Comptrollership and Compliance Unit

Comptrollership and Compliance Unit Mandate

The Comptrollership & Compliance Unit (CCU) is a unit within the Office of the Provincial Comptroller.

• The CCU provides independent and objective assurance to strengthen internal control and oversight of expenditures to medical practitioners, including physicians, oral surgeons, chiropractors and optometrists in accordance with The Health Services Insurance Act (HSIA) delegated by the Minister of Health to OPC.
• Delivers comptrollership oversight by conducting independent, risk-based compliance audits of Fee-For-Service expenditures made under the provincial health insurance plan.
• Communicates audit findings to medical practitioners and provides information regarding billing requirements in the interest of reducing health insurance claims submission inaccuracies.

Legislation

C.C.S.M. c. H35 (gov.mb.ca)

Claims' Information Regulation, M.R. 87/94 (gov.mb.ca)

Payments for Insured Medical Services Regulation, M.R. 73/2003 (gov.mb.ca)

The Personal Health Information Act (PHIA)

Referrals, Complaints and General Inquiries

Please contact our office if you have any information regarding:

• inappropriate medical practitioner claims,
• billing practices, or
• potentially fraudulent activity,
• or for general inquiries related to the audit process at CCU@gov.mb.ca (or call 204-945-6829).

Principles and Purpose of the Audits

Independent, risk-based audits strengthen compliance with the HSIA and medical practitioner fee schedules through deterrence of inappropriate Fee-For-Service expenditures and identification of recoveries where appropriate, in the interest of fiscal accountability, and ensuring value for money with respect to provincial expenditures.

College of Physicians and Surgeons

CPSM Website

Guidelines for Records of User Activity