Regulation - LGIC
Amendments to Regulation 552 under the Health Insurance Act and Corresponding Changes to the Schedule of Benefits- Physician Services and Schedule of Benefits - Dental Services.
Regulation Number(s):
552
Instrument Type:
Regulation - LGIC
Bill or Act:
Health Insurance Act
Summary of Decision:
Changes were made related to payment for physician services in order to promote higher quality patient care which aligns with the current medical evidence and professional guidelines. Other changes were made to ensure that public funding for the provision of health care services is linked to appropriate standards of care as well as appropriate payment for services where technology has improved efficiency and increased productivity.
The changes being made to the OOC/OOP program aim to increase service capacity in the province and align OHIP-funded health services outside Ontario with OHIP-funded services inside the province.
Changes were made to the Schedule of Benefits-Dental Services as a result of the approval for the creation of an Oral and Maxillofacial Reconstruction Program.
The changes being made to the OOC/OOP program aim to increase service capacity in the province and align OHIP-funded health services outside Ontario with OHIP-funded services inside the province.
Changes were made to the Schedule of Benefits-Dental Services as a result of the approval for the creation of an Oral and Maxillofacial Reconstruction Program.
Further Information:
Health Insurance Act
Proposal Number:
13-HLTC012
Posting Date:
Summary of Proposal:
OHIP covers payments for prescribed medically necessary physician and hospital services and certain practitioner services, including specified dental services that are required to be performed in a hospital. The HIA and Regulation 552 set out the legislative and regulatory framework for all insured OHIP provider services, both those provided in-province and OOC/OOP.
The Schedule of Benefits- Physician Services and the Schedule of Benefits- Dental Services under Regulation 552 list the physician and dental services, respectively that are insured under OHIP. In order to make changes to the funding of these services, regulatory amendments are required.
A number of changes were made related to payment for physician services in order to promote higher quality patient care which aligns with the current medical evidence and professional guidelines. Other changes were made to ensure that public funding for the provision of health care services is linked to appropriate standards of care as well as appropriate payment for services where technology has improved efficiency and increased productivity.
The changes being made to the OOC/OOP program aim to increase service capacity in the province and align OHIP-funded health services outside Ontario with OHIP-funded services inside the province.
As a result of the approval for the creation of an Oral and Maxillofacial Reconstruction Program, the ministry made complementary changes to the Schedule of Benefits - Dental Services.
The Schedule of Benefits- Physician Services and the Schedule of Benefits- Dental Services under Regulation 552 list the physician and dental services, respectively that are insured under OHIP. In order to make changes to the funding of these services, regulatory amendments are required.
A number of changes were made related to payment for physician services in order to promote higher quality patient care which aligns with the current medical evidence and professional guidelines. Other changes were made to ensure that public funding for the provision of health care services is linked to appropriate standards of care as well as appropriate payment for services where technology has improved efficiency and increased productivity.
The changes being made to the OOC/OOP program aim to increase service capacity in the province and align OHIP-funded health services outside Ontario with OHIP-funded services inside the province.
As a result of the approval for the creation of an Oral and Maxillofacial Reconstruction Program, the ministry made complementary changes to the Schedule of Benefits - Dental Services.
Contact Address:
Jody Hill
Health Services Branch
Negotiations and Accountability Management Division
370 Select Drive, Kingston ON K7M 8T4
Health Services Branch
Negotiations and Accountability Management Division
370 Select Drive, Kingston ON K7M 8T4
Effective Date:
October 1, 2012
Decision:
Approved