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Massage Today
December, 2003, Vol. 03, Issue 12

Reimbursement Fees to Ontario Massage Therapists Slashed

By Editorial Staff

Editor's note: The following article was excerpted from "New Regulations Cut Reimbursement Fees to Ontario Chiropractors," which appeared in Nov. 3 issue of Dynamic Chiropractic (

The Ontario government recently introduced a series of measures designed to reform the province's auto insurance system.

Included in the reforms are new fee schedules that drastically reduce the maximum amount insurers are required to pay health care providers, including massage therapists, for their services.

Effective Nov. 1, massage therapists, occupational therapists, registered nurses, physiotherapists, podiatrists and other providers will see fee reductions ranging from 30 percent to 50 percent - in some cases, as low as $49 - and chiropractors' hourly fees will be reduced to a maximum of $95 an hour for services rendered to patients injured in automobile accidents.1

The reforms were drafted in response to the province's escalating insurance premiums. According to Statistics Canada, a census and survey information provider, auto insurance rates in Ontario jumped an average of 27.7 percent from April 2002 to April 2003.4

While the insurance industry has blamed the rate increases on a sputtering economy and the aftereffects of the Sept. 11, 2001 terrorist attacks, figures from the Insurance Bureau of Canada show that private property and casualty insurers made $1.1 billion in the first half of 2003, nearly four times the amount made over the same time span the previous year.

According to the Toronto Star, provincial officials estimate the new fee limits will save insurance companies approximately $400 million per year. In an interview with the Star, George Cooke, a past chairman of the Insurance Bureau of Canada, said the fee cuts and other changes would trickle down from the insurance industry and translate to substantial savings to drivers, who would see a reduction in their insurance premiums.5

Some health care providers in the province, however, are worried the cuts are so severe that they may force practitioners to stop serving auto accident victims.

"It is sure hard to follow the logic of their numbers," said Jeff Lear, an official with the Ontario Association of Speech Language Pathologists and Audiologists. Speech language pathologists will see a 30 percent fee reduction under the new regulations.5

Members of the Ontario chiropractic profession have also questioned the reforms, and are concerned about the effect they will have on access to care. "Coming two days after the insurance industry announced profits of over $1 billion in the first half of the year, the announcement is hard to understand," said Dennis Mizel, DC, president of the Ontario Chiropractic Association. "Like all health professionals, I'm worried that the impact of this change will be that people injured in auto accidents have to wait longer to receive the care they need, and in turn, this well mean they're off work longer, and they're more likely to develop chronic injuries. The government should rethink this drastic announcement, in light of the effect it will have on access to care."2

"We would have preferred to see more modest cuts in professional fees and then see what happens in six months," added Carlan Stants, DC, chair of the Coalition of Regulated Health Professional Associations and Allied Organizations. The coalition was formed in October 2001 to represent the interests of the professional health care community on issues related to automobile insurance. Dr. Stants said that while some elements of the bill (such as the preapproved framework for whiplash treatments and an existing ban on payment of cash settlements within a year of an injury claim) will produce substantial savings for insurers, the new fee limits could cause an undue burden on some health care providers. "It is almost like it is too much all at once," he said.3


  1. Ontario Gazette, Sept. 27, 2003.
  2. Telephone interview with Dr. Robert Haig, Ontario Chiropractic Association, Oct. 1, 2003.
  3. Daw J. Health professionals face steep cuts. Toronto Star, Sept. 18, 2003.
  4. Thompson J. Insurance: rising rates and risks. CBC News Online, June 25, 2003.
  5. Daw J. Fee cuts to hurt services, therapists say. Toronto Star, Sept. 19, 2003.


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