The changes are part of Budget 2018 and include extending:
These initiatives are included within the PHO Services Agreement. The changes provide additional subsidies to enable practices to charge patients no more than $18.50 for enrolled adults and $12.50 for enrolled youth aged 14-17 for a standard day time nurse or GP consultation.
Historically in Medtech PMS systems the Z or HUHC has always taken precedence over the 1 or CSC when a patient has both available to them. However with the introduction of the new CSC initiative, the CSC will take priority for a patient with both cards.
At the moment, and until changes are made to the applications, when invoicing a CSC/HUHC patient practices have been advised they should manually adjust the patient fee to the CSC price. This issue was included in Bulletin 7 sent out from the Ministry of Health (MOH).
What does the CSC scheme mean for patients with a HUHC?
The HUHC benefits for patients are not outlined in the PHO Services Agreement and as such HUHC benefits vary nationally (funding rates are noted in the agreement). HUHC patients with a CSC will be entitled to CSC lower cost visits when a practice has opted-in. Benefits for HUHC holders without a CSC are up to the practice to determine. The HUHC funding stream remains unchanged by the CSC initiative. The MOH website has been updated to reflect this.
Updating dependants of CSC holders
A new ASR file (PHO import) will be available to your practice within the next week which will contain updated information for dependants of CSC holders. Please refer to the instructions on how to run this file. The MOH has released key messaging and call centre scenarios to support communications about the new primary care initiatives. Some of these scenarios could be helpful to frontline staff resolving queries from patients.For more information contact your practice support person.
Non-Very Low Cost Access (VLCA) practices had the option to:
VLCA practices will be paid capitation for enrolled CSC holders at the same rates as non-VLCA practices. This will be accompanied by other changes to capitation for VLCA practices that are all included in the practice financial modelling. These changes will take place automatically, no action is required.
It's very likely you will have questions, please contact your practice support person in the first instance. We'll be working closely with the MOH implementation team and feeding back all your questions.
Regular updates will be provided via our weekly newsletter and website. We'll also make all MOH bulletins available as they are released (see above).