MPX Initial Assessment and Testing - sector letter

Interim Funding Framework to Support Primary Care’s Response to Monkeypox 7 October 2022

Tēnā koutou katoa, With community transmission of Monkeypox (MPX) now confirmed in Aotearoa New Zealand, this letter provides you with the approach that will be used to implement a national assessment and testing framework to support those people suspected of contracting MPX. Te Whatu Ora recognises and values the critical role that general practice, Hauora providers and urgent care partners will play in our MPX response and are pleased to introduce the following interim funding framework that will apply until 7 November 2022. Further guidance will be provided on how services will be supported after 7 November 2022 in due course, after consultation with key stakeholders.

The MPX assessment and testing framework will apply to: 1. anyone who meets the MPX Case definition (available on HealthPathways); or 2. where the practitioner has strong suspicion of MPX infection after consultation with a Medical Officer of Health; or 3. where the Medical Officer of Health has recommended a test be undertaken.

People who do not meet the above criteria should not be tested and the usual co-payments should apply.

Services must be delivered by a general practitioner or nurse practitioner and follow the clinical algorithm available on Health Pathways. The case definition and clinical algorithm may be updated from time to time. Updates will be published on Health Pathways and communicated to the primary care sector.

The provision and funding of MPX assessments and testing will be in addition to any existing funding.

The claiming conditions for this service requires there is no: • • •

charge/patient co-payment for this service, including issuing prescriptions claim for a GMS clawback simultaneous claim against any other funding stream for this service.

Standard fee for service prices of $180 will apply for an initial consultation and $90 for one follow-up consultation per patient. The follow-up consultation is to be delivered within two weeks of the initial consultation, if clinically warranted. Usual patient co-payments will apply for any additional services required.

An additional premium will apply for those services delivered by urgent care clinics or delivered by general practices out of hours. For the purposes of this service, out-of-hours is defined as: • • •

8pm to 8am Mondays to Thursdays; or 5pm Fridays to 8am Mondays; or Any public holiday.

These fees are outlined in Table 1 below.

Table 1: Event

MPX Fee For Service Funding Framework (GST Exclusive)* Standard hours pricing ($)

Urgent care and out-ofhours pricing ($) Initial consultation 180 270 1x follow-up consultation 90 135 * These rates only apply for services delivered until 7 November 2022 We would be grateful if you could please establish a payment mechanism with your general practice and urgent care providers. We appreciate this is short notice, however we are keen to ensure that barriers to accessing testing is removed for the priority population covered by the Case Definition.

If you have any queries, please contact covidcareinthecommunity@health.govt.nz

Ngā mihi nui, Matt Hannant Director Outbreak Response Te Whatu Ora cc:

Maura Thompson, CEO, GPNZ GMs Planning and Funding, All Te Whatu Ora Districts Primary Care Portfolio Managers, All Te Whatu Ora Districts