ontario regulation 404/10
made under the
Health Insurance act
Made: October 27, 2010
Filed: October 28, 2010
Published on e-Laws: October 29, 2010
Printed in The Ontario Gazette: November 13, 2010
Amending Reg. 552 of R.R.O. 1990
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:
15. Amendments dated October 1, 2010.
2. Subsections 37.1 (6) to (8) of the Regulation are revoked and the following substituted:
(6) If, under this Regulation or under an agreement to which the Government of Ontario is a party, the fee payable for a laboratory service set out in the schedule of laboratory benefits and rendered by a physician is nil, the fee payable for an insured service rendered in relation to the laboratory service by a physician in a public hospital is nil.
(7) Despite subsection (6), if a physician who practises laboratory medicine in a public hospital renders a diagnostic consultation in relation to a laboratory service set out in the schedule of laboratory benefits at the request of another physician, the fee payable for the diagnostic consultation is the fee set out in the schedule of benefits.
(8) For the purposes of subsection (7), a diagnostic consultation occurs when a physician in a public hospital gives a written opinion with respect to tissue, slides or specimens,
(a) that were prepared in a licensed laboratory that is not in the public hospital where the physician providing the diagnostic consultation practises;
(b) that were prepared for the purpose of providing an insured service; and
(c) that are referred to the physician providing the diagnostic consultation by the physician requesting the diagnostic consultation.
(9) In subsection (8),
“licensed laboratory” means a laboratory licensed under the Laboratory and Specimen Collection Centre Licensing Act.
3. This Regulation is deemed to have come into force on October 1, 2010.