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Appendix 1

DEFINITIONS "appropriate specialist" means a medical practitioner actively involved in the beneficiary's care with expert knowledge in the proposed service and/or specialty that will deliver the out of country service;

"BC rate" means insured emergency medical services, provided by an out of country physician, will be paid up to the payment rates listed in the Medical Services Commission Payment Schedule. “BC rate” for in-patient hospital services is the standard ward rate, established for in-patient care in BC

"Emergency rate" means insured emergency in-patient hospital services, in an accredited out of country hospital, will be paid up to $75 per day in accordance with the Hospital Insurance Act and Regulations, Section 6 (2) (b)

"experimental and developmental treatment" means treatment that has not been the subject of reputable Phase III clinical trials with the trial findings published in peer reviewed medical literature;

"facility" means a hospital or part of a hospital, the prime function of which is to provide medically necessary services and/or treatment to patients. A facility must be duly registered as a medical hospital, by the appropriate accreditation body, in the jurisdiction where the facility is located;

“health authority” means the Provincial Health Services Authority (PHSA) or one of the five health authorities that provide access to a coordinated network of health care services, in BC;

health care practitioner” means a person who is entitled to practice under an enactment:

  • a)

    a chiropractor,

  • b)

    a dentist,

  • c)

    an optometrist,

  • d)

    a podiatrist,

  • e)

    a midwife,

  • f)

    a nurse practitioner,

  • g)

    a physical therapist,

  • h)

    a massage therapist,

  • i)

    a naturopathic practitioner, or

  • j)

    an acupuncturist;

medical practitioner” means a person who is entitled to practice under the Medical Practitioners Act;

practitioner” means a medical practitioner, as defined above, or a health care practitioner who is registered with the Medical Services Plan;

"payment schedule" means a payment schedule established under section 26 of the Medicare Protection Act;

"proven value" means a treatment that has been the subject of a reputable Phase III clinical trial with the results of the trial published in peer reviewed medical literature;

"reciprocal agreement" means an agreement between BC and another Canadian province or territory to pay for insured services provided in a province or territory to a resident of another province or territory when that resident presents with a valid Provincial Health Registration Card;

"supplementary benefits" means services provided by a chiropractor, podiatrist, physical therapist, naturopath, optometrist, massage therapist, acupuncturist or osteopath;


Medical Services Commission Out of Country Funding Guidelines January 19, 2011


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