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O. Reg. 8/08: GENERAL

filed January 24, 2008 under Health Insurance Act, R.S.O. 1990, c. H.6

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ontario regulation 8/08

made under the

Health insurance act

Made: January 22, 2008
Filed: January 24, 2008
Published on e-Laws: January 25, 2008
Printed in The Ontario Gazette: February 9, 2008

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


1. Paragraph 9 of the definition of “schedule of benefits” in subsection 1 (1) of Regulation 552 of the Revised Regulations of Ontario, 1990 is revoked and the following substituted:

9. Amendments dated November 19, 2007 (effective as of February 1, 2008).

2. Section 37.1 of the Regulation is amended by adding the following subsections:

(2.9) Despite anything in this Regulation, and despite anything in this Regulation as it existed at any time after September 19, 1999, but subject to subsection (2.10), the insured service described as gastric bypass or partition for morbid obesity (fee schedule code S120 in the schedule of benefits) does not include, and shall be deemed never to have included, the service described as adjustable gastric banding by laparoscopic or open surgical method.

(2.10) Subsection (2.9) does not affect the authority of the Appeal Board to direct the General Manager to make a payment for laparoscopic gastric banding in the same amount and subject to the same conditions as a payment could have been made for gastric bypass or partition for morbid obesity (fee schedule code S120) in response to a claim for payment for adjustable gastric banding by laparoscopic or open surgical method made in an appeal to the Appeal Board, if notice of the appeal was served on the General Manager before November 19, 2007.

3. (1) Subject to subsection (2), this Regulation comes into force on the day it is filed.

(2) Section 1 comes into force on February 1, 2008.