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1、FrançaisHealthInsuranceActR.S.O.1990,CHAPTERH.6ConsolidationPeriod:FromMay30,2017tothee-Lawscurrencydate.Lastamendment:2017,c.11,Sched.3,s.11.LegislativeHistory:R.S.O.1990,c.H.6,s.18.0.5(2);1992,c.32,s.15;1993,c.10,s.53;1993,c.2,s.12;1993,c.32,s.2;1994,c.17,s.68-74
2、;1996,c.1,Sched.H,s.1-35;1996,c.21,s.51;1997,c.16,s.7;1998,c.18,Sched.G,s.54;1999,c.10,s.1,2;2000,c.26,Sched.H,s.1;2000,c.42,Sched.,s.17-19;2001,c.8,s.32,33;2002,c.18,Sched.I,s.8;2004,c.3,Sched.A,s.85;2004,c.5,s.36-43;2004,c.13,s.1;2006,c.19,Sched.C,s.1(1);2006,c.1
3、9,Sched.L,s.3,11;2006,c.21,Sched.F,s.136(1);2006,c.35,Sched.C,s.53;2007,c.8,s.209;2007,c.10,Sched.C;2007,c.10,Sched.G,s.1-34(Butsee2015,c.20,Sched.15,s.19);2007,c.10,Sched.P,s.16;2007,c.16,Sched.B;2009,c.26,s.11(Butsee2015,c.20,Sched.15,s.20);2009,c.33,Sched.6,s.61
4、;2009,c.33,Sched.18,s.11,17(2);2015,c.18,s.1;2015,c.20,Sched.15,s.1-14;CTS23OC07-1;CTS23OC07-2;2016,c.30,s.38;2017,c.11,Sched.3,s.11.CONTENTS1.DefinitionsAdministration2.AdministrationofPlanbyMinister3.Ontario-Canadaagreement4.GeneralManager4.1Collectionofpersonali
5、nformationJointCommittee5.JointCommitteeontheScheduleofBenefits5.1ReviewBoardestablished5.2Disclosure5.3Disqualification5.4PhysicianServicesPaymentCommitteeMedicalEligibilityCommittee7.MedicalEligibilityCommitteeReporttoAssembly9.ReporttoAssemblyOntarioHealthInsura
6、ncePlan10.OntarioHealthInsurancePlancontinued11.Righttoinsurance11.1Healthcard11.2Insuredservices12.Entitlementtoinsuredservices13.Choiceofphysicianorpractitioner14.Otherinsuranceprohibited15.Billing–physicians15.1Billing–practitioners15.2Transitional16.Billingnumb
7、ers16.1Directiontomakepaymentstoentity17.Accountsforinsuredservices17.1Feespayableforinsuredservices17.2Feespayable,healthfacilities18.Paymentofaccounts18.0.6Settlement18.0.7Transitional18.2Reviewofreferrals18.2.1Practitionersandhealthfacilities18.3Physicianpayment
8、reviewprocess19.Whenservicesnotmedicallynecessary4819.2Refusalofclaims,entitlement20.AppealtoAppealBoard21.PowersofAppealBoard22.Parties23.Eviden
