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EPN501 - Scheme Medical Adviser (SMA) Services – new provider and framework effective from 1 July 2017

Audience

  • Civil Service and New Fair Deal employers – particularly individuals responsible for making referrals to the Scheme Medical Adviser (SMA)
  • Departmental IT security units (ITSUs)
  • Departmental Occupational Health Providers (DOHPs)

Actions

  • To note:
    • the approach to face-to-face appointments booked by HA in July 2017;
    • the approach for medical report requests for inflight       cases;
    • the change in process for charging of inflight cases;
    • the change to HML’s dedicated email inbox; and
    • the application process for injury benefit cases.

Timing

  • Immediate

Detail

1. In EPN487 (25 January 2017) we announced that the Scheme Medical Adviser (SMA) is changing from Health Assured (HA) to Health Management Limited (HML) with effect from 1 July 2017. We have now transitioned to the new provider and this EPN contains important information for employers on the transition

Face-to-face appointments booked by HA for clinics in July 2017

2. In order to limit the impact of the transition, HA continued to book face-to-face clinic appointments for employees in July 2017.  Once the appointment is completed a medical report will be issued to HML so that they can continue to process the case. 

3. The clinic will send the invoice to HA for payment and HA will then invoice the employer for the cost of the clinic.

Medical Report requests for Inflight cases

4. HA continued to request reports from medical professionals on cases up to 30 June 2017. Reports completed after 30 June will be sent to HML so that they can continue to process the case. 

5. The medical professional will send the invoice to HA for payment and HA will then invoice the employer for the cost of the report.

Change in process for charging for Inflight cases

6. In EPN498 we confirmed that in flight cases would be partially processed by HA and HML, with the balance of work between the two providers reflecting the timeline and circumstances of each case. HA will invoice employers directly, immediately following the transition on 1 July 2017. HML will invoice for the work they have undertaken on the case once it is closed.

7. Where an in-flight case required either a face-to-face appointment or a medical report, the employer may receive multiple invoices from HA.

8. We can assure employers that the total charges for each case will not exceed the charges agreed by HA at the time the case was submitted. 

Health Management Contact details

9. Employers are asked to note the change to HML’s dedicated email inbox. Revised contact details are attached. Emails sent to the old address will be forwarded to the new inbox.

Injury Benefit claims

10. Please note that there is no change to the process for Injury Benefit claims.  You should continue to send applications for Injury Benefit claims to MyCSP.  For details of how to make an Injury Benefit claim, please refer to:

http://www.civilservicepensionscheme.org.uk

We will also send EPNs on the following subjects in the coming weeks:

  • How to amend the current referral forms so that consent can be given for referrals to be seen by DOHPs when they are made electronically (or part-electronically) through the HML Online Portal.
  • The approach to the transfer of data from HA to HML for closed referral cases.

Other information

If you require further assistance on the content of this EPN please contact smaproject@cabinetoffice.gov.uk

If you have a question about the distribution of EPNs contact employerpensionnotice@cabinetoffice.gov.uk

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

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 MyCSP.