A-29, r. 2 - Regulation respecting hearing devices and insured services

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Full text
chapter A-29, r. 2
Regulation respecting hearing devices and insured services
HEALTH INSURANCE — HEARING DEVICES
Health Insurance Act
(chapter A-29, s. 69)
A-29
September 1 2012
O.C. 869-93; O.C. 382-2006, s. 1.
CHAPTER I
DEFINITIONS
1. In this Regulation,
“Act” means the Health Insurance Act (chapter A-29);
“assistive listening device” means the aids and devices in the text transmission category, of the following types: decoders, TTYs (or TDDs), TTYs with large display or Braille display, portable VCO (voice carry over) TTYs, and TTY modems; the aids and devices in the sound transmission category, of the following types: telephone amplifiers, frequency modulation systems, magnetic loops, personal amplifiers, wireless frequency modulation amplification systems or wireless infrared amplification systems for television, and aids of the vibrotactile type; the aids and devices in the environmental control systems category, of the following types: visual and tactile aids, adapted alarm clocks (visual), adapted alarm clocks (tactile), and adapted alarm clocks (for deaf-blind persons); the visual and tactile aids and devices in the environmental control systems category are telephone monitors, door monitors, fire alarm monitors, sound monitors, baby cry monitors and signal receivers;
“BI-CROS” means a standard behind-the-ear hearing aid on one ear equipped with a second microphone for the other ear;
“BI-FROS” means a BI-CROS arrangement connected to the side microphone through the eyeglasses frame;
“CRIS-CROS” means a double CROS arrangement;
“CROS” means a behind-the-ear hearing aid placed on one ear and equipped with a microphone placed on the other ear;
“distributor” means a rehabilitation centre for persons with a hearing deficiency offering technical aid services and holding a permit issued by the Minister under section 437 of the Act respecting health services and social services (chapter S-4.2) or section 136 of the Act respecting health services and social services for Cree Native persons (chapter S-5) that distributes assistive listening devices, or a physical or legal person that has entered into an agreement with the Board authorized by the Government under section 23 of the Act respecting the Régie de l’assurance-maladie du Québec (chapter R-5) and that distributes assistive listening devices;
“focal-CROS” means a CROS arrangement with the microphone placed in the external auditory canal or connected to a tube extending into the external auditory canal;
“FROS” means a CROS arrangement connected to the microphone through the eyeglasses frame;
“hearing aid” means the aids and devices in the analogue category, of the following types: in-the-ear hearing aids, behind-the-ear hearing aids, body hearing aids and eyeglass hearing aids; hearing aids in the programmable analogue category, of the following type: in-the-ear hearing aids and behind-the-ear hearing aids; hearing aids in the digital category, of the following types: in-the-ear hearing aids and behind-the-ear hearing aids;
“hearing device” means comprises hearing aids and assistive listening devices;
“high-CROS” means a CROS behind-the-ear hearing aid with high-frequency emphasis;
“in-the-ear” means hearing aid inserted in the ear including the full-shell, half-shell and low profile types, but excluding canal and completely-in-the-canal hearing aids;
“IROS” means standard (monaural) behing-the-ear hearing aid with an open earmold;
“mini-CROS” means a CROS arrangement that is not connected by a tube to the elbow of the hearing aid;
“ multi-CROS” means a BI-CROS hearing aid with a separate on/off switch for each microphone;
“open BI-CROS” means a BI-CROS hearing aid with an open earmold;
“person with a hearing deficiency” means
(1)  an insured person whose hearing loss in one ear, evaluated according to American National Standards Institute Standards S3.1, S3.6 and S3.21, is not less than 25 db, measured by air conduction, on average, over a frequency range of 500, 1,000, 2,000 and 4,000 Hz and who is 12 to 18 years of age;
(2)  an insured person whose hearing loss in one ear, evaluated according to American National Standards Institute Standards S3.1, S3.6 and S3.21, is not less than 25 db, measured by air conduction, on average, over a frequency range of 500, 1,000, 2,000 and 4,000 Hz and who is enrolled in and is pursuing a program leading to a diploma, certificate or attestation of studies recognized by the Minister of Education, Recreation and Sports or the Minister of Higher Education, Research, Science and Technology;
(3)  an insured person whose ear with the greater hearing capacity has a hearing loss evaluated according to American National Standards Institute Standards S3.1, S3.6 and S3.21 at not less than 35 db, measured by air conduction, on average, over a frequency range of 500, 1,000 and 2,000 Hz;
(4)  an insured person under 12 years of age whose hearing loss could compromise his speech or language development;
(5)  an insured person with a hearing loss who has other impairments and whose functional limitations taken as a whole prevent his social, academic or occupational integration;
“Uni-CROS” means 2 hearing aids connected to a single microphone.
O.C. 869-93, s. 1; O.C. 738-95, s. 1; O.C. 535-97, s. 1; O.C. 382-2006, ss. 2 and 28; O.C. 1090-2011, s. 1; S.Q. 2013, c. 28, s. 205.
2. A hearing aid comprises
(1)  the following special arrangements;
(a)  a CROS arrangement and its variations (FROS, high-CROS, mini-CROS, focal-CROS and power-CROS);
(b)  a BI-CROS arrangement and its variations (BI-FROS, open BI-CROS and multi-CROS);
(2)  the options and accessories provided for the Tariff for insured hearing aids and related services (chapter A-29, r. 8) referred to in section 4.
A hearing aid does not include
(a)  a hearing aid with a maximum sound pressure of over 130 db (20 S.P.L.), except upon presentation of a medical certificate from an otorhinolaryngologist attesting that such a hearing aid is needed;
(b)  (subparagraph revoked);
(c)  a CRIS-CROS and a Uni-CROS arrangement.
O.C. 869-93, s. 2; O.C. 382-2006, s. 3; O.C. 584-2014, s. 1.
3. The definitions appearing in section 1 of the Act apply to this Regulation.
O.C. 869-93, s. 3.
CHAPTER II
TERMS AND CONDITIONS FOR ALLOCATION
4. The hearing devices and services listed in the Tariff for insured hearing aids and related services (chapter A-29, r. 8) made by the Board under section 72.1 of the Act and the hearing devices and services referred to in section 17 are, subject to the provisions of this Regulation, considered insured services for the purposes of the seventh paragraph of section 3 of the Act.
O.C. 869-93, s. 4; O.C. 382-2006, s. 4.
5. (Revoked).
O.C. 869-93, s. 5; O.C. 535-97, s. 2; O.C. 382-2006, s. 5.
6. For a person with a hearing deficiency, the Board shall assume the cost of purchasing a hearing aid referred to in this Regulation, or the cost of replacing a hearing aid belonging to a person with a hearing deficiency with a hearing aid referred to in this Regulation:
(1)  in the case of the initial fitting or the replacement of a hearing aid for a person with a hearing deficiency described in paragraphs 1 to 3 of section 1, upon the production of
(a)  a medical certificate from an otorhinolaryngologist confirming the hearing loss, indicating whether or not it is a permanent hearing loss, and specifying any medical indication or contraindication with regard to the device;
(b)  an audiogram and an attestation of the need for a hearing aid issued and signed by an audiologist following an overall evaluation of the deficiencies and functional limitations carried out by the audiologist, in the case of a person with a hearing deficiency 65 years of age or over, at the time of the examination;
in other cases, an audiogram and an attestation of the need for a hearing aid issued and signed by an audiologist or by an otorhinolaryngologist;
notwithstanding the foregoing, the attestation referred to in the 2 paragraphs of this clause shall not be considered for the purposes of this subparagraph if it gives the trademark of the hearing aid, the name of a hearing aid acoustician or any name he uses in the practice of his profession, or the name of a hearing aid manufacturer or distributor;
(c)  an attestation of school attendance for a person with a hearing deficiency described in paragraph 2 of the definition of “person with a hearing deficiency” in section 1;
(2)  in the case of an initial fitting or a replacement for a person with a hearing deficiency described in paragraphs 4 and 5 of the definition of “person with a hearing deficiency” in section 1 and at the time of allocating the hearing aids provided for in the second and third paragraphs of section 23, upon the production of
(a)  a medical certificate from an otorhinolaryngologist confirming the hearing loss, indicating whether or not it is a permanent hearing loss, and specifying any medical indication or contraindication with regard to the device;
(b)  an overall assessment of the impairment and functional limitations by an audiologist or a speech therapist;
(c)  an attestation of the need for a hearing aid produced and signed by an audiologist. Such attestation may not be considered for the purposes of this paragraph if it gives the trademark of a hearing aid, the name of a hearing aid acoustician or any name he uses in the practice of his profession, or the name of a hearing aid manufacturer or distributor;
(d)  a specific recommendation by an audiologist where the second prosthesis of a binaural device is provided;
(e)  an attestation of school attendance in the case of a person with a hearing deficiency referred to in subparagraph 2 of the second paragraph of section 23;
(f)  an attestation issued by a recognized institution referred to in the sixth paragraph of section 3 of the Act, in the case of a person with a hearing deficiency referred to in the second paragraph of section 23, to the effect that he is also a visually handicapped person within the meaning of the Act.
Moreover, the hearing aid must be furnished and the services rendered in Québec by a hearing aid acoustician who is a member of the Ordre des audioprothésistes du Québec.
The certificate, audiogram, attestation of the need for a hearing aid, overall assessment and recommendation referred to in this section shall have been issued within a one-year period preceding the date of the initial fitting or replacement of the hearing aid.
Notwithstanding the foregoing, where the otorhinolaryngologist has already indicated in a medical certificate that the hearing loss is permanent, a new certificate shall not be required.
O.C. 869-93, s. 6; O.C. 535-97, s. 3; O.C. 1403-2001, s. 1; O.C. 382-2006, ss. 6 and 28; O.C. 1090-2011, s. 2.
7. For a person with a hearing deficiency, the Board shall assume the cost of purchase, replacement or repair of an assistive listening device referred to in this Regulation only if it is essential to the integration of the person into school or the workplace, to the person’s independence at home or in a training environment, to the person’s participation in family life or to the person’s safety, in the case of an initial purchase of any assistive listening device or a replacement of the devices referred to in sections 37 and 38 and in the cases described in paragraphs 1 and 2 of section 16, upon production of
(1)  a medical certificate from an otorhinolaryngologist confirming the hearing loss, indicating whether or not it is a permanent hearing loss, and specifying any medical indication or contraindication with regard to the device;
(2)  an audiogram produced and signed by an audiologist;
(3)  an overall assessment of the impairment and functional limitations by an audiologist or speech therapist;
(4)  a recommendation for an assistive listening device by an audiologist. Such recommendation may not be considered for the purposes of this section if it gives the trademark of an assistive listening device or the name of a distributor or manufacturer of an assistive listening device an assistive listening device manufacturer;
(5)  an attestation issued by a recognized institution referred to in the sixth paragraph of section 3 of the Act, in the case of a person with a hearing deficiency who is supplied with a hearing device referred to in section 43, to the effect that he is also a visually handicapped person within the meaning of the Act;
(6)  an attestation issued by a recognized institution referred to in the sixth paragraph of section 3 of the Act, to the effect that the person with a hearing deficiency is also a visually handicapped person within the meaning of the Act, if he invokes the latter reason in order for the Board to assume for him, under section 37, the initial purchase cost of a hearing device.
Moreover, the assistive listening device shall be furnished and the services rendered in Québec by a distributor.
The certificate, audiogram, overall assessment and recommendation referred to in this section shall have been issued within a one-year period preceding the date of the initial purchase or replacement of the assistive listening device.
Despite the third paragraph, the audiogram required may be more than 1 year old, provided that the audiologist making the overall assessment and the recommendation is able to confirm, on the basis of the audiogram, that the person concerned meets the criteria for hearing impairment described in this Regulation.
Notwithstanding the foregoing, where the otorhinolaryngologist has already indicated in a medical certificate that the hearing loss in permanent, a new certificate shall not be required.
O.C. 869-93, s. 7; O.C. 535-97, s. 4; O.C. 1403-2001, s. 2; O.C. 382-2006, ss. 7 and 28.
7.1. (Revoked).
O.C. 535-97, s. 5; O.C. 1403-2001, s. 3.
8. Where the Board has assumed the cost of purchase, replacement or repair of a hearing device no longer referred to in Tariff for insured hearing aids and related services (chapter A-29, r. 8), all the rules of application of this Regulation, except those relating to the purchase of a hearing device, apply to such a hearing device insofar as they are applicable.
O.C. 869-93, s. 8; O.C. 535-97, s. 6.
9. In accordance with the terms and conditions provided for in this Regulation, the Board shall assume the cost of repairing a hearing device listed in the Tariff for insured hearing aids and related services (chapter A-29, r. 8), that is not listed in the Tariff but is referred to in section 17 or that is of the same category and same type as a device listed in the Tariff but that already belongs to the person with a hearing deficiency at the time the person would first be entitled to a hearing device under this Regulation.
O.C. 869-93, s. 9; O.C. 535-97, s. 7; O.C. 1403-2001, s. 4; O.C. 382-2006, s. 8.
10. Any hearing device that is no longer used by a person with a hearing deficiency subsequent to his death or a change in his hearing or physical condition shall be returned to the Board.
O.C. 869-93, s. 10; O.C. 382-2006, s. 28.
CHAPTER III
GENERAL RULES OF APPLICATION
11. Each hearing device furnished to a person with a hearing deficiency shall include a guarantee that parts will be available for a minimum period of 6 years from the time when the person with a hearing deficiency takes possession of the hearing device.
O.C. 869-93, s. 11; O.C. 382-2006, s. 28.
12. Any hearing device furnished to a person with a hearing deficiency shall include a minimum one-year warranty beginning after the date on which the person with a hearing deficiency takes possession of the hearing device.
Such warranty shall include any fitting of repair done to a hearing device functioning under normal conditions.
Any earmold shall include a 30-day warranty beginning when the person with a hearing deficiency takes possession of the earmold.
O.C. 869-93, s. 12; O.C. 535-97, s. 8; O.C. 382-2006, s. 28.
13. The Board shall assume the cost of repairs of a hearing device only where such hearing device is used according to the manufacturer’s instructions and for the purposes for which it was designed and intended.
O.C. 869-93, s. 13; O.C. 535-97, s. 9.
14. The cost of repair of a hearing device after the warranty has expired, but during its minimum duration, shall not exceed 70% of the cost of purchasing that hearing device. The minimum duration of a hearing device is set at 6 years from the date on which a person with a hearing deficiency takes possession of the hearing device.
O.C. 869-93, s. 14; O.C. 535-97, s. 10; O.C. 382-2006, s. 28.
15. Subject to section 16, the Board shall assume, on behalf of a person with a hearing deficiency, the cost of repairing a hearing device after its minimum duration has expired, provided total repairs do not exceed 60% of the cost of purchasing that hearing device.
O.C. 869-93, s. 15; O.C. 535-97, s. 11; O.C. 1403-2001, s. 5; O.C. 382-2006, s. 28.
16. The Board shall assume the cost of replacing a hearing device when
(1)  the hearing or physical condition of the person with a hearing deficiency has changed to the point where his hearing device is no longer effective;
(2)  the capacity of the person with a hearing deficiency to operate the controls has diminished to the point where he can no longer operate the hearing device;
(3)  premature deterioration of the hearing device is caused by a high level of acidity in the perspiration, a high level of toxic fumes or a high level of dust pollution;
(4)  deterioration is caused by accidental damage;
(5)  the repair estimate for the hearing device before the expiry of its minimum duration exceeds 70% of the cost of purchasing that hearing device;
(6)  the hearing device no longer functions under normal conditions upon the expiry of its minimum duration;
(7)  the repair estimate for the hearing device after the expiry of its minimum duration, plus the total cost of repairs since the expiry of its minimum duration, exceeds 60% of the cost of purchasing that hearing device.
Notwithstanding subparagraphs 4 to 7 of the first paragraph, the Board shall not assume the cost of replacing a hearing device on the sole ground that is was used negligently or that it was lost, stolen or destroyed.
The Board shall not assume the cost of replacing a hearing device under such circumstances during the entire period between the time it was lost, stolen, destroyed or irreparably damaged and the expiry of the minimum duration of the lost, stolen, destroyed or irreparably damaged hearing device. That period ceases where the person with a hearing deficiency, at his own expense, replaces the lost, stolen, destroyed or irreparably damaged hearing device with an insured hearing device similar in function and in cost and so notifies the person referred to in this Regulation who had supplied the lost, stolen, destroyed or irreparably damaged hearing device to him. That person shall so notify the Board.
An insured hearing device purchased by a person with a hearing deficiency at his own expense is deemed to have a minimum duration of at least 2 years.
O.C. 869-93, s. 16; O.C. 535-97, s. 12; O.C. 382-2006, s. 28.
16.1. An insured person, a distributor, a hearing aid acoustician or an institution claiming reimbursement from the Board of the cost of purchase, adjustment, replacement or repair of a hearing device provided or distributed under this Regulation must send, using the form provided by the Board, the following information, which may vary depending on the medium used or depending on whether the case involves a request for special consideration or a claim for payment:
(1)  the health insurance number, the expiration date indicated on the health insurance card and the information required by the Board to identify the insured person who received the property or service;
(2)  the name, dispenser number and, where applicable, permit number of the distributor or institution, and the name, member number in the Ordre des audioprothésistes du Québec and dispenser number of the hearing aid acoustician who provided the property or the service described, as well as the reference number of the request for special consideration or the claim for payment;
(3)  the hearing loss in each ear assessed according to the conditions provided for in this Regulation, and the information contained in the medical certificate referred to in subparagraph a of subparagraph 1 of the first paragraph of section 6 and in subparagraph 1 of the first paragraph of section 7, and, in the case of a request for special consideration;
(4)  the date the impression was made and the date of service;
(5)  the code for the good or service, side of the body, type, the code for the apparatus allocated, the reference code for the apparatus, the serial number, the number of units, the amount claimed, the date on which the property was allocated or the service rendered and, where applicable, the reason for replacement;
(6)  the indicator for the program referred to in the claim for payment;
(7)  a statement by the insured person confirming that the person received the property or service described and authorizing the Board to make the payment;
(8)  the necessary information for identifying the recipient of the payment; and
(9)  a statement by the hearing aid acoustician or the distributor confirming that the information provided is accurate and complete.
O.C. 1090-2011, s. 3.
17. Upon request for special consideration submitted previously to the Board by a hearing aid acoustician or a distributor for a person with a hearing deficiency, the Board may assume the cost of purchase, fitting, replacement or repair of a hearing device not listed in the Tariff for insured hearing aids and related services (chapter A-29, r. 8), under the terms and conditions prescribed in this Regulation, if it is demonstrated that the hearing device is of the same category and same type as a hearing device listed in the Tariff, that it corresponds to the specific hearing deficiency of the person involved and that no device listed in the Tariff corresponds to that specific deficiency.
O.C. 869-93, s. 17; O.C. 535-97, s. 13; O.C. 382-2006, ss. 9 and 28.
CHAPTER IV
SPECIFIC RULES OF APPLICATION
DIVISION I
HEARING AIDS
18. Each part of a hearing aid that may come into contact with the user’s skin shall
(1)  be resistant to the corrosion and deterioration that such contact may cause;
(2)  consist of nonallergenic materials, except for the material used in earmolds;
(3)  be free of cellulose nitrate.
O.C. 869-93, s. 18.
19. Upon the purchase or replacement of a hearing aid, the Board pays the hearing aid acoustician or an institution that operates a rehabilitation centre offering technical aid services for persons with a hearing deficiency and that holds a permit issued by the Minister under section 437 of the Act respecting health services and social services (chapter S-4.2) or section 136 of the Act respecting health services and social services for Cree Native persons (chapter S-5), where the services are rendered by a hearing aid acoustician in its employ, the tariff fixed by the Board under section 72.1 of the Health Insurance Act (chapter A-29) to cover all of the following services:
(1)  the cost of the services required for the fitting and adjustment of the hearing aid during the first year following the date on which the person with a hearing deficiency takes possession of the hearing aid and, notwithstanding section 9, the cost of the services and parts required for any repair of the hearing aid done under warranty and the cost of the services required for any repair not done under warranty but required during the warranty period;
(2)  the loan of a hearing aid while repairs are being done to the hearing aid during the first year of use;
(3)  the cost of purchasing the initial batteries, up to a maximum of 2;
(4)  the repair estimate for a hearing aid after the warranty period where the estimate exceeds 70% of the cost of purchasing that hearing aid during the minimum duration, or where the estimate plus the total cost of repairs since the minimum period has expired exceeds 60% of the cost of purchasing that hearing aid;
(5)  the cost of the services required to add, during the first year following the date on which the person with a hearing deficiency takes possession of the hearing aid, options or accessories that are provided for in Part I of Schedule I of the Tariff for insured hearing aids and related services (chapter A-29, r. 8) or that were provided for therein at the time of the purchase or replacement of the hearing aid.
The Board shall assume the cost of options or accessories without including that cost in the amount initially paid and provided for in the first paragraph only if the options or accessories are added to the hearing aid or replaced and are provided for in Part I of Schedule I of the Tariff for insured hearing aids and related services or were provided for therein at the time of the purchase or replacement of the hearing aid.
The tariff in the first paragraph is increased by the amount provided for in the Tariff for insured hearing aids and related services where an initial earmold is provided, or in the case of the allocation of an in-the-ear type hearing aid, a shell impression is made.
O.C. 869-93, s. 19; O.C. 535-97, s. 14; O.C. 1403-2001, s. 6; Decision 2001-12-12, s. 1; Decision 2004-04-14, s. 1; Decision 2005-04-13, s. 1; O.C. 382-2006, s. 10; O.C. 1090-2011, s. 4.
20. If a person with a hearing impairment dies, the Board shall assume the cost to cover the time required and spent by the hearing aid acoustician in accordance with the tariff per quarter hour or fraction thereof and a maximum amount the Board establishes under section 72.1 of the Act. The tariff and maximum amount include the earmold or the shell impression.
O.C. 869-93, s. 20; Decision 2001-12-12, s. 2; Decision 2004-04-14, s. 2; Decision 2005-04-13, s. 2; O.C. 382-2006, s. 11.
21. Upon production of supporting documents, the Board shall assume, after the warranty period and under the conditions provided for in this section, the following costs for hearing aid repairs:
(1)  in the case of repairs done exclusively by the manufacturer:
(a)  the cost of the parts, up to the cost of reconditionning at the manufacturer’s cost, plus the cost of the time required for the repairs;
(b)  the cost of the time required by the hearing aid acoustician, added to the cost provided for in clause a of this subparagraph;
(2)  in the case of repairs done exclusively by the hearing aid acoustician or exclusively by the institution that operates a rehabilitation centre offering technical aid services for persons with a hearing deficiency and that holds a permit issued by the Minister under section 437 of the Act respecting health services and social services (chapter S-4.2) or section 136 of the Act respecting health services and social services for Cree Native persons (chapter S-5):
(a)  the cost of the parts:
(b)  the cost of the time required by the hearing aid acoustician, added to the cost provided for in clause a of this subparagraph.
The cost of the time required by the hearing aid acoustician shall be assumed by the Board up to a maximum of 2 hours or 8 quarter-hours or fractions thereof, per year, for each hearing aid, in accordance with the tariff fixed by the Board under section 72.1 of the Act, per quarter hour or fraction thereof.
The cost of repairs includes the loan of a hearing aid.
O.C. 869-93, s. 21; O.C. 535-97, s. 15; O.C. 1403-2001, s. 7; Decision 2001-12-12, s. 3; Decision 2004-04-14, s. 3; Decision 2005-04-13, s. 3; O.C. 382-2006, s. 12; O.C. 1090-2011, s. 5.
22. (Revoked).
O.C. 869-93, s. 22; O.C. 535-97, s. 16.
23. The Board shall assume, according to the terms and conditions prescribed by this Regulation, the cost of purchase, fitting, replacement or repair of only one hearing aid.
A person with a hearing deficiency may be eligible for a binaural device if the person meets any of the following requirements:
(1)  the person is 18 years of age or under and the device is required in speech and language training, in learning at school or in reinforcing such training or learning;
(2)  the person is 19 years of age or older and the device permits a marked improvement of the threshold of speech intelligibility which is essential to pursue recognized studies or employment for remuneration or a benefit, including as a self-employed worker, a worker benefiting from support for workplace integration and job retention or a trainee developing employability skills;
(3)  the person has a visual deficiency within the meaning of the regulation made by the Government under subparagraph h.1 of the first paragraph of section 69 of the Act and the deficiency is such that it justifies the use of a second hearing aid.
Similarly, a person with a hearing deficiency who, on 8 June 2006, is under 19 years of age and already has a binaural device continues to be eligible for the device even after attaining 19 years of age.
O.C. 869-93, s. 23; O.C. 535-97, s. 17; O.C. 382-2006, s. 13.
24. The Board shall also assume, after the first year following the date on which a person with a hearing deficiency takes possession of a hearing aid, the cost of the time devoted by a hearing aid acoustician to that person with a hearing deficiency where he added to the person’s hearing aid or replaced an option or accessory that is provided for in Part I of Schedule I of the Tariff for insured hearing aids and related services (chapter A-29, r. 8) or that was provided for therein at the time of the purchase or replacement of the hearing aid, up to a maximum of one quarter of an hour or fraction thereof, per 3-month period, for each person with a hearing deficiency.
The rate per quarter hour or fraction thereof for the time devoted by a hearing aid acoustician to a person with a hearing deficiency, as provided for in the first paragraph, is fixed by the Board under section 72.1 of the Act.
The cost of the time devoted by a hearing aid acoustician shall not be assumed by the Board where the hearing aid acoustician supplies an “earmold and tube” “shell impression” provided for in Division I of Part III of Schedule I of the Tariff for insured hearing aids and related services.
O.C. 869-93, s. 24; O.C. 535-97, s. 18; O.C. 1403-2001, s. 8; Decision 2001-12-12, ss. 4; Decision 2004-04-14, s. 4; Decision 2005-04-13, s. 4; O.C. 382-2006, ss. 14 and 28.
25. In the case of body hearing aids, the Board shall assume the cost of replacement of one cord, cover, receiver, harness and case per year of use.
O.C. 869-93, s. 25.
26. The Board shall each year assume, for each person with a hearing deficiency, the cost of earmolds or shell impressions, whether or not made of nonallergenic materials, for each ear fitted with a device. Their number shall be determined as follows:
(1)  under 6 years of age: 3 earmolds;
(2)  6 to 11 years of age: 2 earmolds;
(3)  12 to 18 years of age: 2 earmolds or shell impressions;
(4)  19 years of age or over: one earmold or shell impression;
(5)  (subparagraph replaced).
Notwithstanding the foregoing, the Board shall assume that cost only when the earmold or shell is not in good working order.
The Board shall also assume, for each ear fitted with a device, the cost of the earmold which caused the initial allergy.
The costs that the Board assumes under the first and second paragraphs are determined in Division I of Part III of Schedule I of the Tariff for insured hearing aids and related services (chapter A-29, r. 8).
O.C. 869-93, s. 26; O.C. 535-97, s. 19; O.C. 1403-2001, s. 9; Decision 2001-12-12, s. 5; O.C. 382-2006, ss. 15 and 28.
27. The Board shall assume the cost of the initial purchase or replacement of an in-the-ear type hearing aid for a person with a hearing deficiency who is at least 12 years of age and whose hearing loss does not exceed 70 db within the frequency range of either 500, 1,000, 2,000 or 4,000 Hz, or for a person with a hearing deficiency who is 19 years of age or over and whose hearing loss does not exceed 85 db within any of the Hz frequency ranges previously mentioned.
O.C. 869-93, s. 27; O.C. 535-97, s. 20; O.C. 382-2006, ss. 16 and 28.
28. (Revoked).
O.C. 869-93, s. 28; O.C. 535-97, s. 21; O.C. 382-2006, s. 17.
DIVISION II
ASSISTIVE LISTENING DEVICES
29. The audiometric measure for allocating assistive listening devices shall be calculated according to American National Standards Institute Standards S3.1, S3.6 and S3.21, on average, over a frequency range of 500, 1,000, 2,000 and 4,000 Hz for the better ear.
O.C. 869-93, s. 29; O.C. 535-97, s. 22; O.C. 382-2006, s. 18.
30. At the time of the initial purchase or replacement of an assistive listening device, the Board shall pay a distributor a lump sum covering all of the following services:
(1)  the cost of the services required at the time the assistive listening device is distributed, including instructions for the installation and use thereof;
(2)  the cost of repairs during the first year, from the date on which the person with a hearing deficiency takes possession of the assistive listening device;
(3)  the loan of an assistive listening device while repairs are being done to the assistive listening device during the first year of use;
(4)  the repair estimate for an assistive listening device after the warranty period where the estimate exceeds 70% of the cost of purchasing that assistive listening device during the minimum duration or where the estimate plus the total cost of repairs since the minimum period has expired exceeds 60% of the cost of purchasing that device;
(5)  the removal and installation by the distributor of the magnetic loop or the environmental controls.
For all the services listed in the first paragraph, the lump sum to be paid is the sum fixed by the Board under section 72.1 of the Act in respect of each of the following devices:
(1)  decoders;
(2)  TTYs (with or without printer);
(3)  adapted TTYs (large display, Braille display or portable VCO);
(4)  TTY modems;
(5)  telephone amplifiers (portable or freehand);
(6)  frequency modulation systems;
(7)  personal amplifiers;
(8)  magnetic loops;
(9)  wireless amplification systems for television (infrared or frequency modulation);
(10)  vibrotactile aids;
(11)  telephone monitors;
(12)  door monitors;
(13)  fire alarm monitors;
(14)  baby cry or sound monitors;
(15)  adapted alarm clocks (visual, tactile or for deaf-blind persons).
O.C. 869-93, s. 30; O.C. 535-97, s. 23; Decision 2002-10-10, s. 1; Decision 2004-04-14, s. 5; Decision 2005-04-13, s. 5; O.C. 382-2006, ss. 19 and 28.
31. Upon production of supporting documents, the Board shall assume the cost of repairing assistive listening devices after the warranty period in the following manner:
(1)  the tariff fixed by the Board under section 72.1 of the Act per quarter hour or fraction thereof for the repair or partial replacement;
(2)  the cost of the parts.
For the purposes of this section, the cost of repairs includes the loan of an assistive listening device.
O.C. 869-93, s. 31; O.C. 535-97, s. 24; O.C. 1403-2001, s. 10; Decision 2002-10-10, s. 2; Decision 2004-04-14, s. 6; Decision 2005-04-13, s. 6; O.C. 382-2006, s. 20.
31.1. The Board shall pay the distributor 60% of the lump-sum amounts fixed in respect to the monitors for all the services provided for in section 30 for the reinstallation of the monitors listed in subparagraphs 11 to 14 of the second paragraph of section 30 following a move.
O.C. 382-2006, s. 21.
§ 1.  — Text transmission devices
32. The Board shall assume the cost of purchase or replacement of one decoder per dwelling for a person with a hearing deficiency who is capable of using one and whose hearing loss is measured at not less than 71 db, or at not less than 55 db where he has a marked difficulty with auditory discrimination.
O.C. 869-93, s. 32; O.C. 535-97, s. 25; O.C. 382-2006, s. 28.
33. The Board shall assume the cost of purchase or replacement of a teletypewriter for a person with a hearing deficiency who is capable of using one, who is able to decode and transmit a simple message and whose hearing loss in measured at not less than 71 db, or at not less than 55 db where he has a marked difficulty with auditory discrimination.
O.C. 869-93, s. 33; O.C. 382-2006, s. 28.
34. The Board shall assume the cost of purchase or replacement of an adapted TTY with large display or Braille display for a person with a hearing deficiency who is capable of using one, who is able to decode and transmit a simple message and whose hearing loss is measured at not less than 71 db, or at not less than 55 db where he has a marked difficulty with auditory discrimination combined with a visual impairment.
O.C. 869-93, s. 34; O.C. 382-2006, ss. 22 and 28.
34.1. The Board shall assume the cost of purchase or replacement of a portable VCO (voice carry over) TTY for a person with a hearing deficiency who is capable of using one and is able to decode a written message and transmit a message by voice, and whose hearing loss is measured at not less than 71 db, or at not less than 55 db where that person has a marked difficulty with auditory discrimination.
O.C. 382-2006, s. 23.
34.2. The Board shall assume the cost of purchase or replacement of a TTY modem for a person with a hearing deficiency who is capable of using one and is able to decode and transmit a message by voice, and whose hearing loss is measured at not less than 71 db, or at not less than 55 db where that person has a marked difficulty with auditory discrimination and if the modem is being furnished to the person instead of a TTY.
O.C. 382-2006, s. 23.
§ 2.  — Sound transmission devices
35. The Board shall assume the cost of purchase of a sound transmission device for a person with a hearing deficiency who does not have a hearing aid or if, following a one-month period after taking possession of the initial hearing aid, a sound transmission device is required.
O.C. 869-93, s. 35; O.C. 382-2006, s. 28.
36. The Board shall assume the cost of purchase or replacement of a telephone amplifier for a person with a hearing deficiency whose hearing loss is measured at not less than 55 db, or at not less than 35 db where he has a marked difficulty with auditory discrimination over the telephone.
Notwithstanding the foregoing, the Board shall assume the cost of the “no-hands” model only where the person with a hearing deficiency is unable to use the “portable” model because he has difficulty operating his hearing aid.
O.C. 869-93, s. 36; O.C. 382-2006, s. 28.
37. The Board shall assume the cost of purchasing or replacing a frequency modulation system for a person with a hearing deficiency who is under 6 years of age, for a person with a hearing deficiency whose hearing loss is measured at not less than 25 db and who is enrolled in and is pursuing an adult education program leading to a diploma, certificate or other attestation of studies recognized by the Minister of Education, Recreation and Sports or is enrolled in or is pursuing a program of studies leading to such a diploma, certificate or other attestation and offered by a college or university-level educational institution recognized by the Minister of Higher Education, Research, Science and Technology, or for a person with a hearing deficiency who is also a visually handicapped person within the meaning of the Act.
O.C. 869-93, s. 37; O.C. 535-97, s. 26; O.C. 382-2006, s. 28; S.Q. 2013, c. 28, s. 204.
38. The Board shall assume the cost of purchasing or replacing a personal amplifier for, notwithstanding section 29, a person with a hearing deficiency referred to in paragraph 2 of section 1 or for any person with a hearing deficiency to whom a personal amplifier is supplied instead of a hearing aid.
For the purposes of this section, a person with a hearing deficiency living in a residential and long-term care centre operated by an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) is deemed to meet the condition of living independently at home as provided for in section 7.
O.C. 869-93, s. 38; O.C. 535-97, s. 27; O.C. 1403-2001, s. 11; O.C. 382-2006, s. 28.
39. The Board shall assume the cost of purchase or replacement of one magnetic loop per dwelling for a person with a hearing deficiency who has a hearing aid equipped with an inductor coil and whose hearing loss is measured at not less than 55 db, or at not less than 41 db where he has a marked difficulty in hearing the television or radio.
O.C. 869-93, s. 39; O.C. 535-97, s. 28; O.C. 382-2006, s. 28.
40. The Board shall assume the cost of purchase or replacement of one wireless frequency modulation amplification system or wireless infrared amplification system for television per dwelling for a person with a hearing deficiency whose hearing loss is measured at not less than 55 db, or at not less than 41 db where he has a marked difficulty in hearing the television or radio.
Notwithstanding the foregoing, the Board shall assume the cost of purchase or replacement of a receiver compatible with the wireless amplification system in place in the dwelling for each person with a hearing deficiency in the dwelling who meets such criteria.
O.C. 869-93, s. 40; O.C. 535-97, s. 29; O.C. 382-2006, ss. 24 and 28.
40.1. The Board shall assume the cost of purchase or replacement of a vibrotactile aid for a person with a hearing deficiency if the device is being furnished to the person instead of a hearing aid.
O.C. 382-2006, s. 25.
§ 3.  — Environmental control systems
41. The Board shall assume the cost of purchasing or replacing one visual or tactile type environmental control system per dwelling for a person with a hearing deficiency whose hearing loss is measured at not less than 55 db.
Notwithstanding the foregoing, the Board shall not assume the cost of purchasing or replacing a visual type environmental control system if the dwelling already has a tactile type environmental control system.
Under the circumstances described in the second paragraph, the Board shall, however, assume the cost of purchasing or replacing a personal vibrating receiver for each person with a hearing deficiency who lives in the dwelling and meets the terms and conditions prescribed in this Regulation.
O.C. 869-93, s. 41; O.C. 535-97, s. 30; O.C. 382-2006, s. 28.
42. Notwithstanding the first paragraph of section 41, the Board shall assume the cost of purchasing or replacing one tactile type environmental control system per dwelling if the dwelling does not already have such a system or, where it does, if the system no longer meets the safety needs of any of the persons with a hearing deficiency who live in the dwelling and meet the terms and conditions prescribed by this Regulation.
The Board shall assume the cost of purchasing or replacing only one monitor per function per dwelling.
For the purposes of the second paragraph, a monitor may have any of the following functions: detecting the ringing of the telephone, the ringing of the door bell, the crying of a baby, or sounds.
In addition, the Board shall assume the cost of purchasing or replacing only one fire detector per floor per dwelling.
In the case of the installation of a visual type environmental control system, the Board shall not assume the cost of purchasing or replacing more than 4 signal receivers per dwelling.
O.C. 869-93, s. 42; O.C. 535-97, s. 31; O.C. 382-2006, ss. 26 and 28.
43. The Board shall assume the cost of purchase or replacement of an adapted alarm clock, visual or tactile, for a person with a hearing deficiency whose hearing loss is measured at not less than 55 db or an adapted alarm clock for the deaf and blind if he is also visually impaired.
O.C. 869-93, s. 43; O.C. 382-2006, s. 28.
FINAL
44. This Regulation replaces paragraph q of section I, Division XIX and Schedule C of the Regulation respecting the application of the Health Insurance Act (R.R.Q., 1981, c. A-29, r. 1).
O.C. 869-93, s. 44.
45. (Omitted).
O.C. 869-93, s. 45.
(Revoked)
O.C. 869-93, c. V; O.C. 1471-93, s. 1; O.C. 1593-94, s. 1; O.C. 475-95, s. 1; O.C. 1395-95, s. 1; O.C. 110-96, s. 1; O.C. 1328-96, s. 1; O.C. 535-97, ss. 32 and 33; O.C. 1394-97, s. 1; O.C. 74-98, s. 1; O.C. 1472-98, ss. 1 to 4; O.C. 1246-99, s. 1; Decision 2000-03-08, ss. 1, 2, 3 and 4; Decision 2001-10-10, s. 1; Decision 2001-12-12, s. 6; Decision 2002-10-10, s. 3; Decision 2004-04-14, s. 7; Decision 2004-10-13, s. 1; Decision 2005-04-13, s. 7; O.C. 382-2006, s. 27.
REFERENCES
O.C. 869-93, 1993 G.O. 2, 3497
O.C. 1471-93, 1993 G.O. 2, 5747
O.C. 1593-94, 1994 G.O. 2, 4380
O.C. 475-95, 1995 G.O. 2, 1258
O.C. 738-95, 1995 G.O. 2, 1683
O.C. 1395-95, 1995 G.O. 2, 3061
O.C. 110-96, 1996 G.O. 2, 1197
O.C. 1328-96, 1996 G.O. 2, 4345
O.C. 535-97, 1997 G.O. 2, 1826
O.C. 1394-97, 1997 G.O. 2, 5265
O.C. 74-98, 1998 G.O. 2, 511
O.C. 1472-98, 1998 G.O. 2, 4751
O.C. 1246-99, 1999 G.O. 2, 4239
S.Q. 1999, c. 89, s. 53
Decision 2000-03-08, 2000 G.O. 2, 1339
O.C. 1403-2001, 2001 G.O. 2, 6160
Decision 2001-10-10, 2001 G.O. 2, 6162
Decision 2001-12-12, 2002 G.O. 2, 253
Decision 2002-10-10, 2002 G.O. 2, 5701
Decision 2004-04-14, 2004 G.O. 2, 1372
Decision 2004-10-13, 2004 G.O. 2, 2994
Decision 2005-04-13, 2005 G.O. 2, 1111
O.C. 382-2006, 2006 G.O. 2, 1483
O.C. 1090-2011, 2011 G.O. 2, 3098
S.Q. 2013, c. 28, ss. 204 and 205
O.C. 584-2014, 2014 G.O. 2, 1402