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Experts wanted by Health Ministry

Health experts are being sought to help set up a system which would provide pre-certification of diagnostic medical testing in Bermuda.

A press statement released today by the Ministry of Health, Seniors and Environment said the ministry would be asking for a Request for Information (RFI) that would lead to the pre-certification.

The Ministry “is seeking information and creative ideas for solutions to implement, manage and operate a system to provide pre-certification of diagnostic medical testing for Bermuda’s healthcare system,” read the statement

“The Ministry is seeking industry experts to submit RFI responses that will assist with assessing the most advantageous and cost effective solution. The information gathered by this RFI will help determine the optimal approach to procuring a new solution.

“Information will be gathered from different interested companies and will be used to evaluate the sourcing process with an official open RFP. The information submitted will be evaluated by the Ministry in conjunction with the Office of Project Management & Procurement. The information submitted will be evaluated based on the potential vendor’s experience in the area of pre-certification and the ability to meet requirements.

“Potential vendors will demonstrate successful experience in establishing and managing a pre-certification system in a sophisticated jurisdiction. The system must involve physicians, public and private insurers and providers of medical testing services.

“Interested parties that require any additional information may contact Mr James Shubert, Business Analyst, Health Insurance Department at (441) 295-9210 or jkshubert@gov.bm for further details.

“Full details and tender documents may be obtained at www.gov.bm or from the Health Insurance Department’s reception desk on the second floor of Sophia House, 48 Church Street, Hamilton during regular business hours from Monday to Friday.”

Completed submissions must be returned (via e-mail to jkshubert@gov.bm) no later than 5pm on 31st October, 2014. Late submissions will not be considered.

“Bermuda has a higher rate of utilisation of advanced imaging equipment than most OECD countries,” explained the Minister of Health, Seniors and Environment the Hon. Jeanne Atherden JP MP. “Some procedures present risk to patients and their use should be minimised. Increased use of medical imaging has led to concerns globally about the impact of cumulative radiation exposure on individuals and public health. In addition, the utilisation increases have had a significant impact on the cost of healthcare in Bermuda.

“As a result, we are seeking a centralised utilisation management agency, contracted by the Health Insurance Department (HID), which will pre-certify all eligible diagnostic imaging and clinical laboratory procedures. Public and private payers will be required to adhere to HID’s pre-approvals for their insurance plans.

“Pre-certification will promote the delivery of quality healthcare in a cost effective manner, improve standardisation in the ordering of diagnostic tests, and reduce unnecessary utilisation of and duplication in diagnostic testing (both medical imaging and clinical laboratory tests).”

Pre-certification is planned to apply to select medical imaging procedures (e.g. MRI, CT scans, Echocardiography, etc); and to specific clinical laboratory test orders and orders with a cumulative value above $300. Orders by specialists and diagnostic testing for emergencies will not have to be pre-certified. Self-referrals will be subject to pre-certification.