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Cuts to CT scan fees could be rolled back

Closed facility: Ewart Brown has shut the CT scan unit at the Brown-Darrell clinic (Photograph by Akil Simmons)

The Bermuda Government may roll back steep cuts made to medical imaging fees which were blamed last month for the closure of a private scanning clinic.

However, last night the Opposition hit back at claims that the One Bermuda Alliance administration had “ignored” technical advice and singled out diagnostic imaging for sharper fee cuts than those suggested.

The reductions, recommended by the Bermuda Health Council, were decried last month by Ewart Brown, the former premier, who runs two private clinics offering medical scans.

The CT scan unit at his Brown-Darrell clinic in Smith’s, which provided computer-processed X-ray imaging, was shut on January 31 after Dr Brown said the cuts left the business unsustainable.

The possibility of fee cuts being partially reversed emerged in Friday’s House of Assembly, when OBA MP Trevor Moniz asked Kim Wilson, the Minister of Health, whether there was “any intention of changing the fees going forward”.

In response, Ms Wilson said that three independent reviews before June 2017 had suggested relative value methodology as a technique for calculating medical fees.

She added: “That’s the internally accepted methodology used in the US, Canada, Europe, the UK. It places a logical, rational and transparent fee structure on healthcare to assist in containing the cost.”

She said the OBA administration had disregarded recommendations from the Bermuda Health Council, telling the House: “The former government ignored that technical advice and decided to apply fees that were much lower than what was being provided for, with respect to the relative value units provided by the technical officers of the Bermuda Health Council.

“I can say that this government is committed to reducing healthcare costs. We will be applying the relative values going forward, starting with the Bermuda Hospitals Board.”

MPs also heard that the BHB, along with Dr Brown’s clinics, have each received payments directly from Ministry of Health funds, to compensate them for their lost earnings.

Ms Wilson said that after an agreement was reached on December 8, 2017, a payment of $120,000 had been settled for Brown-Darrell Clinic, and $480,000 for Dr Brown’s other business, Bermuda Healthcare Services.

The BHB’s payment is still being calculated based on levels of use, and Ms Wilson said she would not know that amount until the end of March.

Opposition leader Jeanne Atherden responded last night: “Ms Wilson’s statement is misleading.

“The previous administration did not ignore technical advice from the Bermuda Health Council. The council’s diagnostic imaging fee schedule used the relative value methodology with a conversion factor of 83.8.”

Every type of diagnostic imaging service comes with a specific code, with a conversion factor used to calculate the dollar value of a fee. The same conversion factor was applied to all diagnostic imaging services, Ms Atherden said.

The former health minister added: “It was that fee schedule that was suggested to the minister, accepted, and passed by the legislature.”

Ms Wilson was unavailable for comment yesterday — but Mr Moniz said he had asked the question in Parliament because “I just want these things to be out in the open”.

He said he had asked the minister whether the Progressive Labour Party administration had been threatened with legal action.

Ms Wilson responded: “Prior to this agreement being settled on December 8, 2017, there were discussions taking place between the Government and the Attorney-General.”

Speaking to The Royal Gazette, Mr Moniz said: “The public is entitled to more information about what discussions took place, and how these numbers were arrived at, and why they’re paying this amount of money.

“Either they negotiated and arrived at an agreement or they didn’t. What I would like to know is, did [Dr Brown] have leverage on them?”

Contacted last night for comment, Dr Brown responded: “There were absolutely no negotiations between myself and the Government concerning the fees. The Government told us exactly what the minister told the House.”

Asked if he had been informed of any potential raising of imaging fees, and whether that might salvage his CT unit, Dr Brown said: “No, I have not.”