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Notice of the making of this Statutory Instrument was published in
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“Iris Oifigiúil” of 26th July, 2013.
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I, JAMES REILLY, Minister for Health, in exercise of the powers conferred on me by section 9 of the Financial Emergency Measures in the Public Interest Act 2009 (No. 5 of 2009) (as adapted by the Health and Children (Alteration of Name of Department and Title of Minister) Order 2011 ( S.I. No. 219 of 2011 )), having complied with subsections (4), (7) and (13) of that section, with the consent of the Minister for Public Expenditure and Reform, hereby make the following regulations:
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1. These Regulations may be cited as the Health Professionals (Reduction of Payments to Ophthalmologists, Optometrists and Dispensing Opticians) Regulations 2013.
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2. In these Regulations-
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“residential setting” means any of the following:
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(a) a nursing home within the meaning of section 2 of the Health (Nursing Homes) Act 1990 (No. 23 of 1990);
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(b) a home, centre or institution or a part of a home, centre or institution at which residential services are provided to-
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(i) persons with disabilities, in relation to their disabilities, or
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(ii) other dependent persons, in relation to their dependencies,
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by the Health Service Executive, a person who enters into an arrangement under section 38 of the section 39 of the Health Act 2004 ;
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(c) a centre within the meaning of section 62 of the Mental Health Act 2001 (No. 25 of 2001);
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“disability” means disability as defined in section 2 of the Disability Act 2005 (No. 14 of 2005) and the term “substantial restriction” in that definition shall be construed as meaning a restriction as described in paragraphs (a) and (b) of section 7(2) of that Act.
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3. These Regulations shall apply to payments in respect of-
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(a) services rendered by an ophthalmologist, optometrist or dispensing optician to or on behalf of the Health Service Executive under the Community Optometric Services Scheme, the Community Spectacle Dispensing Services Scheme and the Health Amendment Act Card Scheme, and
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(b) services rendered by an ophthalmologist to or on behalf of the Health Service Executive under the Community Medical Ophthalmic Services Scheme and the Community Ophthalmic Services Medical Treatment Scheme.
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4. The amount of a payment that shall be made to an ophthalmologist, optometrist or dispensing optician in respect of a service referred to in Regulation 3 from the date of the making of these Regulations shall be those specified in Schedules 1, 2, 3 and 4.
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5. The following regulations are hereby revoked, namely:
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(a) the Health Professionals (Reduction of Payments to Ophthalmologists, Optometrists and Dispensing Opticians) Regulations 2009 ( S.I. No. 195 of 2009 );
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(b) the Health Professionals (Reduction of Payments to Optometrists for Certain Services) Regulations 2011 ( S.I. No. 261 of 2011 ).
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SCHEDULE 1
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Services rendered by an ophthalmologist, optometrist or dispensing optician under the Community Medical Ophthalmic Services Scheme, the Community Optometric Services Scheme, the Community Spectacle Dispensing Services Scheme or the Health Amendment Act Card Scheme
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Reference Number (1)
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Service (2)
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Amount (3)
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Eye Examination
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1.
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Eye examination by optometrist
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€22.51
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2.
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Eye examination by ophthalmologist
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€24.78
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3.
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Medical eye examination by ophthalmologist
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€49.58
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4.
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Eye examination by optometrist with dilation
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€45.03
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5.
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Domiciliary eye examination by optometrist (other than a domiciliary eye examination carried out by an optometrist in a residential setting) including any subsequent visits to fit appliances
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€67.53
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6.
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Dilation by optometrist in connection with a domiciliary eye examination (other than dilation in connection with a domiciliary eye examination carried out by an optometrist in a residential setting)
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€22.51
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Single Vision Complete Appliances
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7.
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Spectacles - distance
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€42.07
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8.
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Spectacles - reading
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€42.07
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9.
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Spectacles - uncollected
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€29.32
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10.
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Contact lenses
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€42.07
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Repairs
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11.
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Replacement frame (patients own lenses)
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€12.16
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Single Vision Lenses to Patients Own Frame
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12.
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Replacement distance lens (1) to patient’s own frame
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€16.35
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13.
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Replacement distance lenses (2) to patient’s own frame
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€32.71
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14.
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Replacement reading lens (1) to patient’s own frame
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€16.35
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15.
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Replacement reading lenses (2) to patient’s own frame
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€32.71
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Other Items - Single Vision Appliances
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16.
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Lenticular lens (1 surface)
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€11.64
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17.
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Lenticular lenses (2 surfaces)
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€23.28
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18.
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Lenticular lenses (3 surfaces)
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€34.92
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19.
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Lenticular lenses (4 surfaces)
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€46.56
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20.
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Tinted lens (1)
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€7.43
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21.
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Tinted lenses (2)
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€14.87
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22.
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Tinted lenses (3)
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€22.30
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23.
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Tinted lenses (4)
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€29.74
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24.
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Prism (1)
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€6.30
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25.
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Prisms (2)
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€12.60
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26.
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Prisms (3)
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€18.90
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27.
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Prisms (4)
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€25.20
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28.
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Prisms (5)
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€31.50
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29.
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Prisms (6)
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€37.80
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30.
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Prisms (7)
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€44.10
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31.
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Prisms (8)
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€50.40
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Bifocals
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32.
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Spectacles bifocal complete to standard frame
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€83.70
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Bifocal Lenses
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33.
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Replacement bifocal lens (1) to patients own frame
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€37.21
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34.
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Replacement bifocal lenses (2) to patients own frame
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€74.42
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Other Items -Bifocal
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35.
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Tinted lens (1)
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€8.21
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36.
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Tinted lenses (2)
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€16.42
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37.
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Prism (1)
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€8.76
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38.
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Prisms (2)
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€17.51
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SCHEDULE 2
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Additional services rendered by an ophthalmologist, optometrist or dispensing optician under the Health Amendment Act Card Scheme
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Reference Number(1)
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Service (2)
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Amount (3)
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Eye Examination
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1.
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Eye examination for contact lenses (grant)
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€68.44
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Single Vision Complete Appliances
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2.
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Contact lenses - standard or disposable - per pair (grant)
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€64.34
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3.
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Single vision spectacles - with glass lenses - distance
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€122.18
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4.
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Single vision spectacles - with glass lenses - reading
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€122.18
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5.
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Single vision spectacles - with plastic lenses - distance
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€131.27
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6.
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Single vision spectacles - with plastic lenses - reading
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€131.27
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Repairs
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7.
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Complete new frames
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€90.60
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Single Vision Lenses to Non-Standard Frame
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8.
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Single vision lens (1) (glass) - distance
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€23.54
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9.
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Single vision lenses (2) (glass) - distance
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€47.10
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10.
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Single vision lens (1) (glass) - reading
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€23.54
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11.
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Single vision lenses (2) (glass) - reading
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€47.10
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12.
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Single vision lens (1) (plastic) - distance
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€26.84
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13.
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Single vision lenses (2) (plastic) - distance
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€53.67
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14.
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Single vision lens (1) (plastic) - reading
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€26.84
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15.
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Single vision lenses (2) (plastic) - reading
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€53.67
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Additional Specification for Lenses to all Spectacle Types
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16.
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Special grant towards additional specification for lens (1) - all spectacle types
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€81.81
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17.
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Special grant towards additional specification for lenses (2) - all spectacle types
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€163.62
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Other Items - Single Vision Appliances
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18.
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Anti-reflective coating on plastic lens (1)
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€18.14
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19.
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Anti-reflective coating on plastic lenses (2)
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€36.28
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20.
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Plastic lens (1) adult
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€4.55
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21.
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Plastic lenses (2) adult
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€9.10
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Bifocals
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22.
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Fused bifocal spectacles to standard frame
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€163.01
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23.
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Varifocal spectacles - glass or plastic to standard frame
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€250.80
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Bifocal Lenses
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24.
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Bifocal lens (1) to non-standard frame
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€47.89
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25.
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Bifocal lenses (2) to non-standard frame
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€95.78
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26.
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Varifocal lens (1) (grant)
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€94.82
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27.
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Varifocal lenses (2) (grant)
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€189.64
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SCHEDULE 3
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Services rendered by an ophthalmologist under the Community Ophthalmic Services Medical Treatment Scheme
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Reference Number (1)
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Service (2)
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Amount (3)
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Acute Treatment
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1.
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Inflammatory or infective eye conditions - first visit
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€75.76
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2.
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Inflammatory or infective eye conditions - subsequent visits
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€59.51
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3.
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Removal of corneal/conjunctival foreign body - first visit
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€75.76
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4.
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Removal of corneal/conjunctival foreign body - subsequent visits
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€59.51
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5.
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Sudden visual loss - first visit
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€75.76
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6.
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Sudden visual loss - subsequent visits
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€59.51
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7.
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Vitreo/Retinal conditions - first visit
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€75.76
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8.
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Vitreo/Retinal conditions - subsequent visits
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€59.51
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9.
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Epilation - first visit
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€75.76
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10.
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Epilation - subsequent visits
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€59.51
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Chronic Treatment
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11.
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Glaucoma - first visit
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€75.76
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12.
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Glaucoma - subsequent visits
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€59.51
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13.
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Glaucoma - annual visits
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€75.76
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14.
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Cataracts, Pre-operative - first visit
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€75.76
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15.
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Cataracts, Pre-operative - subsequent visits
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€59.51
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16.
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Cataracts, Pre-operative - annual visits
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€75.76
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17.
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Cataracts, Post-operative - first visit
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€75.76
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18.
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Cataracts, Post-operative - subsequent visits
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€59.51
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19.
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Cataracts, Post-operative - annual visits
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€75.76
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20.
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Age related macular degeneration - first visit
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€75.76
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21.
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Age related macular degeneration - subsequent visits
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€59.51
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22.
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Age related macular degeneration - annual visits
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€75.76
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23.
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Diabetic ophthalmic management - first visit
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€75.76
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24.
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Diabetic ophthalmic management - subsequent visits
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€59.51
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25.
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Diabetic ophthalmic management - annual visits
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€75.76
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26.
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Vitreo/Retinal conditions - first visit
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€75.76
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27.
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Vitreo/Retinal conditions - subsequent visits
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€59.51
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28.
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Vitreo/Retinal conditions - annual visits
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€75.76
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29.
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Neuro-Ophthalmological conditions - first visit
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€75.76
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30.
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Neuro-Ophthalmological conditions - subsequent visits
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€59.51
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31.
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Neuro-Ophthalmological conditions - annual visits
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€75.76
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32.
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Chronic inflammatory conditions - first visit
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€ 75.76
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33.
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Chronic inflammatory conditions - subsequent visits
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€59.51
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34.
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Chronic inflammatory conditions - annual visits
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€75.76
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35.
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Management of ocular naevi/tumours - first visit
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€75.76
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36.
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Management of ocular naevi/tumours - subsequent visits
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€59.51
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37.
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Management of ocular naevi/tumours - annual visits
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€75.76
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Surgical treatment
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38.
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Recurrent corneal erosion/ulcer surgery
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€108.22
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39.
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Removal of corneal epithelium
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€108.22
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40.
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Corneal scraping
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€108.22
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41.
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Removal of corneal sutures
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€108.22
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42.
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Excision of conjunctival cyst/granuloma
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€108.22
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43.
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Injection of antibiotic/steroid
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€108.22
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44.
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Electrolysis/cryotherapy for trichiasis
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€108.22
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45.
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Injection for blepharospasm
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€108.22
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46.
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Everting sutures for entropion
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€108.22
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47.
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Repair of injury to eyelid
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€108.22
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48.
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Excision of chalazion or other eyelid lesion
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€108.22
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49.
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Removal of peri-orbital skin lesions
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€108.22
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50.
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Dilating and syringing/probing of duct
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€108.22
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51.
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Lacrimal sac washout
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€108.22
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52.
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Incision of lacrimal abscess
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€108.22
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53.
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Surgery to lacrimal punctum
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€108.22
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54.
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Insertion of plugs
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€108.22
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55.
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Correction of everted punctum
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€108.22
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56.
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Removal of lacrimal duct tubes
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€108.22
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57.
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Domiciliary visits
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€108.22
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SCHEDULE 4
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Services rendered by an optometrist in one or more residential settings under the Community Optometric Services Scheme, the Community Spectacle Dispensing Services Scheme or the Health Amendment Act Card Scheme
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Reference Number (1)
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Service (2)
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Amount (3)
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1.
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Domiciliary eye examination or examinations carried out by an optometrist in one or more residential settings on a particular day including any subsequent visits to fit appliances:
(a) 1st patient
(b) 2nd patient
(c) Each additional patient up to a maximum of 15 patients on the day concerned
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€67.53
€45.02
€22.51
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2.
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Dilation carried out by an optometrist in one or more residential settings on a particular day in connection with a domiciliary eye examination:
(a) 1st patient
(b) 2nd patient
(c) Each additional patient up to a maximum of 15 patients on the day concerned
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€22.51
€15.00
€7.50
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The Minister for Public Expenditure and Reform consents to the foregoing Regulations.
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GIVEN under my Official Seal,
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24 July 2013.
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BRENDAN HOWLIN,
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Minister for Public Expenditure and Reform.
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GIVEN under my Official Seal,
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24 July 2013.
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JAMES REILLY,
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Minister for Health.
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EXPLANATORY NOTE
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(This note is not part of the Instrument and does not purport to be a legal interpretation.)
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These Regulations apply to payments to ophthalmologists, optometrists and dispensing opticians in respect of services under the Community Optometric Services Scheme, the Community Spectacle Dispensing Services Scheme and the Health Amendment Act Card Scheme and to ophthalmologists under the Community Medical Ophthalmic Services Scheme and Community Ophthalmic Services Medical Treatment Scheme.
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