July 22, Details of discipline/tier assignments can be found at Schedule A, attached.

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1 Government of Newfoundland and Labrador Department of Health and Community Services July 22, TO: ALL PHYSICIANS RE: NEW ON-CALL RATE STRUCTURE INTRODUCTION The Department of Health and Community Services (HCS), in consultation with the Newfoundland and Labrador Medical Association (NLMA), has established new rates of payment for on-call. HCS and the NLMA compiled data from a survey of on-call intensity conducted in late 2014, and jointly established an average on-call intensity value for each discipline in the province. Applying an average on-call intensity value means that physicians in the same discipline will receive the same on-call payment rate regardless of where they practice in the province. NEW ON-CALL RATES The new four-tiered rate structure became effective May 1, 2016: Tier 1 $ ($12.51 per hour) Tier 2 $ ($11.12 per hour) Tier 3 $ ($9.73 per hour) Tier 4 $ ($8.34 per hour) Details of discipline/tier assignments can be found at Schedule A, attached. It is to be noted that some on call groups split their on call across more than one site. The corresponding fee reflects this separation. This applies to pathology at Health Science Centre and St. Clare s in St. Johns and for pathology at the facilities in Grand Falls-Windsor, Gander and Clarenville. For details please see the on-call manual which includes the appropriate rate. The above tier assignments were used to calculate the retroactive payments for , which retroactive payments were issued on April 22, Questions regarding MCP billing should be directed to MCP by calling the toll free number. Other questions regarding the content of this Newsletter should be directed to the Medical Consultant by larryalteen@gov.nl.ca.

2 Appendix "A" On-call Rota/Tier Assignments Effective May 1, 2016 Tier Fee Code Rota General Hospital General Surgery General Hospital Internal Medicine General Hospital Radiology General Hospital Cardiology General Hospital Nephrology General Hospital Endocrinology HCC Orthopaedic Surgery HCC Respirology HCC Gastroenterology Janeway Radiology Janeway Paediatric General Surgery Janeway Paediatric Orthopaedic Surgery St. Clare's General Surgery St. Clare's Internal Medicine St. Clare's Radiology - After Hours Carbonear General Surgery Carbonear Internal Medicine Carbonear Radiology Clarenville General Surgery Clarenville Internal Medicine Clarenville Radiology Burin General Surgery Burin Internal Medicine Burin Radiology Gander General Surgery Gander Internal Medicine Gander Orthopaedic Surgery Gander Radiology Grand Falls General Surgery Grand Falls Internal Medicine Grand Falls Radiology Corner Brook General Surgery Corner Brook Internal Medicine Corner Brook Radiology Corner Brook Orthopaedic Surgery

3 Stephenville General Surgery Stephenville Internal Medicine St. Anthony General Surgery St. Anthony Internal Medicine Goose Bay General Surgery Labrador City General Surgery Ferryland GPs Miller Centre GPs Miller Centre GPs Waterford GPs General Hospital GPs General Hospital Anaesthesia General Hospital Ophthalmology General Hospital Interventional Radiology General Hospital Urology General Hospital Perinatology General Hospital Psychiatry General Hospital OBS-GYN Non-Elective Services General Hospital Obstetrical Anaesthesia Interventional Cardiology Janeway Anaesthesia Janeway Psychiatry Janeway Cardiology St. Clare's Anaesthesia Carbonear GPs Carbonear Anaesthesia Carbonear OBS-GYN Clarenville GPs Burin GPs Clarenville Anaesthesia Clarenville OBS-GYN Clarenville Psychiatry Burin Anaesthesia Burin OBS-GYN Burin Psychiatry Gander GPs Gander Anaesthesia Gander OBS-GYN Gander Psychiatry Gander Ophthalmology (Fee code expires ) New fee code to be billed is Central Ophthalmology effective

4 St. Alban's GPs Grand Falls GPs Grand Falls GP Obstetrics Grand Falls Anaesthesia Grand Falls OBS-GYN Grand Falls Psychiatry Grand Falls Ophthalmology (Fee code expires ) New fee code to be billed is Central Ophthalmology effective Central Ophthalmology Effective to be billed by institutions 0205 and Corner Brook GPs Stephenville GPs Corner Brook Anaesthesia Corner Brook OBS-GYN Corner Brook Psychiatry Corner Brook Ophthalmology Provincial Urology Stephenville Anaesthesia St. Anthony GPs Flower's Cove GPs Roddickton GPs Forteau GPs St. Anthony Anaesthesia St. Anthony OBS-GYN St. Anthony Psychiatry Goose Bay GPs Churchill Falls GPs Labrador City GPs Nain GPs Goose Bay Anaesthesia Goose Bay OBS-GYN Labrador City Anaesthesia Labrador City OBS-GYN Janeway Paediatric Surgery Clinical Associates General Hospital Plastic Surgery General Hospital Cardiac Surgery General Hospital Neurosurgery General Hospital Haematology General Hospital Gynecological Oncology HCC Thoracic Surgery Janeway Paediatrics

5 Janeway Haematolgy/Oncology St. Clare's Vascular Surgery Medical Oncology Radiation Oncology Carbonear Paediatrics Clarenville Paediatrics Burin Paediatrics Gander Paediatrics Grand Falls Paediatrics Corner Brook Paediatrics St. Anthony Paediatrics Janeway Neonatology Clinical Associates HCC ICU Clinical Associates General Hospital Neurosurgery Clinical Associates General Hospital Neurology General Hospital Nuclear Medicine General Hospital Infectious Diseases General Hospital Pathology General Hospital Hyperbaric Medicine HCC Rheumatology HCC Neuropathology HCC Pathology HCC Haematopathology Janeway Neonatology Janeway PICU Janeway Child Protection Janeway Endocrinology Janeway Pathology St. Clare's ENT St Clare's Pathology Grand Falls Pathology Gander Pathology Grand Falls ENT Clarenville Pathology Corner Brook Pathology Provincial Medical Officers of Health