3.2.2 Rural Continuing Medical Education Program Policy Individual Physicians

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1 3.0 Physician Compensation 3.2 Continuing Medical Education Program 1.0 Purpose Rural Continuing Medical Education Program Policy Individual Physicians The Rural Continuing Medical Education (RCME) benefits provide funding for medical education activities to support the maintenance of those medical skills and credentials required for rural practice. These benefits are in addition to the CME entitlement provided for in the Working Agreement between the Government and The Doctor s of BC (DoBC) (administered through DoBC). 2.0 Guidelines 2.1 Principles RCME funds should be used in a manner that provides cost effective continuing medical education for physicians. Physicians will be notified at least annually of the RCME entitlement available. Island Health in consultation with the Continuing Professional Development Committee (CPDC) of the Health Authority Medical Advisory Committee (HAMAC) will regularly review and evaluate the reimbursement guidelines and effectiveness of the RCME funding and the reverted funds process. Island Health Guidelines for use of funds will follow the Ministry of Health Services RCME Policy and the relevant DoBC guidelines wherever possible. The DoBC CME rates will be the minimum reimbursement expense rates. Issuing Authority: Vice President & Chief Financial Officer; Executive Management Committee Page 1 of 7

2 2.2 A resident physician that practices in one or more of the RSA communities covered by the Rural Subsidy Agreement (RSA) for the number of years set out in the table below is eligible for RCME funding. Funding amounts are based on the degree of isolation of his/her community as determined by the Joint Standing Committee (JSC). Physicians are entitled to RCME funds once they complete their residency requirements of nine (9) months out of a calendar year. Please review the Ministry of Health s RCME Policy for complete details. Communities Up to 2 years 3rd & 4th year Over 4 years A Communities: General Practice $1,320 $3,520 $5,720 B Communities: General Practice $440 $2,640 $4,840 C Communities: General Practice $0 $2,200 $4,400 D Communities: General Practice $0 $1,100 $2,200 A Communities: Specialists $1,800 $4,800 $7,800 B Communities: Specialists $600 $3,600 $6,600 C Communities: Specialists $0 $3,000 $6,000 D Communities: Specialists $0 $1,500 $3,000 RELOCATING BETWEEN RSA ELIGIBLE COMMUNITIES Moving to Eligible Communities A physician who qualifies for RCME and moves to another community covered by the RSA continues to get credit for the time in the previous community, but will receive the RCME amount based on the rates for the new community. A physician can request unspent/banked RCME funds be transferred to another HA when relocating to another community covered by the RSA. Moving to In-eligible Communities A physician who qualifies for RCME and who does not stay in a community covered by this Agreement for the entire twelve months is eligible for a proportionate amount of the sum set out in Policy Section 2. If the physician uses the entire sum and subsequently leaves before the end of the twelve-month period, any overpayment is owed to the HA. RETIRING FROM REGULAR PRACTICE When a physician retires from regular practice, he/she can use their accumulated RCME funds for up to three years from their date of retirement, if their intent is to provide locum services in rural areas, while maintaining residency in British Columbia. After the three year period, any unspent funds will revert back to the community RCME program. LOCUMS A locum physician is not eligible for RCME funding unless that locum physician resides and practices within eligible RSA communities for a period of at least nine (9) months. A locum who does not meet the eligibility criteria for RCME may submit a written application to the Joint Standing Committee on Rural Issues (JSC) for review as an exceptional circumstance. hysician Eligibility Issuing Authority: Vice President & Chief Financial Officer; Executive Management Committee Page 2 of 7

3 2.3 Reimbursment Criteria Information regarding allowable claims is contained in Table 1 of this policy. Claims may be only be made AFTER attendance at a CME event and within one year of attendance or purchase. Certificates of Attendance and Proof of CME credit hours MUST be submitted for each CME event. Minimum 3.5 credit hours daily average for each education day is required for reimburesment. Claims must be submitted with copies of itemized receipts or cancelled cheques and other documentary evidence showing the name of the organization, date and location of meeting or course. Copies of credit card statements or chits are not sufficient as receipts. Photocopies of original receipts will be accepted only if original receipts are needed for subsidiary reimbursement from another source if items are not fully covered by this program (including but not limited to Canada Revenue Agency, DoBC, etc.) Applicants shall sign a guarantee that multiple sources will not be used to reimburse the same expenses. Social activities included in the cost of the registration will not be reimbursed. Dispute Resolution Physicians who have submitted claims that are considered ineligible under the criteria below are able to appeal those decisions to HA Medical Advisory Committee. Such appeals will be considered on a case-by-case basis. A final appeal may be submitted to the JSC for consideration. 2.4 Expenses reimbursed Accredited Courses and Conferences Medical conferences, symposia, courses, or society meetings that are sponsored or cosponsored by a recognized medical education body (i.e. university, hospital, provincial/state/local medical society or association) and where there has been physician involvement in the planning/facilitating/presenting and that are directed towards a medical and/or health care provider audience are eligible for reimbursement. Physicians undertaking learning where travel is not integral to participation will only be reimbursed for tuition/materials fees and overhead fees. Elective travel and accommodation will not be reimbursed. Non-accredited Courses, Conference and Informal Training Programs Claims for non-accredited courses, conferences and informal training programs must be accompanied by a statement of education objectives for the learning event and be PRE APPROVED by signature of the designated authorized Medical Health Leader. Physicians whose applications are rejected may appeal to the area Medical Director or HA Vice- President of Medicine Issuing Authority: Vice President & Chief Financial Officer; Executive Management Committee Page 3 of 7

4 outside continental North America; aboard cruise ships; not sponsored by recognized medical education bodies; or informal traineeships. Reasonable Travel Days Reimbursement is available for reasonable travel days to and from the CME event from the physician s home community. If the CME event is part of a longer holiday, the travel days and expenses will be calculated as though they occurred just before and after the CME event using the most expedient and cost effective method of travel. Course Fees REQUIRED: Certificate of Attendance, number of study credits earned & registration receipt Reimbursed at 100% less social activities Membership dues are not reimbursed (unless dues plus course fee are less than nonmember registration fees) Courses or events aboard cruise ships must have the registration fee separated from the overall cruise package price and it must be comparable to a land-based event - Accommodation expense may be claimed against the cruise price Reference Accommodation section below. Air Travel REQUIRED: Airline receipts with flight costs per person indicated Economy fares reimbursed at 100% Mileage REQUIRED: Mileage calculation between the community of residence and the learning opportunity Gas and/or repair receipts are not accepted Local transportation (i.e. 25 kilometres or less round trip) will not be reimbursed Car Rental/Taxi/Parking REQUIRED: Car rental receipt, parking receipts, taxi receipts, fuel receipts Reimbursed at 100% during dates of conference Car rental fuel receipt are reimbursed at 100% Accommodation REQUIRED: Itemized hotel receipts indicating applicable room costs and taxes Accommodation expenses for local courses/conferences within 25 kilometers are not reimbursed Accommodation for courses or events aboard cruise ships will be averaged based on a minimum of 3.5 credit hours daily for each education day Meals and Miscellaneous Sundry Able to be prorated into half days No receipts required Issuing Authority: Vice President & Chief Financial Officer; Executive Management Committee Page 4 of 7

5 Practice Overhead Able to be prorated into half days No receipts required Paid on a Monday to Friday basis unless Physician indicates they regularly work weekends. Medical Educational Materials (Medical Texts/Journals/Audio Visual CME/Practice Based Small Group Learning/Small Group Learning Madules) REQUIRED: receipts with item description, date and amount paid Reimbursed at 100% Membership/Association fees, as well as costs for journals that are benefits of membership are not eligible for reimbursement CME distance learning (where travel is not integral to participation) will only be reimbursed for tuition/materials fees and overhead fees. Elective travel and accommodation will not be reimbursed. Electronic Equipment Purchases (for CME purposes only) REQUIRED: Itemized receipt Reimbursed at 100% Purchased for the educational use of an individual physician Can include: computers, digital cameras, tablets, smart phones, and camcorders. Multiple computers and items purchased for office administration purposes are not eligible for reimbursement (e.g. office networks, fax/copiers, billing station, EMR). Internet Access Fees REQUIRED: Two internet fee statements - one from the beginning and one from the end of the year being claimed, plus any months in which a rate change occurs Reimbursed at 100% (include receipt for any month a rate change was made) CME Software/Online CME Subscriptions (for CME purposes) REQUIRED: itemized receipts Reimbursed at 100% Software used for creating CME is acceptable (ie PowerPoint, Word) Software for office functions (ie EMR, billing) will not be reimbursed Library Donations Donations of up to $100 will be reimbursed at 100% Reimbursment Amounts Please refer to Appendix A for more information on reimbursable CME amount Issuing Authority: Vice President & Chief Financial Officer; Executive Management Committee Page 5 of 7

6 2.5 Reimbursement Procedure Complete and sign the Rural Continuing Medical Education Reimbursment form Include copies of itemized receipts (credit card statements and/or chits will not be accepted) Send claim and supporting documents via one of the following methods: 1) Scan and to: 2) Fax to: (250) ) Mail to: Physician Compensation Nanaimo Regional General Hospital 1200 Dufferin Crescent Nanaimo, BC V9S 2B7 Upon receiving the completed application package, the application will be reviewd to ensure it falls within allocation limits and available funds. 2.6 Expired Funds A physician may bank RCME for up to three (3) years; however, eligibility for RCME for any year expires at the end of two (2) subsequent years. Upon expiry of eligibility, or upon leaving the communities covered by this agreement, any sum remaining from that set aside for that physician transfers to the Health Authority to be used for that Rural Community RCME fund. The annual date for calculation of expired RCME funds for the Health Authority is March 31st. 2.7 Reverted RCME Funds The Health Authority must use any RCME reverting to it, in consultation and agreement with the Local Area Medical Advisory Committee for CME purposes. Issuing Authority: Vice President & Chief Financial Officer; Executive Management Committee Page 6 of 7

7 Table 1 Expense Type Maximum Reimbursement Conditions No maximum cost no restriction on location within continental North America proof of CME credits. Course, Conference or Symposium costs Ground Transportation Air Transportation Accommodation Current government mileage rate Economy flights reimbursed at 100% Maximum $400/night when staying at a hotel $80/day for room & board (with friends/relatives) Must provide Certificate of Attendance, itemized receipts and Current government mileage rate up to the cost of an economy airfare plus relevant ground transportation Car rental eligibile with itemized receipts. Only economy fare is eligible. Receipts or e-ticket confirmation required (must show name, dates and location). Itemized receipts required for hotel. No receipts required for room & board Meals and Miscellaneous Maximum $95/day Receipts not required Overhead Medical Education Materials (Medical Texts/Journals/AudioVisual CME/PBSG) CME Software/Online CME Subscriptions Electronic Equipment Purchases for CME Purposes (Computers, digital cameras, smart phones, tablets, camcorders Private Practice: $300/day for each full office day missed ER, APP, Anesthesia, etc.: $180/day for each full day missed Reimbursed at 100% Reimbursed at 100% Reimbursed at 100% Monday Friday basis unless physician indicates they regularly work weekends. Itemized receipts required. Must be for medical educational purposes. Itemized receipts required. Must be for medical educational purposes. Software for office functions are not eligible (i.e EMR etc ) Receipts required. Personal computer with a component of educational use. Items purchased for office use are not eligible Internet Access Fees Reimbursed at 100% Two statements required one for the 1 st month and one from the last month you are claiming, plus any months in which a rate change occurs Issuing Authority: Vice President & Chief Financial Officer; Executive Management Committee Page 7 of 7