S.I. No. 262/2009 - Health Professionals (Reduction of Payments To General Practitioners) Regulations 2009
2009
262
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S.I. No. 262 of 2009
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HEALTH PROFESSIONALS (REDUCTION OF PAYMENTS TO GENERAL PRACTITIONERS) REGULATIONS 2009
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Notice of the making of this Statutory Instrument was published in
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"Iris Oifigiúil" of 14th July, 2009.
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I, MARY HARNEY, Minister for Health and Children, in exercise of the powers conferred on me by section 9 of the Financial Emergency Measures in the Public Interest Act 2009 (No. 5 of 2009), having complied with subsections (4) and (7) of that section, with the consent of the Minister for Finance, hereby make the following regulations:
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1. These Regulations may be cited as the Health Professionals (Reduction of Payments to General Practitioners) Regulations 2009.
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2. In these Regulations-
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"Capitation Agreement" means an agreement between the Health Service Executive (HSE) and a general practitioner made in accordance with the conditions specified by the Minister for Health and Children in 1989 regarding the provision of services to eligible persons under section 58 of the Health Act 1970 (No. 1 of 1970) by general practitioners, as amended from time to time;
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"day consultation" means a consultation during normal hours of a general practitioners surgery as agreed between the Health Service Executive and that general practitioner;
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"Fee Per Item Agreement" means an agreement between the Health Service Executive and a general practitioner made in accordance with the conditions specified by the Minister for Health and Children in 1972 regarding the provision of services to eligible persons under section 58 of the Health Act 1970 (No. 1 of 1970) by general practitioners, as amended from time to time;
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"late consultation" means a consultation other than a day consultation or a night consultation;
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"night consultation" means a consultation during the period between midnight and 8 a.m. the following day.
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3. These Regulations shall apply to payments in respect of services rendered by a general practitioner to or on behalf of the Health Service Executive under the General Medical Services Scheme, the Health (Amendment) Act 1996 and the Maternity and Infant Care Scheme.
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4. The payments that shall be made to a general practitioner in respect of the services referred to in Regulation 3 from the date of the making of these Regulations shall be those specified in Tables 1 to 18 below.
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TABLE 1
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Services rendered under the General Medical Services (GMS) Scheme - Capitation Agreement - general practitioner capitation rates
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Service
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Amount
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Male patient aged under 5 years living 3 miles or less from the surgery
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€76.98
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Male patient aged under 5 years living more than 3 miles but not more than 5 miles from the surgery
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€81.07
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Male patient aged under 5 years living more than 5 miles but not more than 7 miles from the surgery
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€87.11
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Male patient aged under 5 years living more than 7 miles but not more than 10 miles from the surgery
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€93.09
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Male patient aged under 5 years living more than 10 miles from the surgery
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€100.48
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Male patient aged 5 years or more and less than 16 years living 3 miles or less from the surgery
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€44.68
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Male patient aged 5 years or more and less than 16 years living more than 3 miles but not more than 5 miles from the surgery
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€46.38
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Male patient aged 5 years or more and less than 16 years living more than 5 miles but not more than 7 miles from the surgery
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€48.87
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Male patient aged 5 years or more and less than 16 years living more than 7 miles but not more than 10 miles from the surgery
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€51.29
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Male patient aged 5 years or more and less than 16 years living more than 10 miles from the surgery
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€54.33
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Male patient aged 16 years or more and less than 45 years living 3 miles or less from the surgery
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€57.03
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Male patient aged 16 years or more and less than 45 years living more than 3 miles but not more than 5 miles from the surgery
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€59.23
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Male patient aged 16 years or more and less than 45 years living more than 5 miles but not more than 7 miles from the surgery
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€62.49
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Male patient aged 16 years or more and less than 45 years living more than 7 miles but not more than 10 miles from the surgery
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€65.68
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Male patient aged 16 years or more and less than 45 years living more than 10 miles from the surgery
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€69.60
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Male patient aged 45 years or more and less than 65 years living 3 miles or less from the surgery
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€113.91
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Male patient aged 45 years or more and less than 65 years living more than 3 miles but not more than 5 miles from the surgery
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€119.19
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Male patient aged 45 years or more and less than 65 years living more than 5 miles but not more than 7 miles from the surgery
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€126.98
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Male patient aged 45 years or more and less than 65 years living more than 7 miles but not more than 10 miles from the surgery
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€134.65
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Male patient aged 45 years or more and less than 65 years living more than 10 miles from the surgery
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€144.22
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Male patient aged 65 years or more and less than 70 years living 3 miles or less from the surgery
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€120.00
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Male patient aged 65 years or more and less than 70 years living more than 3 miles but not more than 5 miles from the surgery
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€134.67
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Male patient aged 65 years or more and less than 70 years living more than 5 miles but not more than 7 miles from the surgery
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€156.46
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Male patient aged 65 years or more and less than 70 years living more than 7 miles but not more than 10 miles from the surgery
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€177.85
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Male patient aged 65 years or more and less than 70 years living more than 10 miles from the surgery
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€204.46
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Patient aged 70 years or more
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€280.31
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Patient aged 70 years or more, residing in a private nursing home (approved by the HSE) for continuous periods in excess of 5 weeks
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€896.07
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Female patient aged under 5 years living 3 miles or less from the surgery
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€75.09
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Female patient aged under 5 years living more than 3 miles but not more than 5 miles from the surgery
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€79.19
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Female patient aged under 5 years living more than 5 miles but not more than 7 miles from the surgery
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€85.27
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Female patient aged under 5 years living more than 7 miles but not more than 10 miles from the surgery
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€91.25
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Female patient aged under 5 years living more than 10 miles from the surgery
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€98.63
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Female patient aged 5 years or more and less than 16 years living 3 miles or less from the surgery
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€45.19
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Female patient aged 5 years or more and less than 16 years living more than 3 miles but not more than 5 miles from the surgery
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€46.88
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Female patient aged 5 years or more and less than 16 years living more than 5 miles but not more than 7 miles from the surgery
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€49.43
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Female patient aged 5 years or more and less than 16 years living more than 7 miles but not more than 10 miles from the surgery
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€51.81
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Female patient aged 5 years or more and less than 16 years living more than 10 miles from the surgery
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€54.80
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Female patient aged 16 years or more and less than 45 years living 3 miles or less from the surgery
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€93.26
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Female patient aged 16 years or more and less than 45 years living more than 3 miles but not more than 5 miles from the surgery
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€95.46
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Female patient aged 16 years or more and less than 45 years living more than 5 miles but not more than 7 miles from the surgery
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€98.70
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Female patient aged 16 years or more and less than 45 years living more than 7 miles but not more than 10 miles from the surgery
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€101.37
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Female patient aged 16 years or more and less than 45 years living more than 10 miles from the surgery
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€105.81
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Female patient aged 45 years or more and less than 65 years living 3 miles or less from the surgery
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€125.17
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Female patient aged 45 years or more and less than 65 years living more than 3 miles but not more than 5 miles from the surgery
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€130.45
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Female patient aged 45 years or more and less than 65 years living more than 5 miles but not more than 7 miles from the surgery
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€138.21
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Female patient aged 45 years or more and less than 65 years living more than 7 miles but not more than 10 miles from the surgery
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€145.93
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Female patient aged 45 years or more and less than 65 years living more than 10 miles from the surgery
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€155.43
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Female patient aged 65 years or more and less than 70 years living 3 miles or less from the surgery
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€133.87
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Female patient aged 65 years or more and less than 70 years living more than 3 miles but not more than 5 miles from the surgery
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€148.56
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Female patient aged 65 years or more and less than 70 years living more than 5 miles but not more than 7 miles from the surgery
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€170.34
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Female patient aged 65 years or more and less than 70 years living more than 7 miles but not more than 10 miles from the surgery
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€191.75
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Female patient aged 65 years or more and less than 70 years living more than 10 miles from the surgery
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€218.37
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Supplementary out-of-hours fee
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€3.76
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TABLE 2
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Services rendered under the General Medical Services (GMS) Scheme - Capitation Agreement - out-of-hours payments (in respect of consultations other than day consultations or consultations occurring as part of an overflow in respect of normal surgery hours)
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Service
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Amount
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Surgery consultation - out-of-hours payment
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€46.59
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Domiciliary visit - out-of-hours payment where the patient lives 3 miles or less from the surgery
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€46.59
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Domiciliary visit - out-of-hours payment where the patient lives more than 3 miles but not more than 5 miles from the surgery
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€62.17
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Domiciliary visit - out-of-hours payment where the patient lives more than 5 miles but not more than 7 miles from the surgery
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€69.98
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Domiciliary visit - out-of-hours payment where the patient lives more than 7 miles but not more than 10 miles from the surgery
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€77.68
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Domiciliary visit - out-of-hours payment where the patient lives more than 10 miles from the surgery
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€93.24
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Domiciliary visit - out-of-hours payment where a consultation involving an additional GMS patient occurs during the same domiciliary visit
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€36.37
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TABLE 3
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Services rendered under the General Medical Services (GMS) Scheme - payments to a general practitioner (GP) in respect of temporary residents, EEA visitors and emergency consultations where a GP sees another GP's GMS patient in an emergency
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Service
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Amount
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Surgery - day consultation
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€46.59
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Surgery - late consultation
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€46.59
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Surgery - night consultation
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€46.59
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Domiciliary visit - day consultation with patient living 3 miles or less from the surgery
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€46.59
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Domiciliary visit - day consultation with patient living more than 3 miles but not more than 5 miles from the surgery
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€62.17
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Domiciliary visit - day consultation with patient living more than 5 miles but not more than 7 miles from the surgery
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€69.98
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Domiciliary visit - day consultation with patient living more than 7 miles but not more than 10 miles from the surgery
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€77.68
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Domiciliary visit - day consultation with patient living more than 10 miles from the surgery
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€93.24
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Domiciliary visit - late consultation with patient living 3 miles or less from the surgery
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€46.59
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Domiciliary visit - late consultation with patient living more than 3 miles but not more than 5 miles from the surgery
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€62.17
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Domiciliary visit - late consultation with patient living more than 5 miles but not more than 7 miles from the surgery
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€69.98
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Domiciliary visit - late consultation with patient living more than 7 miles but not more than 10 miles from the surgery
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€77.68
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Domiciliary visit - late consultation with patient living more than 10 miles from the surgery
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€93.24
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Domiciliary visit - night consultation with patient living 3 miles or less from the surgery
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€46.59
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Domiciliary visit - night consultation with patient living more than 3 miles but not more than 5 miles from the surgery
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€62.17
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Domiciliary visit - night consultation with patient living more than 5 miles but not more than 7 miles from the surgery
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€69.98
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Domiciliary visit - night consultation with patient living more than 7 miles but not more than 10 miles from the surgery
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€77.68
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Domiciliary visit - night consultation with patient living more than 10 miles from the surgery
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€93.24
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TABLE 4
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Services rendered under the General Medical Services (GMS) Scheme - Capitation Agreement - payments to a general practitioner (GP) in respect of special items of service
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Service
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Amount
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Excisions/cryotherapy/diathermy of skin lesions
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€29.14
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Suturing of cuts and lacerations
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€29.14
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Draining of hydroceles
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€29.14
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Treatment and plugging of dental and nasal haemorrhages
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€29.14
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Recognised vein treatment
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€29.14
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Electrocardiography (ECG) tests and their interpretation
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€29.14
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Instruction in the fitting of a diaphragm
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€29.14
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Removal of adherent foreign bodies from the conjunctival surface of the eye
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€29.14
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Removal of lodged or impacted foreign bodies from the ear, nose and throat
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€29.14
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Nebuliser treatment in the case of acute asthmatic attack
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€43.73
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Bladder catheterization
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€43.73
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Advice and fitting of a diaphragm
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€49.05
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Counselling and fitting of an intra uterine contraceptive device (IUCD)
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€78.49
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Attendance by GP at HSE-convened case conference
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€72.88
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TABLE 5
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Services rendered under the General Medical Services (GMS) Scheme - Capitation Agreement - allowance in respect of a general practitioner whose practice is eligible for a rural practice allowance
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Service
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Amount
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Rural practice allowance (per annum)
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€19,055.31
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TABLE 6
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Services rendered under the General Medical Services (GMS) Scheme - Capitation Agreement - fees payable to a general practitioner (GP) for dispensing in accordance with the circular titled "Certain matters relating to the provision of services under section 58 of the Health Act 1970 " dated 24 September 1999
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Service
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Amount
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Opt-in GP (dispensing doctor)
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€44.69
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Pilot GP (dispensing doctor)
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€51.56
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Continuous GP (dispensing doctor)
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€14.66
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TABLE 7
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Services rendered under the General Medical Services (GMS) Scheme - Capitation Agreement - payment to a general practitioner for a second medical opinion
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Service
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Amount
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Fee for second medical opinion
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€31.09
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TABLE 8
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Services rendered under the General Medical Services (GMS) Scheme - Capitation Agreement - maximum allowances in respect of practice support payable on the basis of a general practitioner's GMS panel size
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Service
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Amount
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Nursing subsidy (per year) - 1 years experience
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€32,903.63
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Nursing subsidy (per year) - 2 years experience
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€34,731.60
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Nursing subsidy (per year) - 3 years experience
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€36,559.59
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Nursing subsidy (per year) - 4 or more years experience
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€40,215.55
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Secretarial subsidy (per year) - 1 years experience
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€21,935.75
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Secretarial subsidy (per year) - 2 years experience
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€23,763.74
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Secretarial subsidy (per year) - 3 or more years experience
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€25,591.70
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Practice manager subsidy (per year) - based on first point of nursing subsidy
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€32,903.63
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TABLE 9
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Services rendered under the General Medical Services (GMS) Scheme - Capitation Agreement - maximum allowances payable to a general practitioner (GP) in respect of locum expenses
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Service
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Amount
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Annual leave (per day)
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€231.77
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Annual leave (per week)
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€1,622.39
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Sick leave (per day) during the first week
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€231.77
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Sick leave (per week) for the first week
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€1,158.85
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Sick leave (per day) from week 2 to week 26
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€231.77
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Sick leave (per week) from week 2 to week 26
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€1,622.39
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Sick leave (per day) from week 27 to week 52
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€115.89
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Sick leave (per week) from week 27 to week 52
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€811.20
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Study leave (per day)
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€231.77
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Study leave (per week)
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€1,622.39
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Maternity leave (per day)
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€231.77
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Maternity leave (per week)
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€1,622.39
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Paternity leave (per day)
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€231.77
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Adoptive leave (per day)
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€231.77
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Adoptive leave (per week)
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€1,622.39
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Annual leave - former District Medical Officer:(a) maximum rate - payable for each of the first 3 days annual leave in a year(b) medium rate - payable for each of the next 25 days annual leave in that year(c) minimum rate - payable for each other annual leave day in that year
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€78.11€66.81€57.48
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Statutory leave - meetings of statutory bodies (per day)
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€231.77
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Attendance at Irish Medical Organisation GP meetings (per day)
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€231.77
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TABLE 10
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Services rendered under the General Medical Services (GMS) Scheme - Capitation Agreement - payment to a general practitioner in respect of the registration of asylum seekers
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Service
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Amount
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Asylum seeker/non EU registration fee (a once-off superannuable registration fee)
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€179.25
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TABLE 11
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Services rendered under the General Medical Services (GMS) Scheme - Fee Per Item Agreement - general practitioner consultation fees
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Service
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Amount
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Surgery - day consultation with patient
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€12.83
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Surgery - late consultation with patient
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€18.25
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Surgery - night consultation with patient
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€36.09
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Domiciliary visit - day consultation with patient (urban)
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€18.93
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Domiciliary visit - day consultation with patient living 3 miles or less from the surgery
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€18.93
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Domiciliary visit - day consultation with patient living more than 3 miles but not more than 5 miles from the surgery
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€24.79
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Domiciliary visit - day consultation with patient living more than 5 miles but not more than 7 miles from the surgery
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€33.30
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Domiciliary visit - day consultation with patient living more than 7 miles but not more than 10 miles from the surgery
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€41.76
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Domiciliary visit - day consultation with patient living more than 10 miles from the surgery
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€52.22
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Domiciliary visit - late consultation (urban)
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€24.79
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Domiciliary visit - late consultation with patient living 3 miles or less from the surgery
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€24.79
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Domiciliary visit - late consultation with patient living more than 3 miles but not more than 5 miles from the surgery
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€32.08
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Domiciliary visit - late consultation with patient living more than 5 miles but not more than 7 miles from the surgery
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€41.76
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Domiciliary visit - late consultation with patient living more than 7 miles but not more than 10 miles from the surgery
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€55.48
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Domiciliary visit - late consultation with patient living more than 10 miles from the surgery
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€65.05
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Domiciliary visit - night consultation (urban)
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€48.61
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Domiciliary visit - night consultation with patient living 3 miles or less from the surgery
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€48.61
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Domiciliary visit - night consultation with patient living more than 3 miles but not more than 5 miles from the surgery
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€62.49
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Domiciliary visit - night consultation with patient living more than 5 miles but not more than 7 miles from the surgery
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€79.05
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Domiciliary visit - night consultation with patient living more than 7 miles but not more than 10 miles from the surgery
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€88.20
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Domiciliary visit - night consultation with patient living more than 10 miles from the surgery
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€95.75
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TABLE 12
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Services rendered under the General Medical Services (GMS) Scheme - Fee Per Item Agreement - payment for a consultation by a general practitioner at a home for the aged
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Service
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Amount
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Sessional rates (per 3 hour session) - consultation at a home for the aged
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€85.99
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TABLE 13
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Services rendered under the General Medical Services (GMS) Scheme - Fee Per Item Agreement - allowance in respect of a general practitioner whose practice is eligible for a rural practice allowance
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Service
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Amount
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Rural practice allowance (per annum)
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€8,276.04
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TABLE 14
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Services rendered under the General Medical Services (GMS) Scheme - Fee Per Item Agreement - allowance in respect of locum and practice expenses
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Service
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Amount
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Allowance in respect of locum and practice expenses (per annum)
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€1,611.12
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TABLE 15
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Services rendered under the General Medical Services (GMS) Scheme - Fee Per Item Agreement - payments to a general practitioner in respect of special items of service
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Service
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Amount
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Excisions/cryotherapy/diathermy of skin lesions
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€26.36
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Suturing of cuts & lacerations
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€26.36
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Draining of hydroceles
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€26.36
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Treatment and plugging of dental and nasal haemorrhages
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€26.36
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Recognised vein treatment
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€26.36
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Electrocardiography (ECG) tests & their interpretation
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€26.36
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Instruction in the fitting of a diaphragm
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€26.36
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TABLE 16
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Services rendered under the General Medical Services (GMS) Scheme - payment to a general practitioner (GP) pursuant to the agreement titled "Agreement with registered medical practitioners for provision of services to certain persons with limited eligibility under section 58 of the Health Act 1970 as substituted by the Health (Amendment) Act, 2005"
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Service
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Amount
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GP visit card registration fee in respect of each first-time qualified person for a GP visit card registered to the GP subject to the agreed overall limit on the aggregate of all such payments
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€32.20
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TABLE 17
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Services rendered under the Health (Amendment) Act 1996
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Service
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Amount
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Surgery - consultation fee
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€35.87
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Domiciliary visit - consultation fee
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€47.31
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TABLE 18
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Services rendered under the Maternity and Infant Care Scheme
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Service
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Amount
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Patients first visit
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€45.14
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Visits 2-8 (per visit)
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€32.51
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Visit 9
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€45.14
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Where complete services are provided - patients first pregnancy
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€285.37
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Where complete services are provided - pregnancies other than the patients first pregnancy
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€317.88
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Additional visits by patients with major conditions, e.g. diabetes, hypertension - fee per visit subject to a maximum of 5 visits
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€32.51
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Emergency delivery
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€270.89
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The Minister for Finance consents to the foregoing Regulations.
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GIVEN under my Official Seal,
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7 July 2009
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BRIAN LENIHAN.
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Minister for Finance.
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GIVEN under my Official Seal,
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7 July 2009
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MARY HARNEY.
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Minister for Health and Children.
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EXPLANATORY NOTE
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(This note is not part of the Instrument and does not purport to be a legal interpretation)
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These Regulations provide for a reduction of payments to general practitioners in respect of services under the General Medical Services Scheme, the Maternity and Infant Care Scheme and the Health (Amendment) Act 1996 .
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