Assisted Dying Service provision and payment

Information for the sector on the provision of, and payment for, assisted dying services.

The funding mechanism to pay health practitioners for providing parts of the assisted dying service has been created through a Section 88 Notice (the notice), under the New Zealand Public Health and Disability Act 2000. The section 88 notice was approved by the Minister of Health and published in the New Zealand Gazette. It came into effect from 7 November 2021.

Medical practitioners and nurse practitioners working in primary care, private practice and other non-district health board (DHB) settings who provide parts of the service can receive funding on a fee-for-service basis for the parts of the process or services they provide.

The notice sets out five main modules with a fixed price payment that can be claimed, based on an estimate of the number of hours involved for the services. A travel allowance can also be claimed.

The five main modules that can be claimed for are:

  • Application and first opinion of eligibility (module one)
  • Independent assessment of eligibility (module two)
  • Competency assessment by a psychiatrist (if deemed necessary) (module three)
  • Advising of decision about eligibility or ineligibility and follow-up (module four)
  • Prescribing and administration of medicines (module five)

Equity and accessibility 

The notice aims to ensure the assisted dying service can be responsive to support individual needs. In some cases, complexity or location may place additional demands on an attending practitioner’s time and it is essential this is not a barrier for people wanting to access the service. A travel allowance will compensate for actual costs of travel, to support the provision of services in peoples’ homes and other settings. This allowance will pay reasonable and actual costs on invoice. 

Two of the modules also include some flexibility in payment rates to recognise that some cases may be particularly complex and may require more time at certain points of the process. This complexity may be related to clinical, social or cultural considerations.

Providing assisted dying services

To deliver assisted dying services, health practitioners must be appropriately qualified. They may be:

  • a medical practitioner who is registered with the Medical Council of New Zealand and holds a current practising certificate, or
  • a registered medical practitioner whose scope of practice includes psychiatry, or
  • a nurse practitioner that is registered with the Nursing Council of New Zealand as a practitioner of the profession of nursing and whose scope of practice permits the performance of nurse practitioner functions; and holds a current practising certificate.

Public hospitals are required to be a facility of last resort for assisted dying under the Crown Funding Agreement. District Health Boards (DHBs) are not expected to provide appropriately qualified staff to directly provide the assisted dying service. However, appropriately qualified DHB staff can potentially provide the assisted dying service if they wish to and as agreed as part of their DHB role. In these situations, the practitioner and the DHB do not receive any additional funding. Practitioners employed by DHBs could also provide the service as part of their private practice (outside their DHB role). In these situations, practitioners could access funding under section 88.

Claiming for assisted dying services

To claim for assisted dying services, qualified practitioners must submit a form under the Assisted Dying Section 88 Notice 2021 to the Ministry of Health:

A completed form must be provided even if the practitioner already has a payee/provider number. A practitioner must have a separate individual payee/provider number under the assisted dying notice. The payment may be to the individual, their business entity or their practice. A practitioner’s eligibility to receive payment will be validated prior to any payment being made for assisted dying services under the notice. Eligibility requirements include:

  • having a valid practising certificate
  • have completed the training requirements (find Assisted Dying Service training on LearnOnline)
  • have delivered the assisted dying services outlined in Modules 1 to 5 of the notice
  • be part of a general practice; private practice; or other non-district health board settings.

Claims for payment will be automatically generated in the assisted dying service IT platform. Health practitioners will be able to view the status of their activities through a dashboard system. There will be a video and user guide to the IT platform available after 7 November. 

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