A-28, r. 1 - Regulation respecting the application of the Hospital Insurance Act

Full text
3. Insured services shall include the following services when they are required from a medical or dental standpoint and, in the latter case, to the extent that they are insured services for the purposes of subparagraph b of the first paragraph of section 3 of the Health Insurance Act (chapter A-29) or for the purposes of the second paragraph of section 3 of that Act:
(a)  for beneficiaries who are in-patients at a hospital centre:
i.  lodging and meals;
ii.  necessary nursing care;
iii.  diagnostic services for the purpose of maintaining health, preventing disease and assisting in the treatment of any injury, disease or disability;
iv.  the furnishing of medications, prostheses and ortheses which may be integrated with the human body, the list of which appears in Schedule A, and of biological products and related preparations, on the conditions that, in a physician’s or specialized nurse practitioner’s opinion, they are required and that they are administered in a hospital centre;
v.  the use of operating rooms, delivery rooms and anaesthetic facilities, including the necessary equipment and supplies;
vi.  the furnishing of routine surgical supplies;
vii.  the use of radiotherapy facilities;
viii.  the use of physiotherapy facilities;
ix.  the services rendered by hospital centre staff;
(b)  for beneficiaries who are outpatients at a hospital centre:
i.  clinical services for psychiatric care provided during the day or at night;
ii.  electroshock therapy, insulin therapy and behavior therapy;
iii.  emergency care;
iv.  minor surgery care;
v.  radiotherapy;
vi.  diagnostic services;
vii.  physiotherapy, ergotherapy and inhalation therapy;
viii.  audiology and speech therapy;
ix.  orthoptics;
x.  the services or examinations which a resident must undergo in order to obtain employment, which he must undergo during his employment or which are required by an employer or his representative, provided that such examinations or services are required by an Act of Québec other than the Act respecting collective agreement decrees (chapter D-2).
The services covered by the first paragraph shall also be insured services when they are required:
(a)  for the purposes of mechanical, hormonal or chemical contraception;
(b)  for the purposes of surgical sterilization, namely a tubal ligation or vasectomy;
(c)  for the reanastomosis of the uterine tubes or the vas deferens;
(d)  for the extraction of a tooth or the excision of a root where, for that purpose, the beneficiary’s state of health necessitates hospital services.
R.R.Q., 1981, c. A-28, r. 1, s. 3; O.C. 1490-82, s. 2; O.C. 1321-84, s. 1; O.C. 197-86, s. 1; O.C. 1257-87, s. 1; O.C. 1981-88, s. 1; O.C. 668-91, s. 1; O.C. 696-91, ss. 1 and 5; S.Q. 2020, c. 6, s. 51.
3. Insured services shall include the following services when they are required from a medical or dental standpoint and, in the latter case, to the extent that they are insured services for the purposes of subparagraph b of the first paragraph of section 3 of the Health Insurance Act (chapter A-29) or for the purposes of the second paragraph of section 3 of that Act:
(a)  for beneficiaries who are in-patients at a hospital centre:
i.  lodging and meals;
ii.  necessary nursing care;
iii.  diagnostic services for the purpose of maintaining health, preventing disease and assisting in the treatment of any injury, disease or disability;
iv.  the furnishing of medications, prostheses and ortheses which may be integrated with the human body, the list of which appears in Schedule A, and of biological products and related preparations, on the conditions that, in a physician’s opinion, they are required and that they are administered in a hospital centre;
v.  the use of operating rooms, delivery rooms and anaesthetic facilities, including the necessary equipment and supplies;
vi.  the furnishing of routine surgical supplies;
vii.  the use of radiotherapy facilities;
viii.  the use of physiotherapy facilities;
ix.  the services rendered by hospital centre staff;
(b)  for beneficiaries who are outpatients at a hospital centre:
i.  clinical services for psychiatric care provided during the day or at night;
ii.  electroshock therapy, insulin therapy and behavior therapy;
iii.  emergency care;
iv.  minor surgery care;
v.  radiotherapy;
vi.  diagnostic services;
vii.  physiotherapy, ergotherapy and inhalation therapy;
viii.  audiology and speech therapy;
ix.  orthoptics;
x.  the services or examinations which a resident must undergo in order to obtain employment, which he must undergo during his employment or which are required by an employer or his representative, provided that such examinations or services are required by an Act of Québec other than the Act respecting collective agreement decrees (chapter D-2).
The services covered by the first paragraph shall also be insured services when they are required:
(a)  for the purposes of mechanical, hormonal or chemical contraception;
(b)  for the purposes of surgical sterilization, namely a tubal ligation or vasectomy;
(c)  for the reanastomosis of the uterine tubes or the vas deferens;
(d)  for the extraction of a tooth or the excision of a root where, for that purpose, the beneficiary’s state of health necessitates hospital services.
R.R.Q., 1981, c. A-28, r. 1, s. 3; O.C. 1490-82, s. 2; O.C. 1321-84, s. 1; O.C. 197-86, s. 1; O.C. 1257-87, s. 1; O.C. 1981-88, s. 1; O.C. 668-91, s. 1; O.C. 696-91, ss. 1 and 5.