GP Focused Practice Committee

Dear Physician: Re: GP Focused Practice Designation Thank you for your correspondence requesting that the Ministry of Health and Long-Term Care and the Ontario Medical Association consider you for a GP Focused Practice Designation. We provide the following information to assist you in filing all relevant information to the Committees attention. Your application was assessed against a set of criteria described in the 2004 framework Agreement (Appendix E, Article 8.1), the 2007 Reassessment (Articles 17-18 and Appendix C), and the 2008 Physician Services Agreement (Article 5.7.1-5.7.2).The Physician Services Committee (PSC) has directed the GP Focused Practice Committee to review appeals made for GP Focused Practice Designation. As per the Agreement, to obtain designation as a GP Focused Practice, the GP should be billing consults for referred patients as a significant portion of billings and providing a report back to the referring GP. The GP Focused Practice physician should be able to demonstrate that they meet a reasonable combination of the criteria of which acknowledgement of the Royal College of Physicians and Surgeons (RCPS) as a focused practice area or appropriate training or qualifications must be included. The following are a list of criteria that are to be met in order to be considered eligibile for the GP focused practice designation: A demonstrated need of the focused practice area in the specific community, such as: o o o o o Number of patients requiring the services A lack of similar services in the community or in the surrounding communities Wait time for the services within the community or in the surrounding communitites Travel distance to the service in a neighboring community Consideration of reasonableness of any period of waiting with respect to patient health outcomes

Acknowledgement of the Royal College of Physicians and Surgeons (RCPS) as a focused practice area e.g. existing speciality area. Appropriate training or qualifications to support the particular area of focus: o o Training in the specialty / subspecialty in another country or jurisdiction Additional courses and/or certification in the particular area of practice
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Physician Services Committee Secretariat 150 Bloor Street, 8th Floor Toronto, ON M5S 3C1 Fax: Email: (416) 340-2961 Secretariat@pscs.ca

GP Focused Practice Committee

o Hospital privileges associated with the area of practice where appropriate

Illustrated support from the community for the services. This could include: o o o o Local Specialists and/or Family Practitioners LHINs CCACs Hospitals

As well, a number of GPs in the community routinely refer patients to the specific GP focused practice. The number referring would need to reflect what would be reasonably expected for the condition/service and the local GP supply. A substantial percentage of the Focused Practice phyisicans time must be spent in this area of practice. Physicians will be considered a GP (specific focused practice) when 50% or more the dollar value of their annual FFS billings in the preceding 12 months consist of those for that specific focused practice.

I trust that the above information provides sufficient detail / clarity to assist you with compiling all necessary information related to your appeal. Please complete the attached questionnaire and consent form (the questionnaire may be completed electronically prior to printing, if preferred). Send your documents to the Physician Services Committee Secretariat at the following address: Physician Services Committee Secretariat 150 Bloor Street, 8th Floor Toronto, ON M5S 3C1 Email: Secretariat@pscs.ca We thank you for your cooperation in this matter.

Physician Services Committee Secretariat 150 Bloor Street, 8th Floor Toronto, ON M5S 3C1 Fax: Email: (416) 340-2961 Secretariat@pscs.ca

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GP Focused Practice Committee

Physician Services Committee Secretariat 150 Bloor Street, 8th Floor Toronto, ON M5S 3C1 Fax: Email: (416) 340-2961 Secretariat@pscs.ca

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GP Focused Practice Committee Questionnaire

Section 1 Physician Information:

Last Name: Given Name(s): Middle Initial:

Practice Mailing Address: Unit #: Building/Complex:

Street:

Street #:

City / Town:

Province: Postal Code:

Telephone, Fax, E-mail: Telephone: Ext:

ON
Fax:

Ext:

() -
E-mail Address:

() -
Mail

Fax E-mail

Preferred method of correspondence:

Additional Information: OMA Section:

OHIP Billing Number:

Section 2 - Focused Practice Information:

1. Please indicate your area of focused practice (Must be recognized by RCPS).

2. What percentage of your time do you usually spend in your focused area of practice?
<25% 25-49% >50%

3. What percentage of your FFS billings in the last year was in your focused area of practice?
<25% 25-49% >50%

4. How many General Practitioners in the community routinely refer patients to you? General Practitioners 5. How many patients per week do you treat in your focused area of practice? Patients 6. Which main fee codes in your focused area of practice have the largest impact on access bonus? 1 of 3

GP Focused Practice Committee Questionnaire

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GP Focused Practice Committee Questionnaire

Section 3 - Community Need: 1. Approximately how many patients in your community require services in your area of focused practice? Patients 2. Approximately how many physicians in your community provide care in your focused area of practice? General Practitioners Specialists

3. Please estimate the average patient wait time in your community to receive the services in your focused
area of practice.

Weeks 4. Please estimate the average travel time to an area outside of your community where the patients can
receive the services in your focused area of practice. <30 minutes 30-59 minutes > 60 minutes

Section 4 - Supporting Documents:

1. In a separate covering letter accompanying this form, please discuss any information relevant to your specific situation that the committee should be aware of when reviewing your application. 2. Please attach documents for any educational seminars, CME programs, internships, or related training activities that you have attended in support of your focused area of practice.

3. Please attach up to three (3) letters from your community supporting your application for the exemption
status in your area of practice. These could include letters from local Specialists, Family Physicians, LHINs, CCACs, and hospitals.

Section 5 - Consent Form: 1. Please fill out and sign the attached form, Consent to disclosure of billing and financial information.

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GP Focused Practice Committee Questionnaire

CONSENT TO DISCLOSURE OF BILLING AND FINANCIAL INFORMATION TO: AND TO: AND TO: THE GENERAL MANAGER OF THE ONTARIO HEALTH INSURANCE PLAN (the General Manager) THE MINISTER OF HEALTH AND LONG-TERM CARE MOHLTC/OMA GP FOCUSED PRACTICE COMMITTEE

I, ________________________, hereby authorize the General Manager to disclose to the GP Focused Practice Committee, the following information relating to amounts paid by the Plan to me for Insured Services rendered by me during the past two (2) years: - date of service; - fee code for service, where applicable; - amount paid for service; - base rate payment amounts, where applicable; - diagnostic code, where applicable; - encrypted patient numbers; - facility number, where applicable; and - group number, where applicable. This consent shall be valid until I revoke this consent in writing to the General Manager. I acknowledge and understand that the purpose of the disclosure of this information by the General Manager to the GP Focused Practice Committee is to assist the Committee to assess my eligibility as a GP Focused Practice physician.

Dated at ___________________ this ______ day of _____________________ , _________. __________________________ Signature __________________________ Name ___________________________ Address ___________________________ ___________________________

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