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AR 87/2006 PODIATRIC BENEFITS REGULATION

(Consolidated up to 15/2016)

ALBERTA REGULATION 87/2006

Alberta Health Care Insurance Act

PODIATRIC BENEFITS REGULATION

Table of Contents

                1      Definitions

                2      Eligibility

                3      Benefits payable


                4      Included in amount of benefits

                5      Benefit limit

                6      Repeal

List of Podiatric Services

Definitions

1   In this Regulation,

                               (a)    “Act” means the Alberta Health Care Insurance Act;

                              (b)    “benefit period” means a period of 12 consecutive months beginning on July 1 of each year;

                               (c)    “podiatric services” means the services in the List of Podiatric Services in this Regulation;

                              (d)    “Schedule of Podiatric Benefits” means the Schedule of Podiatric Benefits prepared and published by the Department of Health and approved by the Minister.

AR 87/2006 s1;170/2012

Eligibility

2(1)  Benefits are payable in accordance with the regulations under the Act for podiatric services provided to a resident of Alberta by a podiatrist in Alberta or in the City of Lloydminster within the meaning of section 2 of the City of Lloydminster Act.

(2)  Notwithstanding subsection (1), benefits are not payable for podiatric services if a declaration under section 25 of the Health Insurance Premiums Act is in effect in respect of the person who receives the services.

AR 87/2006 s2;308/2006

Benefits payable

3(1)  The benefits payable for podiatric services and the descriptions of those services are set out in the Schedule of Podiatric Benefits.

(2)  Notwithstanding subsection (1), the benefits payable for podiatric services provided to a resident of Alberta by a podiatrist are limited to the lesser of

                               (a)    the amount claimed, and

                              (b)    the rates established in the Schedule of Podiatric Benefits.

Included in amount of benefits

4   The benefits payable for podiatric services provided to a resident of Alberta by a podiatrist include an amount for the following:

                               (a)    performing the podiatric services;

                              (b)    administration;

                               (c)    recording of information regarding the services provided unless the recording of the information is for the purposes of a third party;

                              (d)    completing and submitting claims;

                               (e)    discussion or correspondence with a referring health care professional regarding treatment or a service to be provided to a patient directly related to managing the patient’s care, unless otherwise provided in this Regulation or the Alberta Health Care Insurance Regulation.

Benefit limit

5   The benefits payable for each resident for podiatric services provided within each benefit period are limited to a maximum of $250.


Repeal

6    The Podiatric Benefits Regulation (AR 152/95) is repealed.

 

7   Repealed AR 15/2016 s4.

List of Podiatric Services   

                               (a)        diagnostic interview and evaluation or consultation;

                              (b)    other physical medicine - musculoskeletal manipulation;

                               (c)    other immobilization, pressure and attention to wound;

                              (d)    other injection or infusion of other therapeutic or prophylactic substances;

                               (e)    incision, division and excision of cranial and peripheral nerves;

                               (f)    injection into peripheral nerve;

                               (g)    other incision of bone without division;

                              (h)    other division of bone tarsals and metatarsals;

                               (i)    excision of bunion (bunionectomy);

                               (j)    local excision of lesion or tissue of bone;

                              (k)    removal of internal fixation device;

                               (l)    closed reduction of fracture (without internal fixation);

                             (m)    other arthrotomy;

                              (n)    incision of muscle, tendon, fascia and bursa;

                              (o)    invasive diagnostic procedures on muscle, tendon, fascia and bursa;

                              (p)    incision of skin and subcutaneous tissue;

                              (q)    excision of skin and subcutaneous tissue;

                               (r)    suture of skin and subcutaneous tissue;

                               (s)    other operations on skin and subcutaneous tissue;

                               (t)    ill-defined operations;

                              (u)    diagnostic radiology.

AR 87/2006 List;136/2006