Dear clients,

This is a summary of the RAMQ announcements published in October 2022 following the introduction of the Lettre d’entente 368, about improving access to first line medical services. Please remember that this summary is only pointing the main details, and that a thorough reading of all RAMQ publications is always recommended.

New form for transferring patients to the group of physicians

The RAMQ introduces form 4517 Entente pour l’inscription de patients à un groupe de médecins – Lettre d’entente no 368.

From now on, a doctor who can no longer handle the medical care of their clientele (retirement, reorientation, house move, death, etc.) may transfer blocks of their registered patients using one of the three following options:

To another physician via form 4381 Entente de transfert pour la prise en charge en bloc de patients inscrits – Lettre d’entente no 304;
To the group of physicians at their clinic via form 4517 (those patients will not be considered as being referred by the GAMF);
A combination of those two types of transfers.

The physician who ends up not transferring the entirety of their clientele will have to make sure each remaining registration ends on the same date as their practice. Those patients will then become orphan and have the choice to subscribe on the Guichet d’accès à un médecin de famille at their convenience.

Visite de suivi

A clarification is added to infolettre 141 regarding the visite de suivi for patients registered collectively.

If the patient is seen outside of the group registration, meaning the appointment is not scheduled on the Guichet d’accès à la première ligne (GAP), but instead they showed up directly at the walk-in clinic, you cannot claim the visit de suivi. This would be considered outside of Lettre d’entente no 368. Therefore, in those cases, you may claim the visite ponctuelle mineure ou complexe.

Office fees

Since the terms from the Entente particulière relative aux services de médecine de famille, de prise en charge et de suivi de la clientèle (40) do not apply to the group registration, visits from your participation to Lettre d’entente no 368 do not count towards the requirements for the billing of office fees (codes 19928-19928).

Sites of a GMF

Contrary to what was said in the infolettre 141, only one group of physicians may exist in a GMF, regardless of how many sites it is made of. The group can be made of doctors working in different sites from the same GMF. If a multisite group is created in your GMF, no other group can be created.

Therefore, if you work at multiple sites of a GMF, you must bill the group registration forfaits at the site where the patient was assigned to you, no matter where you saw them. However, the medical services must be billed at the site where the patient was seen.

**Change to the number of forfaits allowed for the group registration**

A modification is made to paragraphe 1.13 de la Lettre d’entente no 368 visant à accroître l’accès à l’offre de services en première ligne et l’interdisciplinarité.

Contrary to what was originally announced in section 1.1.2 of infolettre 141, the number of forfaits allowed for the group registration corresponds to the number of patients coming from the Guichet d’accès à un médecin de famille that the group of physicians committed to.

In addition, the number of forfaits for a trimester is determined per the contract agreed between your group and your département régional de médecine générale. If your contract is changed during a trimester, the highest number of patients will be used to determine the number that applies for that trimester.

Exemple

A group of physicians agrees to collectively register 1 000 patients for the trimester from December 1st, 2022, to February 28th, 2023. For that trimester, if the physicians have opened at least 250 time slots (0,25 slot per patient), the requirements will be met and the physicians will be allowed to claim 1 000 forfaits.

If, on March 15th, they agree to register an additional 200 patients, they will then be allowed to share 1 200 for the trimester from March 1^st to May 31st. However, they will need to open 300 time slots for the requirements to be met.

This modification comes into force retroactively as of June 1st, 2022.