4 Included in
amount of benefits
5 Expiry
6 Coming into
force
List of Podiatric Surgery Services
Definitions
1 In this Regulation,
(a) “Act”
means the Alberta Health Care Insurance Act;
(b) “podiatric
surgeon” means a podiatrist that
(i) possesses current certification granted by the American Board of
Podiatric Surgery, and
(ii) has been granted surgical privileges by a regional health
authority in a hospital or in an accredited surgical facility under contract to
that regional health authority;
(c) “podiatric
surgery services” means the services in the List of Podiatric Surgery Services
in this Regulation;
(d) “podiatric
wound care specialist” means a podiatrist that
(i) possesses current certification in Prevention and Treatment of
Diabetic Foot Wounds and in Diabetic Foot Wear granted by the American Board of
Multiple Specialties in Podiatry, and
(ii) has been granted surgical privileges by a regional health
authority in a hospital or in an accredited surgical facility under contract to
that regional health authority;
(e) “Schedule
of Podiatric Surgery Benefits ” means the Schedule of Podiatric Surgery
Benefits prepared and published by the Department of Health and Wellness and
approved by the Minister.
Eligibility
2(1) Benefits
are payable in accordance with the regulations under the Act for podiatric
surgery services provided in Alberta to a resident of Alberta by a podiatric
surgeon or podiatric wound care specialist.
(2) Notwithstanding
subsection (1), benefits are not payable for podiatric surgery services if a
declaration under section 25 of the Health Insurance Premiums Act is in
effect in respect of the person who receives the services.
Benefits payable
3(1) The
benefits payable for podiatric surgery services and the descriptions of those
services are set out in the Schedule of Podiatric Surgery Benefits.
(2) Notwithstanding
subsection (1), the benefits payable for podiatric surgery services provided in
Alberta to a resident of Alberta by a podiatric surgeon or podiatric wound care
specialist are limited to the lesser of
(a) the
amount claimed, and
(b) the
rates established in the Schedule of Podiatric Surgery Benefits.
Included in amount of
benefits
4 The benefits payable for podiatric
surgery services provided in Alberta to a resident of Alberta by a podiatric
surgeon or podiatric wound care specialist include an amount for the following:
(a) performing
the podiatric surgery services;
(b) administration;
(c) recording
of information regarding the services provided unless the recording of the
information is for the purposes of a third party;
(d) completing
and submitting claims;
(e) discussion
or correspondence with a referring health care professional regarding treatment
or a service to be provided to a patient directly related to managing the
patient’s care, unless otherwise provided in this Regulation or the Alberta
Health Care Insurance Regulation (AR 76/2006).
Expiry
5 For the purpose of ensuring that this
Regulation is reviewed for ongoing relevancy and necessity, with the option
that it may be repassed in its present or an amended form following a review,
this Regulation expires on February 15, 2016.
Coming into force
6 This Regulation comes into force on June
1, 2006.
List of Podiatric Surgery
Services
(a) suture
of cranial and peripheral nerves;
(b) freeing
of adhesions and decompression of cranial and peripheral nerves;
(c) cranial
or peripheral nerve graft;
(d) other
cranial or peripheral neuroplasty;
(e) invasive
diagnostic procedures on peripheral nervous system;
(f) sequestrectomy;
(g) bone
graft;
(h) open
reduction of fracture (without internal fixation);
(i) closed
reduction of dislocation of joint;
(j) open
reduction of dislocation of joint;
(k) arthroscopy;
(l) arthrodesis
of foot and ankle;
(m) arthroplasty
of foot and toe;
(n) other
operations on joints;
(o) arthroplasty
of knee and ankle;
(p) division
of muscle, tendon and fascia;
(q) excision
of lesion of muscle, tendon, fascia and bursa;
(r) suture
of muscles, tendon and fascia;
(s) reconstruction
of muscle and tendon;
(t) other
plastic operations on muscles, tendon and fascia;
(u) other
operations on muscle, tendon, fascia and bursa;
(v) amputation
of lower limb;
(w) free
skin graft;
(x) flap
or pedicle graft;
(y) other
repair and reconstruction of skin and subcutaneous tissue.
