January 27, 2002

Dear Dr. Bachan Singh:

Subject: Anaesthetist’s Proposal to New CDM Review Committee 2001

In view of the request from the New CDM Review Committee 2001 (see Appendix I), I have compiled some information (see Appendices II and III) upon which I have made a proposal for your perusal, comments, and counter-proposals. The proposals only pertain to those codes that mainly affect the anaesthetists.

Across-the-Board Increase to be Applied to Current CDM

The last major increase was in the financial year 1993 that was implemented in July 1992 (Refer to Appendix II). From that last major increase to now (i.e. 1992 to 2001), the CPI has increased 37.9 %. As the doctors’ fees have been increased by 7.7 % during those years (after adjusting for the 1 % increase to compensate for the transfer of the credit card charges to the doctors), this means that the doctors’ fees have lagged behind inflation by 28.0 %.

Hence, I suggest that we propose an across-the-board increase of 28 % on the current CDM unit price.

Adjustment of Unit Prices After Applying Proposed 28 % Fee Increase

In the poll conducted on 15 June 2001, we had agreed on the following,

I propose that we ask for an increase of the unit price for Central Venous Catheterisation to RM50 but leave the other codes as it is (assuming a 28 % increase).

Introduction of New Codes Not Found in Current CDM

Cardio-Pulmonary Resuscitation (Adult)

There was apparently some resistance to the introduction of this code. As we can easily make up the charges using other codes and taking into account the introduction of the Emergency/After Office-Hours Consultation Charge, I feel there is less need for this code and I propose that we drop our request for this code.

Patient Controlled Analgesia

The previous suggestion was for a unit price of RM35.00 and I think we should maintain this.

Epidural for Patients in Labour

We had proposed the fee for this to follow the recommendation by the previous CDM Review Committee and I think the figure of RM59.97 (adjusted to RM60.00) is fair and should be maintained.

Anaesthesia and Sedation for Radiological Procedures

Here we had proposed a base fee of RM30.00 unit price and a maintenance fee of RM50.00/hour unit price. To simplify it a bit, rather than calculate to the nearest minute, I suggest that we change it to calculating in blocks of 15 minutes. That is, the maintenance unit price is to be RM12.50 per 15 minutes or part thereof.

Minimum Anaesthetic Professional Fee

Previously, our proposal had been either RM40.00 unit price or a flat RM200.00. Although the unit price scheme is probably “fairer”, implementation may be very difficult. I, therefore, propose that we drop the unit price scheme and only propose the flat fee scheme of RM200.00 per case.

You will find a Reply Form in Appendix IV. Please make your suggestions in the appropriate column, add any other comments you have in the space provided, attach any supporting evidence you may have for our proposals and return the form to me by Saturday, 2 February 2002. You may place the Reply Form in my pigeonhole or hand them directly to me. If you do not reply or if the reply cell in the respective row is left blank, I shall assume that you agree with my suggestion for that item.

Yours truly,

Dr. Ngun Kok Wah.
Anaesthetic Representative,
New CDM Review Committee 2001.