Quebec's specialists reach deal on fees for ultrasounds, auxiliary services
Agreement caps tense week of negotiations as fee ban takes effect
Quebec's federation of medical specialists (FMSQ) announced Friday that it has reached two agreements in principle with the provincial government on the elimination of fees for ultrasounds and auxiliary services tied to publicly insured procedures.
Diane Francoeur, the FMSQ's president, said the two agreements will solve "a majority" of concerns related to the removal of the fees — but not all.
"A lot of confusion remains for both doctors and patients when it comes to what is allowed and what isn't," she said.
The agreement in principle comes on the heels of Thursday's partial agreement between the government and Quebec's federation of general practitioners on auxiliary fees.
Diagnostic services, minor surgeries
Francoeur said the agreement on auxiliary fees for services insured by the province will permit medical clinics to continue providing diagnostic services and minor surgeries such as vasectomies.
Regarding small procedures, for example, the government will now cover the cost of instruments used in biopsies that were previously covered by fees charged to the patient.
Francoeur said the two sides also reached an agreement regarding physiatry services that will see a supplementary room and equipment added to the Université de Montréal's teaching hospital, the CHUM.
Ultrasounds
Dr. Vincent Oliva, the president of the Quebec Radiologists Association, said a compromise agreement had been reached that will cover all procedures.
Quebec's elimination of fees for ultrasounds last Dec. 29 sparked a battle between the province and radiologists over how much the province should have to pay radiologists for procedures through the provincial health insurance agency, RAMQ.
Quebec's Health Minister Gaétan Barrette had said the province won't "allow profit" on publicly funded exams.
One aspect of Friday's agreement on ultrasounds concerns technical fees, which cover personnel and equipment costs.
Oliva said a compromise figure was reached on that fee, which will be the focus of an external evaluation in the coming months to determine the real costs.
"We'll adjust our fees based on their findings," Oliva said.
"What's key is a fee structure that ensures that the clinics remain viable and don't operate at a loss."
$40.2M from specialists
Francoeur said the FMSQ is putting in $30 million to make up for the lost fees in order to ensure access to vital ultrasound examinations, such as breast exams.
"We'll do what needs to be done to ensure the system can respond to the most urgent cases," she said.
In all, Francoeur said her federation will contribute $40.2 million to help make up for the shortfall resulting from the abolition of the fees, which have been the subject of prolonged controversy in Quebec.
Public health care advocates called them a violation of the Canada Health Act, but the fees have become an important source of revenue for medical clinics.
One estimate put the amount paid by Quebecers in auxiliary health care fees each year at upwards of $70 million a year.
Today's agreement in principle still has to be ratified by FMSQ's members.