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The Chairperson / Group Representative SAMA Specialist PPC

Dear Doctor

Re: Postponement in implementing of the 21 CPT / TIERED Consultation Codes

As you are aware, the SA Medical Association (SAMA) and the Risk Advisory Panel (RAP) of the Board of Healthcare Funders (BHF), have been having discussions on the process and impact of the implementation of the 21 Consultation/Visit codes (E & M codes) on 1 May 2002.

The RAP Committee is an effective vehicle. Dr Herc Hoffman (RAP) made a significant contribution, through the impact studies done by him, to the successful solving of most of the problems facing service providers as well as funders with the implementation of the CPT™ consultation/visit codes.

The Tariff and Risk Commission of the BHF, however, must still discuss the possible effect of certain of the impact studies done, and other changes to the Relative Values, after which the BHF Council must approve these decisions. The Profession and Industry need to manage this process to avoid disruption and confusion on both sides.

The new code's impact varies between groups. The cost neutral nature of the implementation does make the matter more complicated. The S-PPC aims not to compromise any group with the implementation.

The SAMA requested an urgent meeting with the decision-makers in the BHF structures, as it is vitally important to reach a firm agreement between the funding industry and the service providers, before implementing the CPT™ consultation structure.

The BHF Tariff and Risk Commission, is not yet in agreement to have such a meeting. The Copyright issue does put relations under pressure.

Important factors are administration, interpretation and implementing of this structure by the funding industry as well as the service providers. The current default mechanism is not acceptable.

Taking the above into account, the SAMA and the Specialist PPC have decided to postpone the implementation of the 21 CPT™ consultation/visit codes until a firm decision and commitment can be reached between the SAMA and BHF.

When an enforceable agreement is in place, to the benefit of the Specialist group as a whole, the S-PPC can proceed with implementation. Our "verbal agreement'" is not acceptable yet, and has NO legal or other standing.

SAMA will inform its members via the next Medigram. Could you please do the same to inform your Group's members, to prevent uncertainty?

Do not hesitate to contact the office, Glenda or myself, if necessary.

Kind regards . Jan Talma Chairperson: SAMA Specialist Private Practice Committee 2002-4 JT letter Chairperson & Group Representative.doc