O. Reg. 320/04: GENERAL

 

ontario regulation 320/04

made under the

health INSURANCE act

Made: October 7, 2004
Filed: October 8, 2004
Printed in The Ontario Gazette: October 23, 2004

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

(General)

1. (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:

3. Amendments dated November 1, 2004;

(2) Subsection 1 (1) of the Regulation is amended by adding the following definition:

“schedule of optometry benefits” means the document published by the Ministry of Health and Long-Term Care titled “Schedule of Benefits for Optometry Services” (November 1, 2004), but does not include the “[Commentary…]” portions of the document, or any appendix to the document;

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

(2) A reference to the schedule of benefits or the schedule of optometry benefits in relation to a service is a reference to the relevant schedule in force at the time the service was rendered.

2. Section 17 of the Regulation is revoked and the following substituted:

17. (1) A service rendered by an optometrist in Ontario is an insured service if it is referred to in the schedule of optometry benefits and is rendered in the circumstances or under the conditions referred to in the schedule of optometry benefits.

(2) The basic fee payable by the Plan for an insured service prescribed under subsection (1) is the fee payable under the schedule of optometry benefits. 

3. (1) Subsection 24 (1) of the Regulation is amended by striking out the portion before paragraph 1 and substituting the following:

(1) The following services rendered by physicians or practitioners are not insured services and are not part of insured services unless, in the case of services rendered by physicians, they are specifically listed as an insured service or as part of an insured service in the schedule of benefits or, in the case of services rendered by optometrists, they are specifically listed as an insured service or as part of an insured service in the schedule of optometry benefits:

. . . . .

(2) Subsection 24 (1) of the Regulation is amended by adding the following paragraph:

28. A service rendered to a person who is 20 or more years of age and less than 65 years of age that is rendered solely for the purpose of refraction.

(3) Paragraph 2 of subsection 24 (2) of the Regulation is amended by striking out “26 or 27” and substituting “26, 27 or 28”.

4. This Regulation comes into force on November 1, 2004.