Assisted Dying Service funding and payment

The Assisted Dying Services Notice 2021 (the Notice) sets out the service specifications and payment rules for remuneration of medical and nurse practitioners providing assisted dying services.

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.

• Module 1: Application and first opinion of eligibility – paid to the attending medical practitioner (AMP).
• Module 2: Independent assessment of eligibility – paid to the independent medical practitioner (IMP).
• Module 3: Competency assessment (if required) – paid to the psychiatrist
• Module 4: Decision about eligibility, including provisional arrangements, or ineligibility, including follow up – paid to the AMP.
• Module 5: Prescribing and administration of medication – paid to the AMP, and the attending nurse practitioner (ANP), if involved.

The Assisted Dying Section 88 Notice User Guide explains the modules and claim processes. Details of the modules, including what happens if a practitioner only completes part of a module, are on page five onwards of the Assisted Dying Section 88 Notice User Guide.

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

Medical and nurse practitioners must meet all the eligibility criteria in the notice in order to claim. These include:

• having a valid practising certificate
• completing the required training – the five Providing Assisted Dying Services e-learning modules
• providing assisted dying services as outlined in Modules 1 to 5 of the Notice
• providing services as part of a general practice; private practice; or other non-DHB settings.

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. Public hospitals are required to be a facility of last resort for assisted dying under the Crown Funding Agreement.

Practitioners employed by DHBs may also provide the service as part of their private practice (outside their DHB role). In these situations, practitioners could access funding under the Notice if they meet the other eligibility requirements.

Details about eligibility requirements are on page 12 onwards of the Assisted Dying Section 88 Notice User Guide.

Additional payments are available outside of the five main modules. These additional payments are to ensure the assisted dying service can be responsive and support individual needs.

• Obtaining clinical notes: In cases where the AMP is not the person’s usual health practitioner, the AMP can claim funding for obtaining clinical notes and on pay this to the health practitioner who provided the notes.
• Travel allowance: Practitioners who are travelling to provide assisted dying services can be compensated for actual costs of travel to support access to the service in rural areas and regions with a low number of available practitioners.
• Complex cases: The AMP can claim additional funding for Module 1 or Module 4 if a complex case requires more time at these parts of the process. This complexity may be related to clinical, social or cultural considerations, including providing support for whānau.
• Supporting practitioner: A payment is available for a supporting practitioner to provide support to the AMP the first time they administer the medication (Module 5). This practitioner can be a medical practitioner or a nurse.

Details about the modules, additional payments and pricing are on page six onwards of the Assisted Dying Section 88 Notice User Guide. Prices indicated are exclusive of GST.

Registering under the Notice

To register for payments, please complete the Assisted Dying Service Notice 2021 Practitioner Request Form and send to DunedinAASupport@Health.govt.nz.

• S88 Assisted Dying Notice Application Form (Word, 269 KB)
• S88 Assisted Dying Notice Application Form (PDF, 355 KB)

Please also provide:

• proof of your bank account (for example, a deposit slip, bank statement or bank letter)
• your GST status
• a copy of your annual practicing certificate
• proof of your COVID-19 vaccination status, or your NHI number and confirmation that the Ministry can use this to verify your status.

You must have a separate individual payee/provider number under the Notice. The payment may be to the individual, their business entity or their practice. 

The Ministry will then verify that you have completed training and that your practicing certificate is current prior to payment being made for assisted dying services under the Notice. Please note, this verification process may take two-three business days.

Receiving payments

Payments will be automatically generated from the HARP system on completion of the relevant forms that are required for each module. Please ensure you complete the required tick boxes in the forms related to payments. Further details are in the Quick guide to HARP – Assisted dying case management system, available in LearnOnline.

Payments will be made on or before the 22nd of the month (or the next working day) following the Ministry’s acceptance of the claim.

For any questions or concerns about payments, please email AssistedDying@health.govt.nz. 

Practitioners travelling to a person to provide assisted dying services may be able to claim travel expenses. Details of the available travel allowance are on page ten of the Assisted Dying Section 88 Notice User Guide.

To claim for travel expenses, please supply a tax invoice by email to AssistedDying@health.govt.nz – whether this includes GST or not depends on whether you are GST registered.

You can use your own invoice template, or download and complete the appropriate invoice template below.

• Not GST registered – Assisted dying service travel invoice template (Excel, 26 KB)
• GST registered – Assisted dying service travel invoice template (Excel, 26 KB)

Your invoice should:

• calculate travel time to the nearest 15 minutes and charge at the rate in the Notice ($120.80 for medical and nurse practitioners and $193.02 for psychiatrists)
• calculate mileage of over 20kms at the Disability Support Services travel in-between travel rate ($0.63.5 per km as at 15/03/2022 - please refer to this page for updates to this rate)
• detail the charges separately as they relate to each assisted dying case (this can be separate line items on the same invoice rather than different invoices)
• note the travel destinations, and explain the need to travel or stay overnight
• be accompanied by GST receipts, where relevant, such as for costs of flights/public transport, or meal and accommodation reimbursements.

If you have any queries about what you can claim or need pre-approval for flights or accommodation please email AssistedDying@health.govt.nz