O. Reg. 253/00: GENERAL

 

ONTARIO REGULATION 253/00

made under the

Health Insurance Act

Made: March 21, 2000
Filed: May 1, 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 and 150/00.  Previous amendments are listed in the Table of Regulations in the Statutes of Ontario, 1998.

1. (1) Item 2 of the Table to subsection 8 (2) of Regulation 552 of the Revised Regulations of Ontario, 1990 is amended by striking out paragraph 1 in Column 2 and substituting the following:

1. The medication must be prescribed by a physician on the medical staff of a hospital listed in Group O in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act or Group O in the list of hospitals maintained by the Minister under subsection 32.1 (2) of that Act.

(2) Item 4 of the Table to subsection 8 (2) of the Regulation is amended by striking out paragraph 1 in Column 2 and substituting the following:

1. The medication must be prescribed by a physician on the medical staff of a hospital listed in Group S in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act or Group S in the list of hospitals maintained by the Minister under subsection 32.1 (2) of that Act.

(3) Item 5 of the Table to subsection 8 (2) of the Regulation is amended by striking out paragraph 1 in Column 2 and substituting the following:

1. The medication must be prescribed by a physician on the medical staff of a hospital listed in Group T in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act or Group T in the list of hospitals maintained by the Minister under subsection 32.1 (2) of that Act.

(4) Item 6 of the Table to subsection 8 (2) of the Regulation is amended by striking out paragraph 1 in Column 2 and substituting the following:

1. The medication must be prescribed by a physician on the medical staff of a hospital listed in Group U in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act or Group U in the list of hospitals maintained by the Minister under subsection 32.1 (2) of that Act.

2. (1) Subsection 9 (1) of the Regulation is revoked and the following substituted:

(1) Subject to section 10 and subsection 11 (1), an insured person is entitled to in–patient services and out–patient services in the following hospitals, without paying any charge to the hospital for such services:

1. A hospital listed in Schedule 2.

2. A hospital listed in Group A, B, C, E, F, G or J in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act.

3. A hospital listed in Group A, B, C, E, F, G or J in the list of hospitals maintained by the Minister under subsection 32.1 (2) of the Public Hospitals Act.

(2) Subsection 9 (6) of the Regulation is revoked and the following substituted:

(6) Subject to subsection 11 (1), an insured person is entitled to receive computerized axial tomography scanning services in a hospital listed in Group M in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act or a hospital listed in Group M in the list of hospitals maintained by the Minister under subsection 32.1 (2) of that Act, without paying any charge to the hospital for such services.

(3) Subsection 9 (7) of the Regulation is revoked.

(4) Subsection 9 (8) of the Regulation is revoked and the following substituted:

(8) It is a condition of payment by the Plan to a hospital for the performance of a computerized axial tomography scan that the scan be performed by and on the premises of a hospital listed in Group M in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act or a hospital listed in Group M in the list of hospitals maintained by the Minister under subsection 32.1 (2) of that Act.

3. Subsection 10 (2) of the Regulation is revoked and the following substituted:

(2) This section applies only with respect to an insured person receiving,

(a) insured in–patient services provided in a hospital listed in Part II of Schedule 1, Part II of Schedule 2 or Part II of Schedule 4 or a hospital listed in Group F or G in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act or Group F or G in the list of hospitals maintained by the Minister under subsection 32.1 (2) of that Act; or

(b) insured in–patient services provided in a hospital listed in Group A, B or C in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act or Group A, B or C in the list of hospitals maintained by the Minister under subsection 32.1 (2) of that Act, if the insured person is awaiting placement in a hospital referred to in clause (a) or another institution.

4. Subsection 15 (1) of the Regulation is revoked and the following substituted:

(1) Ambulance services are insured services if,

(a) they are provided by an ambulance service operator listed in Schedule 7 or by an ambulance service operated by the Province of Ontario;

(b) the hospital to or from which the services are required is listed in Schedule 1 or 4 or in Group A, B, C, E, F, G or J in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act or Group A, B, C, E, F, G or J in the list of hospitals maintained by the Minister under subsection 32.1 (2) of that Act; and

(c) the insured person pays a co–payment of $45 to that hospital.

5. (1) Subsection 35 (1) of the Regulation is revoked and the following substituted:

(1) The following hospitals are designated for the purpose of the Plan:

1. The hospitals listed in Schedule 2.

2. The hospitals listed in Group A, B, C, E, F, G or J in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act.

3. The hospitals listed in Group A, B, C, E, F, G or J in the list of hospitals maintained by the Minister under subsection 32.1 (2) of the Public Hospitals Act.

(2) Subsection 35 (3) of the Regulation is revoked and the following substituted:

(3) Each hospital listed in Group M in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act or Group M in the list of hospitals maintained by the Minister under subsection 32.1 (2) of that Act is designated for the purpose of performing computerized axial tomography scans.

(3) Subsections 35 (4), (5), (6) and (7) of the Regulation are revoked.

(4) Subsection 35 (8) of the Regulation is revoked and the following substituted:

(8) If a hospital pays for a computerized axial tomography scan performed on a scanner that is not installed and operated on the premises of a hospital listed in Group M in the Schedule to Regulation 964 of the Revised Regulations of Ontario, 1990 (Classification of Hospitals) made under the Public Hospitals Act or a hospital listed in Group M in the list of hospitals maintained by the Minister under subsection 32.1 (2) of that Act, no claim to recover the cost of the scan is an allowable expense that may be made against the Plan.

6. Schedules 9 and 10 to the Regulation are revoked.

7. This Regulation shall be deemed to have come into force on August 1, 1999.