O. Reg. 371/00: GENERAL

 

ONTARIO REGULATION 371/00

made under the

Health Insurance Act

Made: June 21, 2000
Filed: June 23, 2000

Amending Reg. 552 of R.R.O. 1990

(General)

Note: Since the end of 1998, Regulation 552 has been amended by Ontario Regulations 58/99, 59/99, 60/99, 85/99, 108/99, 177/99, 178/99, 201/99, 232/99, 271/99, 334/99, 368/99, 482/99, 483/99, 490/99, 67/00, 149/00, 150/00, 253/00, 300/00, 322/00, 368/00, 369/00 and 370/00.  Previous amendments are listed in the Table of Regulations in the Statutes of Ontario, 1998.

1. (1) Subsection 37.5 (1) of Regulation 552 of the Revised Regulations of Ontario, 1990 is revoked and the following substituted:

(1) The fee payable for an insured service rendered by a physician who is a general practitioner during a fiscal year referred to in Column 1 of Table 1 to this section shall be decreased in accordance with subsection (2) if the total amount payable for insured services rendered by the physician between the beginning of the fiscal year and the day the service is rendered exceeds the threshold amount set out opposite the fiscal year in Column 2 of Table 1 to this section.

(1.1) The fee payable for an insured service rendered by a physician who is a specialist during a fiscal year referred to in Column 1 of Table 2 to this section shall be decreased in accordance with subsection (2) if the total amount payable for insured services rendered by the physician between the beginning of the fiscal year and the day the service is rendered exceeds the threshold amount set out opposite the fiscal year in Column 2 of Table 2 to this section.

(2) Paragraphs 1, 2 and 3 of subsection 37.5 (2) of the Regulation are revoked and the following substituted:

1. In the case of an insured service rendered during a fiscal year referred to in Column 1 of Table 1 or Table 2 to this section, as the case may be, if the total amount payable for insured services rendered by the physician between the beginning of the fiscal year and the day the insured service is rendered is equal or exceeds the threshold amount set out opposite the fiscal year in Column 2 of the Table but is less than the threshold amount set out opposite the fiscal year in Column 3 of the Table, the fee payable for the insured service is two–thirds of the basic fee otherwise payable.

2. In the case of an insured service rendered during a fiscal year referred to in Column 1 of Table 1 or Table 2 to this section, as the case may be, if the total amount payable for insured services rendered by the physician between the beginning of the fiscal year and the day the insured service is rendered is equal or exceeds the threshold amount set out opposite the fiscal year in Column 3 of the Table but is less than the threshold amount set out opposite the fiscal year in Column 4 of the Table, the fee payable for the insured service is one–third of the basic fee otherwise payable.

3. In the case of an insured service rendered during a fiscal year referred to in Column 1 of Table 1 or Table 2 to this section, as the case may be, if the total amount payable for insured services rendered by the physician between the beginning of the fiscal year and the day the insured service is rendered is equal or exceeds the threshold amount set out opposite the fiscal year in Column 4 of the Table, the fee payable for the insured service is one–quarter of the basic fee otherwise payable.

(3) Subsection 37.5 (3) of the Regulation is amended by adding the following paragraph:

3. A non–elective service that is rendered by a physician in a hospital on or after April 1, 2000 during the following hours:

i. Between 6:00 o’clock in the evening of any Monday, Tuesday, Wednesday or Thursday and 7:00 o’clock in the morning the next day.

ii. Between 6:00 o’clock on any Friday evening and 7:00 o’clock on the following Monday morning.

iii. Between 7:00 o’clock in the morning and 6:00 o’clock in the evening of any day that is a holiday.

(4) Subsection 37.5 (4) of the Regulation is amended by striking out “Despite subsection (1)” at the beginning and substituting “Despite subsections (1) and (1.1)”.

(5) Subsection 37.5 (4.1) of the Regulation is amended by striking out “Despite subsections (1) and (2)” at the beginning and substituting “Despite subsection (1), (1.1) and (2)”.

(6) Subsection 37.5 (5) of the Regulation is amended by adding the following definition:

“holiday” means New Years Day, Good Friday, Victoria Day, Canada Day, the first Monday of August, Labour Day, Thanksgiving Day, Christmas Day and December 26.

(7) The Table to section 37.5 of the Regulation is revoked and the following substituted:

TABLE 1

THRESHOLD AMOUNTS FOR GENERAL PRACTITIONERS

Column 1	Column 2	Column 3	Column 4
Fiscal year	Total amount payable	Total amount payable	Total amount payable
For the fiscal years beginning April 1, 1996, April 1, 1997 and April 1, 1998	$300,000	$325,000	$350,000
For the fiscal year beginning April 1, 1999	320,000	345,000	370,000
For the fiscal year beginning April 1, 2000 and any subsequent fiscal year	330,000	355,000	380,000

TABLE 2

THRESHOLD AMOUNTS FOR SPECIALISTS

Column 1	Column 2	Column 3	Column 4
Fiscal year	Total amount payable	Total amount payable	Total amount payable
For the fiscal years beginning April 1, 1996, April 1, 1997 and April 1, 1998	$380,000	$405,000	$430,000
For the fiscal year beginning April 1, 1999	400,000	425,000	450,000
For the fiscal year beginning April 1, 2000 and any subsequent fiscal year	410,000	435,000	460,000