The dispute between Quebec and radiologists about charging for cortisone injections lasted for months, to the extreme despair of the association representing these medical specialists. But also to patients who say they have been held hostage because medical imaging laboratories have decided to reduce their volume or interrupt service.
Representatives of the Ministry of Health and Social Services (MSSS), the Federation of Medical Specialists (FMSQ) and the Association of Quebec Radiologists (ARQ) will hold the first meeting on Wednesday to resolve the dispute.
The ARQ president regrets that the file is progressing no turtle on the part of the ministry.
It’s really hard to have voice and hearing on the other side […] I don’t understand why it took so long because the federation contacted them for the first time before the holidays to meet with themsaid Dr. Magalie Dubé, in an interview with The Canadian Press.
The dispute stems from a differing interpretation between the Régie de l’assurance maladie du Québec (RAMQ) and radiologists about a billing code for infiltrations under fluoroscopy. This treatment involves injecting cortisone into the joints to relieve pain and inflammation in patients with joint problems.
Arthrography makes it possible to see the joint and target the needle while the procedure is being performedexplanation of ARQ.
RAMQ conducted a control exercise with radiologists under an agreement between MSSS and FMSQ on medical fees. Régie now has a different view on the reimbursement of equipment, rent and staff costs paid by clinic owners to offer injections, according to Drs. Dubé. He denounced a unilateral decision of Régie.
” For us, the words of the billing codes are clear. However, this is a technique we have been doing for 40, 50 years and where we have always used the same billing codes. “
RAMQ audits have resulted in retroactive claims of several million dollars from approximately 180 radiologists for a period from 2017 to 2019. These amounts are disputed by radiologists and may be the subject of arbitration in Administrative Labor Tribunal in the fall, Drs. Dubé.
Neither the MSSS nor the RAMQ were willing to comment specifically on the change in interpretation, especially since reviews are still underway.
Hostage
Following this change, clinics decided to stop this medical work or slow down the pace. If they continue to offer service at the same level as before, many clinics will do the procedures at a loss because they are denied reimbursement from RAMQ, Drs. Dubé.
There are clinics that may have a little more solid back, and can afford to accept losses in the short term, but others don’t. Clinics are like SMEs, some are stronger than others and can continuehe added.
Patients can go to hospitals, but they do not have the capacity to guarantee this treatment within always reasonable deadlines, according to ARQ.
Although the service is maintained with many clinic owners, Drs. Dubé, the situation poses a problem for many patients in the water. This was the case of Lucie Bisaillon, who was surprised to learn that her usual clinic no longer offered treatment when she made her appointment at the reminder.
He said he searched for several hours before finding another clinic that would perform the injection, allowing him to relieve his pain and be able to walk effortlessly. She had to use more medication while waiting for her next appointment.
” For my hostage. There were people even more mortgaged to me and we were held hostage. Instead of negotiating and trying to come to an agreement, treatment is stopped and people suffer. “
A cumulative action
MSSS regrets the attitude of the radiologists concerned and their association with this file.
By e-mail, the department indicated that it had increased interventions and correspondence both in medical imaging laboratories and with the Association des radiologistes du Québec so that the injection service is maintained and that they stop their pressure tactics.
He mentioned existence informed the Collège des médecins du Québec to also look into its service delays, which have all the appearance of an integrated action.
ARQ has denied taking the patients hostage and believes the ball is in the MSSS court. Stopping treatment heartbreaking radiologist-owners, said Drs. Dubé.
If a pressure method is considered, service is completely suspended.
There were clinics that stopped for a while, but they decided to continue a bit because they wanted to continue serving patients in the region, and because the hospitals didn’t provide.he mentioned.
In Quebec, approximately 70,000 infiltrations under fluoroscopy are performed each year in radiology clinics.
Source: Radio-Canada
