Non-University Medical Research time not paid by Ontario Government

The OHIP Schedule of Benefits states the following on page GP 14; please refer to part D of ‘Constituent and common elements of insured services http://www.health.gov.on.ca/english/providers/program/ohip/sob/physserv/genpre.pdf) which is also reproduced below for your convenience:

COMMON ELEMENTS OF INSURED SERVICES

All insured services include the skill, time, and responsibility involved in performing, including when delegated to a non-physician in accordance with the Delegated Procedures Section (GP50) of the General Preamble, supervising the performance of the constituent elements of the service.

Unless otherwise specifically listed in the Schedule, the following elements are common to all insured services.

D. Obtaining and reviewing information (including history taking) from any appropriate source(s) so as to arrive at any decision(s) made in order to perform the elements of the service.

Appropriate sources include but are not limited to:

1. patient and patient’s representative

2. patient charts and records

3. investigational data

4. physicians, pharmacists, and other health professionals

5. suppliers and manufacturers of drugs and devices

6. relevant literature and research data.

Additional elements of research carried out by you for the patient is considered sources of information that are used to arrive at decisions pertaining to the patient’s health. 

As stated above, this is not a service that is billable to either OHIP or the patient, but is part of the initial assessment that was carried out.

The above research provided by courtesy of the OMA economics department