Bulletin

In the Schedule of Benefits, Physicians Services, Section B-10 of the Preamble deals with procedures that may be performed in the office on behalf of the physicians by a person in his/her employ while under the physician’s direct supervision and claimed as an insured benefit of OHIP.

The Plan interprets the wording to mean:

1. The procedures are performed in an office owned or leased by the physician.  As a general rule, the procedures will be carried out in the office wherein the physician provides all medical services within the scope of his/her specialty.  Any exceptions to this rule will be subject to the written approval of the Plan.
   

2. The person is an employee as evidenced by payments made to the employee and usual deductions for tax, Canada Pension, and Unemployment Insurance, as dictated by Revenue Canada, are being made.  According to Revenue Canada, “Every Employer is required by law to deduct Canada Pension Plan Contributions and Unemployment Insurance Premiums from the pensionable and insurable wages, salaries, and other remuneration, including any taxable benefit they pay or provide their employees as the case may be.  They must remit their amounts to Revenue Canada, Taxation, along with their employer contribution and premiums on behalf of their employees.”

 For clarification, Section B-10 is restated with salient points underlined :

"...when procedure(s) are carried out by a physician’s employee(s) under the direct supervision of the physician in his/her office, the usual claims may be made for procedure(s) which are generally and historically accepted as those which may be carried out by the nurse or other medical assistant in the employ of the physician. "