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O. Reg. 676/00: GENERAL

filed December 20, 2000 under Health Insurance Act, R.S.O. 1990, c. H.6

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ONTARIO regulation 676/00

made under the

health insurance act

Made: December 13, 2000
Filed: December 20, 2000

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


1. Subsection 22 (10) of Regulation 552 of the Revised Regulations of Ontario, 1990 is revoked and the following substituted:

(10) Payment for an insured service provided by a medical laboratory is subject to the following conditions:

1. The medical laboratory shall not accept payment for the service from any other person.

2. The medical laboratory must be a party to a written verification agreement with the General Manager at the time the service was rendered.

(11) In subsection (10),

“verification agreement” means an agreement between a medical laboratory and the General Manager in which the medical laboratory authorizes the General Manager or a person designated by the General Manager to examine records in the medical laboratory’s possession, on such terms as the parties may agree to, in order to verify that,

(a) all insured services for which accounts were submitted to the Plan were in fact performed by the medical laboratory,

(b) all insured services performed by the medical laboratory were authorized by a physician, midwife or registered nurse in the extended class, and

(c) the Plan has not paid more for an insured service performed by the medical laboratory than the amount payable for the service under the Plan.

2. This Regulation comes into force on March 1, 2001.