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Today’s special member message spotlights two important issues. Members will see a key updates about increases to remuneration and new fees effective October 1, 2023, with links to new billing advice and quick reference guides. First up, you will see a recap of our Leaders’ Town Hall and election advocacy.

Leaders’ Town Hall and Election Advocacy

On Wednesday, we hosted a first here at Doctors Manitoba. A Health Care Town Hall with the leaders of the main three political parties in Manitoba. Premier Heather Stefanson, Wab Kinew and Dougald Lamont answered questions from physicians, including about the NDP plan to reopen ERs, the PC plan to expand the scope of practice for pharmacists, and the Liberal plan for primary care. Over 2,000 tuned in live or have watched the town hall on demand. You can watch it anytime on our YouTube Channel.

All three leaders recognized the shortage of physicians and other health care providers, and all pledged to focus on recruitment and retention. All three support an expansion of the medical school. All three have pledged to expand inpatient hospital capacity in some form. All three have pledged to increase funding for health care. Beyond this, they each have different plans, some of which align with our Prescription for Health Care, a seven-point plan to improve the health care system. You can see the PC Plan for Building Healthy Communities here, the NDP Plan for Fixing Health Care here, and the Liberal platform here.

Our town hall received widespread media coverage, including:

  • Party leaders explain how’ and why’ on doctors’ turf (Winnipeg Free Press). Read the article here. If you do not have access, you can view an alternative version here.
  • CTV News story summarizing the Town Hall (Watch here — <2 minutes)
  • Political leaders share prescriptions for health-care in town hall with Manitoba doctors (CBC News). View here.
  • Provincial leaders discuss health care during Doctors Manitoba forum (CTV News). View here.

Thank you to the hundreds of members who have contributed ideas to form our Prescription for Health Care, or have taken the time to submit questions for the Leaders’ Town Hall. 

Advance polls are open until tomorrow, September 30, and election day is on October 3. Find out how to vote here.

New Fees and Increased Remuneration

Under the new Physician Services Agreement, new and enhanced remuneration and funding for physicians will take effect on October 1. As this is an historic Agreement for physicians — the biggest in Manitoba’s history with $268 million in new funding — there are a lot of changes and new tariffs to better support your practice. Our team is here to guide you through the changes and help you adopt them into your practice, every step of the way. 

In fact, this is the most complex bundle of changes in an Agreement that we can remember. In this newsletter, we will walk you through some of the most significant changes for the profession. Over the next few weeks, we will continue to profile other advancements taking effect in October that could benefit your practice. 

Under the Physician Services Agreement, market adjustments will be made for every tariff and alternate funded agreement effective October 1, 2023. While an updated Physician’s Manual has not yet been posted by Manitoba Health, though we understand it should be available early next week. When available, you will find it here on the Manitoba Health website. In the meantime, we have prepared in-depth information and quick reference billing advice, all of which is now available. Once the new Manual is posted, we will comb through it to ensure everything we negotiated is reflected. 

Tariff Rate Tables and Alternate Funded Agreements: We have updated the Member Portal with finalized Fee-For-Service Rate Tables and signed Alternate Funded Agreements. You can view them here in our revamped Remuneration Information Centre (log in required). This includes the same information you saw during ratification, plus the finalized rate tables and agreements. 

There are now three new blocs of practice for infectious disease, respirology, and endocronology. You will find your rate tables under Internal Medicine in the Remuneration Information Centre.

Infectious disease specialists, respirologists and endocrinologists wishing to
move to the new bloc of practice should contact:

Practitioner Registry/​User Site Maintenance
2047882567 or 2047867225
practitionerregistry@gov.mb.c

New Fee-for-Service Tariffs

Our team has prepared a series of billing articles about new and enhanced tariffs. We are also hosting two billing webinars next week to provide more information and take your questions. 

Webinar for Family Medicine and Primary Care

Webinar for Specialty and Hospital Care

You will be able to submit questions when registering, and ask live during the webinars. Both sessions will also be available for on-demand streaming 

New and Enhanced Communication Tariffs

New tariffs will support more physician-to-physician collaboration to better serve your patients. This includes tariffs for both the referring and responding physicians for eConsultations, as well as for phone or video calls. These are significant advancements that have been negotiated to support your practice. We’ve prepared a summary of the new and existing communication tariffs, to help you understand how and when you can claim for collaborative discussions about patient care. Read our overview about communication tariffs.

Join either webinar on October 4 or October 5 to learn more (recording will be available).

eConsultation has been piloted in Manitoba for some time, with ad hoc remuneration structures. New tariffs are now in place, offering $27.33 for the referring physician and $60 per fifteen minutes for the consulting physician. There are two eConsult platforms currently in use, BASE and Store & Forward. Hundreds of eConsults are submitted monthly from over 500 primary care physicians to dozens of different specialty groups. Read more about eConsultation tariffs and how to register for the eConsult platforms.

Phone & Video Communication between doctors is now recognized with new tariffs, including $25 for the initiating physician and $50 for the responding physician. This is a significant advancement from the existing tariffs which offered $16.50 to only the responding physician. Learn more about phone and video communication between physicians.

New Extended Visit Tariff

Family physicians and pediatricians now have access to a new tariff for extended visits involving two or more patient complaints and lasting 20 minutes or longer. The new extended visit is available in-person or on video, and is approved as a provisional tariff for an 18-month period. Doctors Manitoba and Manitoba health will evaluate its value and effectiveness. Learn more about the new extended visit tariff here.

Join our webinar on October 4 to learn more (recording will be available)

New Visit Premiums and Supplements

Two new tariffs will enhance the value of patient visits in hospital and in community-based physician practices.

Hospital Visit Premium: All patient visits in hospital ERs or inpatient wards will now be eligible for a 15% premium. A new tariff has been created and must be claimed along with eligible hospital visit tariffs. Read more here.

Join our webinar on October 5 to learn more (recording will be available)

Community-Based Practice Supplement: Every visit taking place in eligible community-based practices will now be eligible for a supplement of $3.50. Learn more about why this new tariff was developed and how to claim it.

Join either webinar on October 4 or October 5 to learn more (recording will be available)

Simplified Visits for Family Medicine, Pediatrics and OBGYN

The new Agreement brings a new simplified visit page that will make it easier and more intuitive to bill, while also applying a gender equity lens to more appropriately compensate physicians for pelvic exams and pap tests. Read more about the new simplified visit structure, and access our quick reference guides to help.

Join our webinar on October 4 to learn more (recording will be available)

Permanent Virtual Visit Tariffs

Virtual care is now permanent in Manitoba! In most cases, this will mean business-as-usual as the temporary tariffs negotiated during the pandemic will remain, at 100% of the equivalent in-person rate. This is quite significant as several provinces have discounted some virtual visit rates. There are a few significant changes, and we encourage all physicians who offer virtual care to review the changes carefully. This includes no longer requiring start and stop times for all existing tariffs, important changes for episodic virtual care, and the introduction of a new extended video visit for family physicians and pediatricians. See our new Virtual Visit billing guide here.

Join either webinar on October 4 or October 5 to learn more (recording will be available)

Tray Fees

Several procedures are now eligible for tray fees, and some existing procedures have been upgraded to higher tray fees. Further, all tray fees are receiving significant increases to reflect escalating costs, including a 20% increase for minor and major tray fees and a 74% for endoscopic tray fees. Learn more about the changes here.

Join either webinar on October 4 or October 5 to learn more (recording will be available)

Immunization Delegation

Did you know that under the new Agreement, physicians can fully delegate immunizations to qualified providers in their practice, and still claim the tariff? While a small step towards funding other providers in your practice, it’s a potential giant leap for the profession in shifting how fee-for-service billing can support team-based care. Learn more about immunization delegation here.

Other New and Enhanced Tariffs:

  • Interfacility transport — There is now a new tariff for physicians receiving an interfacility transfer in rural hospitals, PCHs, and community hospitals. Read more.
  • Specialist On Call has a significant increase to reflect a new responsibility to respond to secure messaging (i.e. Cortext) when on-call. Learn more here.
  • Remote Community Differentials of 35% will now apply in designated communities. Find out more about this and which communities qualify.
  • Extended hours premiums for primary care are now permanent. Read our summary here.

Join either webinar on October 4 or October 5 to learn more (recording will be available)

Coming April 1

There are several additional increases and new tariffs coming on April 1, 2024. Work continues on preparing these advancements, which include:

  • Family Medicine Plus, Manitoba’s new longitudinal family practice model. 
  • Continuing Patient Management for Specialists
  • 2% across the board increases for all tariffs and alternate funded agreements.

New and Enhanced Benefits

We have negotiated important enhancements to our physician benefit programs for you:

  • One-time Special Retention Payments of $21,000 are being sent to all eligible physicians. If you have not received your payment deposited directly into your account, a cheque will be sent today. 
  • Our Maternal / Parental leave benefit has increased to up to $2,000 per week, up from a maximum of $1,400 per week. This will be applied retroactively to August 142023
  • A new Rural and Northern Retention Benefit will be created, with the first payments expected in 2026
  • CMPA Rebates for your liability insurance will have a lower deductible and simplified calculation. 

Questions and Further Guidance

Questions? Need Advice? Contact us at practiceadvice@​doctorsmanitoba.​ca.