C2.1 ED Services - On-site Coverage
Sessional fees and fee-for-service payments shall be payable for work performed at the Queen Elizabeth Hospital (“QEH”), Prince County Hospital (“PCH”), Kings County Memorial Hospital (“KCMH”), and Western Hospital (“WH”) Emergency
Departments. The number of funded hours of on-site coverage for each of these facilities, as of the signing of this Agreement, is listed in Appendix “E”.
Funded hours for on-site coverage shall be paid by an hourly sessional fee which shall be billed using the site-specific fee code listed in the Tariff of Fees. Effective October 1, 2012, a premium of 8% shall apply for on-site coverage provided on weekends and statutory holidays.
C2.2 In addition to sessional fees, Emergency Department Physicians (“EDPs”) and ED locum physicians shall be paid a percentage of the value of all submitted and approved shadow billing claims that have a service date on or after the following dates:
Apr-01-2010 Oct-01-2012 Oct-01-2013 Oct-01-2014 22% 24% 26% 28%
C2.3 The number of funded on-site coverage hours at each hospital is determined by taking into account patient volume and acuity of illness. The precise daily requirements for EDP coverage may vary from time to time according to patient volume and acuity of illness, and shall be determined by the Head of each Emergency Department (PCH and QEH) or applicable Medical Director (KCMH and WH) . All coverage hours actually provided in accordance with daily requirements shall be paid so long as the annual cost
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-approved by the Minister. For monitoring purposes, Health PEI shall provide quarterly reports to the Head of each Emergency Department or applicable Medical Director with respect to actual costs to date. In the event that the quarterly report indicates that there is an unused accumulation or an excess utilization of one hundred (100) funded hours or more, the Head of the Emergency Department or applicable Medical Director shall meet with the Joint Consultation Committee to discuss and determine any action required.
C2.4 If the workload in the Emergency Department warrants a change in the total number of funded on-site coverage hours at a hospital, then requests for a change in funded
coverage hours and/or additions to the EDP complement shall be addressed in the usual manner through the Physician Resource Planning Committee.
C2.5 Rural Hospital Incentive and On-Call Retainer
(a) For the term of this Agreement, “rural hospital” shall mean Souris Hospital, Kings County Memorial Hospital (Montague), Stewart Memorial Hospital (Tyne
Valley), Community Hospital (O’Leary), or Western Hospital (Alberton).
(b) Each permanent full-time physician whose principal place of practice is within the catchment area of a rural hospital shall receive an annual Rural Hospital
Incentive, payable in equal monthly installments, provided the physician
maintains active medical staff privileges at that hospital and participates equitably in the on-call rotation for that hospital.
(c) The annual Rural Hospital Incentive shall be:
(i) $5,000 for physicians practicing at a rural hospital with an emergency department where the physician is remunerated with the ED On-site sessional fee (or equivalent) defined in Article C2.1; or
(ii) $20,000 for physicians practicing at a rural hospital without an emergency department.
(d) Such incentive payments shall be pro-rated for permanent part-time physicians, and shall not apply to locum physicians. A physician may be eligible to receive only one of the above incentive payments.
(e) The Rural Hospital On-Call Retainer shall be paid to one (1) physician per rural hospital per twenty-four (24) hour period:
(i) using fee code 0040 for the provision of in-patient on-call services and after-hours emergency department on-call services at a rural hospital with a 24-hour Emergency Department; or
(ii) using fee code 0185 for the provision of in-patient on-call services at a rural hospital without a 24-hour emergency department.
(f) In addition to the Rural Hospital On-Call Retainer, physicians shall be paid fee-for-service for all approved claims for services rendered while on-call, which in the case of alternate pay physicians must be outside the physicians’ regularly scheduled hours of work.
C2.6 In the event that Health PEI decides to fund certain on-site Emergency Department coverage at a hospital listed in sub-article C2.5, and the affected physicians through the Medical Society have been consulted and have agreed to provide such on-site coverage, then remuneration shall be in accordance with the sessional fees and fee-for-service payments set out in sub-articles C2.1 and C2.2.
C2.7 Other Provisions Respecting Emergency Departments
All of the following paragraphs apply at all times to services provided in the
Emergency Departments at QEH and PCH; and to KCMH and WH between the hours of 8:00 a.m. and 10:00 p.m. (generally known as “Site 4 visits”).
(a) All services (irrespective of type) provided outside an Emergency Department, i.e., non-site 4 visits, shall continue to be paid by Health PEI on a fee-for-service basis. For the purpose of this paragraph, “outside the Emergency Department”
means any other location within the hospital or outside the hospital, including but not limited to a private medical clinic. For greater certainty, any emergency physician who bills fee-for-service outside an Emergency Department shall be paid at the full rate in the Tariff of Fees for all fee-for-service work that is
rendered, shall not be regarded as a locum, and article C11 herein shall not apply.
It is expected that such services shall primarily occur outside the EDP’s scheduled shift duty.
(b) EDPs shall be entitled to retain all payments for third party billings and other uninsured services, including payments for medical reports. The documentation associated with these services, i.e. writing reports, must be completed outside sessional hours. EDPs shall not be required to work additional offset time for examining/treating uninsured patients. Sessional claims shall be submitted using current billing numbers and a hospital-specific sessional fee code.
(c) EDPs shall submit shadow billing claims, as required in Article A18 for all services provided to patients during their ER shifts. Except for those physicians who are salaried, the shadow billing claims shall be submitted, at physicians’ own expense, using individual billing numbers.
(d) An EDP who occasionally provides primary care to patients in the Emergency Department outside of that physician’s regular ER shift duty shall be paid by Health PEI on a fee-for-service basis, subject to the following:
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-(i) An EDP who covers an ER shift on a particular day shall not be entitled to bill fee-for-service for Site 4 visits provided on that same day. For the purpose of this Article, “same day” is defined as the 24-hour period commencing at 0001 hours during which the shift is worked. For shifts extending over 0001 hours, the day during which the FFS billing restriction applies, is the day in which the longest portion of the shift is worked.
(e) Scheduling of physicians for Emergency Department coverage shall be the responsibility of the Head of Emergency or Medical Director, as applicable, at each hospital.
(f) Each group of EDPs at QEH, PCH, KCMH and WH shall enter into a service coverage contract with Health PEI. The contract to be entered into is attached hereto as Appendix “D”.
(g) If the workload in the Emergency Department warrants a change in the total hours of physician coverage, then requests for a change shall be addressed in the usual manner through the Physician Resource Planning Committee.