The applicant disputed entitlement to, inter alia, ACBs in the amount of $2,250.00 for invoices during the period of February 1 to 28, 2022. The respondent noted that it had requested written confirmation as to the fee breakdown, as the submitted hourly rates were well beyond the allowable hourly rate under the Guideline. The applicant had filed an invoice from the AC provider, New Age, which noted an hourly rate of $45.00. The respondent noted that it had filed an Explanation of Benefits confirming that the payment for ACBs for the disputed period of February 1 to 28, 2022 had been paid at the maximum hourly rate of $14.90 per hour in accordance with the Guideline. The Explanation of Benefits had also confirmed that payment in the amount of $750.00 total for the disputed invoice had been provided. While there was also an issue whether New Age had actually received the payment, no substantial evidence was submitted on the issue by either party and it was not addressed. Adjudicator Rosenthall agreed with the respondent that the FSCO Guideline No. 01/18 (“Guideline”) establishes the maximum hourly rates used to calculate the maximum monthly ACBs, in accordance with s. 19(2)(a) of the Schedule. Furthermore, the applicant made no submissions to justify paying over the Guideline rate, other than referring to the respondent as “arguing for an hourly rate below minimum wage”. As such, Adjudicator Rosenthall agreed that the respondent’s decision to pay AC rates pursuant to the Guideline was in keeping with Malitskiy v. Unica Insurance Inc., and concluded that the calculation of $750.00 by the respondent was correct. The remaining issues were dismissed.
