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Further BMA advice following the BUPA Ophthalmology Network announcement

19 April 2007

Letter to all consultant ophthalmologists


Dear Colleague

BUPA

Further to our letter dated 29 March 2007, you will be aware that BUPA is instituting changes to the way it reimburses its subscribers for ophthalmology procedures from 16 April.

The BMA advice is to continue to follow good practice, namely to inform patients of the following:

• the estimated cost of their treatment, and
• that they may be short-falled because of unilateral actions taken by BUPA

The account should, of course, be sent to the patient, who is responsible for payment regardless of his/her insured status.

Read below a BMA statement to patients which you might find helpful.

Best wishes,

Yours sincerely

Derek Machin
Chairman
Private Practice Committee

Rhod Daniel
Chairman
Ophthalmic Group Committee

BMA statement

BUPA Ophthalmology

Dear Patient,

You have been referred by your GP/optometrist for treatment to your eyes. As a BUPA-insured patient it is important that you are aware that the unilateral actions of BUPA may cause you to be short-falled by the insurance company in relation to the fees charged by your ophthalmologist, i.e. an element of the fee may be payable by you. This situation has arisen through BUPA’s efforts to impose a BUPA Ophthalmology Network. In an effort to prevent this situation, the BMA has had long discussions with BUPA, but to no avail.

The vast majority of consultant ophthalmologists have declined to join BUPA’s Ophthalmology Network because of the restrictions involved. BUPA has announced reductions of between 40–50% of the reimbursement it will be making to its subscribers who require certain ophthalmological treatment.

This situation is highly regrettable, and has come about through BUPA’s unilateral actions and not because of any action taken by your consultant.

Yours sincerely,

Derek G Machin
Chairman
BMA Private Practice Committee

Rhod Daniel
Chairman
BMA Ophthalmic Group Committee