Revised fees review process

A revised fees review process has been endorsed by PSAAP.

The fees framework and fees review process are set out in clause F22 of the PHO services agreement. In 2024, PSAAP initiated a working group to review this process as it was seen as time-consuming and costly for providers, and in most cases did not result in any recommended changes to the fees set by providers.

The new process is based on five key principles that should be applied when contracted providers are considering fee increases, and whether an increase is reasonable. These include:

• supporting timely access to primary care
• general practice sustainability
• partnership between PHOs and contracted providers
• flexibility to accommodate the unique characteristics of a practice
• fair and reasonable for patients, general practices and funders.

The key changes in the process include:

• an increased role for PHOs to work collaboratively with their Contracted Providers to support financial sustainability and to monitor fee levels and proposed increases to balance financial sustainability and affordability and access for patients; and
• referral to the independent fees review committee will only be made if the Contracted Provider, PHO and Health NZ are unable to agree on the reasonableness of the increase.

To support the application of the new process, the Fees Review Referenced document has been updated. Read the new version. 

Any pātai / questions please contact primary.care@tewhatuora.govt.nz.