BUPA & PPP Ophthalmology Tenders
July 16th 2007
There remains confusion about the BUPA Insurance ophthalmology tender. BUPA was due to announce its national network in April and its London networks on 1st July 2007. Neither announcement has been made. There is also confusion for patients at pre-authorisation as some are being redirected and others are being left with their choice of consultant and hospital. Even the patient reimbursement rates for consultant fees seem to vary.
Most of the hospital groups and the stand alone independent hospitals have not been able to agree terms with BUPA and whilst the profession is not party to these negotiations the indications are that hospitals are not acquiescing and indeed cannot do so even if they wished without the participation of their consultant ophthalmologists. The BMI group is charging BUPA insured patients up front for ophthalmic treatment.
The overall picture is therefore very confused and most difficult from a patient’s viewpoint.
There seems little doubt that the majority of ophthalmologists have made their personal decisions to avoid the managed care agenda that would ensue if this type of network were to take hold. Their main concern now is to continue to treat all their patients to the best of their ability and without interference.
However, a new possibility is the fact that PPP is preparing to roll out its own network for ophthalmology and this was announced at the FIPO meeting on 23rd May. There has been no official approach to the consultants about this network and the terms and conditions are not yet available for full comment.