O. Reg. 318/06: GENERAL

 

ontario regulation 318/06

made under the

health insurance act

Made: June 14, 2006
Filed: June 16, 2006
Published on e-Laws: June 19, 2006
Printed in The Ontario Gazette: July 1, 2006

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

(General)

1. The definition of “schedule of benefits” in subsection 1 (1) of Regulation 552 of the Revised Regulations of Ontario, 1990 is amended by adding the following paragraph:

2. Amendments dated July 1, 2006;

2. (1) Section 37.1 of the Regulation is amended by adding the following subsection:

(2.4) Despite subsection (2), the amount payable for those services rendered to an insured person on or after April 1, 2004 and no later than March 31, 2006 that are set out in the section of the General Preamble of the schedule of benefits entitled “Emergency Department Sessional Fees” is increased by 2.5 per cent.

(2) Section 37.1 of the Regulation is amended by adding the following subsection:

(2.5) Despite subsection (2), the amount payable for the following services rendered on or after October 1, 2005, as those services are defined in the schedule of benefits as it read on April 1, 2006, is the fee payable under that version of the schedule of benefits:

1. Subsequent visit by the most responsible physician - second day following the hospital admission assessment (C123).

2. Subsequent visit by the most responsible physician - day following the hospital admission assessment (C122).

(3) Section 37.1 of the Regulation is amended by adding the following subsections:

(2.6) Despite subsection (2), the amount payable for the following services rendered on or after July 1, 2006 to an insured person who falls into the age group described in Column 2 of the following Table is increased by the percentage specified in Column 3 opposite the age group:

1. A consultation, limited consultation or repeat consultation rendered by a specialist, as those services are defined in the schedule of benefits.

2. A surgical procedure listed in Parts K to Z inclusive of the schedule of benefits.

3. Basic and time unit surgical assistant services listed in Parts K to Z inclusive of the schedule of benefits.

TABLE

 

Column 1	Column 2	Column 3
Item	Age Group	Percentage Increase
1.	Less than 30 days of age	30%
2.	At least 30 days but less than one year of age	25%
3.	At least one year but less than two years of age	20%
4.	At least two years but less than five years of age	15%
5.	At least five years but less than 16 years of age	10%

(2.7) Despite subsection (2), the amount payable for the following services rendered on or after July 1, 2006 to an insured person who is at least 70 years of age, as those services are defined in the schedule of benefits, is increased by 15 per cent:

1. A general assessment (A003, A903, C003, W102, W109 or W903).

2. An intermediate assessment (A007).

3. Subsection 38.0.0.1 (6) of the Regulation is revoked.

4. (1) Subject to subsections (2) to (5), this Regulation comes into force on the day it is filed.

(2) Subsection 2 (1) is deemed to have come into force on April 1, 2004.

(3) Subsection 2 (2) is deemed to have come into force on October 1, 2005.

(4) Section 3 is deemed to have come into force on January 1, 2006.

(5) Section 1 and subsection 2 (3) come into force on July 1, 2006.