 |
 |
 |
 |
 |
 |
 |
 |
 |
Help Suzanne Aucoin
Jan. 31, 2007 - OHIP News Release
Ontario Government to Review Out-of-Country Health Coverage Program
News Release Printable Version [PDF]
January 30, 2007
TORONTO – Elements of the Ontario Health Insurance Plan’s out-of-country health
coverage program will be reviewed based on advice received from Ombudsman André
Marin, Health and Long-Term Care Minister George Smitherman announced today.
“Our government is committed to continue building a public health care system that is
responsive to the needs of Ontarians,” Smitherman said. “We appreciate the advice of
the Ombudsman as it will assist us in our goal of making the out-of-country health
coverage program work better for Ontario patients.”
The government will take immediate steps to provide physicians with better access to
information about the province’s out-of-country health coverage program.
For Ontario residents traveling outside of Canada, OHIP covers only emergency health
services. Out-of-country elective medical services that are readily available in Ontario
are not covered by OHIP.
Patients can receive prior approval from OHIP for out-of-country medical services, if it
is determined the services are :
* Not experimental and generally accepted in Ontario as appropriate for any person in
the same medical circumstances as the patient
* Not performed in Ontario or performed in Ontario but necessary that the patient
travel outside of Canada to avoid delay that would result in death or medically
significant irreversible tissue damage.
Other elements of the review will be implemented in the spring, and will deal with
additional issues raised by the Ombudsman including the need to provide greater
information about funding for particular treatments, to ensure that decisions about
funding for out of country treatment are consistent and based on evidence and to
improve the quality of reasons provided when requests are denied.
The Ombudsman’s advice stemmed from the case of Ms. Suzanne Aucoin, who was
originally denied funding for out of country chemotherapy with the drug Erbitux.
Following the Ombudsman’s investigation, the Ministry has agreed to reimburse Ms.
Aucoin for her costs.
In communicating the decision to Ms. Aucoin, the Deputy Minister on behalf of the
Ministry of Health and Long-Term Care, apologized for the difficulties Ms. Aucoin
experienced in resolving this issue.
For further information :
Members of the media :
David Spencer, 416-327-4320
Minister's Office
A.G. Klei , 416-314-6197
Ministry of Health and Long-Term Care
Members of the general public :
1-866-532-3161
Ontario Government to Review Out-of-Country Health Coverage Program
News Release Printable Version [PDF]
January 30, 2007
TORONTO – Elements of the Ontario Health Insurance Plan’s out-of-country health
coverage program will be reviewed based on advice received from Ombudsman André
Marin, Health and Long-Term Care Minister George Smitherman announced today.
“Our government is committed to continue building a public health care system that is
responsive to the needs of Ontarians,” Smitherman said. “We appreciate the advice of
the Ombudsman as it will assist us in our goal of making the out-of-country health
coverage program work better for Ontario patients.”
The government will take immediate steps to provide physicians with better access to
information about the province’s out-of-country health coverage program.
For Ontario residents traveling outside of Canada, OHIP covers only emergency health
services. Out-of-country elective medical services that are readily available in Ontario
are not covered by OHIP.
Patients can receive prior approval from OHIP for out-of-country medical services, if it
is determined the services are :
* Not experimental and generally accepted in Ontario as appropriate for any person in
the same medical circumstances as the patient
* Not performed in Ontario or performed in Ontario but necessary that the patient
travel outside of Canada to avoid delay that would result in death or medically
significant irreversible tissue damage.
Other elements of the review will be implemented in the spring, and will deal with
additional issues raised by the Ombudsman including the need to provide greater
information about funding for particular treatments, to ensure that decisions about
funding for out of country treatment are consistent and based on evidence and to
improve the quality of reasons provided when requests are denied.
The Ombudsman’s advice stemmed from the case of Ms. Suzanne Aucoin, who was
originally denied funding for out of country chemotherapy with the drug Erbitux.
Following the Ombudsman’s investigation, the Ministry has agreed to reimburse Ms.
Aucoin for her costs.
In communicating the decision to Ms. Aucoin, the Deputy Minister on behalf of the
Ministry of Health and Long-Term Care, apologized for the difficulties Ms. Aucoin
experienced in resolving this issue.
For further information :
Members of the media :
David Spencer, 416-327-4320
Minister's Office
A.G. Klei , 416-314-6197
Ministry of Health and Long-Term Care
Members of the general public :
1-866-532-3161