Preferred Provider Arrangements for Prior Approved Out-of-Country Health Services

Regulation 552 under the Health Insurance Act authorizes the Ministry of Health and Long-Term Care (MOHLTC) to enter into funding agreements - preferred provider arrangements  (PPAs) - with out-of-country (OOC) hospitals and health facilities.  Facilities are selected for PPA status using criteria appropriate to the insured medical service that is covered by the PPA.  PPAs are reviewed periodically to ensure that the selection process is current, competitive and open. 

If an insured health service is covered by one or more PPAs, but an Ontario patient receives the service or an equivalent service from an OOC provider that has not entered into a PPA with the MOHLTC, then the amount payable is nil.

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