).

What is the penalty for fraud under the Criminal Code?

Conviction can result in the following penalties:

  • Where the value of the fraud exceeds $5000:

    Conviction may result in imprisonment for a term of up to 10 years

  • Penalties may also include:

    Fines, probation, and/or a restitution order

Would a conviction under the Workplace Safety Insurance Act or the Criminal Code affect my licence to practice?

In cases where a health care practitioner is convicted, the WSIB notifies the appropriate regulatory body and provides a factual summary. The regulatory body will take whatever action it deems necessary.

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