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EPN407 - Scheme Medical Adviser - Undercharging by Capita Health and Wellbeing - Recovering the undercharge

Audience:

This notice will be of interest to: 

  • Staff responsible for Scheme Medical Adviser (SMA) referrals.

Action: 

To note: 

  • The SMA is Capita Health and Wellbeing (CHW)
  • CHW has been undercharging for one ‘product’ since the new contract came into effect on 1 July 2013 (the product has however been undercharged from 1 September 2013)
  • EPN361 detailed the charges applying under the revised contract and was clear that the product was to be charged at a new higher rate
  • CHW will be contacting employers who have been undercharged for this product setting out the level of underpayment and requesting payment of the amount(s)

Timing:

Immediate

  1. Background

    EPN361 (Scheme Medical Advice Services – New framework agreement effective from 1 July 2013) announced that CHW would be continuing as SMA following a competitive procurement, also providing Civil Service employers with a tariff of the newly revised contract prices.  Product number 11 on the tariff is:

    Obtaining further medical evidence or third party reports (does not include medical appeals, where such reports must be provided by the appellant).
  2. The tariff is clear that the charge for this product is £143.
  3. The undercharge

    Although the new contract price is clear in the tariff CHW has been charging for this product at the ‘old’ contract price of £35.  This is as a result of an administrative error on CHW’s part.  No other products on the tariff are similarly affected.  The undercharge applies to this product as delivered on or after 1 September 2013 .
  4. Having recently discovered the undercharge CHW is now charging the correct price and will continue doing so going forward.  This is a relatively high volume product and the total of the undercharge across all Civil Service employers is commensurately significant for CHW.  There is, therefore, a need for CHW to re-coup the undercharges on this product – as they are entitled to do within the terms of the contract under which the product has been provided to you.
  5. Next Steps

    CHW will shortly be writing to affected employers stating their undercharge.  Please work with CHW, going through the details that they send to you to ensure they are correct.  Please await CHW’s contact.
  6. Recognising however that this will be an unexpected call on your finances, depending on the value of your undercharge CHW will speak to you to discuss the way forward in more detail, including a sensible timetable for payment to be agreed between you. CHW is, however, aiming to resolve these payments by 31 December 2014.

Contact

If you have a question about the distribution of EPNs or you need to receive them in a different format contact employerpensionnotice@cabinet-office.gsi.gov.uk.

You can find electronic copies of the Employer Pension Guide, all current EPNs and forms on our website.

This notice is for employers and should not be issued to scheme members.

If members have a question about their pension they can find information on this website or by contacting your Pension Service Centre.