Remuneration on the rise

THE 2013 MEDICARE FREEZE has been a cause of concern across the medical profession. The issue flows into the NSW public hospital system with respect to remuneration for VMOs engaged on fee-for-service contracts. Fee-for-service Visiting Medical Officers are paid in accordance with the CMBS. As a result of the freeze, these VMOs have been denied any increase in remuneration over the past five years. This is in contrast with the indexation of 2.5% p.a. consistently provided to Sessional Visiting Medical Officers (noting that 2.5% p.a. is the maximum increase achievable since 2011 under NSW public sector wages policy).

Following a lengthy advocacy period by AMA (NSW), NSW Health has agreed* to provide fee-for-service Visiting Medical Officers with year-on-year increases in line with their sessional colleagues**. Since the negotiations began in 2016, the increase will include a back payment to 1 January 2017. In practical terms, fee-for-service VMOs will shortly receive:

1. A first lump sum payment calculated at 2.5% of total claims paid between 1 January 2017 and 30 June 2017;
2. A second lump sum payment calculated at 5.06% of total claims paid between 1July 2017 and 30 June 2018; and
3. Another 2.5% increase from 1 July 2018, which will bring VMO remuneration up to 107.69% of the scheduled MBS fee.

Going forward, the maximum increase under NSW wages policy will be applied again in July 2019 and July 2020. Any additional allowances under the fee-for-service determination will be calculated on top of this amount (e.g. emergency afterhours services from 1 July 2018 will be paid at 119.46% of the MBS fee, or 129.23% for regional VMOs residing within 50km of the applicable hospital).

The agreement will expire on 30 June 2021 and it is anticipated that negotiations for a 2021-22 increase and beyond will commence well prior to the expiry date. Any changes to NSW wages policy will need to be taken into account.

It is important to note that the increase is being provided in lieu of, rather than in conjunction with, CMBS fee indexation scheduled to be introduced on 1 July 2018 (for GPs) and 1 July 2019 (for Specialists).

To mitigate any potential losses, we have secured the option to exit the agreement in any particular year if the scheduled indexation proves more beneficial than the 2.5% increase. Increases from previous years would not be forfeited by exiting the agreement.

Back payment will also be available for VMOs who left the VMoney system prior to 1 July 2018 provided they held a Fee-for- Service contract on or after 1 January 2017.

Healthshare will contact former VMOs at their last known email address and provide a Retrospective VMO Payment Form for completion. The lump sum payments will be transferred into the bank account of your choosing. NSW Health have agreed to a 1 November 2018 window for receipt of these claims. Please ensure you check your email regularly and are in contact with AMA (NSW) should you not have received the form by 15 August.

For those who continue to provide VMO services from 1 July 2018, the lump sum payments and increases will be calculated and applied automatically following the processing of your next VMoney claim from July 2018. You do not need to do anything beyond submitting your next monthly claim as normal, although you will not receive the retrospective payments until you submit your next claim.

We acknowledge the work of the AMA (NSW) VMO Working Party in achieving this result. The VMO Working Party was led by Councillor Dr Fred Betros and includes a number of other VMOs from metropolitan and regional hospitals.

For further information regarding VMO payments, as well as suggestions for other projects for the VMO Working Party, please contact Andrew Campbell at (02) 9439 8822 or andrew.campbell@amansw.com.au.

Should you require accounting advice regarding the payments, we can arrange an obligation-free consultation with our commercial partners Cutcher & Neale.